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EAHP 2012 Report – Winners of the Best Poster Award
by Zara Qadir – Every year, the EAHP holds a best poster competition to encourage hospital pharmacists from all over Europe and beyond, to share best practices and key studies in their field. This year, at the 40th EAHP conference, the 470 posters covered a wide range of topics from technology such as robotic production, to risk management and patient safety. Congratulations to this year’s winners!
First Prize: Assistant Professor Jesse Swen
Poster Title: Genetic risk factors for type 2 diabetes mellitus and response to sulfonylurea treatment
During the closing ceremony, Professor Roberto Frontini, Director of the EAHP, presented the first prize to a pharmacogenomic study from the Leiden University Medical Centre in The Netherlands. Assistant Professor and Clinical Pharmacist, Jesse Swen, set out to investigate whether genetic risk factors for type 2 diabetes mellitus (T2DM) are associated with response to oral anti-diabetic treatment with sulfonylureas (SU).
Professor Swen recruited over two hundred type 2 diabetes mellitus patients (n=207) from four primary care centres. All patients had already started treatment with sulfonylureas. The primary endpoint was defined as the point when patients achieved a stable sulfonylureas dose defined as the first period of more than 270 consecutive days without a dose adjustment, or when there was initiation of another sulfonylureas, insulin or metformin. The secondary endpoints were defined as stable dose of prescribed sulfonylurea, and time to stable SU dose.
Twenty single nucleotide polymorphisms consistently associated with T2DM in 19 genes were selected (TCF7L2, KCNJ11 etc.). A genetic risk score per patient was calculated based on the number of risk alleles. Statistical analysis, a chi-squared (χ2), was used test to compare the primary endpoint between the groups scoring differently for genetic risk.
The Leiden researchers found that mean genetic risk score was 19.0 (95% CI 18.7- 19.4), and the genetic risk score was negatively associated with achievement of stable sulphonylurea dose. The study found that 84.7% of the patients in the low risk group (n=59) achieved a stable dose versus 74.1% and 62.3% of the patients in the intermediate risk group (n=81) and high-risk group (n=62; p=0.004).
However, no significant effect of genetic risk score was found on those achieving a stable sulphonylurea. Patients carrying more than 17 of the T2DM risk alleles showed a marginally significant increased time to stable dose (hazard ratio: 0.81; 95% confidence intervals, 0.75-1.01, P=0.058). In the poster, Professor Swen concluded that, “in this study, patients with an increased genetic risk of T2DM are less responsive to sulphonylureas.”
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Second Poster Prize Winner: Dr. Claudia Mildner
Poster Title: Closing the gap – improving patient safety with better drug information
In Germany, patients are not always sufficiently informed about their current and future drug treatment. Hospitals are not licensed to hand out medications to patients at their day of discharge, and medication gaps can occur after hospital discharge. Researchers from three institutions in Germany (Gutenberg University Mainz, Klinikum der Stadt Ludwigshafen, Diakonoie Krankenhaus Bad Kreuznach, Mutterhaus der Borromäerinnen and the Katholisches Klinikum Koblenz) set out to compare whether the involvement of clinical pharmacist would impact on patients’ knowledge of medicines at discharge.
Dr. Claudia Mildner, lead author in the study, used a questionnaire to compare patient satisfaction for the two different styles of discharge management. The researchers surveyed patients using a questionnaire across eleven different wards in the five different hospitals.
During phase one of the study, there was no involvement of a clinical pharmacist (n=847 patients) and approximately 50% of patients were prescribed new drugs, which were recommended to be continued after discharge. “Before intervention of the hospital pharmacist 12% of patients didn´t get information about their newly prescribed drugs, neither in hospital or in outpatient settings,” explained Dr. Mildner. Even when patients were informed about their medicines, 22% of patients were either not satisfied, or only partially satisfied.
In phase 2 (n=617 patients), all patients were trained in using their newly-prescribed medicines, so the information ratio rose to 100%. The patient satisfaction regarding the quality of education increased to around 89%.
Each patient received an illustrated patient-specific medicines plan, which was reported to be helpful by more than 80% of patients. The patients’ general practitioners also confirmed that their patients were better informed (over 36% improvement) which helped reduce their involvement and effort (reported as 22% less GP effort required). Dr. Mildner summarised the research findings: ‘By involving clinical pharmacists, the gap in patients` knowledge about their medicines was reduced. GPs found their patients better informed and appreciated the reduced time and effort”.
Dr. Mildner plans to carry a follow-up story in order to establish a service for pharmaceutical counselling. “So our study is being used to try to change legislation in Germany, so that hospitals are allowed to hand out drugs at the day of patients´ discharge and that this hand out of drugs must be combined with pharmaceutical counseling,” she concluded.
