Kurt E Hersberger

• Prof.Dr.sc.nat
• University of Basel

Die vorliegenden Empfehlungen wurden auf Initiative des Vereins Pharmaceutical Care Network-Switzerland (www.pcn-s.ch) erstellt. Eine achtköpfige «Steering-Gruppe» setzte bewusst den Fokus auf «Empfehlungen zum Umgang mit Medikamenten an Schnittstellen». Nach einem ersten online Meeting mit 16 Personen, welche ihrerseits in ihren Netzwerken nach Vo...

Pharmacogenetic (PGx) testing is a promising approach for optimizing drug therapies. However, there is limited knowledge regarding its real-world utilization and long-term impact in clinical practice. This study assessed how often PGx information informs treatment decisions and evaluated patients’ perspectives on its use and non-use, identifying en...

Background In clinical practice, family medication history is not routinely assessed as part of a patient’s family health history (FHH). The information is self-reported and can depend on the individual’s subjective perception. To illustrate how pharmacogenetic (PGx) testing results could be used to validate self-reported family medication history...

Background Non-adherence to antihypertensive agents is common, mainly because of the low perceived burden of high blood pressure. General practitioners (GPs) are unable to predict whether patients are adhering to a recommended treatment. Knowledge about adherence might be of clinical interest in patients non-responding to antihypertensive treatment...

Background Direct oral anticoagulants (DOAC) effectively prevent recurrent ischaemic events in atrial fibrillation (AF) patients with recent stroke. However, excellent adherence to DOAC is mandatory to guarantee sufficient anticoagulation as the effect quickly subsides. Aim To investigate the effect of intake reminders on adherence to DOAC. Metho...

A woman with ocular hypertension suffered from severe bradycardia, hypotension and syncope attacks in temporal relation with ophthalmic timolol application. Topically applied timolol is nasally absorbed and has been shown to reach potentially relevant systemic concentrations. Timolol is mainly metabolized by CYP2D6, which exhibits interindividual m...

Purpose Pharmacogenetics (PGx) is an emerging aspect of personalized medicine with the potential to increase efficacy and safety of pharmacotherapy. However, PGx testing is still not routinely integrated into clinical practice. We conducted an observational case series study where PGx information from a commercially available panel test covering 30...

Background: Pharmacogenetic (PGx) testing and counselling (short: PGx service) in the community pharmacy is not routinely practiced. We propose a comprehensive pharmacist-led service where PGx information is integrated into medication reviews. Aim: To evaluate the pharmacist-led service comprising PGx testing and counselling (PGx service) from t...

Introduction: Opioid agonist treatment (OAT) is the first-line treatment for opioid use disorder (OUD). Simultaneously, opioids are essential medicines in acute pain management. The literature is scarce on acute pain management in individuals with OUD, and guidelines are controversial for patients on OAT. We aimed at analyzing rescue analgesia in...

Background Hepatitis C virus (HCV) infections are a public health burden worldwide and often go undetected until sequelae develop. Offering HCV screening for the different vulnerable populations in community pharmacies could help prevent further undetected HCV infections. This pilot aimed to assess the feasibility and pharmacist acceptance of HCV r...

Genetic predisposition is one factor influencing interindividual drug response. Pharmacogenetic information can be used to guide the selection and dosing of certain drugs. However, the implementation of pharmacogenetics (PGx) in clinical practice remains challenging. Defining a formal structure, as well as concrete procedures and clearly defined re...

We report the case of a 50-year-old male with major depressive disorder (MDD) to illustrate the challenge of finding effective antidepressant pharmacotherapy and the role that the patient’s genetic makeup may play. Recent treatment attempts before clinic admission included venlafaxine and fluoxetine. Venlafaxine was discontinued due to lack of resp...

Purpose Pharmacogenetic (PGx) panel testing could help to determine the heritable component of a rheumatoid arthritis (RA) patient’s susceptibility for therapy failure and/or adverse drug reactions (ADRs) from methotrexate (MTX). Considering the literature mentioning the potential applicability of PGx panel testing within MTX regimens, we discuss t...

In Zeiten der Corona-Pandemie sind pharmazeutische Dienstleistungen gefragt wie kaum je zuvor: von Antigen-Schnelltests über die Bestimmung der Antikörper-Titer hin zur Grundimmunisierung und fliessend weiter zur Booster-Impfung. Die vielen Anstrengungen der Vorjahre im Bereich von Public Health scheinen sich für die Apotheken endlich auszuzahlen:...

Background Counseling patients on medication adherence could be ameliorated in pharmacy practice. There is a lack of simple and practical strategies to address medication adherence with patients in daily practice. The goal was to develop and test a framework that allows pharmacy teams to define and apply a strategy to address medication adherence i...

Background: Infections with the hepatitis C virus (HCV) are a global public health burden due to their risk of morbidity and mortality. Because of a low HCV prevalence in the overall population in Switzerland (<1%), screening programs target specific at-risk populations for testing. Research from Scotland showed that around twice as many individual...

Introduction: Calculating patients’ medication availability from dispensing or refill data is a common method to estimate adherence. The most often used measures, such as the medication possession ratio (MPR), average medication supplies over an arbitrary period. Averaging masks the variability of refill behavior over time. Goal: To derive a new ab...

Background The negative impact of the COVID-19 outbreak on stroke care has been reported, but no data exist on the influence of the lockdown on medication adherence to antithrombotic treatment for stroke prevention. We present a comparison of electronic adherence data of stroke patients treated with direct oral anticoagulants (DOAC) prior to and du...

Background It is known that only 50% of patients diagnosed with major depressive disorders (MDD) respond to the first-line antidepressant treatment. Accordingly, there is a need to improve response rates to reduce healthcare costs and patient suffering. One approach to increase rates of treatment response might be the integration of pharmacogenetic...

Information on medication adherence is missing in patient files, although it might be helpful to optimize treatment. An adherence report that presents data from electronic adherence monitoring and provides recommendations regarding pharmacological treatment could close this gap. We aimed to develop an adherence reporting form that combines suitable...

Comparison of several regimens of oral vitamin D including an individually calculated loading regimen with the aim of achieving serum values > 75 nmol/l. Interventional, randomized, 3-arm study in vitamin D-deficient outpatients. Participants were allocated to supplementation of 24,000 IU vitamin D monthly over three months, using either a monthly...

To enable application-oriented training of Swiss pharmacists on pharmacogenetic (PGx) testing, an advanced, digital training program was conceptualized based on the Miller’s Pyramid framework, using a blended learning approach. The PGx advanced training program included an asynchronous self-study online module, synchronous virtual classroom session...

Background: Hospital stays are often associated with medication changes, which may lead to drug-related problems (DRPs). Medication reconciliation and medication reviews are strategies to detect and resolve DRPs. Methods: A descriptive cohort study was conducted using DRPs collected during routine pharmacist-led medication reconciliation and med...

Background Patients with polypharmacy are challenged with the management of their daily medication. Medication management strategies for direct oral anticoagulants (DOAC) are especially important to guarantee medication adherence and to prevent thromboembolic events. Patients are often left alone with finding an appropriate strategy. Objective(s)...

Background: Pharmacists are increasingly involved in strategies to fight antimicrobial resistance by ensuring optimised antibiotic (AB) use, including adherence support. Successful adherence interventions should be tailored to patients' barriers and validated instruments are needed. This study aimed to identify adherence barriers to AB treatment,...

In the herein reported case of a 42-year-old woman diagnosed with anxiety and depression, a long history of antidepressant ineffectiveness and adverse drug reactions was decisive for an in-depth medication review including pharmacogenetic panel testing. In detail, treatment attempts with paroxetine and escitalopram were ineffective and discontinued...

We report two cases of patients who developed severe adverse drug reactions including persistent movement disorders, nausea, and vertigo during treatment with quetiapine at maximum daily doses ranging between 300 and 400 mg. The extensive hepatic metabolism of quetiapine is mainly attributed to cytochrome P450 3A4 (CYP3A4). However, there is recent...

Alleles of the human leukocyte antigen (HLA) system have been associated with the occurrence of idiosyncratic adverse drug reactions (ADRs). Accordingly, it is assumed that pre‐emptive testing for the presence of certain HLA alleles (HLA‐typing) could prevent these ADRs in carriers. In order to perceive the current evidence for HLA‐associated ADRs,...

Background: Our goal was to determine vitamin B12 (cobalamin) deficiency with different diagnostic strategies, to propose the best possible laboratory strategy, and to synthesize the relevance of biomarkers in the diagnosis of a cobalamin deficiency. Methods: We performed a secondary data analysis. The testing strategies were (i) vitamin B12 sol...

Background: Our goal was to determine vitamin B12 (cobalamin) deficiency with different diagnostic strategies, to propose the best possible laboratory strategy, and to synthesize the relevance of biomarkers in the diagnosis of a cobalamin deficiency. Methods: We performed a secondary data analysis. The testing strategies were (i) vitamin B12 solely...

Pharmacogenotyping is applied to determine the hereditable component of a patient's susceptibility to experience therapy failure and/or adverse drug reactions (ADRs). We present the case of a female patient diagnosed with breast cancer and treated with tamoxifen as recurrence therapy who experienced various ADRs. Pharmacogenotyping revealed variant...

Readmissions to the hospital are frequent after hospital discharge. Pharmacist-led interventions have been shown to reduce readmissions. The objective of this study was to describe pharmacist-led interventions to support patients’ medication management at hospital discharge in Switzerland and to compare them to international guidelines. We conducte...

Objectives To describe how stroke survivors with atrial fibrillation implement direct oral anticoagulant treatment and propose appropriate metrics to describe adherence. Materials and Methods Stroke patients with atrial fibrillation electronically recorded their self-administered direct oral anticoagulants (apixaban, dabigatran, edoxaban, rivaroxa...

In many countries, community pharmacies provide sexual-health-related services to limit the spread of sexually transmitted infections (STIs), including chlamydia testing. To identify suitable target groups for pharmacy-based chlamydia testing in Switzerland, we aimed to assess chlamydia prevalence, identify risk groups, and delineate screening stra...

We report the case of a patient with major depression treated with high-dose bupropion due to prior detected subtherapeutic blood concentrations at standard dosing. Pharmacogenetic panel testing identified the patient as a carrier of the CYP2B6*6 allele, which has been associated with reduced bupropion metabolism and decreased concentrations of the...

An acceptable degree of digital literacy has always been present among the pharmacy teaching staff in Basel, with PowerPoint being the main vehicle to present teaching materials in front of full or half classes. Because cell phones became inseparable from students over the past years, mobile voting (movo.ch) or e-quizzes (mentimeter.com) have been...

An acceptable degree of digital literacy has always been present among the pharmacy teaching staff in Basel, with PowerPoint being the main vehicle to present teaching materials in front of full or half classes. Because cell phones became inseparable from students over the past years, mobile voting (movo.ch) or e-quizzes (mentimeter.com) have been...

Objectives: Particularly at transitions of care points information concerning current medication tends to be incomplete. A medication chart that contains all essential information on current therapy is likely to be a helpful tool for patients and healthcare providers. We aimed to investigate any type of benefits associated with medication charts pr...

Introduction Potentially inappropriate prescribing (PIP, including potentially inappropriate medication, PIM) is frequent. In research and practice, the use of PIP lists could optimize a patient's medication. However, they are barely used, possibly because of their limited user-friendliness. This study aimed at evaluating the opinions of pharmacist...

Background: To assess adherence to and preference for vitamin D substitution with different pharmaceutical forms and frequencies of administration. Methods: A focus group of stakeholders aimed at preparing the design of an interventional, randomized, cross-over study with 2 × 2 groups obtaining monthly or weekly vitamin D products in liquid or s...

Atrial fibrillation (AF) accounts for up to one third of strokes, one of the lead mortality causes worldwide. The European Society of Cardiology guidelines recommend opportunistic screening as a means to increase the odds of early detection and institution of appropriate treatment according to risk factors identified. However, in most countries the...

Background: Therapy with oral anticoagulation (OAC) can be challenging, especially in high risk groups such as chronic patients. Gaps in patient knowledge about OAC are linked to reduced effectiveness and safety of treatment. The objectives of this study were i) to assess OAC knowledge gathered during an intermediate medication review (MR) in patie...

Background To assess adherence to and preference for vitamin D substitution with different pharmaceutical forms and frequencies of administration. Methods A focus group of stakeholders aimed at preparing the design of an interventional, randomized, cross-over study with 2 x 2 groups obtaining monthly or weekly vitamin D products in liquid or solid...

Background: To assess adherence to and preference for vitamin D substitution with different pharmaceutical forms and frequencies of administration. Methods: A focus group of stakeholders aimed at preparing the design of an interventional, randomized, cross-over study with 2 x 2 groups obtaining monthly or weekly vitamin D products in liquid or soli...

Background: Transitions of care are high-risk situations for the manifestation of medication discrepancies and, therefore, present threats for potential patient harm. Medication discrepancies can occur at any transition within the healthcare system. Methods: Fifth-year pharmacy students assessed a best possible medication list (BPML) during a medic...

The role of pharmacists is changing; in many countries, pharmacists have acquired new competencies. A survey conducted in 2013 mapped the clinical pharmacy services in Swiss hospitals by quantifying full-time equivalents (FTE) and depicting clinical pharmacy activities. The aim of this survey was to update these results and analyze the development...

Abstract Background Poor medication-adherence is common in chronic lung patients, resulting in reduced health-outcomes and increased healthcare-costs. This study aimed to investigate the impact of an acoustic reminder and support calls on adherence to inhaled therapy in asthma and COPD patients and to determine their effect on exacerbations. Method...

Aim The aim of this study was to assess the cost effectiveness of the Pill Protect (PP) genetic screening test for venous thromboembolism (VTE) risk compared with standard of care (SoC), for women considering combined hormonal contraceptives (CHCs) in Switzerland. Methods A two-part microsimulation model was developed to estimate VTE events, costs...

Background Pharmaceutical Care Network Europe (PCNE) proposed a definition and classification system (type 1, 2a, 2b, 3) for medication review in 2016. However, to date, a description of the implementation and remuneration of such procedures across Europe is lacking. Objective The aim of this study was to describe the medication review procedures...

Medication review and medication reconciliation are systematic processes with the aim of increasing patient safety as well as effectiveness and efficiency on different levels. Whereas medication reconciliation is defined as the formal process of obtaining a complete and accurate list of each patient's current medications with the main aim of detect...

This chapter aims to provide a summary of different approaches to the payment of pharmaceutical care that have been adopted in selected countries. Each of them is described in brief, with the ultimate goal of highlighting the pros and cons of each approach. The second part of the chapter elaborates on a possible solution to make pharmaceutical care...

Objectives: Since 2002, Swiss community pharmacists have dispensed emergency contraception (EC) as pharmacist-only medicine ideally using the official Swiss protocol. Our study aimed to determine pharmacists’ resolution of an imaginary EC case, compliance with the protocol, and provision of information on the risk of sexually transmitted infections...

Objective: To improve discharge prescription quality and information transfer to improve post-hospital care with a pragmatic in-hospital service. Design: A single-centre, randomized controlled trial. Setting: Internal medicine wards in a Swiss teaching hospital. Participants: Adult patients discharged to their homes, 76 each in the intervention...

Background Oral anticoagulation therapy has proven beneficial impact on the prevention of thromboembolic events. However, the use of antocoagulatns also increases the risk of bleeds. To maximize the benefits and minimize the risks of the treatment, guidance on appropriate use of oral anticoagulants is essential. An international guideline describin...

Background Pharmacist-led cognitive services (PLCS) are increasingly necessary in primary care as a response to patient-centered care. However, the implementation rate and remuneration models of PLCS are either absent or superficially described in the literature. Objective The aim of this study is to review the implementation of PLCS in primary ca...

Background: Patient counselling and addressing drug-related problems are the pharmacist’s key activities to ensure the safe and effective use of medicines. This study aimed to describe the dispensing practice of prescribed medicines in daily community pharmacy practice and to identify factors influencing counselling provision; Methods: An observati...

Background: Non-adherence to direct oral anticoagulants (DOACs) remains a matter of concern, especially for patients with a recent stroke. However, data on electronically monitored adherence and adherence-improving interventions are scarce. Aims: We aim to use electronic monitoring in DOAC-treated stroke patients to (i) evaluate the effect of an ed...

Background The burden of asthma and COPD among patients is high and people affected are frequently hospitalized due to exacerbations. There are numerous reasons for the lack of disease control in asthma and COPD patients. It is associated with non-adherence to guidelines on the part of the health care provider and with poor inhalation technique and...

Background The tool CLEO in French language is designed for estimating the potential relevance of pharmacists’ interventions (PIs) in three independent dimensions with regard to process-related, clinical, economic, and humanistic impact. Objective We aimed to translate CLEO into German (CLEOde), to demonstrate its feasibility in daily practice, and...

Background: In pharmacotherapy, the achievement of a target clinical outcome requires a certain level of medication intake or adherence. Based on Haynes's early empirical definition of sufficient adherence to antihypertensive medications as taking ≥80% of medication, many researchers used this threshold to distinguish adherent from non-adherent pat...

Background: Medication review is important in an era, in which polypharmacy is increasing. To date, no agreed international definition of medication review exists. Objective The aim was to reach agreement on an internationally applicable definition of medication review. Setting An international group of experts in medication review. Methods: A wo...

Objective Few studies have examined associations between patient knowledge of direct oral anticoagulants (DOAC) and clinical outcomes, mostly because of the lack of validated questionnaires for assessing knowledge. The aim of this study was to develop and validate a questionnaire to self-assess knowledge of DOAC. Methods Twelve anticoagulation exp...

Questions of the KODOA-test translated to English (for informative purpose; the English version has not been validated).

Background Inappropriate prescribing is linked to increased risks for adverse drug reactions and hospitalisation. Combining explicit and implicit criteria of inappropriate prescribing with the information obtained in patient interviews seems beneficial with regard to the identification of drug-related problems (DRPs) in hospitalised patients. Objec...

Background Since 2010, Swiss pharmacists have been offering their patients a Polymedication Check (PMC), a new cognitive pharmacy service in the form of a medication review for patients taking ≥4 prescribed medicines for a period >3 months. While a first publication of this project reported on the impact of the PMC on patients’ adherence, the prese...

Objectives The Drug-Associated Risk Tool (DART) has been developed as a self-administered questionnaire for patients with the aim of stratifying patients according to their risk of drug-related problems (DRPs). We aimed to validate the ability of the questionnaire to distinguish between hospitalised patients showing lower and higher numbers of DRPs...

Introduction: The scope of community pharmacy practice varies widely across different countries and health care systems. Cognitive pharmaceutical services are daily provided to the patients in community pharmacies [1]. According to the PGEU, pharmacy services can be divided into: “Core services” (essential services provided by all pharmacies), “Bas...

Introduction Identifying patients with a high risk for drug-related problems (DRPs) might optimise the allocation of targeted pharmaceutical care during the hospital stay and on discharge. Objective To develop a self-assessment screening tool to identify patients at risk for DRPs and validate the tool regarding feasibility, acceptability and the r...

Background While dispensing prescribed medicines, pharmacists frequently encounter technical and clinical problems that require a pharmaceutical intervention. Objective To describe the pharmaceutical interventions performed by community pharmacists while dispensing prescribed medicines and to investigate, in-depth, the patient-reported problems wit...

Aims Assessment of the impact of type 2 diabetes (T2DM) and metformin use on vitamin B12 (VB12) associated biomarkers and their suitability to represent VB12 supply. Methods Differences of VB12, holotranscobalamine (HoloTc), the biologically active fraction (%AB12)=HoloTc/VB12*100 and homocystein (Hcy) were analysed i) among diabetic outpatients wi...

The poster describes the consensus method used to achieve country/region consensus within the PRACTISE survey respondents.

Interprofessionelle Ausbildung (IPE) ist definiert als «mit, von und über einander lernen». Das Kennenlernen der gegenseitigen Kompetenzen während der Ausbildung, soll die Kommunikation und die Zusammenarbeit zwischen den Berufsgruppen in der zukünftigen Praxis vereinfachen. Gemäss der WHO führt IPE zu interprofessioneller kollaborativer Praxis, we...

Background: Despite progress in pharmacological and non-pharmacological treatment in recent years, the burden of disease among patients with asthma and chronic obstructive pulmonary disease (COPD) is high and patients are frequently hospitalized due to exacerbations. Reasons for uncontrolled diseases are manifold, but are often associated with poo...

Objectives To assess subjective swallowing difficulties (SD) with medication intake and their practical consequences in patients suffering from systemic sclerosis (SSc) with a novel self-report questionnaire. Design and setting Based on a systematic literature review, we developed a self-report questionnaire and got it approved by an expert panel....

Rationale, aims, and objectives: During the dispensing process, pharmacists may come across technical and clinical issues requiring a pharmaceutical intervention (PI). An intervention-oriented classification system is a helpful tool to document these PIs in a structured manner. Therefore, we developed the PharmDISC classification system (Pharmacis...

Background Patients with substance use disorders grow older thanks to effective treatments. Together with a high prevalence of comorbidities, psychological problems, and low social support, these patients are at high risk for medication non-adherence. Established treatment facilities face challenges to accommodate these complex patients within thei...

Background: Despite great efforts in establishing optimal asthma management, asthma may remain uncontrolled. To effectively manage chronic diseases, such as asthma, it is important to train patients in self-management skills. Objectives: The aim of this study was to assess the potential benefit of standardised asthma education in Switzerland for...

Rationale, aims, and objectives: Pharmaceutical care involves patient-centred pharmacist activity to improve medicines management by patients. The implementation of this service in a comprehensive manner, however, requires considerable organisation and effort, and indeed, it is often not fully implemented in care settings. The main objective was t...

IntroductionMulticompartment compliance aids (MCA) are widely used by patients. They support the management of medication and reduce unintentional nonadherence. MCA are filled with medicines unpacked from their original packaging. Swiss pharmacists currently provide MCA for 1–2 weeks, although little and controversial information exists on the stab...

Background After hospital discharge, community pharmacists are often the first health care professionals the discharged patient encounters. They reconcile and dispense prescribed medicines and provide pharmaceutical care. Compared to the roles of general practitioners, the pharmacists’ needs to perform these tasks are not well known. Objective Thi...