Interpretable one-class classification framework for prescription error detection using BERT embeddings and dimensionality reduction.

Ensuring accurate prescriptions and proper medication administration is critical for patient safety and effective clinical outcomes. Identifying and preventing prescription errors can significantly reduce healthcare costs and adverse health effects. Current solutions range from rule-based systems, which rely on predefined rules and clinical expertise but lack adaptability to unexpected errors, to supervised machine learning approaches, which are hindered by limited labeled error data and opaque algorithmic processes.

Etilefrine: A Novel Treatment for Refractory, Life-Threatening Chylothorax in the Newborn.

There are few evidence-based treatment options for chylothorax in newborns. We report on 5 cases of preterm newborn infants who received drainage and continuous etilefrine infusion for clinically significant, refractory chylothorax. Irrespective of the cause of the effusion, etilefrine infusion was associated with a clear decrease in chylous output within 2 to 4 days of initiation with heart rates and blood pressures maintained within the age-normal limits.

Drug Incompatibilities and Complex Assemblies: Let Us Remain Vigilant!

: Multi-lumen devices that limit physicochemical incompatibilities (PCIs) are frequently used in neonatal intensive care units where premature infants receive numerous infusions. The aim of the study was to investigate a PCI that occurred despite the use of a device of this type (EDELVAISS Multiline NEO, Doran International, Toussieu, France). : A 7-week-old preterm infant received ganciclovir at therapeutic dosage for cytomegalovirus (CMV) infection.

Innovative Design of an Augmented Reality Device for Anesthesia: User Insights and Usability Evaluation.

Patient care involves multiple healthcare professionals and carries inherent risks. Addressing human factors is essential to mitigating these risks and improving professional practices. Cognitive aids are one strategy to standardize tasks based on clinical guidelines.

Evaluation of a score for identifying hospital stays that trigger a pharmacist intervention: integration into a clinical decision support system.

Objectives: The objective of the study was to determine, after medication review, the patient risk score threshold that would distinguish between stays with prescriptions triggering pharmacist intervention (PI) and stays with prescriptions not triggering PI.

Materials And Methods: The study was retrospective and observational, conducted in the clinical pharmacy team. The patient risk score was adapted from a Canadian score and was integrated in the clinical decision support system (CDSS).

[Comparison of gemcitabine production costs in individualized and standardized doses].

Introduction: Cancer chemotherapy doses are often adapted to patients' body surface area and produced individually. Alternatively, dose-banding promotes batch production of clinically defined fixed doses, for which a standard deviation of±5% determines a band incorporating individual doses calculated on the basis of body surface area. The aim is to compare the costs of individualized and batch production of gemcitabine in a centralized chemotherapy reconstitution unit.

Physicochemical stability of a polysorbate-80-containing solvent compounded in the hospital pharmacy and used to reconstitute a biologic for nebulisation.

Objectives: To assess the long-term physicochemical stability of a solvent (10 mM phosphate buffer pH 6.5 containing sodium chloride (145 mM) and polysorbate 80 (PS80) 0.02%) used to reconstitute a biologic for nebulisation.

Clinical pharmacy activities specific to patients treated with lithium.

Objectives: Medication compliance in lithium-treated patients is poor (43-46%) and may be responsible for relapse or toxicity. Improving understanding of treatment principles leads to increased medication adherence. To do this, targeted and personalised pharmaceutical interviews on lithium were developed and implemented by a clinical pharmacy team in adult psychiatric departments of the Lille university hospital center.

Intracerebroventricular anaerobic dopamine in Parkinson's disease with L-dopa-related complications: a phase 1/2 randomized-controlled trial.

Continuous compensation for cerebral dopamine deficiency represents an ideal treatment for Parkinson's disease. Dopamine does not cross the digestive and blood-brain barriers and is rapidly oxidized. The new concept is the intracerebroventricular administration of anaerobic dopamine (A-dopamine) using an abdominal pump connected to a subcutaneous catheter implanted in the third ventricle, near the striatum.

Method for the detection and quantification of viral contamination during the preparation of gene therapy drugs in a hospital pharmacy.

Objective: The objective of the present study was to develop a method for sampling and detecting an adenovirus-derived gene therapy (GT) vector on isolator worksurfaces.

Methods: We used a quantitative PCR (q-PCR) to detect the viral genome in standard dilutions of pure GT product and extracts of sampled surfaces. We compared three devices for surface sampling (a cotton compress, a cotton swab and a polyester flocked swab) and performed positive control, negative control and induced contamination tests for each.

Use of two general-purpose scales to assess clinical pharmacy activities in a cell transplantation unit.

Introduction: The general-purpose rating scales used by clinical pharmacists to rate their activities have not been extensively studied in specialist care units. This study aims to describe drug-related problems (DRPs) and pharmacist interventions (PIs) in a French hematopoietic cell therapy (HCT) unit and to evaluate the PIs' likely clinical, economic, and organizational impacts.

Methods: We retrospectively assessed all DRPs reported and all PIs issued between December 2018 and December 2021.

Potential Sampling Errors in Stability Studies Due to Dead Volume in Closed System Transfer Devices.

Background: Closed system transfer devices (CSTD) help to reduce the exposure of healthcare professionals to hazardous drugs. They may be used in stability studies conducted on anticancer drugs. During a stability study about polyolefin bags of gemcitabine, Tevadaptor® device was suspected of causing a bias in the evaluation of the concentrations of the first aliquots extracted from the bags.

[Evaluation of the economic impact and the patient pathway in the treatment of chronic total occlusion].

Objectives: Chronic total occlusion (CTO) of coronary arteries is defined as complete absence of antegrade coronary flow without iodine passage, since more than 3 months. Coronary revascularization is a highly resource-intensive angioplasty procedure involving numerous medical devices (MDs). Its consumption and associated costs are not covered by either the medical act classification (CCAM) or the hospitalization fees and additional MD funding.

Translation of the REMEDI[e]S (Review of potentially inappropriate MEDIcation pr[e]scribing in Seniors) explicit criteria into seminatural language for use in prescription support systems: A multidisciplinary consensus.

Background: By recovering data in an ordered manner and at the right time, clinical decision support systems (CDSSs) are designed to help healthcare professionals make decisions that improve patient care.

Objectives: The aim of the present study was to translate the REMEDI[e]s tool's explicit criteria, France's first reference list of potentially inappropriate drugs for the elderly, into seminatural language, in order to implement these criteria as alert rules and then enable their computer coding in a CDSS.

Methods: This work was carried out at Lille University Hospital by a team of clinical pharmacists with expertise in the use of pharmaceutical decision support systems, in collaboration with the authors of the REMEDI[e]s tool.

Evaluation of the Impact of Infusion Set Design on the Particulate Load Induced by Vancomycin-Piperacillin/Tazobactam Incompatibility.

Introduction: Drug incompatibilities are among the most common medication errors in intensive care units. A precipitate can form and block the catheter or cause an adverse event in the patient. Intensive care units have implemented various strategies for limiting the occurrence of these incompatibilities, which have already been studied in vitro under standardized conditions.

The Infusion of Piperacillin/Tazobactam with an Elastomeric Device: A Combined 24-H Stability Study and Drug Solution Flow Rate Analysis.

Bacterial respiratory tract infections (e.g., in patients with cystic fibrosis) may be treated with the intravenous infusion of a piperacillin/tazobactam (P/T) solution through an elastomeric device.

[Use of a pharmaceutical decision support system in the valuation of hospital stays: Evaluation through 3 examples in collaboration with the department of medical information].

Introduction: Pharmacy decision support systems (PDSS) help clinical pharmacists to prevent and detect adverse drug events. The coding of hospital stays by the department of medical information (DMI) requires expertise, as it determines hospital revenues and the epidemiological data transmitted via the French national hospital database. The aim was to study the interest and feasibility of using a PDSS, in collaboration with the DMI, to help with the coding of hospital stays.

Assessment of chemical contamination by cancer drugs during use of the RIVA compounding robot: A pilot study.

Introduction: Many hospitals are now investing in robotic compounding system for the preparation of cytotoxic agents. The objective of the present study was to describe contamination by cytotoxics inside and outside the RIVA robot (ARxIUM, Winnipeg, Canada).

Material & Methods: We applied a risk analysis to determine which locations inside and outside the compounding robot should be monitored.

Augmented Reality Eyewear for Assisting in the Preparation and Control of Cancer Therapies: Assessing the Learning Curve and Level of Adoption.

Since March 2022, the centralized cytotoxic preparation unit at the Lille University Hospital (Lille, France) is equipped with augmented reality eyewear for preparation and quality control. The technology enables a user-friendly guided step by step preparation process. It also assists the user by identifying vials through data matrix scan and recording photos at different stages of preparation in order to replace the in-process double visual inspection which will now be carried out a posteriori during the release control.

Impact of the use of a drug-drug interaction checker on pharmacist interventions involving well-known strong interactors.

Objectives: Several drug-drug interaction (DDI) checkers such as DDI-Predictor have been developed to detect and grade DDIs. DDI-Predictor gives an estimate of the magnitude of an interaction based on the ratio of areas under the curve. The objective of the present study was to analyse the frequencies of DDIs involving well-known strong interactors such as rifampicin and selective serotonin reuptake inhibitors (SSRIs), as reported by a clinical pharmacy team using DDI-Predictor, and the pharmacist intervention acceptance rate.

A prospective, single-centre study of the feasibility of the use of augmented reality for improving the safety and traceability of injectable investigational cancer drug compounding.

The compounding of injectable cancer drugs for clinical trials often requires specific procedures, with limited access to the starting materials and especially the active compound. These characteristics prevent the application of qualitative or quantitative analyses and quality control techniques. Hence, for some very complex compounding operations, double visual inspection is considered to be less reliable, more time-consuming and more human-resource-intensive than other methods.

Retrospective comparison of a weight-based dose every 2 weeks with a fixed dose every month: a real-life analysis of nivolumab in the treatment of advanced melanoma.

Nivolumab was first authorized at a weight-based dose (WBD) of 3 mg/kg every two weeks (Q2W). Since 2017, a fixed dose (FD) regimen [first 240 mg Q2W and then 480 mg per month (Q4W)] was allowed. The objective of the study was to compare a WBD regimen and an FD regimen with regard to effectiveness and safety.

Pharmaceutical Decision Support System Using Machine Learning to Analyze and Limit Drug-Related Problems in Hospitals.

The health product circuit corresponds to the chain of steps that a medicine goes through in hospital, from prescription to administration. The safety and regulation of all the stages of this circuit are major issues to ensure the safety and protect the well-being of hospitalized patients. In this paper we present an automatic system for analyzing prescriptions using Artificial Intelligence (AI) and Machine Learning (ML), with the aim of ensuring patient safety by limiting the risk of prescription errors or drug iatrogeny.