The Spanish Agency for Medicines and Health Products (Aemps) has promoted a

pilot

project

on access to electronic information on medicines in the hospital setting

and suppression of the paper leaflet.

It will start in January 2022

, and its objective is to evaluate the impact on a small group of drugs in the hospital setting. Specifically,

there are 46 presentations

-among which are

Adiro-

, from more than 20 laboratories,

both from the generic and innovative industries

.

In fact, the project also involves the Spanish Society of Hospital Pharmacy (SEFH), in coordination with the Hospital committee of the General Council of Official Associations of Pharmacists, and a series of pharmaceutical companies, mostly integrated in the Pharmaindustry and the Spanish Association of Generic Drugs (Aeseg).

In view of the results, the duration or number of drugs involved in the

pilot

may be extended.

The planned duration of the

pilot

project

will be at least two years

, with an assessment carried out each year through a satisfaction questionnaire completed by the pharmacy services of the hospitals.

In view of the results,

the duration or number of drugs involved in the

pilot

project may be extended

, if so agreed by the parties involved;

these results will be published for general knowledge.

The aim is to

assess at the national level the impact of the deletion of the paper prospectus

, in order to guide

future reviews of pharmaceutical regulation

, especially taking into account the advancement of new technologies and their implementation in the pharmaceutical sector.

The information, by Datamatrix code

To consult the information on the medicines that are part of this

pilot

project

,

the hospital pharmacy services will be able to access the leaflet available in the

Online

Information Center for

Authorized Medicines (CIMA), through a

non-serialized Datamatrix code

that will appear in the primary packaging of containers.

Ana López de la Rica, associate director of the Technical Department of Farmaindustria

, advanced this project in the seventeenth seminar organized by the employers of the innovative industry with the media on November 10.

"

What are the advantages? One of them, and very important, is that we are protecting the environment

. Another is that we will always have in real time the information on the prospectus and the authorized and updated technical sheet," he explained.

All this will be possible, as he commented, thanks to

the Datamatrix code

: "In addition, the supply chain will be more flexible and regulators will reduce the bureaucratic burden they have when updating documents (Word, PDF ...) of technical sheets and prospectuses" .

Avoid relabels

Ana Herranz, national member of hospital pharmacy in the General Council of COF

and head of the hospital pharmacy section at the Gregorio Marañón General University Hospital, maintains to this media that this project has a double objective: "On the one hand, to eliminate the leaflet, which the industry is delighted for its processes, as well as being more sustainable, and we,

in the hospital pharmacy, have always had the demand not to have to relabel drugs

, especially those of high risk that we use in traceability systems ", he points out.

In addition, in line with what Aemps commented in its statement, Herranz explains that "in hospitals, when we need to search for information on a drug, we connect to the CIMA. Then,

this Datamatrix code will take us directly to the CIMA

and, in addition,

We can use it to guarantee the traceability and safety of the use of medicines within the hospital

.

"

How have the drugs that are part of the

pilot

been selected

?

Herranz clarifies that it has been "at the proposal of the industry, and the hospital pharmacy has required the inclusion of drugs that we consider to be a priority, in order to have their traceability".

E

l pilot

includes over 40 presentations (

Nolotil

575 mg hard capsules are confirmed), "but hospitals have 4,000 references.

It is true that we use very little prospect and have no sense.

It is much better code bars in each vial. "

Situation in Europe

What is happening in the rest of Europe?

"

The EMA and the heads of the national drug agencies are working on the

development of an electronic standard for information on semi-structured products

. This will allow easier access through electronic resources to the prospectus and the technical sheet, and will allow the data to be exploited. included in both, "said De La Rica.

"80% of CIMA's prospectus and technical sheets documents are in a semi-structured format"

This tool in which Europe works will be able, according to De La Rica, to

transform all the prospects that are currently authorized, regardless of their format (PDF, html, xml), into a common electronic language,

which is interoperable between the systems. prescription with product information, both for healthcare professionals and patients.

Spain is not in a bad position

, since "thanks to the good work of the Spanish pharmaceutical industry,

80% of the prospectus and technical specifications documents currently published in CIMA are in this semi-structured format."

Of course, he points out that "there is a need for an adjustment to be compatible with the European format in which we are working. But it is important and we are ahead.

This will make it easier for Aemps to develop projects that are related to artificial intelligence

, thanks to that possibility of exploiting data. "

What patients think

The

pilot

project

focuses on hospital drugs, as other countries such as Belgium and Luxembourg have already started, according to De la Rica. But, if it were extended to more drugs,

what would happen to elderly patients unaccustomed to the use of new technologies?

Faced with this question, De La Rica considers the

possibility that in pharmacy offices the leaflets could be printed on paper

. However, it is still necessary to reach the general population: "It will imply a cultural change. We are still very far from that reflection," says Herranz.

For her part,

Carina Escobar, president of the Patient Organizations Platform (

POP

), points out to this medium that the presentations that

a priori

are included in the

pilot

are medicines used in the hospital when the patient is admitted or administered in a hospital during the day: "Normally we do not see these prospects.

What is good, and we always ask, is that they give us information

. When I go to the day hospital to take a medication, I would like to have a file of what they are putting me, with a report on possible interactions and medications with which I should be careful ".

Escobar points out that progress must be made in making information more accessible

"and we patients can understand it, especially when we are sick, that it costs us more."

In this regard, Herranz comments that

"there are more and more pharmacists in day hospitals and they are trying to alleviate and cover this need

; for example, so that intravenous chemotherapy is supplemented with oral drugs in day hospitals. In our hospital in day there are two pharmacists working

full time for them

and we try to make a much more understandable information. But of course,

usually the medication to day hospitals is ready for use, in individualized doses per patient, and that does not carry a leaflet

. But there is many initiatives to improve the information that patients receive. "

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