Second OPERAM meeting in Utrecht

The second OPERAM meeting will take place at 11 and 12 January 2016 in Bunnik close to Utrecht. During this meeting the set up of the OPERAM trial and especially the use of the new version of the STRIPassistant, the implementation of the medication review and adjudication of adverse effects will be discussed. Also the health economics part of the trial and the performance of the systematic reviews and network meta-analysis are topics at this meeting.

Health Relevance of Shingles Vaccination in the Elderly Population

Europe-ExPro is an institute that identifies clinical, economic and patient related issues in certain disease areas that require an assessment by experts. Europe-ExPro brings forth expert procedures on these issues. The expert procedure aims to define the relevance between the new treatment option and the existing treatment options. This is done from different perspectives, such as clinical, economic or patient perspective. By evidence based and practice based methods the relevant differences are validated. The expert procedure results in a report for public use and a manuscript available for submission in an appropriate journal. The link to the website is here provided (see Link).

Deprescribing definition

There is lack of consensus on the definition of deprescribing. A review of Reeve et al., accepted for publication in the British Journal of Clinical Pharmacology (Aug 2015), proposes the following definition: „Deprescribing is the process of withdrawal of an inappropriate medication, supervised by a health care professional with the goal of managing polypharmacy and improving outcomes‟. This definition has not yet been externally validated and further work is required to develop an internationally accepted and appropriate definition.

STRIP-assistant efficacy study published in Drugs and Aging

The results of the effectiveness of the STRIPassistant, a computerized decision support system to improve a medication review, is published in Drugs and Aging. The  study showed that appropriate decisions increased from 58% without the STRIP Assistant to 76% with it (p<0.0001). Inappropriate decisions decreased from 42% without the STRIP Assistant to 24% with it (p<0.0001). The open access article is available on the EPHOR website at Research/articles.

PRAC recommends measures to minimise risks hydroxyzine

EMA’s Pharmacovigilance Risk Assessment Committee (PRAC) has completed a review of medicines containing the antihistamine hydroxyzine. This follows concerns over the risk of possible effects onheart rhythm with these medicines, which are available in most EU countries.

The PRAC considered that hydroxyzine was associated with a small but definite risk of QT interval prolongation and torsade de pointes.

Based on the assessed data, the risk did not differ between indications, and the Committee recommended that hydroxyzine could continue to be used provided that measures to minimise the risk of problems with heart rhythm were taken.

These measures include using the medicine at the lowest effective dose for as short a time as possible. Use is not recommended in the elderly. The maximum daily dose should be no more than 100 mg in adults (50 mg in the elderly if use cannot be avoided). Use must be avoided in patients who already have risk factors for heart rhythm disturbances or are taking other medicines that increase the risk of QT prolongation. Care is also needed in patients taking medicines that slow the heart rate or decrease the level of potassium in the blood, as these also increase the risk of problems with heart rhythm.