Abstracts

Material and methods In our study, we involved 54 inpatients preparations should not have been modified. Preparation mod-
and outpatients (men 16, women 38) in a point of care sur- ification was documented by the nurses for 42/96 prepara-
vey of 40–50 min. After voluntary interviews with a pharma- tions. 6 of the 14 interviewed nurses decided on drug
cist, we checked the medical records of the patients. To modification themselves and 8 nurses had involved the physi-
identify interactions, we used four English language interaction cian in the decision making. 13/14 nurses found that they had
checker databases (Micromedex Interaction Checker, Lexi- not faced any practical problems during drug administration.
Interact, Medscape Interaction Checker and Drugs.com). Regarding possible health risk of dosage form modification, 1
Regarding the heterogenous nomenclature of the active ingre- nurse admitted knowing that drug crushing/dissolving may be
dients of supplements and the fact that a few medicines were a potential health hazard, 11 nurses denied this possibility and
only available in our country and in central Europe, we had 2 nurses had not thought about it before.
to standardise our screening methods. For pharmacokinetic Conclusion Administration of a solid drug dosage form to
and pharmacodynamic properties, and chemical structure of patients with a nasogastric tube, gastrostomy tube or patients
the drugs, we substituted these active ingredients with others with dysphagia has many problems: 80% of all preparations
presented in the databases above. To estimate adherence, we were administrated incorrectly, only 44% of preparation modi-
asked patients to complete the Morisky Medication Adherence fications were documented and less than half of the nurses
Scale-4 survey. involved the physician in the decision making process. There
Results The average number of products taken by patients is a need for implementation of local guidelines for drug
were 8.7 prescribed medicines and 4.7 supplements. 90.8% of administration via feeding tubes, to patients with dysphagia
the patients took at least 1 supplement during 1 month prior and for personnel training.
to the survey. We identified in these 49 patients 68 supple-
ment ingredients, 123 interactions and, in case of 5 patients
(9.3%), we analysed potential severe interactions related to
the use of supplements. By screening for adherence, we found INT-008 EFFICACY OF HYDROXYCHLOROQUINE IN PRIMARY
a rate of 25.5% of non-adherent patients. HAND OSTEOARTHRITIS: A RANDOMISED, DOUBLE
Conclusion Pharmacists should consider that a significant num- BLIND, PLACEBO CONTROLLED TRIAL
ber of patients are taking supplements without any control of
healthcare professionals, so they are exposed to the risk of EJ Ruijgrok*, WC Lee, AEAM Wee, M Kloppenburg, MR Kok, BM Boxma-De Klerk,
NM Basoski. Maasstad Ziekenhuis, Rotterdam, The Netherlands
severe interactions. We should aim to educate patients and
improve interaction checker databases regarding supplement 10.1136/ejhpharm-2017-000640.389
screening.
Background Pharmacological treatment options for hand osteo-
REFERENCES AND/OR ACKNOWLEDGEMENTS arthritis (OA) are limited. Hydroxychloroquine (HCQ) has
This work was supported by the MGYT-KGYSZ.
been used successfully in the treatment of mild rheumatoid
No conflict of interest arthritis for many years and is believed to be beneficial in
hand OA also.
Purpose In this trial we studied the symptom modifying effect
of HCQ in primary hand OA.
INT-007 ADMINISTRATION OF SOLID DOSAGE FORMS TO Methods We conducted a randomised, double blind, placebo
PATIENTS WITH DYSPHAGIA OR VIA FEEDING TUBES controlled, multicentre trial in patients with primary hand
1
L Eesmaa*, ÜH Meren, 1K Luik, 2K Sirkas. East Tallinn Hospital, Estonia; 1; 2Tartu
1
OA. Patients received either hydroxychloroquine 400 mg once
University, Tartu, Estonia a day or placebo during a treatment period of 24 weeks. The
primary outcome was decrease in hand pain in the previous
10.1136/ejhpharm-2017-000640.388 24 hours on a 100 mm visual analogue scale (VAS). Secon-
dary outcomes included change in total score of the Australian
Background Drug administration to patients with dysphagia/via
Canadian Hand Osteoarthritis Index (AUSCAN) and the
feeding tubes is known to be very complicated. Modifying
Arthritis Impact Measurement Scale 2 SF (AIMS2-SF).
oral dosage forms may alter drug stability, pharmacokinetics
Results 196 patients were included (placebo n=98, HCQ
and bioavailability, and harm patients. Manipulation of drug
n=98). Mean (SD) age was 57 (7.4) years; 86% were women.
dosage forms may also influence the health of healthcare
Baseline median (IQR) pain VAS was 50.0 (24.5–62.5) mm in
workers or caretakers.
the placebo group and 45.0 (26.0–60.3) mm in the HCQ
Purpose The aim of the study was to obtain an overview of
group. At 24 weeks, change in pain VAS was not significantly
problems with modifying solid dosage forms and administra-
different between the two groups. There were also no statisti-
tion to patients with dysphagia or feeding tubes in different
cally significant differences in pain VAS at weeks 6 and 12.
hospital wards.
Changes in AUSCAN total score and AIMS2-SF total score in
Material and methods The data were collected over 3 weeks
both groups were similar.
in February and March 2015. All patients with a nasogastric
Conclusions This study shows that 24 weeks of treatment
or gastrostomy tube or with dysphagia were included in the
with HCQ in symptomatic hand OA did not reduce pain
study once. Extraction of nursing records as well as interviews
compared with placebo. Also, no difference was observed in
with nurses were used for data collection.
the change in AUSCAN or AIMS2-SF scores between the two
Results Administration of medications to 21 patients from 7
treatment groups. These results suggest that HCQ should not
different wards was studied. 96 preparations of 64 different
be prescribed in patients with primary hand OA with mild to
medications or dosages, which involved crushing or dissolving
moderate pain symptoms.
solid dosages, were identified. 77/96 administrated

A176 Eur J Hosp Pharm 2017;24(Suppl 1):A1–A288