In 2018, according to the latest report from the French National Cancer Institute (INCa), approximately 400,000 new cases of cancer in France were identified. Fifty-four percent were represented by men and 46% by women. The number of new cases increased between 2010 and 2018 (+6,000 cases for men and 23,000 for women). Hospital pharmacies caring for cancer patients must absorb this flow without having additional human resources or without being able to increase the capacity of the chemotherapy reconstitution unit. And this always while ensuring a quality according to the legal requirements. This increase of activity and the centralization of chemotherapy preparations bring with it new problems: musculoskeletal disorders (MSDs). The objective of this work is, through the improvement of work quality, to prevent and monitor the appearance of MSDs in pharmacy technician team.Initially, using the Nordic questionnaire, an inventory of the pain and genes felt by the staff according to location and duration was conducted with pharmacy technician team. Secondly, an assessment of the risk of occurrence of MSDs in the pharmacy technician team according to the tasks performed was carried out using the Borg CR10 scale and the Occupational Safety and Health Administration (OSHA) checklist.The prevalence of musculoskeletal complaints over the last twelve months and the last seven days within the sample was highest for the wrists/hands (67% and 56%) and head/neck (56% and 33%). The severity index of musculoskeletal problems at work was 50% for the elbow region and 33% for the wrist/hand region. According to the OSHA checklist, the workstations for the preparation of cytotoxics and the workstations for the preparation of analgesics intended for the intrathecal route obtained a score greater than 5, which is equivalent to a risk of occurrence of MSDs. On the positions evaluated using Borg's CR10 scale, the following body regions saw a significant increase in the strain felt after a day of production: head/neck (P-value 0.04), upper back (P-value 0.03), lower back (P-value 0.03) and legs (0.04).This work made it possible to produce a map of the body regions affected, to identify the positions at risk and to assess the level of risk. Several approaches have been defined to prevent MSDs for the pharmacy technician team. Staff training, by one of the physiotherapists, in muscle warm-ups before a production day is planned. In the continuity of this approach, an expertise by an ergonomist, which could not be carried out due to the health situation and the preventive measures would be essential in order to put in place additional preventive and curative actions.

Introduction. - In 2018, according to the latest report from the French National Cancer Institute (INCa), approximately 400,000 new cases of cancer in France were identified. Fifty-four percent were represented by men and 46% by women. The number of new cases increased between 2010 and 2018 (+6,000 cases for men and 23,000 for women). Hospital pharmacies caring for cancer patients must absorb this flow without having additional human resources or without being able to increase the capacity of the chemotherapy reconstitution unit. And this always while ensuring a quality according to the legal requirements. This increase of activity and the centralization of chemotherapy preparations bring with it new problems: musculoskeletal disorders (MSDs). The objective of this work is, through the improvement of work quality, to prevent and monitor the appearance of MSDs in pharmacy technician team. Method. - Initially, using the Nordic questionnaire, an inventory of the pain and genes felt by the staff according to location and duration was conducted with pharmacy technician team. Secondly, an assessment of the risk of occurrence of MSDs in the pharmacy technician team according to the tasks performed was carried out using the Borg CR10 scale and the Occupational Safety and Health Administration (OSHA) checklist.Results/discussion. - The prevalence of musculoskeletal complaints over the last twelve months and the last seven days within the sample was highest for the wrists/hands (67% and 56%) and head/neck (56% and 33%). The severity index of musculoskeletal problems at work was 50% for the elbow region and 33% for the wrist/hand region. According to the OSHA checklist, the workstations for the preparation of cytotoxics and the workstations for the preparation of analgesics intended for the intrathecal route obtained a score greater than 5, which is equivalent to a risk of occurrence of MSDs. On the positions evaluated using Borg's CR10 scale, the following body regions saw a significant increase in the strain felt after a day of production: head/neck (P-value 0.04), upper back (P-value 0.03), lower back (P-value 0.03) and legs (0.04).Conclusion. - This work made it possible to produce a map of the body regions affected, to identify the positions at risk and to assess the level of risk. Several approaches have been defined to prevent MSDs for the pharmacy technician team. Staff training, by one of thephysiotherapists, in muscle warm-ups before a production day is planned. In the continuity of this approach, an expertise by an ergonomist, which could not be carried out due to the health situation and the preventive measures would be essential in order to put in place additional preventive and curative actions.& COPY; 2022 Academie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

•La mise en place de consultations pharmaceutiques est un travail pluridisciplinaire.•Les apports du pharmacien permettent de sécuriser la prise en charge médicamenteuse.•L’intégration des aidants dans le parcours de soin des patients est privilégiée.•La consultation pharmaceutique renforce le lien ville-hôpital autour du patient.•Une équipe pluridisciplinaire optimise le parcours de soin du patient.

OBJECTIVES:The oral route is becoming increasingly important in the panel of anti-cancer therapeutics, but it generates difficulties (adherence, management of adverse effects...). In order to secure medication management, the pharmaceutic team chose to set up pharmaceutical consultations. Its objectives are multiple: understanding of treatment for better adherence, pharmaceutical analysis, enhancement of the city-hospital link. This work presents the setting up of the pharmaceutical consultations and makes an assessment after one year.METHODS:The initial step was a meeting with institutional health professionals who work with patients to define the place, the objectives, and the patients targeted by the pharmaceutical consultation. The targeted patients are all patients receiving temozolomide and some patients initiating oral chemotherapy, considered at risk, on medical solicitation. Documents were created to standardize practices in the team from the collection of information and pharmaceutical analysis until the conduct of the consultation and the consultation report (integrated into the computerized patient's medical file). Activity indicators were defined and collected.RESULTS:Over one year, 65 pharmaceutical consultations were conducted, of which 23 % resulted in pharmaceutical interventions. The average duration of consultation was 34minutes. The whole team (four pharmacists and two residents) was involved in this activity.CONCLUSIONS:Pharmaceutical consultations help secure medical care of patients, providing tools, dedicated and personalized time, pharmaceutical analysis, etc. Ultimately, the goal is to accompany the patient throughout his treatment by having follow-up pharmaceutical consultations, in collaboration with community pharmacists thanks to the city-hospital link that we have established.

Introduction. - During the diagnostic follow-up and treatment of cancerous diseases, patient management may be called into question following allergic drug reactions. Since June 2018, our establishment has offered allergy consultations and skin tests. This allergy activity focuses on the therapeutic arsenal used in oncology (chemotherapy, antibodies, immunotherapy, premedication and iodinated contrast media). The purpose of this article is to describe in detail the implementation of this new production activity by our hospital pharmacy. Methods and results. - Doctors and pharmacists began by creating a standardized model of patient data collection to ensure effective allergy consultations. A panel of skin tests (range of substances and dilutions) and the relevant production methods were also determined. Next, prescription and production software were configured, and the circuit was defined from the initial request for an allergy consultation through to actual testing. Discussion and conclusion. - For this skin-test production activity, the entire circuit has been computerized, from prescription to release of syringes, thereby ensuring safety. While certain aspects of the circuit still require optimization, this activity is an asset in the management of our cancer patients since it avoids erroneous elimination of given lines of treatment. We must strive to develop this activity in order to increase the number of consultation slots for patients. (C) 2019 Elsevier Masson SAS. All rights reserved.

BACKGROUND:Intrathecal analgesia is a method using various molecules alone or in combination. Among these, the association sufentanil/ baclofen is widely used. Instead of moving patients to the few expert centers taking charge of these specific preparations, it could be better to transport syringes to peripheral centers managing pump refilling. That is why, it is interesting to demonstrate the stability of the mixture, and so to be able to ensure the best transport conditions of syringes. METHODS:A stability indicating UPLC-DAD method was developed and validated according to the ICH guidelines. Four mixtures of sufentanil baclofen stored in 5±3°C and 25±2°C were evaluated for seven days and compared to the initial observed concentrations. RESULTS:The stability is demonstrated only for preparations stored at 5±3°C for seven days thanks to relative concentrations (95% confidence intervals of the mean of 3 samples) systematically positioned between 90% and 110%. On the other hand, after few days, degradation products of sufentanil appeared for all mixtures stored at 25°C±2°C. CONCLUSION:This study shows the stability of a weakly and a highly concentrated mixture of sufentanil and baclofen solutions in polypropylene syringes stored at 5±3°C for seven days. This result will allow the transport of the preparation under optimal conditions. Advance preparations for intrathecal pump refills could also be feasible.

Intrathecal analgesia has increased over the past two decades in various indications: chronic refractory pain from cancerous or non-cancerous origins, spasticity. These different indications involve the use of different molecules alone or in combination such as morphine, ropivacaine, bupivacaine, fentanyl, sufentanil, clonidine, baclofen and ziconotide. Pump refills are prepared at the pharmacy under a laminar flow hood. An analytical control should be carried out before release of the preparation. A new method of analytical control by chromatography has been developed and validated according to the International Conference on Harmonization guideline in order to secure the production process.