13th APLF Annual Conference,18-19 October 2025,Aveiro,Portugal - Programme and selected Abstracts

Dear participants,

The XIII National Conference, organized by the Portuguese Association of Pharmacy Technicians (APLF), reinforces the commitment to fostering scientific exchange and discussion among Pharmacy Technicians, bringing together professionals, students, academia, and the professional association. Held on 18–19 October 2025 at Aveiro, this year’s conference embraces the central theme “Medication Safety”, addressing one of the most pressing priorities in healthcare today. The event gathers renowned national and international speakers, ensuring a multidisciplinary and up-to-date approach to the safe and effective use of medicines and health technologies. The scientific programme includes lectures, workshops, debates, and scientific presentations, covering the diverse areas of professional practice and offering a platform for the sharing of innovative ideas, best practices, and research outcomes.

A record-breaking 92 abstracts were submitted for this edition — the highest number ever in the history of the institution, now published in the Therapeutic Advances in Drug Safety, marking a unique contribution to scientific dissemination in the field.

Our thanks go to all participants, to the members of the Organizing and Scientific Committees — composed of dedicated professionals from across the country — and to all authors who have actively contributed by sharing their research and practical experiences, thereby promoting both professional growth and the advancement of the profession.

We hope this conference proves to be a fruitful opportunity for knowledge exchange and networking, and we look forward to continuing this journey of excellence together.

Jorge Balteiro

President of the Organizing Committee of XIII National Conference of APLF

Rui Cruz

President of the Scientific Committee of XIII National Conference of APLF

Cristiano Matos

President of the Portuguese Association of Pharmacy Technicians

XIII National Conference Organizing Committee

Chair: Jorge Balteiro, Escola Superior de Tecnologia da Saúde de Coimbra do Instituto Politécnico de Coimbra (ESTeSC-IPC), Portugal.

Cátia Lopes, Farmácia Viriato - Viseu, Portugal.

Daniela Fernandes, Unidade Local de Saúde de Coimbra – Hospitais da Universidade de Coimbra (HUC)

Eliana Gomes, Unidade Local de Saúde da Região de Aveiro - Hospital Infante Dom Pedro - Aveiro, Portugal.

Hugo Costa, Farmácia Oudinot - Aveiro, Portugal.

Mariana Couras, Hospital do Divino Espírito Santo – Ponta Delgada – Ilha de São Miguel - Açores, Portugal.

Rui Silva, Instituto Português de Oncologia de Coimbra Francisco Gentil, E.P.E. (IPOCFG, E.P.E.), Portugal.

Sara Martins, Farmácia Olivais - Coimbra, Portugal.

Vânia Oliveira, Unidade Local de Saúde de Entre Douro e Vouga – Hospital de São Sebastião – Santa Maria da Feira, Portugal.

Vera Galinha, Escola Superior de Tecnologia da Saúde de Coimbra do Instituto Politécnico de Coimbra (ESTeSC-IPC), Portugal.

Vera Rodrigues, Unidade Local de Saúde de Coimbra – Hospitais da Universidade de Coimbra (HUC), Portugal.

Vítor Silva, Unidade Local de Saúde de Coimbra – Hospitais da Universidade de Coimbra (HUC), Portugal.

XIII National Conference Scientific Committee

Chair: Rui Cruz, Escola Superior de Tecnologia da Saúde de Coimbra do Instituto Politécnico de Coimbra (ESTeSC-IPC), Portugal.

Ana Paula Fonseca, Escola Superior de Tecnologia da Saúde de Coimbra do Instituto Politécnico de Coimbra (ESTeSC-IPC), Portugal.

Fernando Moreira, Escola Superior de Saúde do Politécnico do Porto, Portugal.

Liliana Aranha Caetano, Escola Superior de Tecnologia da Saúde de Lisboa do Instituto Politécnico de Lisboa (ESTeSL-IPL), Portugal.

Luís Miguel Nascimento, Escola Superior de Saúde do Instituto Politécnico de Bragança, Portugal.

Sandra Ventura, Escola Superior de Saúde do Politécnico da Guarda, Portugal.

Tânia Nascimento, Escola Superior de Saúde da Universidade do Algarve (ESSUAlg), Portugal.

APLF Board Members

Cristiano Matos, President of APLF; Carlos Miguel Figueira; Luís Jacinto; Luís Miguel Nascimento; João José Joaquim; Mariana Couras; Nuno Pereira; Pedro Martinho; Pedro Vieira; Regina Vaz; Renato Mesquita; Vítor Silva

Programme

Day 1 – 18 ^th October, 2025

09:30 – Opening Ceremony

Cristiano Matos (President of APLF)

Jorge Balteiro (President of the Organising Committee, XIII National Conference)

Rui Cruz (President of the Scientific Committee, XIII National Conference)

10:00 - Inaugural Conference: “Medication Safety: From Approval to Use”

Moderator: Sofia Antunes (Senior Specialist in Pharmacovigilance, PharmaLex Portugal, LDA, Portugal)

• “Medicinal Product Lifecycle: Safety and Risk Management”– Maria Teresa Herdeiro (Associate Professor with Habilitation, Department of Medical Sciences, University of Aveiro, Portugal) – CONFERENCE-01

• “Medicinal product lifecycle: Regulatory and Quality Management” - André Luz (OWLTECH – Manager and Qualified Person, Portugal) – CONFERENCE-02

11:30 – Panel I: “Medicines in Society and Sport: The Thin Line Between Use and Misuse”

Moderator: Luís Fonseca (Judicial Police, Forensic Science Laboratory – Drugs and Toxic Unit, Portugal)

• “The Medicalisation of Everyday Life and the Trivialisation of Risk: The Trajectory of Addiction” - Graça Vilar (Director, Department of Integrated Intervention, Institute for Addictive Behaviours and Dependencies, I.P., Portugal) – CONFERENCE-03

• “Illicit and Inappropriate Use of Medicines in Portugal: The Current Landscape” - Sara Tábuas (Forensic Science Specialist, Drugs and Toxic Sector of the Forensic Science Laboratory, Judicial Police) – CONFERENCE-04

• “Use of Performance-Enhancing Substances: Factors and Prevalence among Fitness Enthusiasts in Portugal” - Ana Sofia Tavares (Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisboa, Portugal) – CONFERENCE-05

14:30 – Panel II: “Antibiotics: Strategies for Safe and Efficient Use”

Moderator: Cláudia Nazareth (Clinical Director for Hospital Healthcare, Local Health Unit of Coimbra)

• “Antimicrobial stewardship: data-driven behaviour change in proximity” - Francisco Almeida (Infection Prevention and Control and Antimicrobial Resistance Unit – UPCIRA, Local Health Unit São João, Portugal) – CONFERENCE-06

• “Multifaceted interventions to improve antibiotic use - One Health approach” - Fátima Roque (ESS/IPG; BRIDGES – Biotechnology Research, Innovation and Design for Health Products, Portugal) – CONFERENCE-07

• “Rational Use of Antibiotics and the Challenges of Antimicrobial Resistance” - André Peralta Santos (Deputy Director General of Health - DGS - Portugal)Keep the format of previous ones.

16:30 – Panel III: “Artificial Intelligence in Medication Safety and its Impact on the Future of the Profession: Challenges and Opportunities”

Moderator: Fábio Urbano Soares (Edol Laboratories, Portugal; Seeha, United Arab Emirates)

• “Localized AI in Hospital Pharmacy: Medex and Smart Distribution” - António Fonseca (Local Health Unit of Vila Nova de Gaia/Espinho, Portugal) – CONFERENCE-08

• “Artificial Intelligence in Hospital Pharmacy: Revolution or Complement?” - José Miguel Mesquita (Senior Manager, Strategy Unit, Glintt Life Hospitals, Portugal) – CONFERENCE-09

• “Pharmaceutical AI and Care Delivery: Reality or Promise?” - Filipa Fixe (Healthcare Director, KPMG; Visiting Professor, Institute of Social and Political Sciences, University of Lisbon, Portugal)

• “Ideas and Opportunities for Clinical Trials management systems in the age of AI” - Rui Patricio (Universidade of Aveiro, Aveiro, Portugal) – CONFERENCE-10

18:00 – Cultural Moment

Day 2 – 19^th October, 2025

09:00 – Oral Communications (choice from Scientific Committee)

11:00 – Panel IV: “Deprescribing: Less is More”

Moderator: Carla Perpétuo (Local Health Unit of Guarda; BRIDGES – Biotechnology Research, Innovation and Design for Health Products, Polytechnic Institute of Guarda, Portugal)

• “Optimizing Medication Use in Elderly Patients: A Framework for Deprescribing and Rational Prescribing” - Luís Monteiro (Coordinator, USF Esgueira +; Full Professor, Department of Medical Sciences, University of Aveiro; Researcher, Egas Moniz Academic and Clinical Centre, Portugal) – CONFERENCE-11

• “A Multifaceted Intervention to Reduce Potentially Inappropriate Medication in Older Adults” - Daniela Rodrigues (BRIDGES – Biotechnology Research, Innovation and Design for Health Products, Polytechnic Institute of Guarda, Portugal) – CONFERENCE-12

• “Deprescribing in Portugal: Perspectives of Physicians and Older Patients” - Anabela Pereira (RISE-Health, Associated Laboratory, Portugal) – CONFERENCE-13

12:30 – Closing Ceremony and Awards Presentation

Cristiano Matos (President of APLF)

Jorge Balteiro (President of the Organising Committee, XIII National Conference)

CONFERENCES (ABSTRACTS FROM CONFERENCES)

Conference-01

Medicinal Product Lifecycle: Safety and Risk Management

Maria Teresa Herdeiro¹

¹iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal. Corresponding author: Maria Teresa Herdeiro - [e-mail]

Accordingly, to the World Health Organization, Adverse Drug Reactions (ADR) are “unintended, harmful reactions to medicines” ^[1] and Pharmacovigilance is defined as the “science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem”. Pharmacovigilance plays an essential role in the study of medicines safety, since the information from clinical trials has several limitations; the post-marketing surveillance permits detection of the majority of serious and unexpected ADR. The methods currently used in pharmacovigilance are: (1) hypotheses generators (spontaneous reporting and cases reports/case series publication); (2) intensive monitoring programs and (3) observational studies (using primary or secondary data sources), randomized control trials and meta-analyses. ^[2] The ADR spontaneous reporting is the method more used by the pharmacovigilance national systems and has followings advantages: the involvement of all population, covering all marketed drugs, it focuses on the entire life cycle of the drug, does not interfere with the prescription habits, allows to identify very rare ADR and it is inexpensive. However, the underreporting, the reporting delay and incomplete data are some of the disadvantages. The patient’s participation in the pharmacovigilance system introduced by directive 2010/84/UE ^[3] is another important issue for the safety of medicines and the protection of Public Health. The Safety and Risk Management of medicines, included the Risk Management Plan ^[4] incorporated safety specifications (identified and potential risks, missing information, special populations), the pharmacovigilance plan comprised of routine activities (passive pharmacovigilance, including spontaneous reporting and periodic safety reports) and additional activities (active pharmacovigilance, including Post-Authorization Studies).

Keywords: Adverse Drug Reactions, Pharmacovigilance, medicines safety

References

1. World Health Organization, Briefing note, safety of medicines – adverse drug reactions.

2. Härmark L, van Grootheest A.C. (2008). Pharmacovigilance: methods, recent developments and future perspectives. Eur J Clin Pharmacol. 64:743–752.

3. European Parliament and the Council of the European Union. (2010). Directive 2010/84/EU of the European Parliament and of the Council of 15 December 2010 amending, as regards pharmacovigilance, Directive 2001/83/EC on the Community code relating to medicinal products for human use. OJ, 348, 74-99.

4. European Medicines Agency, Guideline on good pharmacovigilance practices (GVP) Module V – Risk management systems (Rev 2)

Conference-02

Medicinal Product Lifecycle: Regulatory and Quality Management

André Luz¹

¹Owltech, Lda, General Manager and QP, Portugal. Corresponding author: André Luz - [e-mail]

The management of the medicinal product lifecycle has evolved significantly with the introduction of ICH Q12: Technical and Regulatory Considerations for Pharmaceutical Product Lifecycle Management that came to complement the previous ICH guidelines with emphasis on ICH Q8, Q9, Q10 and Q11. This guideline establishes a harmonized framework that promotes a more predictable and efficient approach to the medicinal product lifecycle after its development, fostering continual improvement while maintaining product quality and regulatory compliance. This presentation provides a focused examination of the medicinal product lifecycle between its conception until the routine phase. It explores the integration of scientific knowledge, risk-based decision-making, and quality management systems to support enhanced regulatory flexibility. The main point is to enroll several steps that should not be overlooked, all of which aim to streamline communication with regulatory authorities and end up with a controlled product with high quality standards. By embedding these principles into the pharmaceutical quality system, organizations can improve the transparency and robustness of their change management processes, enabling continuous improvement in secured and controlled way together with the Health Authorities. Through regulatory convergence and consistent application of the existent guidelines, the pharmaceutical industry can achieve more efficient lifecycle management, improve global supply continuity, and enhance patient access to high-quality medicines. This discussion underscores the medicinal product lifecycle management is a cornerstone of modern regulatory and quality strategies for medicinal products.

Keywords: Quality, Regulatory Framework, International Guidelines

References

1. The International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) – Quality Guidelines.

2. EudraLex - Volume 4 - Good Manufacturing Practice (GMP) guidelines.

3. Decreto-Lei n.º 176/2006, de 30 de agosto Estatuto do Medicamento (Consolidated version from 22/08/2019).

Conference-03

The Medicalization of Everyday Life and The Trivialization Of Risk: The Trajectory of Addiction

Graça Vilar¹

¹Department of Integrated Intervention, Institute for Addictive Behaviours and Dependencies, I.P., Portugal.

This conference offers a critical reflection on contemporary patterns of pharmaceutical consumption in both society at large and within the realm of sports. It explores the factors underlying the shift from therapeutic use to medication dependence, grounded in the concept of the medicalization of everyday life—defined as the growing tendency to resort to pharmacological solutions as immediate responses to physical, emotional, or social challenges, often without sufficient consideration of associated risks. A central theme is the trivialization of risk: the widespread underestimation of the adverse effects and addictive potential of legally available medications. This phenomenon is exacerbated by overprescription, self-medication, and increasing performance pressures—particularly evident in elite sports. The discussion addresses the multidimensional consequences of this trend: at the individual level (impact on physical and mental health); at the systemic level (increased burden on healthcare systems); and at the ethical level (especially in competitive sports, where fairness and integrity are at stake). Finally, it advocates for a more integrated and preventive approach. Key strategies include promoting the rational use of medicines, investing in non-pharmacological therapeutic alternatives, and implementing robust public policies aimed at regulation, education, and awareness.

Keywords: Medication dependence; medicalization; risk; public health; elite sports; rational use of medicines.

Conference-04

Illicit and Inappropriate Use of Medicines In Portugal: The Current Landscape

Sara Tábuas¹

¹Forensic Science Specialist, Drugs and Toxic Sector of the Forensic Science Laboratory, Judicial Police, Lisbon, Portugal.

The non-therapeutic use of medicines, whether illicit or otherwise inappropriate, has reached a level of growing concern in Portugal and constitutes an emerging threat to public health. Recent seizures have revealed significant circulation of pharmacological substances outside authorised distribution channels, frequently associated with aesthetic enhancement, recreational purposes, or physical performance optimisation. Medicines most commonly identified in this context include anabolic steroids, androgenic and growth hormones, and substances designed to influence sexual function or weight management. Procurement is predominantly via informal networks or the black market, with no assurance as to the quality, authenticity, or safety of the products concerned. The associated health risks are wide-ranging, encompassing hormonal dysfunction, cardiovascular and hepatic complications, behavioural changes, and adverse effects on mental and reproductive health. Use often occurs covertly and is not readily identifiable by healthcare professionals, thereby impeding timely intervention and appropriate monitoring. Addressing this issue requires a coordinated, multidisciplinary approach incorporating preventive strategies, public awareness initiatives, and capacity-building for healthcare professionals, alongside strengthened enforcement and regulatory oversight of unauthorised medicine use. A clear understanding of the true extent of the phenomenon is essential in order to mitigate its impacts and protect population health.

Conference-05

Use of Performance-Enhancing Substances: Factors and Prevalence among Fitness Enthusiasts in Portugal

Ana Sofia Tavares¹

¹Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisboa, Portugal.

Background: Currently, the use of performance-enhancing substances (PES) is no longer limited to elite sports; it is also widespread in gyms and fitness centers, posing a public health concern. Studies on the use of PES among gym-goers are scarce and focus mainly on bodybuilding and the use of anabolic-androgenic steroids, without providing information on social indicators that explain why this specific population uses such substances. Objectives: To investigate the extent of PES use and examine how social indicators, exercise profile, and types of gym practice influence the use of these substances among a sample of gym-goers. Methods: A cross-sectional descriptive study was conducted with a convenience sample of 453 Portuguese gym-goers, recruited directly via email and Facebook from five institutional gyms. Data were collected through a structured online questionnaire between October and November 2017. Statistical analysis included multiple binary logistic regression, the Chi-Square test, Monte Carlo simulation, or Fisher’s exact test. Odds ratios and their 95% confidence intervals were calculated. Results: Among the participants, 11.1% reported using prohibited performance-enhancing substances, with significant variation according to gender, education, occupation, exercise profile, and type of practice. Gender was associated with the class of PES used. Polypharmacy was common among users, increasing the risk of side effects. Peer influence and media appear to play a crucial role in the misuse of PES. Conclusion: The results provide a clear overview of specific factors associated with PES use, which can support prevention strategies in the gym and fitness context.

Keywords: Performance-enhancing substances; gym users; prevalence; social indicators.

Conference-06

Antimicrobial Stewardship: Data-Driven Behaviour Change in Proximity

Francisco Almeida¹

¹Unidade de Prevenção e Controlo de Infeção e Resistência aos Antimicrobianos, Unidade Local de Saúde São João, Porto, Portugal. Faculdade de Medicina da Universidade do Porto; Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal. Corresponding author: Francisco Almeida - [e-mail]

Antimicrobial resistance, Clostridioides difficile infection and drug toxicity can be reduced with interventions directed to the optimization of antibiotic use, which fall into the broad nomenclature of antimicrobial stewardship (AMS). In this lecture, we explore three insights from our experience with AMS: (1) AMS should occur close to the prescribers. Interventions such as pre-authorization or post-prescription validation of restricted antimicrobials can rapidly improve antibiotic use but have limited reach. AMS collaborative interventions occurring in proximity have been shown to improve prescription further, even when restrictive measures are already in place ^[1] and can create a culture of sustained good practices in broader aspects of infection management (such as surgical control of the source of infection or collection of microbiological samples); (2) AMS interventions should be guided by high quality data. Knowing quantity of antibiotic use can pinpoint where an intervention is needed. However, quantitative analysis rarely paints a full picture by itself – a high use of broad-spectrum antibiotics can be justified in some settings. AMS should also incorporate robust quality indicators in intervention design ^[2]; (3) AMS should focus on changing collective behaviours. Antibiotic misuse is usually a result of multiple different barriers within groups of prescribers and should not be attributed solely to lack of knowledge or lack of concern for quality of care ^[3]. An understanding of these barriers should inform intervention design. We illustrate these ideas with a local intervention that successfully reduced empiric ceftriaxone use for community-acquired pneumonia by over 50%.

Keywords: Antimicrobial Stewardship; Quality indicators; behaviour change; Antimicrobial resistance

References

1. Davey P, et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev. 2017 Feb 9;2(2):CD003543

2. Stemkens R, et al. How to use quality indicators for antimicrobial stewardship in your hospital: a practical example on outpatient parenteral antimicrobial therapy. Clin Microbiol Infect. 2023 Feb;29(2):182-187.

3. Hulscher ME, Grol RP, van der Meer JW. Antibiotic prescribing in hospitals: a social and behavioural scientific approach. Lancet Infect Dis. 2010 Mar;10(3):167-75.

Conference-07

Multifaceted Interventions to Improve Antibiotic Use - One Health Approach

Fátima Roque^1,2

¹Biotechnology Research, Innovation and Design for Health Products (BRIDGES), Instituto Politécnico da Guarda, Guarda, Portugal. ²Health Sciences Research Centre (CICS), Universidade da Beira Interior, Covilhã, Portugal. Corresponding author: Fátima Roque - [e-mail]

The inappropriate use of antibiotics in humans and animals, as well as their spread in the environment, has been associated with an increase in antibiotic resistance. Understanding the phenomena associated with this inappropriate use is essential for designing multifaceted interventions. It is therefore important to study the problem of resistance and inappropriate use of antibiotics from a ‘OneHealth’ perspective, in order to understand all the factors, from gaps in therapeutic guidelines, to attitudes and practices in prescribing, dispensing and administration, both in humans and in animals. Any intervention that is designed must take all these factors into account and involve the different stakeholders for the best success in implementation. Multifaceted interventions designed on the basis of attitudes, knowledge associated with prescribing and dispensing, as well as administration and use by the general population and food-producing animals have proven to be effective. Some examples of multifaceted interventions that we have developed in Portugal are educational interventions and the development of tools to support prescribing and dispensing, such as eHaelthResp. Another example of a project that is being developed from a OneHealth perspective is the Edu4OneHealth project. This project initially analysed guidelines and recommendations for the use of antibiotics in veterinary medicine and showed that there is a big difference between countries. The discussion of these phenomena is very important both for a global analysis of the problem of bacterial resistance and for the development of multifaceted interventions at both national and international level.

Conference-08

Localized AI In Hospital Pharmacy: Medex and Smart Distribution

António Fonseca¹

¹Unidade Local de Saúde de Vila Nova Gaia/Espinho, Portugal. Corresponding author: António Fonseca - [e-mail]

Background: Artificial Intelligence (AI) tools such as ChatGPT are designed for broad, global applications but often lack the specificity required for hospital pharmacy workflows [1,2]; moreover, although automated rule-based macros ensure compliance with fixed thresholds, they fail to adapt to evolving and adapting to prescribing patterns. This study introduces the concept of micro-AI: lightweight predictive models trained on Medex data and embedded in Excel via VBA, enabling Senior Diagnostic and Therapeutic Technicians (TSDTs) to detect distribution anomalies and unusual dosages in real time. Objectives: to evaluate a micro-AI pipeline that scores prescribed doses and distribution metrics, flags deviations beyond historical norms and incorporates TSDT verification to refine model accuracy. Methods: export of prescription logs from Medex; training of decision-tree classifiers on distribution volume and dose frequency; integration of scoring routines into Excel/VBA; and deployment in a live TSDT workflow with human-in-the-loop feedback. Results: after six months, we optimized distribution logistics, identifying and adjusting the most frequently dispensed medications and doses, triggering dose-adjustment alerts in approximately 20 % of administrations, automatically detecting non-scheduled doses with 90 % accuracy and generating notifications for mismatched pharmaceutical forms. Conclusions: micro-AI empowers TSDTs as active partners in clinical governance, transforming static checks into a continuous learning cycle that enhances safety, efficiency and adaptability without extensive infrastructure overhaul.

Keywords: hospital pharmacy, micro-AI, TSDT

References

1. Jairoun, A. A., et al. (2023). ChatGPT: Threat or boon to the future of pharmacy practice? Research in Social & Administrative Pharmacy: RSAP, 19(7), 975–976.

2. Roosan, D., Padua, P., Khan, R., Khan, H., Verzosa, C., & Wu, Y. (2024). Effectiveness of ChatGPT in clinical pharmacy and the role of artificial intelligence in medication therapy management. Journal of the American Pharmacists Association: JAPhA, 64(2), 422-428.e8.

Conference-09

Artificial intelligence in hospital pharmacy: revolution or complement?

José Mesquita¹

¹Glintt Global, Porto, Portugal. Corresponding author: José Mesquita - [e-mail]

Hospital pharmacy is undergoing a significant transformation with the introduction of artificial intelligence (AI). This technology optimises processes, increases efficiency, and improves patient safety. AI is revolutionising various areas, including efficient inventory management, predicting medication demand, and preventing waste or stock shortages. This reduces operational costs and ensures medication availability ^[1]. AI also plays a crucial role in therapeutic personalisation, adjusting doses and treatments based on the patient’s clinical profile, making medicine more precise and effective. It helps prevent medication errors by quickly analysing large volumes of clinical data to identify drug interactions, dosage errors, and contraindications. Automated dispensing using robotics increases the accuracy of medication delivery, reducing human errors and ensuring faster distribution ^[2]. While clinical decision-making, human interaction with patients and medical teams, and the critical analysis of complex cases still require human experience and knowledge, AI reduces the workload in repetitive and administrative tasks. This allows pharmacists to focus on cases requiring greater attention and specialised intervention ^[3]. Patient data security and privacy must be priorities, ensuring compliance with health regulations and best practices. The future of hospital pharmacy will be more automated and efficient, with advanced AI systems assisting in medication management, personalisation, and safety. However, human presence remains indispensable to ensure the best patient care. AI should be seen as an ally, not a replacement, as empathy, clinical reasoning, and complex decision-making are intrinsically human capabilities that no technology can fully replicate.

Keywords: Artificial Intelligence, Hospital Pharmacy, Patient Safety

References

1. Sridhar, S. B., Karattuthodi, M. S., & Parakkal, S. A. (2024). Role of Artificial Intelligence in Clinical and Hospital Pharmacy. Application of Artificial Intelligence in Neurological Disorders (pp. 229-259). SpringerLink.

2. Chase, A., Johns, E., Williams, B., Erstad, B. L., & Edwards, C. J. (2025). Artificial Intelligence and Machine Learning. American Journal of Health-System Pharmacy. Oxford Academic.

3. Mayet, A. Y., Khurshid, F., Al-Omar, H. A., Alghanem, S. S., Alsultan, M. S., & Al-jedai, A. H. (2023). Clinical and Operational Applications of Artificial Intelligence and Machine Learning in Pharmacy. MDPI.

Conference-10

Ideas and Opportunities For Clinical Trials Management Systems In The Age of AI

Rui Patricio¹, Ana Gandarinho¹, Ana Daniel¹, Diogo Guerra¹, Mário Vairinhos¹, Rui Raposo¹, Catarina Lélis¹

¹Universidade de Aveiro, Aveiro, Portugal. Corresponding author: Rui Patricio - [e-mail]

Artificial intelligence (AI) promises faster, safer trials, yet current clinical trials management systems (CTMs) show persistent gaps, e.g., poor interoperability, cumbersome interfaces, security concerns, and limited AI readiness, exacerbated by regulatory fragmentation and the shift to decentralised trials ^[1]. This study applies ISO 56007 ^[2] to bridge those gaps by identifying and qualifying ideas and opportunities to inform TRIALS READY’s requirements and concept validation. TRIALS READY targets barriers faced by smaller institutions and start-ups by delivering an affordable, intuitive platform with integrated AI to democratise clinical research. Methods followed ISO 56007’s three phases: (1) identification- mapping opportunities grounded in user needs and the competitor landscape; (2) concept creation- refinement through empathy-led UX/UI and MVP development; and (3) validation- target user testing and evaluation. Evidence was gathered through stakeholder mapping (investigators, patient advocates, study coordinators, pharmacists, data managers, and regulatory staff), participatory design workshops, surveys, interviews, and a literature gap analysis. Results highlight explainable AI with human oversight as a priority macro-theme requirement. It supports the view that increasing CTM adoption simplifies labour-intensive trial management by improving data currency, quality, and overall efficiency ^[3]. An ISO 56007-aligned approach creates a compliance-ready front end that converts documented gaps into implementable CTMS opportunities, aligning AI innovation with user needs and governance expectations. Emphasising user-centred validation likely improves adoption and data quality while strengthening the professional role in health safety ^[4].

Keywords: ISO 56007, Clinical Trials Management, Artificial Intelligence.

References

1. de Jong, A. J., Zuidgeest, M. G. P., Santa-Ana-Tellez, Y., de Boer, A., & Gardarsdottir, H. (2024). Regulatory readiness to facilitate the appropriate use of innovation in clinical trials: The case of decentralized clinical trial approaches. Drug Discovery Today, 29(11), 104180.

2. International Organization for Standardization (2023). ISO 56007:2023—Innovation management: Tools and methods for managing opportunities and ideas—Guidance. ISO.

3. Chakraborty, A., Ghosh, S., & Pal, S. (2022). Re-engineering a Clinical Trial Management System Using Blockchain Technology. Journal of Medical Internet Research, 24(6), e36774.

4. Walden, A., Garvin, L., Smerek, M., & Johnson, C. (2020). User-centered design principles in the development of clinical research tools. Clinical Trials, 17(6), 703–711.

Conference-11

Optimizing Medication Use in Elderly Patients: A Framework for Deprescribing and Rational Prescribing

Luís Monteiro¹

¹Department of Medical Sciences, University of Aveiro, Aveiro, Portugal. Corresponding author: Luís Monteiro - [e-mail]

Objectives: This presentation aims to promote rational prescribing in elderly patients by addressing the challenges of polypharmacy and the need for deprescribing strategies. Methods: A comprehensive review of assessment tools like STOPP/START and APIMedOlder, strategies aimed at reducing inappropriate polypharmacy, and promoting multidisciplinary approaches were used to develop this presentation. It emphasizes shared decision-making, collaborative practice and decision support tools. Results: Successful deprescribing necessitates patient-centered care, including addressing patient concerns and the use of validated criteria, a multidisciplinary team, careful planning, and collaborative practices. Conclusions: Quality improvement initiatives, implementation of decision support tools like APIMedOlder and collaborative practice holds significant potential to optimize medication use, reduce medication-related harm, and improve overall health outcomes for older adults.

Keywords: Deprescribing, Polypharmacy, Elderly.

References

1. Romano S, Monteiro L, Guerreiro JP, Simões JB, Teixeira Rodrigues A, Lunet N, et al. (2024) Effectiveness and cost-effectiveness of a collaborative deprescribing intervention of proton-pump-inhibitors on community-dwelling older adults: Protocol for the C-SENIoR, a pragmatic non-randomized controlled trial. PLoS ONE 19(3): e0298181.

2. A. Rodrigues, D., Roque, F., Herdeiro, M. T., & Monteiro, L. (2024). Translation and Adaptation of the STOPP/START Criteria Version 3 for Potentially Inappropriate Prescribing in Older People to European Portuguese: A Study Protocol. Acta Médica Portuguesa, 37(12), 847–852.

Conference-12

A Multifaceted Intervention to Reduce Potentially Inappropriate Medication in Older Adults

Daniela A. Rodrigues¹, Ana I. Plácido¹, Maria Teresa Herdeiro², Ramona Mateos-Campos³, Adolfo Figueiras^4,5,6, Fátima Roque^1,7

¹Biotechnology Research, Innovation and Design for Health Products (BRIDGES), Instituto Politécnico da Guarda, Guarda, Portugal.²Department of Medical Sciences, Institute of Biomedicine (iBiMED), Universidade de Aveiro, Aveiro, Portugal.³Department of Biomedical and Diagnostic Sciences, Universidade de Salamanca, Salamanca, Spain.⁴Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.⁵Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.⁶Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), Madrid, Spain.⁷Health Sciences Research Centre (CICS), Universidade da Beira Interior, Covilhã, Portugal. Corresponding author: Daniela A. Rodrigues - [e-mail]

Background: Potentially inappropriate medication (PIM) use is highly prevalent among older adults and is associated with adverse drug events, hospitalisations, and increased mortality^[1,2]. Despite the availability of PIM identification tools such as the EU(7)-PIM list ^[3], their application in primary care remains suboptimal. Objectives: To develop, implement, and evaluate a multifaceted intervention to support general practitioners (GPs) in reducing PIM prescribing in older adults. Methods: A mixed-methods approach was employed. First, the APIMedOlder web application was developed using the EU(7)-PIM criteria to support PIM identification. A usability study was then conducted with 15 healthcare professionals to assess its acceptability and practicality. Subsequently, five focus groups with General Practitioners (GPs) explored perceptions of PIM use, barriers to deprescribing, and facilitators for adopting digital tools in clinical practice. Finally, an educational intervention incorporating the APIMedOlder tool was implemented in four Local Health Units (ULS), with four matched units serving as controls. An analysis was performed to evaluate the intervention’s impact on PIM prescribing. Results: The APIMedOlder tool showed good usability (median SUS = 82.5). GPs reported awareness of PIM risks but identified challenges such as time constraints and lack of deprescribing guidance. They considered digital tools helpful if easy to use and evidence-based. Following the intervention, the results suggested a reduction in in PIM use. Conclusions: An educational intervention supported by a user-centred digital tool can promote more appropriate prescribing for older adults in primary care, with potential for broader implementation across similar healthcare contexts.

Keywords: Potentially Inappropriate Medication; Older Adults; Medication Optimization

References

1. Hyttinen, V., Jyrkkä, J., & Valtonen, H. (2016). A systematic review of the impact of potentially inappropriate medication on health care utilization and costs among older adults. Medical Care, 54(10), 950-64.

2. Mekonnen, A. B., Redley, B., de Courten, B., & Manias, E. (2021). Potentially inappropriate prescribing and its associations with health-related and system-related outcomes in hospitalised older adults: A systematic review and meta-analysis. In British Journal of Clinical Pharmacology, 87(11), 4150-72.

3. Renom-Guiteras, A., Meyer, G., & Thürmann, P. A. (2015). The EU(7)-PIM list: A list of potentially inappropriate medications for older people consented by experts from seven European countries. European Journal of Clinical Pharmacology, 71(7), 861-75.

Conference-13

Attitudes Toward Deprescribing In Portugal: Perspectives of Older Adults and Physicians

Anabela Pereira¹, Manuel Veríssimo², Oscar Ribeiro³

¹Centre for Health Technology and Services Research at the Associate Laboratory RISE – Health Research Network (CINTESIS@RISE), Department of Education and Psychology of the University of Aveiro, Aveiro, Portugal.²Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.³Centre for Health Technology and Services Research at the Associate Laboratory RISE – Health Research Network (CINTESIS@RISE), Department of Education and Psychology of the University of Aveiro, Aveiro, Portugal. Corresponding author: Anabela Pereira - [e-mail]

Background: Deprescribing has emerged as a crucial practice in managing polypharmacy amongst ageing populations, particularly relevant in Portugal, one of Europe’s most aged nations. Despite growing evidence supporting its benefits, implementation barriers persist at the healthcare professional, patient, and system levels. Objectives: Our research aimed to investigate attitudes and practices towards deprescribing amongst Portuguese older adults and physicians to inform future healthcare strategies. Methods: Two cross-sectional studies were conducted. One examined deprescribing attitudes in Portuguese older patients (n=192) using the validated Portuguese version of the revised Patients’ Attitudes Towards Deprescribing (rPATD) questionnaire ^[1]. The other, a national survey of Portuguese physicians’ awareness, training, attitudes, and clinical practices (n=425). Results: 83.33% of Portuguese older adults expressed willingness to discontinue medications if recommended by their physicians, despite 90.6% reporting satisfaction with current regimens. Advanced age and female sex positively predicted deprescribing willingness, whilst concerns about stopping medications decreased receptiveness ^[2]. Among physicians, 81.2% demonstrated deprescribing awareness, 98.9% recognised its benefits, and 91.9% reported engaging in deprescribing practices. However, 55.4% lacked deprescribing training, and most did not employ structured methodologies or criteria for identifying potentially inappropriate medications. Training was significantly associated with increased awareness and systematic application of deprescribing methods. Specialty variations were observed, with family medicine and internal medicine specialists demonstrating superior deprescribing knowledge and practices ^[3]. Conclusions: Both stakeholder groups exhibited positive attitudes towards deprescribing, highlighting the need for comprehensive national initiatives addressing identified barriers through targeted educational programmes and policy development to optimise medication management in Portuguese older adults.

References

1. Pereira, A., Ribeiro, Ó., & Veríssimo, M. (2022). Translation, cross-cultural adaptation and validation of the revised Patients’ Attitudes Towards Deprescribing (rPATD) questionnaire to Portuguese: Older adults version. Research in Social and Administrative Pharmacy, 19, 123–132.

2. Pereira, A., Ribeiro, Ó., & Veríssimo, M. (2023). Predictors of older patients’ willingness to have medications deprescribed: A cross-sectional study. Basic and Clinical Pharmacology & Toxicology, 133(6), 703–717.

3. Pereira, A., Veríssimo, M., & Ribeiro, Ó. (2024). Deprescribing in older adults: Attitudes, awareness, training, and clinical practice among Portuguese physicians. Acta Médica Portuguesa, 37(10), 684–696.

ORAL COMMUNICATIONS

TOPIC: PATIENT-CENTERED SAFETY

Abstract-Oral-15 Patient-Centered Safety

Empowering To Care: Development and Implementation of A Digital Educational Resource

Paulo Vieira¹, Tânia Simões¹

¹Unidade Local de Saúde Barcelos/Esposende, EPE, Barcelos, Portugal. Corresponding author: Paulo Vieira - [e-mail]

Background: Medication safety is essential for providing safe, patient-centered healthcare. Despite advances in prescription and administration systems, patients remain vulnerable to medication-related adverse events. Health literacy is a key factor in preventing such events. Educational interventions, such as accessible and informative eBooks, can strengthen patients’ active role in the safe management of their medication. Objectives: This project aimed to develop, implement, and evaluate an educational eBook to promote hospitalized patients’ involvement in medication safety, aligned with recommendations from the WHO, INFARMED, and DGS. The focus was to strengthen health literacy regarding safe medication use during hospitalization and at discharge. Method: The project followed four phases: (1) Identification of informational needs through semi-structured interviews with 20 patients (mean age 67 years; 65% with multimorbidity; average of 6 daily medications), highlighting difficulties in understanding prescriptions, schedules, adverse effects, etc. (2) Development of evidence-based content based on the guidelines from DGS, INFARMED and WHO, in accessible language. (3) Design and production of a visually engaging eBook by a multidisciplinary team (nurses and pharmacists, (4) Pilot testing in two inpatient units, with evaluation via a satisfaction and comprehension questionnaire (n=50); Results: The eBook covered topics such as the patient’s role in medication safety, correct use of medicines, common questions about schedules and interactions, and the importance of reporting allergies or adverse reactions. After reading, 82% of patients reported feeling more confident in questioning and collaborating with healthcare professionals about their medication; 76% found the content easy to understand, and 68% suggested the eBook should be provided at the time of admission. The nursing team highlighted the resource’s usefulness in therapeutic education; Conclusions: In conclusion, the eBook was a feasible and well-accepted strategy to enhance medication safety through health literacy. It supported patient empowerment, improved communication with healthcare teams, and can contribute to safer medication practices.

Keywords: ebook, patient, literacy.

References

1. Centro Hospitalar Universitário de Lisboa Central. (2022). Literacia para a segurança dos cuidados de saúde, Segurança na utilização da medicação. https://www.chlc.min-saude.pt/literacia-para-a-seguranca-dos-cuidados-de-saude/seguranca-na-utilizacao-da-medicacao/

2. Johns Hopkins Medicine. (2025). Medication Management and Safety Tips. https://www.hopkinsmedicine.org/health/wellness-and-prevention/help-for-managing-multiple-medications

3. Ordem dos Farmacêuticos. (2023). Como devo conservar os meus medicamentos?. https://www.ordemfarmaceuticos.pt/pt/artigos/como-devo-conservar-os-meus-medicamentos/

Abstract-Oral-54 Patient-Centered Safety

Complexity of Therapeutic Regimens in Institutionalised Elderly People – A Pilot Study

Andreia Zuckschwerdt¹, Ezequiel Pinto^1,2, Tânia Nascimento^1,2

¹Escola Superior de Saúde, Universidade do Algarve, Faro, Portugal.²Algarve Biomedical Center Research Institute (ABC-RI), Faro, Portugal. Corresponding author: Tânia Nascimento - [e-mail]

Background: Population ageing presents a substantial challenge for healthcare systems due to the increased risk of adverse drug events. In nursing homes (NH), where residents frequently exhibit physical and cognitive frailty, therapeutic regimens are often complex, with a high prevalence of polypharmacy and increased risk of drug interactions. Objective: This study aimed to assess the complexity of therapeutic regimens among institutionalised older adults in NHs in the Algarve region of Portugal. Methods: A descriptive cross-sectional study was conducted, involving the collection and analysis of 101 therapeutic profiles from NH residents prescribed two or more medications. The Medication Regimen Complexity Index (MRCI) was used to evaluate regimen complexity. Results: The sample had a mean age of 84.5 ± 8.4 years and comprised predominantly women (65.3%, n=66). Approximately 83.2% (n=84) were polymedicated (⩾5 medications), with a mean of eight medications per individual. The average MRCI score was 21.7 ± 9.4, indicating a high level of regimen complexity. MRCI Subtotal C, which encompasses additional instructions for administration, contributed the most to the total score (mean = 9.9 ± 4.7). No statistically significant differences in MRCI scores were observed between sexes (p=0.989). However, a strong positive correlation was found between the number of medications and the MRCI score (R=0.906; p<0.001). Conclusions: Therapeutic regimen complexity is elevated among institutionalised elderly individuals and is closely linked to polypharmacy. Routine medication review is essential in this population to optimise pharmacotherapy and minimise the risk of adverse outcomes.

Keywords: Medication Regimen Complexity Index, Nursing homes, Polipharmacy

Acknowledgements

We thank the institution for the support provided in the data collection process and for permitting us to conduct this study. This work was developed within the framework of the Interreg-POCTEP project 0237_NUMAPLUS_5_E - NUMAPLUS - Más allá del nuevo modelo asistencial: regiones cardio aseguradas.

References

1. Andrade, A., Nascimento, T., Cabrita, C., Leitão, H., & Pinto, E. (2024). Potentially Inappropriate Medication: A Pilot Study in Institutionalized Older Adults. Healthcare (Basel, Switzerland), 12(13), 1275.

2. Chen, E. Y., et al. (2019). Medication Regimen Complexity In 8 Australian Residential Aged Care Facilities: Impact Of Age, Length Of Stay, Comorbidity, Frailty, And Dependence In Activities Of Daily Living. Clinical interventions in aging, 14, 1783–1795.

3. Melchiors, A. C., Correr, C. J., & Fernández-Llimós, F. (2007). Tradução e validação para o português do Medication Regimen Complexity Index. Cadernos de Saúde Pública, 23(3), 627–634.

Abstract-Oral-57 Patient-Centered Safety

Anticholinergic Burden In Elderly Patients In Nursing Home: An Observational Study

Maria Matos¹, Ezequiel Pinto^1,2, Tânia Nascimento^1,2

¹Escola Superior de Saúde, Universidade do Algarve, Faro, Portugal.²Algarve Biomedical Center Research Institute (ABC-RI), Faro, Portugal. Corresponding author: Tânia Nascimento - [e-mail]

Background: Population ageing is a major public health challenge, marked by a rising prevalence of chronic disease and functional decline. In polymedicated older adults, the cumulative effect of medications with anticholinergic properties creates a significant anticholinergic burden (ACB), which is linked to increased frailty, cognitive impairment, and other adverse clinical outcomes. Objective: This study aimed to quantify the anticholinergic burden in institutionalised older adults residing in the Alentejo region of Portugal. Methods: A descriptive cross-sectional study was conducted to assess the profiles of elderly people recruited from a random sample of nursing homes in a municipality in the Alentejo region. The anticholinergic burden was calculated using the Anticholinergic Cognitive Burden (ACB) Calculator. Results: The sample comprised 75 residents (mean age: 85.6 ± 7.6 years; 72% female), who were prescribed an average of 10 medications each. Excessive polypharmacy (⩾10 drugs) was present in 56% (n=42) of the participants. An anticholinergic burden was detected in 90.7% (n=68) of individuals, with a mean ACB score of 3.60 ± 2.84. The burden was significantly higher in women (4.19 ± 2.95) than in men (2.10 ± 1.87; p=0.002). A moderate, positive correlation was found between the total number of medications and the ACB score (r=0.499; p<0.001). Conclusions: These findings underscore the high prevalence of anticholinergic medication and anticholinergic burden among institutionalised older adults, particularly among women. Despite the study’s limited sample size, these results highlight the need for regular medication review in geriatric care to mitigate anticholinergic burden and its associated risks.

Keywords: Anticholinergic burden, Nursing Home.

Acknowledgements

We thank the institutions and the pharmacy for the support provided in the data collection process and for permitting us to conduct this study.

References

1. Collamati, A., et al. (2016). Anticholinergic drugs and negative outcomes in the older population: from biological plausibility to clinical evidence. Aging clinical and experimental research, 28(1), 25–35.

2. Pieper, N. T., et al. (2020). Anticholinergic drugs and incident dementia, mild cognitive impairment and cognitive decline: a meta-analysis. Age and ageing, 49(6), 939–947.

3. Ruxton, K., Woodman, R. J., & Mangoni, A. A. (2015). Drugs with anticholinergic effects and cognitive impairment, falls and all-cause mortality in older adults: A systematic review and meta-analysis. British journal of clinical pharmacology, 80(2), 209–220.

Abstract-Oral-69 Patient-Centered Safety

Oral Contraceptive Pill and Psychoaffective Effects

André Coelho¹, Marta Folga¹, Simão Sousa¹, Luís Nascimento¹, Xavier Costa¹*

¹Instituto Politécnico de Bragança, Bragança, Portugal. Corresponding author: Xavier Costa - [e-mail]

Background: Oral contraceptive pills (OCP’s) are widely used for fertility control, yet their potential psychoaffective impact is increasingly debated in clinical research (1). Studies show that users may experience increased negative effects and reduced emotional well-being compared to non-users (2). Experimental data further suggest that hormonal contraception can significantly lower general well-being in healthy women (3). Objective: To assess how the use of OCPs and age are associated with the expression of positive and negative psychoaffective effects. Methodology: A cross-sectional, observational, and descriptive-correlational study with a quantitative approach. The non-probabilistic convenience sample included 291 women (aged 18-44) residing in Northern Portugal. Data were collected through an online questionnaire, which included the scale Positive and Negative Affect Schedule (PANAS-SF). Considering the type of variables, statistical analyses included the Kolmogorov-Smirnov, t-student, and ANOVA tests (p ⩽ 0.05). Results: OCP users reported lower levels of positive affect (M=28.40; SD=8.83) compared to non-users (M=34.51; SD=9.07; p⩽ 0.001). Regarding negative affect, users showed higher levels (M=25.31; SD=10.42) than non-users (M=19.96; SD=7.55; p⩽ 0.001). No significant differences were observed between the age groups (p > 0.05). Conclusion: The findings suggest an association between OCP use and a less favourable emotional profile, regardless of age. This raises critical ethical and clinical concerns about the underestimation of the psycho-subjective effects of oral contraception. In this context, it would be pertinent to consider measures such as periodic psychological follow-up, regular emotional screening, and informative sessions involving mental health professionals.

Keywords: Oral Contraceptive Pill; psychoaffective effects; PANAS scale.

Acknowledgements

A special thanks to all the woman’s participants of this study, thanks also to the authors of the Positive and Negative Affect Schedule (PANAS-SF), (Watson et al., 1988) and its Portuguese validation (Galinha & Pais Ribeiro, 2005).

References

1. Karpowicz, N., et al. (2024). The most common side effects, concerns and discontinuation patterns of oral contraceptive pills among Polish women: A cross-sectional study. Journal of Family & Reproductive Health, 18(3).

2. Shakerinejad, G., et al. (2013). Factors predicting mood changes in oral contraceptive pill users. Reproductive Health, 10(45).

3. Zethraeus, N., et al (2017). A first-choice combined oral contraceptive influences general well-being in healthy women: A double-blind, randomized, placebo-controlled trial. Fertility and Sterility, 107(5), 1238–1245.

TOPIC: PERSONALIZED MEDICINE

Abstract-Oral-16 Personalized Medicine

Towards Improved Diagnosis of Prostate Cancer: A Volatilomics Approach

Beatriz Torres^1,2,3,4, Ângela Carapito^3,4, Vera Constâncio^5,6, Rui Henrique^5,7,8, Carmen Jerónimo^5,7, Joana Pinto^3,4, Paula Guedes de Pinho^3,4

¹Faculty of Pharmacy, University of Porto, Porto, Portugal.²Unidade Local de Saúde de Santo António, Porto, Portugal.³Associate Laboratory i4HB – Institute for Health and Bioeconomy, University of Porto, Porto, Portugal.⁴UCIBIO – Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.⁵Cancer Biology and Epigenetics Group, Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Center Raquel Seruca (Porto.CCC), Porto, Portugal.⁶Doctoral Program in Biomedical Sciences, ICBAS-School Medicine and Biomedical Sciences- University of Porto, Porto, Portugal.⁷Department of Pathology and Molecular Immunology, ICBAS-School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal.⁸Department of Pathology, Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Center Raquel Seruca (Porto.CCC), Porto, Portugal. Corresponding author: Beatriz Torres - [e-mail]

Background: Prostate cancer (PCa) was the fourth most common cancer in 2022, with incidence rates expected to continue rising ^[1]. Early diagnosis is crucial to improve patient survival. Volatile organic compounds (VOCs) have shown potential as non-invasive biomarkers for disease detection, including cancer ^[2]. Aim: This study aimed to investigate VOCs in urine for non-invasive PCa detection and assess their specificity compared to other cancers. Methods: Urine samples from PCa patients (n=50), cancer-free individuals (n=50), and patients with bladder (n=50), lung (n=36), and colorectal (n=27) cancers were analysed using headspace solid-phase microextraction coupled to gas chromatography-mass spectrometry (HS-SPME/GC-MS) (CES IPO: 82/022). Results: Fourteen VOCs from six chemical classes (ketones, aldehydes, alcohols, hydrocarbons, terpenoids, and aromatic hydrocarbons) significantly discriminated PCa from controls. A panel of 10 VOCs showed high diagnostic performance for PCa (sensitivity: 92%, specificity: 94%, accuracy: 93%, AUC: 0.964). The panel also demonstrated effectiveness for detecting lung (sensitivity: 89%) and bladder (sensitivity: 80%) cancers. Some VOCs, had not previously been associated with cancer, suggesting novel biomarker potential. Discussion: The alterations found in the levels of specific urinary VOCs may reflect metabolic changes, such as fatty acid oxidation, inflammation, and oxidative stress ^[3]. This work highlights the potential of urinary VOCs as non-invasive PCa biomarkers. Future research may refine the VOC panel to improve disease specificity and advance clinical validation. Standardised methods should be implemented and compared with established diagnostic approaches to support earlier detection and improve patient outcomes.

Keywords: prostate cancer, volatile organic compounds, gas chromatography-mass spectrometry.

Acknowledgements

This research was supported by national funds from FCT-Fundação para a Ciência e a Tecnologia, I.P., in the framework of the Research Unit on Applied Molecular Biosciences-UCIBIO (projects UIDP/04378/2020 and UIDB/04378/2020), and the Associate Laboratory Institute for Health and Bioeconomy-i4HB (project LA/P/0140/2020).

References

1. Filho, A. M., et al. (2025). The GLOBOCAN 2022 cancer estimates: Data sources, methods, and a snapshot of the cancer burden worldwide. International Journal of Cancer, 156(7), 1336–1346.

2. Bax, C., Taverna, G., Eusebio, L., Sironi, S., Grizzi, F., Guazzoni, G., & Capelli, L. (2018). Innovative diagnostic methods for early prostate cancer detection through urine analysis: A review. Cancers, 10(4), 1–29.

3. Lima, A. R., Pinto, J., Amaro, F., Bastos, M. de L., Carvalho, M., & Guedes De Pinho, P. (2021). Advances and perspectives in prostate cancer biomarker discovery in the last 5 years through tissue and urine metabolomics. Metabolites, 11(3), 181–209.

TOPIC: MEDICATION MANAGEMENT AND SUSTAINABILITY

Abstract-Oral-32 Medication Management and Sustainability

Ciprofloxacin Stability and Degradation Studies: Influence of PH, Temperature and Light Exposure

Andreia Carvalho¹, Carla Patrícia Silva^1,2, Diana Lima^1,2, Ana Paula Fonseca^1,2

¹Polytechnic University of Coimbra, Coimbra Health School, UCP Pharmacy, Portugal.²H&TRC - Centro de Investigação em Saúde e Tecnologia, Lisboa, Portugal. Corresponding author: Andreia Carvalho - [e-mail]

Background: Ciprofloxacin (CF) is a fluoroquinolone antibiotic widely used in clinical practice. Its persistence in the environment and potential to induce bacterial resistance are causes for concern.^[1,2]. Objectives: This study evaluated CF stability under different pH conditions (4, 7.4 and 10) and environmental exposures (cold, room temperature with light, and room temperature without light). Methods: Pure CF from a certified supplier was used. Standards with concentrations of 0.5–10.0 mg/L were prepared for each pH for HPLC calibration. Sample solutions (5 mg/L) were analysed over 27 days, a period sufficient to detect relevant stability or degradation trends. HPLC conditions were: mobile phase of 0.1% formic acid and methanol (65:35, v/v), run time of 7 min, and flow rate of 0.8 mL/min. Results: CF was most stable under cold storage and without light, showing minimal concentration changes. Light exposure caused marked degradation, with concentrations decreasing to about 50% after 27 days. pH had a smaller effect, although degradation was more evident at pH 7.4 and 10 under light exposure. Conclusion: CF stability is strongly influenced by environmental conditions, particularly light and temperature. Greater persistence in cooler, low-light aquatic environments may contribute to the spread of microbial resistance, representing a threat to public health and ecosystems. These findings highlight the need for environmental monitoring and proper management of antibiotic-containing waste.

Keywords: Ciprofloxacin, pH, environment.

Acknowledgements

This study was developed within the framework of the Exploratory Project “SOLCAT: SOLar PhotoCATlysis using magnetic photosensitizers: a sustainable approach for the removal of antibiotics from wastewater” (2023.12723.PEX), with the financial support of the Foundation for Science and Technology (FCT), as well as within the scope of the project I2D: Igniting InterDisciplinarity “SOLarClean: Use of solar radiation for the removal of antibiotics from water”, funded by the School of Health Technology of Coimbra.

References

1. Terp DK, Rybak MJ. (1987). Ciprofloxacin. Drug Intelligence and Clinical Pharmacy, 21(7-8), 568-574.

2. Aref Shariati et al. (2022). The resistance mechanisms of bacteria against ciprofloxacin and new approaches for enhancing the efficacy of this antibiotic. Frontiers in Public Health, 10, 1025633.

Abstract-Oral-72 Medication Management and Sustainability

CSTDs in Hospital Pharmacy: Beyond Safety — The Role of Closed Systems in Drug Cost-Effectiveness

Liliana Rocha¹, Sofia Cardoso¹, Ana Santos¹

¹ULSSM – Hospital Santa Maria, Lisboa, Portugal. Corresponding author: Liliana Rocha - [e-mail]

Background: The use of high-cost cytotoxic drugs in hospital pharmacy requires effective strategies to reduce waste and optimise resources, given the occupational risks involved in their handling. Closed System Transfer Devices (CSTDs) serve as a barrier against environmental contamination and vapour leakage, enabling sterility preservation and safe reuse of surplus drug for up to seven days after opening. Objective: To retrospectively analyze the consumption in the ULSSM pharmacy between January and June 2024, evaluating the cost-effectiveness of implementing CSTDs. Methods: A retrospective cost-minimisation study was conducted, based on consumption records for that period, considering both the value of drugs and the average cost of devices (€14 per preparation with Equashield®). Preservable surplus and savings from avoided waste were assessed, validated via consultation of the pharmacy’s internal databases. Results: Approximately 760 vials of Daratumumab were consumed. CSTD use could prevent the waste of one vial every fifteen preparations, saving about fifty vials. With a unit price of €4000, gross savings are estimated at €220,000. After subtracting device costs (around €6000), net savings approximate €214,000. Conclusion: This retrospective study shows that CSTD use, which is legally required in Portugal by Decree-Law No. 35/2020, at ULSSM yields significant financial benefits, enhancing the cost-effectiveness of managing high-value drugs while ensuring safety.

Keywords: closed systems, cost-effectiveness, hospital pharmacy

References

1. Bar-Ilan, I. (2009). Comparative Study of Vapor Containment Efficiency of Hazardous Drug Transfer Devices. Migal Analytical Chemistry Laboratory.

2. Decreto-Lei n. º35/2020, de 13 de julho. Diário da República n. º134/2020, Série I de 2020-07-13.

3. Hopkins, J. N., Waldman, M., Sahai, R., & Battle, J. (2024). Evaluating drug stability and sterility in single dose vials when accessed with a closed system transfer device. SAGE Open Medicine, 12, 20503121241230449.

TOPIC: AI IN MEDICINES AND HEALTHCARE PRODUCTS

Abstract-Oral-40 AI In Medicines and Healthcare Products

Integrating Professional Knowledge in OTC Recommendation Systems

Beatriz Torres^1,2, Alexandra Oliveira^1,3, Sandra Alves^4,5, Brígida Mónica Faria^1,3

¹ESS, Polytechnic of Porto (ESS-P.PORTO), Porto, Portugal.²Unidade Local de Saúde de Santo António, Porto, Portugal.³Artificial Intelligence and Computer Science Laboratory - LIACC (member of LASI), University of Porto, Porto, Portugal.⁴REQUIMTE/LAQV, ESS, Polytechnic of Porto, Porto, Portugal.⁵Centre for Health Studies and Research of the University of Coimbra / Centre for Innovative Biomedicine and Biotechnology (CEISUC/CIBB), Coimbra, Portugal. Corresponding author: Beatriz Torres - [e-mail]

Background: Community Pharmacy is crucial in promoting public health by improving patients’ quality of life and minimizing medication-related risks ^[1]. While pharmacy professionals are responsible for dispensing both prescription and over-the-counter (OTC) products, current software systems lack comprehensive, up-to-date information about OTC options ^[2]. Although professionals are trained and knowledgeable in advising OTC products, enhancing these systems with reliable and safe algorithm would support them with evidence-based recommendations. Aim: To address this challenge, the development of a structured framework is proposed to guide the design and implementation of an Artificial Intelligence Health Product Recommendation System that incorporates product characteristics and professional knowledge. Methods: For this purpose, it was identified and categorized relevant product attributes (e.g., contraindications, adverse effects) and simultaneously, professionals were consulted to assess the relative importance (least (1) to most important (10)) of each attribute when counselling patients, considering their personal and professional characteristics. Descriptive and inferential statistical analyses were conducted using SPSS to explore the possible relationship between their evaluation about the attributes and their sociodemographic characteristics ^[3]. Results: The attributes with the highest median importance were “Contraindications” and “Symptoms and Duration” (median = 9), while “Adverse Effects,” “Pharmaceutical Form,” and “Price” had the lowest median scores (median = 2). Sociodemographic factors did not significantly influence the importance assigned to each attribute. Discussion: This expert input will allow the development of a weighted distance function to measure similarity between products and the development of clustering techniques to group similar products, resulting in a pharmacist-centred system.

Keywords: health product recommendation system, community pharmacy, non-prescription products.

References

1. Santos, H., et al. (2009). Boas Práticas Farmacêuticas para a farmácia comunitária (BPF) (3a Edição). Ordem dos Farmacêuticos.

2. Veiga, P., et al. (2021). Self-medication consultations in community pharmacy: An exploratory study on teams’ performance, client-reported outcomes and satisfaction. Pharmacy Practice, 19(1), 1–8.

3. IBM Corp. Realeased 2021. IBM SPSS Statistics for Windows, Version 28.8. IBM Corp.

Abstract-Oral-45 AI in Medicines and Healthcare Products

Artificial Intelligence in Pharmacy Practice: Attitudes of Professionals and Barriers to Its Implementation

Ana Margarida Fernandes¹, Rui Santos Cruz^2,3, Pedro Lopes Ferreira^3,4

¹Faculty of Economics, University of Coimbra, Portugal.²Polytechnic Institute of Coimbra, Coimbra Health School, Department of Biomedical Laboratory Sciences, Dietetics and Nutrition, and Pharmacy, Portugal.³Centre for Health Studies and Research of the University of Coimbra (CEISUC), Portugal.⁴Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal. Corresponding author: Ana Margarida Fernandes - [e-mail]

Background: Technological evolution is a growing reality, and Artificial Intelligence is emerging as a promising tool to help in community pharmacy. Understanding professionals’ beliefs, attitudes, and readiness towards its adoption is crucial for its effective integration. Objectives: The aim of this study is to identify the desires, attitudes and barriers that community pharmacy professionals have towards Artificial Intelligence in their work context. Methods: We carried out an observational, cross-sectional study on a sample of pharmacy professionals in the centre of Portugal. Data was collected using a structured questionnaire, previously used in an identical study and with the authors permission, which we culturally adapted and psychometrically validated. It assessed three dimensions: desires, attitudes, and barriers to Artificial Intelligence adoption. Descriptive and inferential statistical analyses were performed. Results: Although professionals demonstrated positive attitudes and interest in eventually applying Artificial Intelligence in their workplace, several barriers were reported. The most frequent were lack of information (81%), lack of training (74%) and lack of practical applicability in the current work context (52%). In addition, 68% rated their knowledge of Artificial Intelligence as low or very low. Conclusion: Despite an overall favourable disposition towards Artificial Intelligence, relevant barriers to its implementation remain, mainly related to insufficient knowledge and training. These findings highlight the importance of developing targeted educational strategies that enhance awareness and confidence, supporting the effective adoption of AI in community pharmacy practice.

Keywords: Artificial Intelligence, Barriers, Attitude

References

1. Alahmari, A. R., Alrabghi, K. K., & Dighriri, I. M. (2022). An Overview of the Current State and Perspectives of Pharmacy Robot and Medication Dispensing Technology. Cureus, 14(8), 1–12.

2. Chalasani, S. H., et al. (2023). Artificial intelligence in the field of pharmacy practice: A literature review. Exploratory Research in Clinical and Social Pharmacy, 12(October), 100346.

3. Jarab, A. S., et al. (2023). Artificial intelligence in pharmacy practice: Attitude and willingness of the community pharmacists and the barriers for its implementation. Saudi Pharmaceutical Journal, 31(8), 8.

TOPIC: OTHER

Abstract-Oral-86 Other

Compounding pharmacy: production of Origanum vulgare l., coriandrum sativum l. and citrus x sinensis (l.) Osbeck oil creams

Rita Cotrim¹, Pedro Martinho², Mário Pádua³, Miguel Zegre³, João Cabaço¹, Mafalda Silva¹, Gonçalo Silva¹, Alexandra Machado⁴, Ana Costa-Veiga^3,5

¹Pharmacy Degree. Escola Superior de Tecnologia da Saúde de Lisboa, Lisboa, Portugal.²Unidade Local de Saúde de Santa Maria, Lisboa, Portugal.³H&TRC - Health & Technology Research Center, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa; Lisboa, Portugal.⁴Centre for Ecology, Evolution and Environmental Changes (CE3C) & Global CHANGE and Sustainability Institute, Faculdade de Ciências da Universidade de Lisboa, Lisboa, Portugal. ⁵CHRC - Comprehensive Health Research Centre, Lisboa, Portugal. Corresponding Author: Ana Costa Veiga - [e-mail]

Background: The growing demand for natural and safe alternatives in veterinary medicine has highlighted the potential of essential oils in pharmaceutical compounding for pets [1,2]. Objectives: Develop and characterize a water-in-oil (W/O) cream formulation, incorporating 2% (w/w) essential oil of Origanum vulgare L., Coriandrum sativum L. and Citrus x sinensis (L.) Osbeck peel, for potential veterinary use in small pets. Methods: Sample formulations were produced using a standardised Portuguese Galenic Formulary-based protocol, ensuring consistent methodology. The excipients were selected to ensure emulsion stability, ease of application, and compatibility with lipophilic active ingredients. The production process involved emulsification of the aqueous and oil phases at 70°C, followed by the incorporation of the essential oils at a concentration of 2% (w/w) and final homogenization ^[3]. Production yields, organoleptic characteristics and the presence of bioactive compounds were assessed. Results: The best performing samples achieved production yields above 80%. Organoleptic evaluation confirmed that the cream exhibited a smooth and homogeneous texture, white colour and a pleasant odour, characteristic of the essential oil, with no signs of rancidity or phase separation. The cream also demonstrated good spreadability and remained stable over a 13-day observation period, regarding its organoleptic characteristics. Conclusions: These results confirm the technical feasibility to manufacture stable W/O creams incorporating essential oils at 2%, supporting their potential use in veterinary topical applications with antimicrobial, anti-inflammatory and wound healing effects. Future studies should investigate the biological efficacy, safety, and large-scale reproducibility of these formulations under in vitro and in vivo conditions.

Keywords: Portuguese essential oils, veterinary topical formulation, water-in-oil cream.

Acknowledgements

This research was funded by Concurso de Investigação, Desenvolvimento, Inovação e Criação Artística (IDI&CA) from Instituto Politécnico de Lisboa, grant number IPL/IDI&CA2024/PLANT-VET_ESTeSL.

References

1. Ebani, V. V., Mancianti, F. (2020). Use of Essential Oils in Veterinary Medicine to Combat Bacterial and Fungal Infections. Veterinary Sciences, 7(4), 193.

2. Laurente-Pachamango, K. G., et al. (2024). Wound healing activity of an essential oil-based cream of Origanum vulgare L. on mice. Pharmacognosy Journal, 16 (2), 292-295.

3. Barbosa, C. M. (2007). Formulário Galénico Português. Centro Tecnológico do Medicamento, Associação Nacional de Farmácias, Lisboa.

Abstract-Oral-88 Other

The Impact of Social Media on The Choice Of Cosmetic Products Among Young Adults Living In The District Of Porto

Beatriz Rodrigues¹; Bruna Sousa¹; Rita Ferraz de Oliveira²; Ana Isabel Oliveira²

¹Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal.²REQUIMTE/LAQV, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal. Corresponding author: Ana Isabel Oliveira - [e-mail]

Background: The skin is the largest organ of the human body, fulfilling essential physiological and protective functions ^[1]. In recent years, the demand for cosmetic products has risen considerably, driven not only by dermatological concerns but also by aesthetic motivations ^[2]. Social media platforms have emerged as influential channels in shaping consumer behaviour, particularly among young adults ^[3]. Objectives: To evaluate the impact of social media on the selection of cosmetic products among young adults aged 18 to 30 residing in the district of Porto. Methodology: Observational, descriptive, cross-sectional study, employing a snowball sampling method. Data were collected through an online questionnaire applied between December 2024 and March 2025, and analysed using SPSS®. Results: A total of 252 participants were included. Higher levels of trust were verified in information sources among participants with dermatological conditions with 63.6% indicating they “trust a lot” in information sources. Male respondents exhibited greater trust in social media content overall (p < 0.001). TikTok emerged as the most influential platform, with 69% of purchases made based on online recommendations. Moreover, both gender and age group influenced the type of information sought (p<0.05). An association was also observed between possible adverse reactions occurrence and subsequent search for professional advice (p < 0.001). Conclusions: These findings suggest that social media exerts a tangible influence on cosmetic purchasing behaviour among young adults, highlighting the need for healthcare professionals to assume a more visible and credible presence within digital platforms.

Keywords: skin care products; social media; consumer behavior

Acknowledgements

This work received financial support from the PT national funds (FCT/MECI, Fundação para a Ciência e Tecnologia and Ministério da Educação, Ciência e Inovação) through the project UID/50006 -Laboratório Associado para a Química Verde - Tecnologias e Processos Limpos.

References

1. Yousef, H., Alhajj, M., Fakoya, A. O., & Sharma, S. (2025). Anatomy, Skin (Integument), Epidermis. Em StatPearls. StatPearls Publishing.

2. Costa, E. F., Magalhães, W. V., & Di Stasi, L. C. (2022). Recent Advances in Herbal-Derived Products with Skin Anti-Aging Properties and Cosmetic Applications. Molecules, 27(21), 7518.

3. Willis, E., & Delbaere, M. (2022). Patient Influencers: The Next Frontier in Direct-to-Consumer Pharmaceutical Marketing. Journal of Medical Internet Research, 24(3), e29422.

Abstract-Oral-89 Other

Role of Community Pharmacy In Animal Health

José Gaspar¹, Juliana Gil¹, Guilherme Santos¹, Ana Lima¹

¹Instituto Politécnico da Guarda, Guarda, Portugal. Corresponding author: José Gaspar - [e-mail]

Background: In a context of greater awareness of animal welfare and the complexity of veterinary care, community pharmacies play a crucial role in animal health, as they are often the first point of contact for pet owners seeking advice on the correct use of veterinary medicines. Objectives: This study aims to assess perceptions and identify improvements in the services provided by community pharmacies. Methods: This study was based on two phases. The first consisted of a review of the literature in Pubmed and GoogleScholar, between January and March 2025, of articles from the last 10 years, using the keywords ‘animal health’, ‘community pharmacy’ and ‘pharmacy professional’. In the second phase, a survey was conducted on GoogleForms, followed by its online dissemination to users and professionals of community pharmacies in Portugal between March and June 2025. Results: The survey obtained 347 responses, with no distinction made between users and pharmacy professionals. It was found that most users prefer the veterinary clinic as their first option, but 28.8% have already turned to pharmacies for animal health issues, motivated by easy access, affordable prices and trust. There is recognition of the potential of pharmacies to offer advice on basic care, although their use is still limited and specific training for pharmacy professionals is considered necessary. Conclusions: Pharmacies have the potential to expand their role in animal health, but there is a need to increase awareness, adequate training and user confidence.

Keywords: Animal health, Community Pharmacy, Pharmacy Technician

References

1. Bennett, K. A., Honey, M. D., & Dedeaux, A. (2018). Assessing pet owner and veterinarian perceptions of need for veterinary compounding services in a community pharmacy setting. International Journal of Pharmacy Practice, 26(6), 535–541.

2. Boothe, D. M. (2006). Veterinary compounding in small animals: A clinical pharmacologist’s perspective. Journal of the American Veterinary Medical Association, 229(8), 1215–1219.

3. Canton L, Lanusse C, Moreno L. Rational pharmacotherapy in infectious diseases: Issues related to drug residues in edible animal tissues. Animals (Basel). 2021 Oct 1;11(10):2878.

POSTER PRESENTATIONS PATIENT-CENTERED SAFETY

Abstract-Post-02 Patient-Centered Safety

Efficacy and Safety Of Topical Antifungals Used In The Treatment Of Vaginal Fungal Infections: A Systematic Review Of Clinical Trials Published Between 2018 And 2024

Tiago Oliveira¹, Ângelo Jesus², Fernando Moreira²

¹Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal.²LAQV/REQUIMTE, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal. Corresponding author: Tiago Oliveira - [e-mail]

Background: Genitourinary infections are clinically important due to the discomforting symptoms, psychological repercussions, and the ease of acquisition and transmission of the human immunodeficiency virus ^[1]. Vulvovaginal candidiasis is the second leading cause of vaginitis and affects 75% of women worldwide ^[2,3]. Objectives: The aim of this study is to analyse the efficacy and safety of the latest topical antifungals for vaginal fungal infections. Methods: Literature searches were performed in the PubMed, Scopus, LILACS, and IBECS databases, according to the PRISMA guidelines. Following the removal of duplicate records, a total of 1326 studies were screened based on predefined inclusion and exclusion criteria. Studies published between 2018 and 2024 were included. This systematic review is registered in the PROSPERO database under the registration number CRD42024527596. Results: Ultimately, 18 studies fulfilled these criteria and were incorporated into the systematic review. Of the 18 clinical trials analysed, 16 assessed topical application alternatives to conventional treatment of genitourinary infections. The comparison between the investigational products and the control groups demonstrated that, overall, the tested products exhibit efficacy comparable to or greater than that of conventional treatments in the management of genitourinary infections. In 14 of the 18 clinical trials included in the systematic review, no adverse effects were reported. Conclusions: Natural topical treatments for vulvovaginal candidiasis show promising efficacy, better tolerability, and greater patient convenience, suggesting potential to improve adherence and contributing to strategies against antifungal resistance.

Keywords: genitourinary infections, vulvovaginal candidiasis, antifungals

References

1. Nasioudis, D., Linhares, I., Ledger, W., & Witkin, S. (2017). Bacterial vaginosis: A critical analysis of current knowledge. BJOG: An International Journal of Obstetrics & Gynaecology, 124(1), 61–69.

2. Anderson, M. R. (2004). Evaluation of Vaginal Complaints. JAMA, 291(11), 1368.

3. Workowski, K. A., Bolan, G. A., & Centers for Disease Control and Prevention. (2015). Sexually transmitted diseases treatment guidelines, 2015. MMWR. Recommendations and Reports: Morbidity and Mortality Weekly Report. Recommendations and Reports, 64(RR-03), 1–137.

Abstract-Post-05 Patient-Centered Safety

Fractionation of Drugs For Intravitreal Administration: Stability Of Prefilled Syringes

Sónia Lopes¹, Ana Gonçalves², Marisa Silva³

¹ULS Santa Maria, Lisboa, Portugal.²ULS de Lisboa Ocidental, Lisboa, Portugal.³ULS da Região de Leiria, Leiria, Portugal. Corresponding author: Sónia Lopes - [e-mail]

Background: Vascular endothelial growth factor inhibitors for intravitreal administration have revolutionized the treatment of age-related macular degeneration. Due to the high price of these drugs, the fractionation of the commercial packages into several syringes, using an aseptic technique, is a way to maximize the available units. The daily manipulation of aflibercept and ranibizumab according to the number of appointments not only generates waste of partially used vials but also does not allow knowing the result of the microbiological analysis of the final product before its administration. Objectives: To propose an optimization of the procedure currently used in order to eliminate waste associated with the daily fractionation of aflibercept 2mg/0.05mL and ranibizumab 0,5mg/0,05mL syringes. Methods: A PubMed search was performed using the keywords aflibercept, ranibizumab and stability. The Summaries of Product Characteristics of aflibercept 40mg/mL and ranibizumab 10mg/mL were also consulted. Results: Several studies have evaluated the stability, efficacy and sterility of prefilled syringes prepared in a laminar air flow cabinet. They concluded that these drugs maintain their properties and sterility for up to twenty-eight days after preparation (stored between 4 and 8ºC). Conclusions: Based on the results obtained, it is suggested that these drugs be handled on a weekly basis. This will eliminate waste associated with daily preparation of syringes, as well as provide knowledge of the respective microbiological control before administering the product to the patient. This would result in the administration of an equally effective but safer product, with less likelihood of complications arising from a non-compliant injection.

Keywords: aflibercept; ranibizumab; stability.

References

1. Farah, J. et al. (2018). Evaluation of aflibercept and ziv-aflibercept binding affinity to vascular endothelial growth factor, stability and sterility after compounding. International Journal of Retina and Vitreous, 4(39).

2. Cao, S., Cui, J., Matsubara, J., & Forooghian, F. (2017). Long-term in vitro functional stability of compounded ranibizumab and aflibercept. Canadian Journal of Ophthalmology, 52(3), 273–276.

3. Sivertsen, M. S., Jørstad, Ø. K., Grevys, A., Foss, S., Moe, M. C., & Andersen, J. T. (2018). Pharmaceutical compounding of aflibercept in prefilled syringes does not affect structural integrity, stability or VEGF and Fc binding properties. Scientific Reports, 8(1), 2101.

Abstract-Post-07 Patient-Centered Safety

Adverse Reactions to Vaccine Excipients: A Search On Pharmacovigilance Databases

Alexandra Marques¹, Cristiano Matos¹ Carolina Valeiro²

¹Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Coimbra, Coimbra, Portugal. ²Faculty of Pharmacy, Universidad de Sevilla, Seville, Spain. Corresponding author: Carolina Valeiro - [e-mail]

Background: Vaccination has been prevented infectious diseases for over 200 years. Vaccines are generally safe, though they have a favourable risk-benefit profile; nonetheless, adverse reactions (AR) can occur. Although commonly attributed to the active agents, increasing attention has been directed toward excipients. Excipients are essential for vaccine formulation yet can elicit hypersensitivity responses or other adverse effects. Objective: Evaluate AR associated with excipients present in six vaccines (Tetanus, Hepatitis B, Influenza, BCG, HIB, and COVID-19) through a comprehensive literature review and an analysis of pharmacovigilance databases. Methods: A mixed-methods approach (a systematic literature review and pharmacovigilance database analysis) was performed to evaluate AR associated with vaccine excipients. Relevant studies published between 2004-2025 were identified using PubMed, ScienceDirect, and Google Scholar. Additional data came from VigiAccess, EudraVigilance, and VAERS databases, focusing on excipient-related AR. Six widely used vaccines were included. Results: Polyethylene Glycol (PEG), polysorbates, aluminum compounds, gelatin, thimerosal, and latex are the excipients more commonly associated with ARs. While relatively uncommon, AR to vaccine excipients were reported across all vaccines, with COVID-19 vaccines showing the highest number of cases. Conclusion: While adverse reactions to vaccine excipients are relatively rare, their recognition remains important. Vaccination is important in preventing diseases and controlling outbreaks. However, maintaining robust pharmacovigilance systems is crucial for promptly identifying and managing excipient-related reactions, ensuring that vaccines remain safe and effective for the population.

Keywords: Vaccine Excipients, Adverse Reactions, Pharmacovigilance

References

1. Caballero, M. L., Krantz, M. S., Quirce, S., Phillips, E. J., & Stone, C. A. (2021). Hidden Dangers: Recognizing Excipients as Potential Causes of Drug and Vaccine Hypersensitivity Reactions. The Journal of Allergy and Clinical Immunology. In Practice, 9(8), 2968–2982.

2. Des Roches, A., Graham, F., Begin, P., Paradis, L., & Gold, M. (2021). Evaluation of Adverse Reactions to Vaccines. Journal of Allergy and Clinical Immunology: In Practice, 9(10), 3584–3597.

3. Pifferi, G., & Restani, P. (2003). The safety of pharmaceutical excipients. Il Farmaco, 58(8), 541–550.

Abstract-Post-10 Patient-Centered Safety

Analysis of The Nomenclature of Protocols For Chemotherapy in the Treatment of Triple Negative Breast Cancer: Scoping Review

Beatriz Martins¹, Marlene Santos^2,3, Fernando Moreira²

¹Escola Superior de Saúde do Instituto Politécnico do Porto, Porto, Portugal.²LAQV/REQUIMTE, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal.³Molecular Oncology & Viral Pathology, IPO-Porto Research Center (CI-IPOP), Portuguese Institute of Oncology, Porto, Portugal. Corresponding author: Beatriz Martins - [e-mail]

Background: Triple-negative breast cancer (TNBC) is the most aggressive subtype of breast cancer and is often treated with chemotherapy-based protocols. However, the lack of standardization in how these protocols are reported in the scientific literature hinders the identification of treatment strategies and contributes to conflicting information, ultimately leading to confusion and reduced clarity in clinical decision-making ^[1]. Objective: This study aimed at evaluating the frequency of adherence to standardized chemotherapy protocol naming strategies in recently published articles, on TNBC treatment. Methods: A search was performed to identify all papers published in PubMed from 2019 to 2024, describing the treatment of TNBC with chemotherapy protocols. Then, all papers were evaluated regarding the adoption of any of the three previously identified standardized nomenclatures, including the HemOnc electronic platform and the standardized recommended nomenclatures ^[2,3]. Results: A total of 122 papers encompassing the mention to 576 therapeutic regimens were analyzed. Inconsistencies were found in the nomenclature, with most of the protocols only occasionally respecting the proposed guidelines, potentially compromising their interpretation in a clinical and scientific context. There was also ambiguity in the representation of the protocols, discrepancies in the identification of the drugs and in the writing of the sequence of administration of the drugs. Conclusion: The nomenclature of chemotherapy protocols is poorly standardised, which compromises the clarity of regimens, patient safety and communication between professionals. This research reinforces the need to establish standardised guidelines at international level.

Keywords: Triple Negative Breast Cancer, Nomenclature, Chemotherapy

References

1. Nevala, W. K., Geng, L., Xie, H., Stueven, N. A., & Markovic, S. N. (2025). PD-L1-Targeting Nanoparticles for the Treatment of Triple-Negative Breast Cancer: A Preclinical Model. International Journal of Molecular Sciences, 26(7).

2. Rubinstein, S. M., Yang, P. C., Cowan, A. J., & Warner, J. L. (2020). Standardizing Chemotherapy Regimen Nomenclature: A Proposal and Evaluation of the HemOnc and National Cancer Institute Thesaurus Regimen Content. JCO Clinical Cancer Informatics, 4, 60–70.

3. Terkola, R., Bardin, C., Lizeaga Cundin, G., Zeinab, N., & Crul, M. (2021). Identifying options for oncology therapy regimen codification to improve standardization-combined results of an expert panel and a review. Journal of Clinical Pharmacy and Therapeutics, 46(5), 1238–1244.

Abstract-Post-11 Patient-Centered Safety

Health Literacy and Medication Adherence in Low-Income Older Adults: Challenges and Opportunities for Medication Safety

Carla Perpétuo^1,2,3, Ana I. Plácido², Alexandra Monteiro², Ramona Mateos-Campos⁴, Maria Teresa Herdeiro⁵, Fátima Roque²

¹Local Health Unit of Guarda (ULSG), Guarda, Portugal.²BRIDGES - Biotechnology Research, Innovation and Design for Health Products, Polytechnic University of Guarda, Guarda, Portugal. ³University of Salamanca, Salamanca, Spain.⁴Area of Preventive Medicine and Public Health, Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain. ⁵Institute of Biomedicine (iBiMED-UA), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal. Corresponding author: Carla Perpétuo - [e-mail]

Background: Insufficient Health literacy (HL) is associated with challenges in understanding medication instructions and low medication adherence, which can compromise both treatment effectiveness and medication safety ^[1]. In Portugal, disparities in HL are particularly evident among older adults with limited education and income, increasing their risk of non-adherence and medication-related adverse events ^[2]. Objectives: Evaluate the levels of HL and medication adherence in low-income older adults, while examining the associations between HL, medication adherence, sociodemographic, economic, and health-related factors. Methods: A cross-sectional study was conducted among low-income older residents in the Beira and Serra da Estrela region. After obtaining informed consent, HL was assessed using the HLS-EU-PT ^[2] questionnaire, and adherence was evaluated with the MAT scale ^[3]. Statistical analysis included descriptive statistics, Spearman correlation, ordinal logistic, and linear regression. Results: Most participants had problematic or inadequate HL, often linked to their low education and incomes. Despite this low HL, overall medication adherence was high, however, unintentional non-adherence (e.g., forgetting doses) was common. HL was positively associated with adherence, education, and financial sufficiency, while it was negatively associated with older age, poorer perceived health, and economic barriers. Completing lower secondary education predicted higher HL, while the ability to pay monthly expenses was a predictor of better adherence. Conclusions: These findings highlight that limited HL remains a critical barrier to effective medication management and safety among low-income older adults. Multidimensional interventions combining education, simplified communication, and community support are essential to improve adherence and prevent medication-related adverse events.

Keywords: Health literacy; Medication adherence; Older adults

Acknowledgements

We would like to thank the CIMRBSE municipalities. This project is co-funded by the European Union through the Erasmus+ Programme, as project nr. 2023-1-PT01-KA220-ADU-000165655. This work is part of the doctoral research conducted by Carla Perpétuo at Salamanca University.

References

1. Babazadeh, T., Ranjbaran, S., Pourrazavi, S., Latifi, A., & Maleki Chollou, K. (2024). Impact of health literacy and illness perception on medication adherence among older adults with hypertension in Iran: a cross-sectional study. Frontiers in Public Health, 12(March), 1–7.

2. Pedro, A. R., Amaral, O., & Escoval, A. (2016). Literacia em saúde, dos dados à ação: tradução, validação e aplicação do European Health Literacy Survey em Portugal. Revista Portuguesa de Saúde Pública, 34(3), 259–275.

3. Barata Delgado, A., & Lima, M. L. (2001). Contributo para a validação concorrente de uma medida de adesão aos tratamentos. Psicologia, Saúde e Doenças, II(2), 81–100.

Abstract-Post-12 Patient-Centered Safety

Impact of Medication Use On The Quality of Life Of Low-Income Older Adults

Carla Perpétuo^1,2,3, Ana I. Plácido², Alexandra Monteiro², Ramona Mateos-Campos⁴, Maria Teresa Herdeiro⁵, Fátima Roque²

¹Local Health Unit of Guarda (ULSG), Guarda, Portugal.²BRIDGES - Biotechnology Research, Innovation and Design for Health Products, Polytechnic University of Guarda, Guarda, Portugal. ³University of Salamanca, Salamanca, Spain.⁴Area of Preventive Medicine and Public Health, Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain. ⁵Institute of Biomedicine (iBiMED-UA), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal. Corresponding author: Carla Perpétuo - [e-mail]

Background: Low-income older populations face unique challenges in accessing and using medication, which can negatively impact their health outcomes ^[1]. Objectives: This cross-sectional study aimed to characterize the medication profile of older adults and explore the relationship between quality of life and medication consumption among low-income older adults living in the Beira and Serra da Estrela region. Methods: Data were collected using a structured questionnaire that assessed sociodemographic characteristics, medication use, and self-perceived quality of life using the EQ-5D-5L scale ^[2]. Results: The results revealed a high prevalence of polypharmacy, with approximately 66% of the 196 participants using five or more medicines. The most prescribed groups included cardiovascular medication, psychotropic drugs (such as anxiolytics and antidepressants), and medication for the digestive tract. Regarding quality of life, approximately 70% of older adults reported mild to moderate difficulties with walking, while half faced challenges with daily activities. Nearly 80% experienced some level of pain or discomfort, and almost 60% reported symptoms of anxiety or depression. Most participants rated their overall health as moderate. The use of medications for the digestive tract, anxiolytics and antidepressants, was positively correlated with the pain/discomfort and anxiety/depression dimensions of the EQ-5D-5L. Consequently, the use of these drug classes is associated with a lower self-perceived quality of life, likely due to the health conditions they are intended to treat rather than the medications themselves. Conclusions: These findings highlight the need for integrated interventions, like encompassing healthcare professionals, supportive health policies, and health education, to further improve the overall quality of life in this vulnerable population.

Keywords: Older adults, Polypharmacy, Quality of life

Acknowledgements

We would like to thank the CIMRBSE municipalities. This project is co-funded by the European Union through the Erasmus+ Programme, as project nr. 2023-1-PT01-KA220-ADU-000165655; This work is part of the doctoral research conducted by Carla Perpétuo at Salamanca University.

References

1. Ferreira, P. L., Ferreira, L. N., & Pereira, L. N. (2013). Contributos para a validação da versão Portuguesa do EQ-5D. Acta Medica Portuguesa, 26(6), 664–675.

2. Gomes, D., Placido, A. I., Mó, R., Simões, J. L., Amaral, O., Fernandes, I., Lima, F., Morgado, M., Figueiras, A., Herdeiro, M. T., & Roque, F. (2019). Daily Medication Management and Adherence in the Polymedicated Elderly: A Cross-Sectional Study in Portugal. International Journal of Environmental Research and Public Health, 17(1), 200.

Abstract-Post-13 Patient-Centered Safety

Impact of Pharmacological Therapy and Pain on The Quality of Life of Patients With Rheumatoid Arthritis: A Patient-Centred Approach In The Bragança District

Cátia P. Esteves¹, Maria Renata Aguiar², Helena Assunção², Emanuel O.S. Lameiras^1,2, Olívia R. Pereira³

¹Instituto Politécnico de Bragança, Bragança, Portugal.²ULSNe (Unidade Local de Saúde do Nordeste), Bragança, Portugal.³Research Centre for Active Living and Wellbeing (LiveWell), Instituto Politécnico de Bragança, Bragança, Portugal. Corresponding author: Olívia Pereira - [e-mail]

Background: Rheumatoid arthritis (RA) is an inflammatory disease characterized by erosive changes in bone and cartilage, which can lead to severe deformities and disabilities, adversely impacting muscle strength, endurance, range of motion, and overall quality of life (QL) ^[1,2]. Objective: Evaluate the impact of pharmacological therapy and pain on QL in patients with RA. Methodology: This study followed an exploratory, cross-sectional, and descriptive design, focusing on patients with RA from Bragança district, under follow-up treated at the Rheumatology Service of ULSNe. The study aims to collect sociodemographic and therapy data, as well as validated scales, on health-related QL (EQ-5D); satisfaction with drug treatment (TSQM) and treatment adherence (MAT). The project was approved from the ULSNe Ethics Committee. Results: Sixty-one individuals were interviewed, the majority of whom were female (85%), with a mean age of 65 years. The most common pharmacotherapeutic groups are Disease Modifying Anti-Rheumatic Drugs (DMARDs) (16.7%); antianaemics (10.6%); Those that act on bone and calcium metabolism (9.7%) and glucocorticoids (5.6%). Analysing the correlation variables, there was a moderate negative correlation between QL and pain intensity; on the other hand, QL correlated positively with satisfaction with treatment, especially related to adverse effects. Also, the correlation between satisfaction with treatment and adherence to therapy was positive. Conclusion: This study concludes that pain intensity and the level of disease activity in patients with RA are negative predictors of QL and that satisfaction with treatment has an impact on adherence to therapy.

Keywords: Rheumatoid Arthritis; Pharmacological Therapy; Quality of Life.

References

1. Figueiredo, E., & Martins, R. (2016). Rheumatoid arthritis: Implications on the functional capacities of people. Servir, 59(3), 26-33.

2. Santos, S. et al. (2024). Avanços na terapia com imunobiológicos para artrite reumatoide: uma revisão de literatura. Caderno Pedagógico, 21(10), e8580.

Abstract-Post-17 Patient-Centered Safety

Combined Oral Contraceptives in Acne: Perception of Young Adults In Higher Education In Portugal

Leonor Dias¹, Inês Esteves¹, Rita Ferraz de Oliveira², Ana Isabel Oliveira²

¹ESS, Polytechnic of Porto, Porto, Portugal.²REQUIMTE/LAQV, ESS, Polytechnic of Porto, Porto, Portugal. Corresponding author: Ana Isabel Oliveira - [e-mail]

Background: Acne vulgaris is a chronic inflammation of the pilosebaceous unit. It can persist into adulthood that possesses combined oral contraceptives (COCs) as a treatment option ^[1]. Objectives: To assess young adults in higher education in Portugal perception regarding COCs use in acne management. Methodology: Observational, descriptive, cross-sectional study using a non-probabilistic convenience sample. Female students taking COC in higher education in Portugal were included. For data collection, a questionnaire was published on Instagram® and data was processed using SPSS 29®. Results: Most participants (61.2%) related their acne to their menstrual cycle, with a greater aggravation in the premenstrual period (36.9%). The majority (90.2%) believes that acne is related to hormones. The area of study and knowledge of the hormones involved in acne were found to be related (p < 0.001). Although the majority (57%) had no knowledge of hormone therapy, among those who did, the COCs was the most cited example (17.3%). Only 22% considered this therapy to be advantageous, the majority of whom were health students (27.1%). A relationship between study area and the effectiveness of hormonal therapy perception was verified (p < 0.001). The majority of the sample believes that COCs help to improve acne, despite the absence of relation with the study field. Conclusion: Health students demonstrated a higher awareness of the COCs for acne treatment. However, there was general misinformation on the subject. These findings highlight the need to enhance health literacy in order to promote a clearer and more accurate understanding of this subject.

Keywords: combined oral contraceptives, acne, perception

Acknowledgements

This work received financial support from the PT national funds (FCT/MECI, Fundação para a Ciência e Tecnologia and Ministério da Educação, Ciência e Inovação) through the project UID/50006 -Laboratório Associado para a Química Verde - Tecnologias e Processos Limpos.

Reference

1. Al Basri, S. F. et al. (2022). Knowledge of Reproductive Age Women About Oral Contraceptive Pills in Al-Qunfudah, Saudi Arabia. Open Access Journal of Contraception, 13, 61–71.

Abstract-Post-18 Patient-Centered Safety

Home Parenteral Nutrition Guidelines: Review of Key Recommendations and Proposal for Standardization

Ana Cerqueira¹, Daniela Gonçalves¹, Marlene Santos^2,3, Fernando Moreira²

¹Escola Superior de Saúde Instituto Politécnico do Porto, Porto, Portugal.²LAQV/REQUIMTE, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal.³Molecular Oncology & Viral Pathology, IPO-Porto Research Center (CI-IPOP), Portuguese Institute of Oncology, Porto, Portugal. Corresponding Author: Daniela Gonçalves - [e-mail]

Background: Implementing home parenteral nutrition (HPN) is a complex process, and the large number of recommendations in this area may hinder the identification of a minimum standard of care, potentially compromising patient safety ^[1]. Objectives: This study aimed to develop a standardized set of recommendations to support healthcare professionals in the safe and effective preparation and administration of HPN. Methods: A literature review was carried out between February 2024 and June 2025 to identify guidelines published by international organisations dedicated to HPN. To assess the methodological quality and transparency of these guidelines, the validated AGREE II instrument was used ^[2]. Recommendations related to the preparation/administration of HPN were extracted whenever the documents achieved moderate or high scores in the domains of rigour of development and applicability. Results: A total of 27 guidelines from 14 different organizations were evaluated. Overall, the domain concerning the scope and purpose achieved the highest score (65 ± 17%). In contrast, the lowest score was observed in the domain of editorial independence (35 ± 20%). Sixteen documents, authored by nine organizations demonstrated moderate to high quality in domains 3 and 5 and were used for the development of the standardized proposal that included as most prominent recommendations: personal protective equipment, aseptic technique, appropriate containers (for preparation) and therapy length (for administration). Conclusion: By identifying key recommendations from dispersed bibliography, it was possible to create a concise, standardized version for the preparation and administration of HPN, based on guidelines with the highest methodological quality.

Keywords: Artificial Nutrition, Parenteral Nutrition, Guidelines

References

1. Kumpf, V. J., Gray, B., Monczka, J., Zeraschi, S., & Klek, S. (2024). Parenteral nutrition at home/longterm parenteral nutrition. American Journal of Health-System Pharmacy: AJHP: Official Journal of the American Society of Health-System Pharmacists, 81(Supplement_3), S112–S120.

2. Brouwers, M. C. et al., & AGREE Next Steps Consortium. (2010). AGREE II: Advancing guideline development, reporting and evaluation in health care. CMAJ: Canadian Medical Association Journal = Journal de l’Association Medicale Canadienne, 182(18), E839-842.

Abstract-Post-19 Patient-Centered Safety

Double-Checking In Cytotoxic Drug Preparation: A Critical Strategy for Medication Safety

Nuno Silva¹, Joana Gomes²

¹Unidade Local de Saúde Santo António (ULSSA), Porto, Portugal.²Unidade Local de Saúde São João (ULSSJ), Porto, Portugal. Corresponding author: Nuno Silva - [e-mail]

Background: The preparation of cytotoxic drugs is a high-risk process requiring technical rigor and strict safety standards. Double-checking by Pharmacy Technicians plays a crucial role in ensuring patient and environmental safety. However, despite guideline recommendations, this practice is not universally adopted across oncology preparation settings ^[1]. Objectives: To emphasize the importance of double-checking in cytotoxic drug preparation and its impact on reducing medication errors and occupational hazards. Methods: A literature review and analysis of error data were conducted, focusing on risk factors and control points in centralised cytotoxic drug preparation. The study focused on Pharmacy Technicians, who are primarily responsible for final verification in Portuguese hospital pharmacies. Results: A preparation error rate of 11.34% was identified (185 errors in 1,957 preparations), including incorrect solvent or drug volumes and infusion device selection. Higher error rates were associated with greater daily workloads. Many errors were linked to the absence or inconsistency of double-checking, highlighting its effectiveness in validating calculations, ensuring proper labelling, and preventing exposure to hazardous agents. Conclusions: Double-checking is a critical safety strategy that reduces the risk of severe medication errors and supports the professional autonomy of Pharmacy Technicians. Its systematic implementation, with defined checkpoints, can enhance the quality and safety of oncological care. While widely recommended, its lack of universal enforcement may contribute to preventable adverse events.

Keywords: Medication safety, cytotoxic drugs, double-checking.

References

1. International Society of Oncology Pharmacy Practitioners (ISOPP). (2022). Standards of Practice for the Safe Handling of Cytotoxic and Hazardous Drugs. Journal of Oncology Pharmacy Practice, 28(3_suppl), S1–S126.

2. Batista, A., Makridaki, D., van der Schors, T., & Kohl, S. (2023). Hazardous medicinal products. European Journal of Hospital Pharmacy, (5), 261–263.

3. European Commission, European Agency for Safety and Health at Work (EU-OSHA). (2023). Guidance for the safe management of hazardous medicinal products at work. European Commission. EQUASHIELD+7osha.europa.eu+7europeanbiosafetynetwork.eu+7

Abstract-Post-24 Patient-Centered Safety

Role of the pharmacy technician in the safety of the medicine mannitol 20%

Georgete Airosa¹, Raquel Loureiro¹, João Caetano¹

¹Unidade Local de Saúde Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal. Corresponding Author: Georgete Airosa - [e-mail]

Background: Mannitol 20% is a hyperosmolar diuretic widely used in hospital settings to reduce intracranial and intraocular pressure, particularly in critically ill patients. Due to its high osmolarity (1098 mOsm/L) and thermosensitive properties, it is prone to crystallisation below 15 °C. This risk demands rigorous procedural control and professional vigilance to prevent embolism or catheter obstruction; Objectives: To identify safety-critical steps in the handling of Mannitol 20% and to assess the role of the hospital pharmacy technician in mitigating medication-related risks. Furthermore, to highlight how standardised pharmacy-led practices can prevent complications related to crystallisation and ensure safe patient outcomes; Methods: A narrative review of technical and regulatory documents was conducted, focusing on hospital pharmacy operations, injectable medication handling, and high-risk drug management protocols; Results: Crystallised solutions can be safely reconstituted by warming in a 60–80 °C water bath with intermittent agitation, followed by cooling to room temperature and administration using a filter. The literature emphasises rigorous visual inspection, appropriate labelling, and complete documentation. Pharmacy technicians are central to verifying compliance with best practices, implementing standard operating procedures, and supporting communication with clinical teams—especially in emergency, intensive care, and surgical units; Conclusions: To ensure availability in emergencies, particularly during colder periods, the product will be stored in temperature-controlled cabinets (20 °C–30 °C) in the pharmacy. A 24-hour access point will be available to Clinical Services, without stock held on-site. In case of crystallisation, the product should be returned to the pharmacy for reversal according to protocol.

Keywords: Mannitol 20%, patient-centered safety, pharmacy technician.

References

1. European Medicines Agency. (2013). Reflection paper on the use of mannitol and related excipients in medicinal products for parenteral use (EMA/CHMP/508188/2013).

2. NHS Injectable Medicines Guide. (2023). Mannitol 20% intravenous infusion. UKMi Medicines Information.

3. Fresenius Kabi Brasil. (2023). Bula do paciente – Solução de Manitol 20%.

Abstract-Post-26 Patient-Centered Safety

Development and implementation of a training manual for pharmacy technicians in the manipulation of cytotoxic drugs

Ana Cândido¹, Helena Santos¹, José Branquinho¹, Margarida Sousa¹, Maria Silva¹, Micheila Cardoso¹, Rui Gonçalves¹, João Caetano¹

¹Unidade Local de Saúde Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal. Corresponding Author: Ana Cândido - [e-mail]

Background: Handling cytotoxic drugs requires high safety standards and uniform procedures, given their toxicity and the associated occupational risk. This manual describes the development and implementation of a cytotoxic drug handling training protocol for pharmacy technicians (PTs) in the hospital pharmacy area. Objectives: To improve safety, standardize practices and update routines, including the reintegration of PTs with previous experience in the area. Methods: The protocol was designed through collaborative meetings between PTs experts in the area of handling and those responsible for the handling unit, based on international standards of good practice ^[1,2,3]. The focus was on standardizing critical procedures, such as the correct use of personal protective equipment, hand hygiene, cleaning procedures, action in the event of a spill, aseptic handling techniques and cytotoxic waste management, in order to guarantee the safety of the preparation and the protection of professionals. Results: Although still in the implementation phase, the protocol has already shown improvements in the coherence and uniformity of aseptic technique practices, in cleaning and hand hygiene procedures, as well as in the integration of professionals, promoting a culture of safety, rigor and continuous updating. Conclusion: The adoption of this manual represents a fundamental step towards consolidating a safer working environment, in line with international quality standards for the handling of cytotoxic drugs. The future prospects are to standardize cytotoxic drug handling practices for all PTs through procedural standards, ensuring compliance.

Keywords: Cytotoxic drugs, training protocol, aseptic technique

References

1. United States Pharmacopeial Convention. (2016). USP General Chapter <800>: Hazardous Drugs—Handling in Healthcare Settings. United States Pharmacopeia and National Formulary (USP–NF).

2. International Society of Oncology Pharmacy Practitioners. (2019). ISOPP Standards of Practice: Safe Handling of Cytotoxics. ISOPP Publications.

3. European Commission. (2022). EudraLex - Volume 4 - Good Manufacturing Practice (GMP) Guidelines: Annex 1 – Manufacture of Sterile Medicinal Products.

Abstract-Post-27 Patient-Centered Safety

Desensitization protocol for cytotoxic drugs

Ana Cândido¹, Helena Santos¹, Margarida Sousa¹, Rui Gonçalves¹, João Caetano¹

¹Unidade Local de Saúde Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal. Corresponding author: Ana Cândido - [e-mail]

Background: Hypersensitivity reactions to cytotoxic drugs represent a significant clinical challenge and can compromise cancer treatment. Desensitization protocols have emerged as an effective strategy to allow the safe administration of these drugs in sensitized patients, through the gradual and controlled administration of the substance, starting with very small doses and progressively increasing until the desired therapeutic dose is reached. Objectives: To describe the application of desensitization protocols at Hospital Garcia de Orta (HGO) and to analyse their efficacy and safety based on current scientific literature. Methods: Literature review of recent studies of desensitization protocols applied to carboplatin, oxaliplatin and docetaxel, including studies with n>100 cycles and rapid protocols of 4-6 h and compare with clinical practice at HGO. Results: Recent studies have shown significant reduction rates in serious adverse reactions of 93-97% for platinums and taxanes. Rapid protocols (4-6 hours), with progressive dose increases and adequate premedication, have been shown to be effective in several studies, contributing to therapeutic continuity without compromising patient safety. At HGO, these protocols have been successfully implemented for carboplatin (3 patients), oxaliplatin (6 patients) and docetaxel (1 patient), allowing therapeutic plans to be maintained without severe adverse reactions. The choice of these drugs reflects their clinical relevance and scientific support. Conclusion: Desensitization protocols are fundamental tools in treatment, ensuring safe therapeutic continuity. The experience of the HGO confirms their relevance in clinical practice, and the future prospect is to expand this approach to other cytotoxic drugs with a high risk of hypersensitivity.

Keywords: Hypersensitivity reactions, cytotoxic drugs, desensitization protocol.

References

1. Madrigal-Burgaleta, R., et al. (2013). Hypersensitivity and desensitization to antineoplastic agents: Outcomes of 189 procedures with a new short protocol and novel diagnostic tools assessment. Allergy, 68(11), 1482–1489.

2. Syrigou, E. I., et al. (2009). Hypersensitivity reactions to oxaliplatin: A retrospective study and the development of a desensitization protocol. Clinical Colorectal Cancer, 8(2), 106–109.

3. Castells, M. C. (2008). Hypersensitivity reactions to chemotherapy: Outcomes and safety of rapid desensitization in 413 cases. Journal of Allergy and Clinical Immunology, 122(3), 574–580.

Abstract-Post-30 Patient-Centered Safety

Preparation of Insulin Eye Drops: Procedure Development and Clinical Application

Jéssica Silveira¹, Ana Ribeiro¹, Anita Dourado¹

¹Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal. Corresponding author: Jéssica Silveira - [e-mail]

Background: Ocular diseases present significant challenges, often requiring targeted local therapies to reduce patient morbidity. Topical insulin has shown promise as a safe and effective treatment for persistent or recurrent corneal epithelial defects. Objectives: To develop and implement a validated compounding protocol for insulin eye drops. Methods: A two-step approach was followed: first, a literature review was conducted using PubMed® (2017–2024) with the terms “insulin AND eye drops”, “topical insulin”, and “stability AND insulin eye drops”. Additional sources included the Summary of Product Characteristics, Stabilis®, and USP <797> on sterile compounding. Secondly, a local compounding protocol was developed and implemented by the Sterile Preparations Unit. Results: Seventeen relevant studies were included, mostly using regular human insulin at 1 IU/mL with vehicles such as 0.9% sodium chloride, balanced salt solution or artificial tears. Reported stability ranged from 7 to 120 days under refrigeration. Concerns regarding insulin adsorption and m-cresol toxicity were identified but considered clinically insignificant. Based on these findings, insulin eye drops are now aseptically compounded in a horizontal laminar airflow cabinet using Actrapid®, diluted to 1 IU/mL in 0.9% sodium chloride and sterile-filtered. A beyond-use date of 10 days under refrigeration was assigned due to the absence of microbiological validation. Testing is planned to support extending the beyond-use date to 21 days, based on physicochemical data from Stabilis®. Conclusions: A safe, reproducible, and clinically useful insulin eye drop protocol was successfully established. However, the absence of complementary stability studies, particularly pH and high-performance liquid chromatograph, remains a limitation.

Keywords: Insulin Eye Drops; Persistent Corneal Epithelial Defects; Hospital Pharmacy

References

1. Tong, C. M., Iovieno, A., & Yeung, S. N. (2020). Topical insulin for neurotrophic corneal ulcers. Canadian Journal of Ophthalmology, 55(5), e170–e172.

2. Diaz-Valle, D. et al. (2021). Topical insulin for refractory persistent corneal epithelial defects. European Journal of Ophthalmology, 31(5), 2280–2286.

3. Vicario-de-la-Torre, M. et al. (2024). Topical insulin eye drops: Stability and safety of two compounded formulations for treating persistent corneal epithelial defects. Pharmaceutics, 16(5), 580.

Abstract-Post-34 Patient-Centered Safety

The barriers to safe medication use in older people - a systematic review

Eliana Afonso¹, Tânia Nascimento^2,3, Agostinho Cruz⁴

¹E2S - Instituto Politécnico do Porto, Polytechnic of Porto, Porto, Portugal.²Escola Superior de Saúde, Universidade do Algarve (ESSUAlg), Portugal.³Algarve Biomedical Center Research Institute (ABC-RI), Universidade do Algarve, Faro, Portugal.⁴LAQV/REQUIMTE, ESS, Polytechnic of Porto, Porto, Portugal. Corresponding author: Eliana Afonso - [e-mail]

Background: The population is ageing, and Portugal stands out as one of the oldest countries in the European Union, with a high ageing index ^[1]. Ageing leads to physiological changes that affect health and pharmacokinetics ^[2]. In Portugal, 36.9% of older adults are polymedicated ^[3]. Aims: The aim of this study was to identify the barriers that older adults face daily and that compromise their safety when taking medicines. Methods: Systematic review according to the PRISMA protocol, registered in PROSPERO, and analysis of the quality of the articles using the JBI Checklist for Systematic Reviews and Research Syntheses. Results: 34 studies were included, of which 33 identified barriers to safe medication use. Internal barriers (78.8%) were identified, including physical limitations (mobility, vision, hearing), cognitive difficulties, social isolation, low health literacy, financial difficulties, and the complexity of pictograms in instructions (before and after training). External barriers (78.8%) were also identified, such as polypharmacy (44.12%) and the complexity of therapeutic regimens (23.53%), which involve communication failures between healthcare professionals and between them and patients, lack of specific training in geriatrics, structural limitations in pharmacies, and complex therapeutic regimens. Polypharmacy, treatment by multiple doctors, and the pharmaceutical form make it difficult to administer medications correctly, reducing adherence to therapy. Conclusion: It is concluded that polypharmacy and low health literacy are key internal barriers, while limited interprofessional collaboration and inadequate pharmacist training constitute external challenges, requiring systemic healthcare reform, including continuing education and improvements in communication between healthcare professionals.

Keywords: Barriers, Community Pharmacy, Safe Use of Medicines

References

1. Rochon, P. A. et al. (2021). Polypharmacy, inappropriate prescribing, and deprescribing in older people: through a sex and gender lens. The Lancet Healthy Longevity, 2(5), e290–e300.

2. Höchel, J. (2019). Does everything get slower with age? Pharmacokinetics in the elderly. In Drug Research (Vol. 69, pp. S7–S8).

3. Pazan, F., & Wehling, M. (2021). Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences. European Geriatric Medicine, 12, 443–452.

Abstract-Post-37 Patient-Centered Safety

Ototoxicity caused by drugs, its relationship with mtDNA and ways to control its progression

Sara Rodrigues¹, Célia A. Gomes², Rui Cruz¹

¹Instituto Politécnico de Coimbra, ESTESC-Coimbra Health School, Farmácia, Portugal. ²Instituto Politécnico de Coimbra, ESTESC-Coimbra Health School, Ciências de Base, Portugal. Corresponding author: Célia Alcobia - [e-mail]

Background: Hearing loss affects people’s well-being, leading to social isolation and depression. The causes of this loss can be congenital or acquired. Ototoxic drugs (aminoglycoside antibiotics ^[1], antineoplastic agents ^[2], and some non-steroidal anti-inflammatory drugs) are important factors in acquired hearing loss, as they interfere with the functionality of hair cells, which are important in the transduction of sound into electrical stimuli. Several clinical conditions predispose individuals to increased auditory susceptibility induced by these drugs, as well as polymorphisms present in the nuclear and/or mitochondrial genome. Objective: The purpose of this study is to understand the action mechanism of ototoxic drugs that lead to hearing loss and to investigate otoprotective strategies currently available on the market or undergoing development. Methods: A review was conducted in PubMed and Scopus databases, search using the keywords “ototoxic drugs”, “mtDNA” and “otoprotective strategies” to identify relevant articles according to inclusion criteria. Results: We selected 23 articles. Analysis of the different studies revealed that the pathophysiological mechanisms underlying ototoxic drugs are mainly associated with mechanisms of apoptosis and necrosis of hair cells. Otoprotective substances, such as antioxidants, anti-inflammatories, and antiapoptotic, can prevent and mitigate ototoxicity ^[3]. Gene therapy and related techniques also open new pathways for understanding the underlying mechanisms of ototoxicity and for the development of more precise and personalized interventions. The small number of clinical trials in humans was also highlighted. Conclusion: Despite the progressive and promising multifactorial approach of otoprotective substances to mitigate the negative impacts of drug-induced ototoxicity, there are still few clinical trials developed in humans.

Keywords: ototoxicity drugs; mtDNA; otoprotective strategies.

References

1. Jospe-Kaufman M, Siomin L, & Fridman M. The relationship between the structure and toxicity of aminoglycoside antibiotics. (2020) Bioorganic and Medicinal Chemistry Letters. Elsevier Ltd; 30(13):127218.

2. Wang X, et al. (2023) Cisplatin-induced ototoxicity: From signaling network to therapeutic targets. Biomed Pharmacother, 157:114045.

3. Fu X., et al. (2021) Mechanism and Prevention of Ototoxicity Induced by Aminoglycosides. Front. Cell. Neurosci, 15:692762.

Abstract-Post-38 Patient-Centered Safety

Safety of statin use on skeletal muscle function in individuals with obesity

Ana Luísa De Sousa-Coelho^1,2, Beatriz Sequeira², Carolina Lopes^1,3, Céu Laranjo⁴, Tina Sanai⁴, Mercedes Sanchez⁴, João Maia-Teixeira⁴

¹Algarve Biomedical Center Research Institute (ABC-Ri), Universidade do Algarve, Faro, Portugal.²Escola Superior de Saúde, Universidade do Algarve (ESSUAlg), Faro, Portugal. ³Faculdade de Medicina e Ciências Biomédicas (FMCB), Universidade do Algarve, Faro, Portugal. ⁴Unidade Local de Saúde do Algarve (ULSALG), Faro, Portugal. Corresponding author: Ana Luísa de Sousa-Coelho - [e-mail]

Background: Statins are commonly prescribed to treat hypercholesterolemia. However, these drugs have been associated with a range of skeletal muscle symptoms, which may lead some patients to discontinue the medication ^[1]. Objectives: The aim of this study was to investigate the effects of statins intake on muscle function in individuals with obesity. Methods: Muscle-related variables were evaluated in a group of patients with obesity, including handgrip strength (HGS), body composition (bioimpedance analysis), and physical performance (sit-to stand test (SST), timed-up and go (TUG), gait speed (GS)). Additional variables included age, sex, body weight (BW), body mass index (BMI), and biochemical analyses. The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee and authorized by the Administrative Board of Centro Hospitalar Universitário do Algarve. Results: From a total of 39 individuals (76.9% female; mean age 49.5 years old; BW 109.9 kg; BMI 40.8 kg/m²), almost half were taking statins (46.2%). Mean values for age, anthropometric, body composition and biochemical variables were not statistically different between those taking statins from those who were not, neither were the muscle function tests GS, TUG, SST or HGS. Interestingly, fat-free mass and skeletal muscle mass both negatively correlated with total cholesterol and LDL-cholesterol, but only in the group of patients taking statins (p<0.05). Conclusions: Patients with obesity who use statins do not exhibit worse outcomes in the parameters evaluated, suggesting its use may be considered safe with respect to skeletal muscle function in this population.

Keywords: Skeletal muscle function; Statins; Obesity

Acknowledgements

This research was funded by the Agency for Clinical Research and Biomedical Innovation (AICIB) with the support of the solidarity account “Todos Por Quem Cuida (TPQC)”, within the scope of the awarded project IMPPACTO.

Reference

1. Abd, T. T., & Jacobson, T. A. (2011). Statin-induced myopathy: a review and update. Expert Opinion on Drug Safety, 10(3), 373–387.

Abstract-Post-49 Patient-Centered Safety

Accurate measurement of injectable medications. Does syringe capacity matter?

Pedro Azóia¹, Rui Silva¹, Cláudia Laranjeira¹, Inês Soares¹, Patrícia Gaspar¹, Prazeres Sacramento¹, Raquel Leitão¹, Raquel Magalhães¹, Sílvia Fonseca¹, Alcina Calhau¹, Beatriz Patrão¹, Clementina Varelas¹

¹Portuguese Institute Of Oncology of Coimbra Francisco Gentil, E.P.E., Coimbra, Portugal. Corresponding author: Pedro Azóia - [e-mail]

Background: The accurate and safe preparation of injectable medications is a complex task, especially when performed in critical situations ^[1,2]. Current guidelines are vague regarding the appropriate use of syringes for measuring small volumes, which is associated with higher measurement error rates ^[3]. Objectives: The purpose of this study was to assess the performance of commercially available syringes in measuring small volumes of medicines. Methods: Five experienced investigators measured 5%, 10%, and 20% of the volume of a 3 mL (n=270) and 10 mL (n=200) syringes, from a specific manufacturer, by drawing sterile water for injection from a vial. Delivered volumes were measured gravimetrically using an electronic balance and converted to volume using the specific gravity of water (1.0 g/mL). Accuracy is represented by the mean and standard deviation of the differences between the measured and expected results, while precision is represented by the relative standard deviation of repeated measurements. For statistical analysis, ANOVA was used (p<0.05). Results: Precision and accuracy tend to significantly (p<0.05) increase as the percentage of volume measured increases. Mean percent error ranged from 5.52% to 107%. The only measurements close to acceptable error (<5%) were observed in the 20% measurement using the 10 mL capacity syringe. Conclusions: The findings suggest that measuring no less than 20% of the syringe’s nominal volume is necessary to ensure accuracy, particularly when handling medications with a narrow therapeutic index. Selecting a syringe with a capacity closely matching the intended volume is essential to promote safe medication administration.

Keywords: Syringe, accuracy, precision.

References

1. Gilliot, S., et al. (2024). Factors influencing accuracy when preparing injectable drug concentrations in appliance with clinical practice: A norepinephrine case study. European Journal of Hospital Pharmacy: Science and Practice, 31(2), 168–170.

2. Instituto Português da Qualidade. (2015). Metrologia na saúde: Guia de boas práticas (1ª ed.). Caparica: IPQ. ISBN 978-972-763-158-2

3. Jordan, M. A., Choksi, D., Lombard, K., & Patton, L. R. (2021). Development of guidelines for accurate measurement of small volume parenteral products using syringes. Hospital Pharmacy, 56(3), 165–171.

Abstract-Post-53 Patient-Centered Safety

Psychotropic drug use among residents of a Nursin home in the algarve, Portugal

Amanda Andrade¹, Salete Sousa², Ezequiel Pinto^1,3, Catarina Cabrita¹, Helena Leitão^3,4, Rocío de la Puerta⁵, Tânia Nascimento^1,3

¹Escola Superior de Saúde, Universidade do Algarve, Faro, Portugal.²Faculdade de Ciências e Tecnologia, Universidade do Algarve, Faro, Portugal.³Algarve Biomedical Center Research Institute (ABC-RI), Faro, Portugal.⁴Faculdade de Medicina e Ciências Biomédicas, Universidade do Algarve, Faro, Portugal.⁵Faculty of Pharmacy, Pharmacology Department, University of Seville, Seville, Spain. Corresponding author: Amanda Andrade - [e-mail]

Background: The incidence of chronic mental illnesses is associated with ageing and, consequently, the use of psychotropic medications is common in older adults, especially those in institutions. Objective: This study aimed to characterise the consumption of psychotropic medications in a nursing home (NH) in the Algarve region of Portugal. Methods: A descriptive cross-sectional study was conducted, analysing the pharmacotherapeutic profiles of 50 residents of a nursing home. Medications were classified according to the Anatomical Therapeutic Chemical (ATC) Classification and those belonging to the psychotropic class were identified (ATC N). The diagnosed pathologies were classified according to the International Classification of Diseases (ICD-10-CM). Results: The sample consisted mainly of women (60%, n=30). Mean age of the residents was 84.8±9.2years, and 50% (n=25) were diagnosed with nervous system diseases (ICD-10 G). A total of 355 medications were identified, of which 114 were psychotropics. Only 18% (n=9) of residents did not have psychotropic medications prescribed. On average, residents take 7.10±3.14 medications, and 82% (n=41) were considered polymedicated (⩾5medications). Residents take a mean of 2.3±1.7psychotropic medications, with no significant differences between sexes (U=360,500; p=0.223) or patients diagnosed with central nervous system diseases (U=257,000; p=0.274). Drugs belonging to ATCN05A (antipsychotic) [52% (n=26)] and ATCN05B (anxiolytic) [32% (n=16)] were the most used. Hypnotics and sedatives (N05C) were used by 20% (n=10) of the elderly. Conclusions: Prevalence of psychotropic medications is high among institutionalised elderly people. These results suggest the importance of healthcare professionals, especially pharmacy professionals, in the continuous evaluation of pharmacotherapy in NH.

Keywords: Nursing Home, Polypharmacy, Psychotropic Drugs.

Acknowledgements

We thank the institution for the support provided in the data collection process and for permitting us to conduct this study. This work was developed within the framework of the Interreg-POCTEP project 0237_NUMAPLUS_5_E - NUMAPLUS - Más allá del nuevo modelo asistencial: regiones cardio aseguradas.

References

1. Corvaisier, M., Brangier, A., Annweiler, C., & Spiesser Robelet, L. (2024). Preventable or potentially inappropriate psychotropics and adverse health outcomes in older adults: Systematic review and meta-analysis. Journal of Nutrition, Health & Aging, 28, 100187.

2. Harrison, S. L., Bradley, C., Milte, R., Ibrahim, J. E., & Crotty, M. (2018). Psychotropic medications in older people in residential care facilities and associations with quality of life: A cross-sectional study. BMC Geriatrics, 18, Article 60.

Abstract-Post-55 Patient-Centered Safety

Use of Potentially Inappropriate Medications in Institutionalised Elderly People According to the EU(7)-PIM List, in a Residential Care Home for The Elderly (ERPI) In The Algarve, Portugal

Catarina Cabrita¹, Amanda Andrade¹, Ezequiel Pinto^1,2, Helena Leitão^2,3, Rocío de la Puerta⁴, Tânia Nascimento^1,2

¹Escola Superior de Saúde, Universidade do Algarve, Faro, Portugal.²Algarve Biomedical Center Research Institute (ABC-RI), Faro, Portugal.³Faculdade de Medicina e Ciências Biomédicas, Universidade do Algarve, Faro, Portugal.⁴Faculty of Pharmacy, Pharmacology Department, University of Seville, Seville, Spain. Corresponding Author: Catarina Cabrita - [e-mail]; Tânia Nascimento: [e-mail]

Background: Polypharmacy in older adults elevates their risk for medication-related problems, including the use of Potentially Inappropriate Medications (PIM), where risks outweigh clinical benefits. This challenge is even more pronounced in institutionalised settings, which often cater for extensive healthcare needs. Objective: The objective of this study is to describe the use of PIM in elderly people institutionalised in a nursing home in the Algarve, Portugal. Methods: A descriptive cross-sectional study was conducted by analysing 58 therapeutic profiles of institutionalised elderly people (⩾65 years old) and identifying PIM using the ApiMedOlder digital tool, which integrates the EU(7)-PIM list. Results: Approximately 57% (n=33) of participants were female with a mean age of 82.0±11.8 years, and consumed 7 medications, on average, with 81.0% (n=47) being polymedicated (⩾5 medications). Considering the total sample, 84.5% (n=49) consumed at least one PIM, with a mean of 2.3±1.8 PIM. There were no statistically significant differences between sexes (U=0.152; p=0.879). The PIM belonged mainly to ATC N (Nervous System) (65.50%; n=38) and ATC A (Gastrointestinal Tract and Metabolism) (51.70%; n=30). Conclusions: The prevalence of PIM use among institutionalised older adults is high, with a notable predominance of medications acting on the central nervous system. This finding underscores the critical need for healthcare teams to conduct regular, thorough reviews of pharmacotherapy to mitigate the risk of adverse events and enhance patient safety in this vulnerable population.

Keywords: Elderly, Potentially Inappropriate Medications, EU(7)-PIM List.

Acknowledgements

We thank the institution for the support provided in the data collection process and for permitting us to conduct this study. This work was developed within the framework of the Interreg-POCTEP project 0237_NUMAPLUS_5_E - NUMAPLUS - Más allá del nuevo modelo asistencial: regiones cardio aseguradas.

References

1. Apimed Older. APIMED – Lista de medicamentos potencialmente inapropriados para idosos.

2. Malakouti, S. K., et al. (2021). A Systematic Review of Potentially Inappropriate Medications Use and Related Costs Among the Elderly. Value in health regional issues, 25, 172–179.

3. Moreira, F. S. M., et al. (2020). Use of potentially inappropriate medications in institutionalized elderly: prevalence and associated factors. Uso de medicamentos potencialmente inapropriados em idosos institucionalizados: prevalência e fatores associados. Ciencia & saude coletiva, 25(6), 2073–2082.

Abstract-Post-56 Patient-Centered Safety

Potential Drug-Drug Interactions in Institutionalised Elderly People – A Pilot Study in The Algarve Region

Miguel Monteiro¹, Andreia Zuckschwerdt¹, Ezequiel Pinto^1,2, Tânia Nascimento^1,2

¹Escola Superior de Saúde, Universidade do Algarve, Faro, Portugal. ²Algarve Biomedical Center Research Institute (ABC-RI), Faro, Portugal. Corresponding Author: Tânia Nascimento - [e-mail]

Background: The ageing population presents a significant challenge to healthcare systems due to the high prevalence of chronic disease and polypharmacy, which increases the risk of potential drug–drug interactions (PDDIs). Studies show a high prevalence of PDDI in institutionalised elderly people. Objective: This study aimed to evaluate the prevalence and characteristics of PDDIs among institutionalised older adults in the Algarve region of Portugal. Methods: A descriptive cross-sectional study was conducted using the therapeutic profiles of 81 residents from various nursing homes in the Algarve. Inclusion criteria required the prescription of two or more medications. PDDIs were identified and classified using the Lexidrug™ interaction screening platform. Results: The sample was predominantly female (70.4%) with a mean age of 85.0 ± 8.4 years. Polypharmacy (⩾5 medications) was observed in 88% of residents, who were taking an average of seven medications each. PDDIs were identified in 85.2% (n=69) of the participants, with a mean of 3.9 ± 3.3 interactions per person. The most frequent were Type C interactions (monitor therapy). Notably, 12.4% (n=10) of individuals had at least one Type X interaction, where risks outweigh potential benefits. No statistically significant differences in the prevalence or type of PDDIs were found according to sex (p>0.05). Conclusions: Prevalence of PDDIs was high, surpassing rates reported in other European studies. These findings underscore the imperative for multidisciplinary healthcare teams to implement systematic medication reviews to identify, manage, and mitigate the risks associated with PDDIs in this vulnerable population.

Keywords: Drug–drug interactions, Nursing homes, Older adults;

Acknowledgements

We thank the institution for the support provided in the data collection process and for permitting us to conduct this study. This work was developed within the framework of the Interreg-POCTEP project 0237_NUMAPLUS_5_E - NUMAPLUS - Más allá del nuevo modelo asistencial: regiones cardio aseguradas.

References

1. Bories, M., Bouzillé, G., Cuggia, M., & Le Corre, P. (2021). Drug-Drug Interactions in Elderly Patients with Potentially Inappropriate Medications in Primary Care, Nursing Home and Hospital Settings: A Systematic Review and a Preliminary Study. Pharmaceutics, 13(2), 266.

2. Lion, S., Evrard, P., Foulon, V., & Spinewine, A. (2023). Drug-drug interactions in nursing home residents: analysis from the COME-ON trial. Age and ageing, 52(1), afac278.

3. Jiang H, Lin Y, Ren W, Lu L, Tan X, Lv X and Zhang N (2025) Potential inappropriate medications and drug–drug interactions in adverse drug reactions in the elderly: a retrospective study in a pharmacovigilance database. Front. Pharmacol. 16:1546012.

Abstract-Post-58 Patient-Centered Safety

Drug Iatrogenesis In Type 2 Diabetes Mellitus

Joana Martins¹, Isabel Andrade², Rui Cruz^1,3

¹Polytechnic Institute of Coimbra, Coimbra Health School, Department of Biomedical Laboratory Sciences, Dietetics and Nutrition, and Pharmacy, Coimbra, Portugal.²Polytechnic Institute of Coimbra, Coimbra Health School, Department of Complementary Sciences, Coimbra, Portugal. ³H&TRC-Health & Tecnhology Research Center, Coimbra Health School, Polytechnic University of Coimbra, Coimbra, Portugal. Corresponding author: Joana Martins - [e-mail]

Background: Type 2 Diabetes Mellitus (T2DM) is a multifactorial, metabolic, chronic disease characterized by persistent hyperglycemia, often associated with several comorbidities. Current therapeutic strategies can control the disease, but medications can cause relevant drug iatrogenesis: hypoglycemia, infections, gastrointestinal complications, among others, which must be carefully monitored, minimizing their impact on the lives of users. Objective: We intend to highlight and describe the most prevalent iatrogenic effects caused by oral antidiabetic drugs used in the clinical practice of T2DM; Methods: We conducted a structured integrative review, based in a search in the PubMed and Scielo databases, according to pre-established inclusion criteria, covering a study period from 2014-2025. Results: Seven articles were selected, comparing the iatrogenic effects of GLP-1, iSGLT-2, and iDPP-4 receptor analogues. Semaglutide (oral/injectable) reduced cardiovascular deaths by lowering HbA1c, weight, and fasting glucose - effects enhanced with tirzepatide. Dapagliflozin, when combined with other antidiabetics, significantly reduced HbA1c, fasting glucose, and body weight. However, 10 mg/day is linked to urogenital infections, nasopharyngitis, and renal damage. Alternatives include empagliflozin, with renoprotective effects, or ipragliflozin. Linagliptin reduced respiratory infections. The iDPP-4 class was uniquely associated with a reduced risk of Parkinson’s disease. Conclusions: Oral antidiabetic medications can cause an adequate reduction in blood glucose levels in people with T2DM. However, they cause a series of adverse effects that must be understood, to optimize correct drug dosing, and improve the quality of life.

Keywords: Diabetes Melitus, iatrogeny, oral antidiabetics.

References

1. Liu, D., Chen, H., Song, F., Ahmed, M. A., & Wu, H. (2020). Adverse Drug Events Observed with the Novel Sodium/Glucose Co-Transporter 2 Inhibitor Ipragliflozin for the Treatment of Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Studies. Advances in therapy, 37(10), 4356–4369.

2. Chen, L., Xue, Q., Yan, C., Tang, B., Wang, L., Zhang, B., & Zhao, Q. (2023). Comparative safety of different recommended doses of sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis of randomized clinical trials. Frontiers in endocrinology, 14, 1256548.

3. Chong, K., Chang, J. K., & Chuang, L. M. (2024). Recent advances in the treatment of type 2 diabetes mellitus using new drug therapies. The Kaohsiung journal of medical sciences, 40(3), 212–220.

Abstract-Post-59 Patient-Centered Safety

Sleep deprivation in athletes – efficacy and risks of benzodiazepines in improving sleep and sports performance

Diogo Correia¹, Jorge Balteiro¹

¹Escola Superior de Tecnologia da Saúde de Coimbra, Coimbra, Portugal. Corresponding author: Diogo Correia - [e-mail]

Background: Benzodiazepines act on GABA-A receptors, causing sedation and relaxation, and are used by athletes to induce sleep and control anxiety. Despite the immediate benefits, they can impair performance due to residual sedation, cognitive impairment, and risk of dependence. Objectives: To evaluate the efficacy and risks of benzodiazepines on sleep and athletic performance, considering immediate benefits and physical and cognitive adverse effects. Methods: This narrative review analyzed studies from the last six years, in PubMed and Google Scholar in this period: September 2024-May 2025. It included open-access studies in Portuguese or English on benzodiazepines in athletes. It excluded non-reviewed, biased, or other-language studies. Results: Benzodiazepines are effective in inducing rapid sleep and reducing anxiety in athletes, but they pose risks such as residual sedation, cognitive impairment and dependence ^[1]. Prolonged use, over two weeks, can impair performance, especially in sports that require focus and fine motor control, such as gymnastics and racket sports ^[2]. Non-pharmacological alternatives, such as sleep hygiene, cognitive behavioral therapy, and mindfulness, are recommended for their sustained benefits and minimal side effects ^[3]. Conclusion: In conclusion, benzodiazepines help with sleep and anxiety in the short term in athletes, but carry risks such as cognitive impairment, residual sedation, and dependence, especially in sports that require focus and fine motor control. Non-pharmacological methods, such as sleep hygiene, cognitive behavioral therapy, and mindfulness, are safer and more effective for long-term performance and health.

Keywords: Benzodiazepines; Sleep and Sports Performance; Adverse Effects

References

1. Holgado, D., et al. (2021). The effect of benzodiazepines on exercise in healthy adult participants: A systematic review. Journal of Addictive Diseases, 1–9.

2. Zamboni, L., Lugoboni, F., & Zandonai, T. (2019). Benzodiazepine abuse among athletes: Pain relief or just a weapon against insomnia? A clinical case study. Scandinavian Journal of Medicine & Science in Sports, 29(12), 1937–1940.

3. Zandonai, T., Peiró, A. M., Fusina, F., Lugoboni, F., & Zamboni, L. (2022). Benzodiazepines in sport, an underestimated problem: Recommendations for sports medicine physicians’ practice. Frontiers in Psychiatry, 13.

Abstract-Post-67 Patient-Centered Safety

Medication Use During Pregnancy: Patterns And Associated Factors

Flávia Medina¹, Leandra Rodrigues^2,3, Joana Coelho^2,4,5, Luís Nascimento^2,3

¹Instituto Politécnico de Bragança, Bragança, Portugal.²Departamento das Tecnologias de Diagnóstico e Terapêutica, Escola Superior de Saúde do Instituto Politécnico de Bragança, Bragança, Portugal.³CIMO- Centro de Investigação da Montanha, Bragança, Portugal.⁴Serviços Farmacêuticos da Unidade Hospitalar de Chaves da Unidade Local de Saúde Centro de Trás os-Montes e Alto Douro, E.P.E., Chaves, Portugal.⁵Centro Académico Clínico de Trás-os-Montes e Alto Douro (CACtmad) – Grupo de Cuidados Continuados e Paliativos, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal. Corresponding Author: Luís Nascimento - [e-mail]

Background: Pregnancy causes physiological changes that can increase vulnerability to illness and alter drug pharmacokinetics, while some medications cross the placenta and affect foetal development, especially during organogenesis. These risks highlight the importance of careful monitoring and support regulatory updates such as the FDA’s 2015 revision of pregnancy risk categories ^[1]. Objectives: To identify factors associated with medicine use during pregnancy and describe consumption patterns among pregnant women in northeastern Trás-os-Montes, Portugal. Methods: A cross-sectional, quantitative, descriptive and correlational study was conducted with 205 women from Bragança and Mirandela, all of whom had experienced at least one pregnancy. Data were collected between April and June 2023 using a structured questionnaire adapted from Guerra et al. (2008) ^[2]. Results: A total of 79.5% reported using medication during pregnancy. The most used substances were folic acid (12.2%), paracetamol (29.3%), and doxylamine-pyridoxine (23.4%). The most frequent groups included dietary supplements, analgesics, and antiemetics. Although supplements are not classified as medicines, their inclusion is justified due to widespread use and relevance during pregnancy. A statistically significant association was found between age and medicine use (p < 0.01). Most women reported having received professional guidance and being aware of the associated risks. Conclusion: Women in northeastern Trás-os-Montes demonstrated awareness of medication risks and used medicines under professional supervision, despite few reporting complications. These results underline the importance of ongoing education and the role of healthcare professionals in ensuring safe medicine use during pregnancy.

Keywords: Pregnancy, medicine use, risks

References

1. U.S. Food and Drug Administration. (2015). *Pregnancy and lactation labeling (drugs) final rule (PLLR)

2. Guerra, B. et al. (2008). Utilização de medicamentos durante a gravidez na cidade de Natal, Rio Grande do Norte, Brasil. Revista Brasileira de Ginecologia e Obstetrícia, 30(1), 12–18.

3. Meneses, J. A. L., & Mendonça, L. A. de. (2022). The importance of pharmaceutical monitoring during pregnancy: the dangers of self-medication. Research, Society and Development, 11(15), e367111537457.

Abstract-Post-70 Patient-Centered Safety

Pharmaceutical Literacy Among Elderly Individuals Who Attend Community Pharmacies

Mariana Gama¹, Clara Rocha^2,3, Rui Cruz^1,3

¹Polytechnic Institute of Coimbra, Coimbra Health School, Department of Biomedical Laboratory Sciences, Dietetics and Nutrition, and Pharmacy, Coimbra, Portugal.²Polytechnic Institute of Coimbra, Coimbra Health School, Department of Complementary Sciences, Coimbra, Portugal. ³H&TRC-Health & Tecnhology Research Center, Coimbra Health School, Polytechnic University of Coimbra, Coimbra, Portugal. Corresponding author: Mariana Morado - [e-mail]

Background: The safe and effective use of medication is based on pharmaceutical literacy, which is of great importance among the elderly population, who are often polymedicated. Objective: This study aimed to assess the pharmaceutical literacy of elderly people using community pharmacies. Methods: Observational, descriptive, cross-sectional study conducted between March and April 2025 in community pharmacies located in the central region of Portugal, selected by convenience. Data were collected using the RALPH questionnaire, which assesses three dimensions of pharmaceutical literacy: functional, communicative, and critical. The sampling criteria included individuals aged 65 or older, cognitively able to respond, undergoing chronic treatment, and who consented to participate. Results: The sample consisted of 42 individuals aged between 65 and 91 years and revealed a female predominance (54.8%), with an overall mean age of 77.26 years. Most participants demonstrated high functional and communicative literacy, but moderate critical literacy. It was found that 59.5% of users did not seek clarification about the usefulness of the medicines. Differences between sexes were not statistically significant, although trends indicate greater functional and critical literacy in males, and communicative literacy in females. Conclusion: This study shows that elderly people who are using medications have good functional and communicative skills in terms of pharmaceutical literacy but have difficulty in critically evaluating information about the medications they are taking. Thus, we highlight the relevance of the role of community pharmacies in identifying users with low literacy, contributing to a safer and more self-aware use of medications and to health promotion.

Keywords: Health literacy; Pharmaceutical literacy; Community pharmacy

References

1. Neiva Pantuzza, L. L. et al. (2022). Medication literacy: A conceptual model. Research in social & administrative pharmacy: RSAP, 18(4), 2675–2682.

2. Gentizon, J., Bovet, E., Rapp, E., & Mabire, C. (2022). Medication Literacy in Hospitalized Older Adults: Concept Development. Health literacy research and practice, 6(2), e70–e83.

3. Vervloet, M. Et al. (2018). Recognizing and Addressing Limited PHarmaceutical literacy: Development of the RALPH interview guide. Research in social & administrative pharmacy : RSAP, 14(9), 805–811.

Abstract-Post-71 Patient-Centered Safety

Self-Medication

Inês Mota¹, Isabel Mendes¹, João Almeida¹, Maria Francisca Pires¹, Tânia Pires^1,2, Luís Nascimento^1,2

¹Instituto Politécnico de Bragança, Bragança, Portugal.²Research Centre for Active Living and Wellbeing (LiveWell), Instituto Politécnico de Bragança, Portugal. Corresponding Author: Luís Nascimento - [e-mail]

Background: Self-medication allows individuals to treat minor health issues without a medical prescription, facilitated by the availability of over-the-counter (OTC) medicines ^[1,2]. This practice requires healthcare professionals, particularly pharmacists, to play a key role in ensuring the safe and rational use of medicines. Objectives: This study aimed to understand the motivations behind self-medication in Portugal and to promote informed and responsible behaviour among the population. Methods: An observational, descriptive, cross-sectional study was conducted between February and June 2025 via an online questionnaire. The target sample was 385 individuals, with a 95% confidence level and a 5% margin of error. A total of 377 participants, all aged 20 or above and residing in mainland Portugal, completed the questionnaire. Results: A total of 91.8% reported engaging in self-medication, mostly women (77.7%), young adults aged 20–24 (58.1%), and residents in the North (60.1%). The majority held a university degree (54.9%) and were single (75.7%). The main motivations were prior knowledge (80.1%) and easy access to medicines (36.4%). The most commonly used medicines were non-steroidal anti-inflammatory drugs (NSAIDs) (87%), antipyretics (67.1%), and antihistamines (32.4%). Although participants showed autonomy in decision-making, healthcare professionals were the main source of influence (51.6%) when purchasing medicines. Conclusions: Self-medication is highly prevalent in Portugal and is largely driven by convenience and confidence. The study assessed motivations through participant responses and sociodemographic data, revealing the importance of health literacy. Responsible self-medication behaviour was promoted through an educational questionnaire and critical data analysis. Strengthening the role of pharmacy professionals is essential in guiding the public and ensuring the rational use of medicines

Keywords: self-medication, role of healthcare professionals, risks of inappropriate medication use.

Acknowledgements

This work is funded by national funds from FCT – Fundação para a Ciência e a Tecnologia, I.P., under the project/support UID/6157/2023.

References

1. May, L., Schaefer, M., & Tamburro, C. (2023). Self‑care with non‑prescription medicines to improve healthcare: a conceptual and economic framework. Frontiers in Public Health, 11, Article 1220984.

2. Pacha Jara, A. G., De la Torre Fiallos, A. V., Guangasig Toapanta, V. H., & Hidalgo Morales, K. P. (2023). Automedicación: un enfoque de revisión sobre sus riesgos, consecuencias y una práctica responsable. LATAM Revista Latinoamericana de Ciencias Sociales y Humanidades, 4(4), 708–721.

Abstract-Post-77 Patient-Centered Safety

The effect of antihistamines on the cardiovascular system: a systematic review

Mariana Soares¹, Ana Isabel Oliveira², Rita Ferraz de Oliveira²

¹Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal.²REQUIMTE/LAQV, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal. Corresponding author: Rita Ferraz de Oliveira - [e-mail]

Background: Antihistamines are widely used for allergic diseases but have been associated with adverse cardiovascular effects. Once considered rare, these effects have gained clinical relevance due to population ageing, polypharmacy, and comorbidities ^[1]. Despite case reports and narrative reviews, recent systematic reviews are lacking. Objectives: To critically assess current evidence on the cardiovascular effects of antihistamines. Methodology: A systematic literature review was conducted using PubMed and ScienceDirect, following PRISMA guidelines. Studies published from January 2013 to May 2025 were considered. Of 99 records identified, 18 duplicates were removed, 75 were excluded by title and abstract, and one after full-text review. Five studies were included. Designs varied (case reports, cohort studies, clinical trials, experimental research), and methodological quality was assessed using Joanna Briggs Institute checklists, selected for their adaptability to multiple study types. Both adult and paediatric populations were included. Results: The findings suggest a possible link between first-generation H1 antihistamines and increased risk of arrhythmias and ischaemic cardiac events, particularly in children. Some studies also noted potential therapeutic benefits in specific contexts, such as long COVID. Overall, evidence remains limited by methodological heterogeneity and small sample sizes. Conclusions: The results support caution in prescribing antihistamines, especially in vulnerable populations, and reinforce the need for further robust studies to better define their cardiovascular safety.

Keywords: antihistamines, cardiovascular system, adverse reactions

Acknowledgements

This work received financial support from the PT national funds (FCT/MECI, Fundação para a Ciência e Tecnologia and Ministério da Educação, Ciência e Inovação) through the project UID/50006 -Laboratório Associado para a Química Verde - Tecnologias e Processos Limpos.

Reference

1. Kim, H. Et al. (2023). Association between First-Generation Antihistamine Use in Children and Cardiac Arrhythmia and Ischemic Heart Disease: A Case-Crossover Study. Pharmaceuticals, 16(8), 1073.

Abstract-Post-78 Patient-Centered Safety

Assessment of patient knowledge on medications for irritable bowel syndrome

Maria Inês Ferreira¹, Catarina Vieira¹, Ana Isabel Oliveira², Rita Oliveira²

¹Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal.²REQUIMTE/LAQV, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal. Corresponding author: Rita Ferraz de Oliveira - [e-mail]

Background: Irritable Bowel Syndrome (IBS) is a multifactorial gastrointestinal disorder that may involve genetic factors, as well as physiological and psychological responses. It affects approximately 10-20% of the world’s population. Although not fatal, it has a significant impact on the quality of life. Knowledge about treatment is essential, as it plays a crucial role in symptom relief ^[1,2]. Objectives: To assess patients’ knowledge about IBS medication and emergency medication administration. Methods: Observational, descriptive, cross-sectional study using a non-probabilistic convenience sample. The pilot study included 22 patients at Padre Américo Hospital, Vale do Sousa, through an anonymous telephone survey, including medication name, action, dosage, duration, precautions, side effects, interactions, storage, and SOS use. Approved by the hospital ethics committee, participants signed informed consent and were anonymously identified using numerical codes. Results: The sample was predominantly female (72.7%) with a mean age of 50 years. The majority (72.7%) knew what to administer and how to administer emergency medication (antidiarrheal, antiflatulents, laxatives, antispasmodics, benzodiazepines), and 63.6% demonstrated adequate knowledge about the diet that worsens symptoms. Significant gaps were found in knowledge regarding dosage, precautions, adverse reactions, contraindication, and medication storage. Conclusions: The present study helped identify existing gaps in patients’ knowledge, demonstrating that it can be a useful tool for assessing awareness of therapeutic interventions in larger patient samples with this condition. Health literacy is crucial to increasing medication adherence and safety. Limitations include the small sample size and the homogeneity of the participants. Future perspectives should include larger and more diverse samples.

Keywords: irritable bowel syndrome, medication knowledge, health literacy

Acknowledgements

This work received financial support from the PT national funds (FCT/MECI, Fundação para a Ciência e Tecnologia and Ministério da Educação, Ciência e Inovação) through the project UID/50006 -Laboratório Associado para a Química Verde - Tecnologias e Processos Limpos.

References

1. Enck, P. et al. (2016). Irritable bowel syndrome. Nature Reviews. Disease Primers, 2, 16014.

2. Ford, A. C., Sperber, A. D., Corsetti, M., & Camilleri, M. (2020). Irritable bowel syndrome. Lancet (London, England), 396(10263), 1675–1688.

Abstract-Post-84 Patient-Centered Safety

Older people’s perception of direct oral anticoagulants

Joana Monteiro¹, Sofia Silva¹, Ana Isabel Oliveira², Rita Ferraz de Oliveira²

¹ESS, Polytechnic of Porto, Porto, Portugal.²REQUIMTE/LAQV, ESS, Polytechnic of Porto, Porto, Portugal. Corresponding author: Rita Ferraz de Oliveira - [e-mail]

Background: Average life expectancy has been increasing, and age is a major risk factor for thromboembolic events ^[1]. In 2024, Portugal had the second-highest percentage of older people in the European Union ^[2]. In 2008, direct oral anticoagulants, targeting specific coagulation factors, were introduced ^[3]. Objectives: To study the knowledge of the elderly about the safe use of this class of medication and its associated risks. Methodology: Observational, descriptive, cross-sectional study using a non-probabilistic convenience sample. A questionnaire was applied to individuals aged 65 and over, with questions about the use of direct oral anticoagulants. Total scores were calculated by summing the individual scores obtained for each question (0-10). Variables analyzed included gender, age, education level, duration of treatment and polymedication. Values of p < 0.05 were considered statistically significant. Results: Thirty-one questionnaires were obtained, with an average perception score of 7.23/10 (minimum: 3/10, maximum: 10/10). Participants demonstrated better understanding in recognizing when symptoms are not related to anticoagulants, but had more difficulty identifying situations requiring prior medical advice. In terms of gender, age, duration of treatment and polymedication, there were no differences regarding knowledge. Only the education level showed differences between low and high education groups (p = 0.024). Conclusion: Most participants demonstrated correct knowledge. However, educational programs with accessible materials and clear language remain essential for the elderly. Ongoing monitoring by healthcare professionals is also essential, with regular consultations addressing both clinical control and the patient’s understanding of the treatment.

Keywords: direct oral anticoagulants, elderly, knowledge

Acknowledgements

This work received financial support from the PT national funds (FCT/MECI, Fundação para a Ciência e Tecnologia and Ministério da Educação, Ciência e Inovação) through the project UID/50006 -Laboratório Associado para a Química Verde - Tecnologias e Processos Limpos.

References

1. Azzoug, C., et al. (2023). Direct Oral Anticoagulants versus Vitamin K Antagonists in Individuals Aged 80 Years and Older: An Overview in 2021. International Journal of Environmental Research and Public Health, 20(2), 1448.

2. Population structure and ageing. (2025). Eurostat. https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Population_structure_and_ageing

3. Mekaj, Y. H., Mekaj, A. Y., Duci, S. B., & Miftari, E. I. (2015). New oral anticoagulants: Their advantages and disadvantages compared with vitamin K antagonists in the prevention and treatment of patients with thromboembolic events. Therapeutics and Clinical Risk Management, 11, 967–977.

Abstract-Post-85 Patient-Centered Safety

Fentanyl poisoning: a review of case reports of the last decade

Joana Neto¹, Cátia Silva¹, Maria Beatriz Silva¹, Cecília Fonseca¹, Eugenia Gallardo^2,3, André RTS Araujo^1,2,4

¹Escola Superior de Saúde do Instituto Politécnico da Guarda, Guarda, Portugal.²Centro Académico Clínico das Beiras (CACB) - Missão de Problemas Relacionados com Toxicofilias, Ubimedical, Covilhã, Portugal.³Laboratório de Fármaco-Toxicologia, UBIMedical, Universidade da Beira Interior, Covilhã, Portugal.⁴BRIDGES, Investigação Biotecnológica para a Inovação e Design de Produtos de Saúde, Instituto Politécnico da Guarda, Guarda, Portugal. Corresponding author: André Araújo - [e-mail]

Background: Fentanyl poisonings represent a growing threat to public health, driven by the inappropriate clinical use and illegal commercialisation of this highly potent synthetic opioid ^[1]. Objectives: The aim of this study was to characterise the epidemiological profile of poisoned individuals, the route of administration, the symptoms of poisoning, the clinical outcome and the treatment provided in fentanyl poisonings. Methods: A review of case reports published between 2015 and 2025 in PubMed database was conducted. Twenty case reports were included after applying the exclusion criteria, totalling 60 cases of fentanyl poisoning. Results: The results revealed that most of the cases of poisoning analysed occurred in the USA (n=47, 78,3%), mainly affecting males (48.3% vs 38.3% in females) and an average age of 36.6 years. Accidental paediatric cases (n=12, 20%) were highlighted, mainly in children up to 5 years of age. The most common route of administration was oral (48.3%), followed by intranasal (21.7%), transdermal (13.3%) and intravenous (5.0%). The most common symptoms included respiratory depression, drowsiness and coma. Naloxone proved to be effective in treatment. Fatal cases showed signs of opioid intoxication in autopsies, such as cerebral oedema and pulmonary congestion. Conclusions: It is concluded that, despite its therapeutic value in the control of severe pain and in anaesthetic procedures, the inappropriate use and illegal marketing of fentanyl pose serious risks to public health. Strict surveillance, patient education and joint responsibility among healthcare professionals, authorities and the pharmaceutical industry are crucial to mitigate these risks and ensure the safe use of fentanyl.

Keywords: Fentanyl, Poisoning, Case Reports.

Reference

1. Jannetto, P. J., et al. (2019). The Fentanyl Epidemic and Evolution of Fentanyl Analogs in the United States and the European Union. Clinical chemistry, 65(2), 242–253.

TOPIC: PERSONALIZED MEDICINE

Abstract-Post-33 Personalized Medicine

Neurocognitive Development In Children With Maple Syrup Urine Disease

Diana Carrasco¹, Susana Sequeira^1,2

¹Escola Superior de Saúde da Universidade do Algarve, Faro, Portugal.²Unidade Local de Saúde do Algarve, Faro, Portugal. Corresponding author: Susana Sequeira - [e-mail]

Background: Maple syrup urine disease is a rare hereditary metabolic disease caused by a deficiency in the activity of the branched-chain alpha-keto acid dehydrogenase complex. This deficiency prevents the breakdown of branched-chain amino acids (leucine, isoleucine and valine), which leads to the toxic accumulation of these amino acids and their respective ketoacids. If not treated quickly, the condition can lead to acute encephalopathy and severe neurological sequelae. Objectives: To assess the intellectual outcome of children affected by leucinosis, by analysing various studies. Methods: A systematic review was carried out. Studies were collected from the PubMed and Web of Science databases, published between 1991 and 2025, which presented results of the intellectual impact on affected children. Five articles were included. Results: The studies analysed show that there is a strong relationship between high leucine levels and intelligence quotient, high values of leucine being associated with lower cognitive performance (median IQ=57). Early diagnosis, through neonatal screening, and prompt treatment have been shown to be decisive for better intellectual outcomes. Episodes of metabolic decompensation and poor adherence to treatment are related to greater neurocognitive damage, while adherence to diet and continuous monitoring have been shown to be protective factors. Even with adequate treatment, many children show alterations in neurocognitive development. Conclusions: It is essential to understand the impact of this disease on the intellectual performance of these children, in order to better target them therapeutically, educationally and socially.

Keywords: Children, Leucine, Intellectual Outcome.

References

1. Bouchereau, J. et al. (2017). Neurocognitive profiles in MSUD school-age patients. Journal of Inherited Metabolic Disease, 40(3), 377–383.

2. Hoffmann, B., Helbling, C., Schadewaldt, P., & Wendel, U. (2006). Impact of Longitudinal Plasma Leucine Levels on the Intellectual Outcome in Patients with Classic MSUD. Pediatric Research 2006 59:1, 59(1), 17–20.

3. Kaplan, P. et al. (1991). Intellectual outcome in children with maple syrup urine disease. The Journal of Pediatrics, 119(1), 46–50.

Abstract-Post-39 Personalized Medicine

The use of nanopharmaceuticals in the treatment of neoplasms - a review

Cateline Cruz¹, Cristiana Midões², Luís Nascimento³

¹Instituto Politécnico de Bragança, Bragança, Portugal.²Instituto Politécnico da Guarda, Guarda / BRIDGES - Biotechnology Research, Innovation and Design of Health Products, Guarda, Portugal.³Instituto Politécnico de Bragança, Research Centre for Active Living and Wellbeing (LiveWell), Bragança, Portugal. Corresponding Author: Luís Nascimento - [e-mail]

Background: Cancer is defined by the uncontrolled growth of cells, primarily driven by genetic mutations. Traditional treatments such as surgery, radiotherapy, and chemotherapy frequently fall short due to issues of non-specific targeting and systemic toxicity [1,2]. However, nanotechnology has decisively emerged as a vital solution to these problems. Nanopharmaceuticals are rigorously formulated, nanoscale pharmaceutical products that have received regulatory approval, while nanoparticle-based therapies represent a broader range of experimental applications ^[3]. Objectives: This review aims to assertively evaluate the relevance and effectiveness of nanopharmaceuticals in treating neoplasms based on solid scientific evidence. Methods: A systematic review was conducted, leveraging PubMed, MeSH Browser, SciELO, and Web of Science, focusing exclusively on articles published between January 2012 and October 2022 that pertain to nanotherapy for cancer. Studies addressing nanopharmaceuticals in non-cancer conditions or solely concentrating on conventional cancer treatments were rigorously excluded. Results: The analysis of ten selected articles demonstrates that nanoparticle-based therapies provide significant advantages over conventional treatments. These include enhanced intracellular uptake, improved biodistribution, and heightened drug accumulation at tumor sites. Notable nanopharmaceuticals such as SGT-94, BCc1, nab-paclitaxel, and others displayed superior pharmacokinetics and targeted delivery while minimizing systemic toxicity. The majority of studies reported robust safety profiles with manageable side effects and no serious toxicity. Conclusion: Nanomedicine represents a groundbreaking strategy for advancing cancer treatment by enhancing therapeutic precision and reducing adverse side effects. The compelling evidence firmly supports the expanding role of nanopharmaceuticals in oncology. It is imperative that further clinical studies validate their long-term efficacy and safety across larger populations.

Keywords: Nanoparticles, Antineoplastic Agents, Drug Delivery Systems

References

1. Gómez-Gallego, D. M., Urcuqui-Inchima, S., & Hernández, J. C. (2016). Efecto inmunomodulador de nanopartículas usadas en nanomedicina. IATREIA, 29(4), 445–457.

2. Irvine, D. J., & Dane, E. L. (2020). Enhancing cancer immunotherapy with nanomedicine. Nature Reviews Immunology, 20(5), 321–334.

3. Petrovic, S., Bita, B., & Barbinta-Patrascu, M.E. (2024). Nanoformulations in pharmaceutical and biomedical applications: Green perspectives. International Journal of Molecular Sciences, 25(11), 5842.

Abstract-Post-43 Personalized Medicine

ANTI-VEGF therapies in neovascular age-related macular degeneration: a scoping review of functional and morphological outcomes in older adults

Marta Queirós¹, Daniela Teixeira¹, Ângelo Jesus², Marlene Santos^2,3, Fernando Moreira², Sara R. Fernandes^1,4

¹Escola Superior de Saúde do Instituto Politécnico do Porto, Porto, Portugal.²LAQV/REQUIMTE, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal.³Molecular Oncology & Viral Pathology, IPO-Porto Research Center (CI-IPOP), Portuguese Institute of Oncology, Porto, Portugal.⁴LAQV, REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal. Corresponding author: Daniela Teixeira - [e-mail]

Background: Age-related macular degeneration (AMD) is one of the leading causes of blindness in individuals over 60 years of age and is classified into two main subtypes: geographic atrophy (dry AMD) and neovascular AMD (wet AMD). Anti-vascular endothelial growth factor (anti-VEGF) agents are the standard treatment for neovascular AMD, although guidelines diverge regarding first-line choices ^[1,2]. Objectives: This scoping review aims to identify and characterize current scientific evidence on the use of anti-VEGF agents in the treatment of neovascular AMD. Methods: A systematic search was conducted in PubMed for observational or experimental studies published between 2020 and April 2025. Eligible studies included individuals aged ⩾60 years, reported on the use of anti-VEGF therapy for neovascular AMD, and assessed both functional (visual acuity) and morphological outcomes. Results: Sixty-five studies met the inclusion criteria – 56 observational studies (prospective cohorts and cross-sectional designs), and nine clinical trials. Aflibercept (34%), faricimab (18%), and ranibizumab (15%) were the most commonly agents. Ranibizumab and aflibercept consistently improved visual acuity, with average gains of 7–15 ETDRS letters. Bevacizumab yielded more variable outcomes. In refractory patients, brolucizumab or faricimab showed anatomical improvements; however, brolucizumab was associated to higher risk of intraocular inflammation. Conclusions: The findings suggest that clinical and anatomical factors, such as persistent subretinal fluid, central retinal thickness, and initial treatment response, may help guide a more individualised selection of anti-VEGF. While ranibizumab and aflibercept remain well-established options, faricimab shows potential, in patients with suboptimal response to conventional agents.

Keywords: Anti-VEGF, Neovascular age-related macular degeneration, Visual acuity outcomes.

References

1. Ma, H., et al. (2023). Anti-VEGF Drugs in Age-Related Macular Degeneration: A Focus on Dosing Regimen-Related Safety and Efficacy. Drugs & Aging, 40(11), 991–1007.

2. Servillo, A., et al. (2023). The state-of-the-art pharmacotherapeutic management of neovascular age-related macular degeneration. Expert Opinion on Pharmacotherapy, 24(2), 197–206.

Abstract-Post-50 Personalized Medicine

Phage Therapy In Hospitals: A New Hope Against Antimicrobial Resistance

Sofia Vieira¹, Cláudia Marques¹, Marlene Ferreira¹, Vanessa Almeida¹, Vânia Oliveira¹

¹Unidade Local de Saúde de Entre Douro e Vouga, Santa Maria da Feira, Portugal. Corresponding author: Sofia Vieira - [e-mail]

Background: The global antimicrobial resistance crisis has created an urgent need for alternative therapies. Phage therapy — using bacteriophages that target and lyse bacteria — has re-emerged as a promising option for treating multidrug-resistant and complex infections. Unlike broad-spectrum antibiotics, phages offer a precise mechanism with less impact on beneficial microbiota. Their non-standardized production classifies them as magistral preparations under EU and national legislation. Objectives: This work aims to clarify the role of phage therapy as a clinical alternative to conventional antibiotics and describe the conditions for its preparation as a compounded medicine within hospital pharmacy services in Portugal, aligned with current regulatory frameworks. Methods: A literature review was conducted (2015–2024) using PubMed and Web of Science, focusing on clinical use, regulatory developments, and compounding methods in hospital pharmacy. Regulatory texts included Portuguese INFARMED Deliberation No. 112/CD/2024, the European Pharmacopoeia (5.31), and the Belgian National Monograph. A clinical case was analysed to illustrate phage therapy implementation in a Portuguese hospital, highlighting compounding, interdisciplinary collaboration, and outcomes. Results: The literature supports the safety and growing efficacy of phage therapy for complex infections. Portuguese INFARMED Deliberation No. 112/CD/2024 defines the regulatory framework for magistral bacteriophage preparation. Phages may be prepared from well-characterized stocks in sterile conditions. Ethical approval may depend on institutional context. A clinical case of Mycobacterium abscessus pulmonary infection showed improvement and tolerance, confirming feasibility. Conclusions: Successful implementation depends on strict adherence to national compounding guidelines. This structured approach supports safe integration into clinical practice as a timely alternative to antibiotics.

Keywords: Phage Therapy, Hospital Pharmacy, Compounded Medicines, Antimicrobial Resistance

References

1. Jalili, M., Ansari, N., Bakhtiari, S., & Jalilian, F. A. (2021). Phage therapy in the treatment of infectious diseases: An overview. Current Drug Therapy, 16(2), 120–128.

2. Maimaiti, Z., Li, Z., Xu, C., Chen, J., & Chai, W. (2023). Global trends and hotspots of phage therapy for bacterial infection: A bibliometric visualized analysis from 2001 to 2021. Frontiers in Microbiology, 13, 1067803.

3. Willy, C. et al. (2023). Phage therapy in Germany—Update 2023. Viruses, 15(2), 588.

Abstract-Post-60 Personalized Medicine

Vitamin D Supplements In The Prevention and/or Treatment Of Breast Cancer: Review Of The Literature

Beatriz Marques¹, João Lima¹, Clara Rocha¹, Jorge Balteiro¹

¹ESTeSC-Coimbra Health School, IPC, Coimbra, Portugal. Corresponding author: Beatriz Marques - [e-mail]

Background: The breast is one of the organs most affected by cancer, making it among the most prevalence and mortality neoplasms globally. Researchers are trying to reverse this situation by studying prevention measures and new treatments. Exposure to vitamin D has been investigated due to its possible antiproliferative effect. Objectives: This work aims to understand the influence of vitamin D supplements in the prevention and/or treatment of breast cancer. Methods: The present study is a narrative literature review, through a search using the keywords “breast cancer”, “supplementation”, “vitamin D”, in the PubMed and Google Scholar databases. Inclusion criteria were studies published in Portuguese or English, open access, published within the last 10 years and relevant to the research question. Results: 28 studies were analyzed [observational (n=16), clinical trials (n=4), meta-analyses (n=8)] exploring the relationship between vitamin D supplementation and breast cancer. Clinical trials showed that supplementation during chemotherapy increased the complete pathological response rate (39.5% versus 16.8%; p<0.001) ^[1]. A 12-month clinical study indicated reduced breast density after regular vitamin D supplementation ^[2]. Observational studies and meta-analyses revealed that over 60% of women diagnosed with breast cancer had vitamin D deficiency (<20 ng/mL), correlated with more aggressive tumors and poorer prognosis ^[3]. Conclusions: These findings support the potential role of vitamin D as an adjuvant in breast cancer therapy, while its prevention effect remains uncertain and needs further investigation. Vitamin D supplementation is beneficial when properly monitored, emphasizing the need for personalized strategies.

Keywords: Breast cancer, supplementation, vitamin D.

References

1. Özkurt, E. et al. (2025). Vitamin D Supplementation During Neoadjuvant Chemotherapy for Breast Cancer Improves Pathological Complete Response: A Prospective Randomized Clinical Trial. World Journal of Surgery, 49(6), 1396–1405.

2. McGuinness, J.E. et al. (2024). Effects of vitamin D supplementation on a deep learning–based mammographic evaluation in SWOG S0812. JNCI Cancer Spectrum, 8(4).

3. Voutsadakis, I. A. (2020). Vitamin D receptor (VDR) and metabolizing enzymes CYP27B1 and CYP24A1 in breast cancer. Spring Nature, 47(12), 9821–9830.

Abstract-Post-61 Personalized Medicine

DPYD Gene Polymorphisms as Key Determinants Of 5-Fluorouracil Therapy Efficacy and Safety

Susete Rodrigues¹, Rui Silva², Elisabete Bogas³, Joana Lucas⁴, Joana Fraga⁵, Sílvia Fonseca², Susana Oliveira⁶, Sónia Guilherme⁶, Ana Mendes⁶

¹Unidade Local de Saúde do Alto Alentejo, EPE, Portalegre, Portugal.²Instituto Português de Oncologia de Coimbra Francisco Gentil, EPE, Coimbra, Portugal.³Unidade Local de Saúde da Cova da Beira, EPE, Covilhã, Portugal.⁴Unidade Local de Saúde do Oeste, EPE, Caldas da Rainha, Portugal.⁵Autoridade Nacional do Medicamento e Produtos de Saúde, IP, Lisboa, Portugal. ⁶Unidade Local de Saúde de Coimbra, EPE, Coimbra, Portugal. Corresponding author: Susete Rodrigues - [e-mail]

Background: 5-Fluorouracil (5-FU) is a widely used anticancer drug, particularly in the treatment of gastrointestinal cancers. However, its narrow therapeutic index and marked between-patient variability in therapeutic response often result in severe toxicity. Objectives: This review aimed to examine the key factors contributing to variability in therapeutic response and toxicity associated with 5-FU therapy. Methods: A narrative review was conducted using articles retrieved from PubMed, with search terms including “5-fluorouracil”, “variability”, “toxicity” and “dihydropyrimidine dehydrogenase”. Inclusion criteria focused on research articles published between 2018 and 2025 that examined the relationship between various factors, including genetic variations, and the efficacy and toxicity of 5-fluorouracil. Eight articles met the inclusion criteria and were included in the review. Results: Several factors influence patient response to 5-FU, including sex, age, body weight, circadian rhythm, drug interactions, and particularly, the activity of dihydropyrimidine dehydrogenase (DPD) -the enzyme responsible for 5-FU catabolism. DPD activity is primarily determined by variants in the highly polymorphic DPYD gene. Among Europeans, the most frequent and clinically significant variants include c.1236G>A and c.2846A>T (polymorphisms associated with reduced activity), and c.1905+1G>A and c.1679T>G (polymorphisms linked to complete enzyme deficiency). Patients carrying these polymorphisms are at increased risk of severe toxicity and require significant dose reductions (25 to 50%) or avoidance of 5-FU. Conclusions: DPYD gene variants are the primary determinants of 5-FU-related toxicity. Although DPYD genotyping provides valuable guidance for initial dose selection, therapeutic drug monitoring remains essential for optimizing dosing, given the multifactorial nature of between-patient variability in 5-FU response.

Keywords: 5-Fluorouracil, dihydropyrimidine dehydrogenase, toxicity.

References

1. Tron, C., Lemaitre, F., Boisteau, E., Le Sourd, S., Lièvre, A. (2021). When helping the minority of patients may hurt the majority: The case for DPD phenotyping and 5-fluorouracil therapeutic drug monitoring. Digestive and Liver Disease, 53(2), 258–260.

2. Glewis, S. et al. (2025). Feasibility and population exposure of 5-fluorouracil using therapeutic drug monitoring (PREDICT-5FU): A multicentre clinical trial. British Journal of Clinical Pharmacology, 91(7):1965–1974.

3. Amstutz, U. et al. (2018). Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for Dihydropyrimidine Dehydrogenase Genotype and Fluoropyrimidine Dosing: 2017 Update. Clinical Pharmacology and Therapeutics, 103(2), 210–216.

TOPIC: MEDICATION MANAGEMENT AND SUSTAINABILITY

Abstract-Post-28 Medication Management and Sustainability

Closed-System Drug-Transfer Devices in Hazardous Drug Handling: Improving Occupational Safety

Cláudio Lourenço Oliveira¹, Cristiano Matos¹, João José Joaquim¹, Vítor Silva²

¹Escola Superior de Tecnologia da Saúde de Coimbra, Instituto Politécnico de Coimbra, Coimbra, Portugal.²Hospitais da Universidade de Coimbra (HUC), Unidade Local de Saúde (ULS) Coimbra, Coimbra, Portugal. Corresponding author: Cláudio Oliveira - [e-mail]

Background: Handling of hazardous drugs, such as antineoplastic agents, immunosuppressants, and antivirals, poses serious occupational risks, particularly in hospital settings and pharmaceutical compounding units. Exposure can occur through skin contact, inhalation, or contaminated surfaces, leading to adverse health effects such as reproductive toxicity, genetic damage, and increased cancer risk which constitutes a significant occupational hazard for healthcare workers^[1,2]. Objective: This review aims to compare closed-system drug transfer devices (CSTDs) with conventional drug-handling methods, considering factors such as quality, efficacy, and occupational safety. Methods: A narrative literature review was conducted, selecting studies published from 2010 onwards based on relevance to CSTDs and occupational safety. Sources included PubMed® and Google Scholar®, with inclusion based on title, abstract screening, and reference analysis. Results: International guidelines and multiple studies indicate that CSTDs significantly reduce occupational exposure. A multicenter study found that using a standardized CSTD protocol reduced surface contamination from 66.7% to 5.8% (Bartel et al., 2018). CSTDs also preserve the integrity of drug preparations by maintaining a closed, contamination-resistant environment, reducing the risk of compromised sterility or degradation. These improvements enhance both patient and worker safety while extending the usability of expensive medications. Nevertheless, CSTDs implementation involves economic and logistical challenges, including initial investment, integration into workflows, and staff training, which may limit their adoption in low-resource settings. Conclusion: CSTDs are a key innovation in hazardous drug management, offering enhanced protection for healthcare professionals and contributing to the safety and quality of compounding practices.

Keywords: Cytotoxic, antineoplastic agents, closed-system transfer devices

References

1. Bartel, S. B., Tyler, T. G., & Power, L. A. (2018). Multicenter evaluation of a new closed system drug-transfer device in reducing surface contamination by antineoplastic hazardous drugs. American Journal of Health-System Pharmacy, 75(4), 199–211.

2. Suspiro, A., & Prista, J. (2012). Occupational exposure to anticancer drugs and adverse health effects. In Revista Portuguesa de Saude Publica (Vol. 30, Issue 1, pp. 76–88). Ediciones Doyma, S.L.

Abstract-Post-41 Medication Management and Sustainability

Enhancing Pharmacy Technician Roles: Immunisation Training Program Development

Carolina Valeiro¹, Vítor Silva², Jorge Balteiro³, Diane Patterson⁴, Gilberto Bezerra⁴, Karen Mealiff⁴, Cristiano Matos¹, Ângelo Jesus⁵, João Joaquim³

¹European Association of Pharmacy Technicians, Brussels, Belgium.²Hospitais da Universidade de Coimbra (HUC), Unidade Local de Saúde de Coimbra, Coimbra, Portugal.³Escola Superior de Tecnologia da Saúde de Coimbra, Instituto Politécnico de Coimbra, Coimbra, Portugal. ⁴Technological University of the Shannon: Midlands, Athlone Campus Athlone, Ireland.⁵Escola Superior de Saúde do Instituto Politécnico do Porto, Porto, Portugal. Corresponding author – João Joaquim – [e-mail]

Background: Pharmacy technicians (PTs) are increasingly involved in immunisation services, enhancing accessibility and reducing pharmacies’ workload by taking on supportive tasks and helping with vaccine administration. Expanding their responsibilities requires appropriate training to ensure competence and regulatory compliance. Objective: Design and develop a training programme that equips PTs with the knowledge and skills necessary to support immunisation services safely and effectively. Methods: Comparative analysis of nine immunisation training programmes for health professionals (3 specific for PTs). Programmes were identified through official education providers and professional associations across multiple countries. Data on training organiser (e.g., institution or regulatory body), structure, duration, content, delivery methods, and certification were extracted. Results: A training program totalling 8-10 hours was developed, comprising 5-6 hours of theoretical instruction and 3-4 hours of supervised practical training. Modules included are immunology, anatomy, physiology, public health, pharmacovigilance, vaccine-specific knowledge, clinical safety, ethics, and hands-on practice. The course employs a diverse range of teaching methods (e-learning, virtual lectures, case-based discussions, role-playing exercises, and simulations). Competence is evaluated through quizzes, case analyses, and practical assessments. The programme is currently in the piloting phase and has not yet been implemented. Conclusions: By synthesizing evidence from existing curricula and aligning training content with the evolving role of PTs, this programme offers a structured, flexible, and practice-oriented approach to skills development. Its implementation may strengthen the readiness of PTs to participate in immunisation services, improve public health outcomes, and promote workforce.

Keywords: Pharmacy Technicians, Immunisation Training, Curriculum Development, Vaccine Delivery

Acknowledgements

This work was developed on behalf of the Erasmus+ KA2 project “Introducing Pharmacy Technicians as Immunizers through E-Learning” (2024-1-BE01-KA210-VET-000251165), funded by the European Commission.

References

1. DeMarco, M., Carter, C., Houle, S. K. D., & Waite, N. M. (2022). The role of pharmacy technicians in vaccination services: A scoping review. Journal of the American Pharmacists Association, 62(1), 15-26.e11.

2. Miran, N. K. et al. (2024). Vaccine administration by pharmacy technicians: Impact on vaccination volume, pharmacy workflow and job satisfaction. Exploratory Research in Clinical and Social Pharmacy, 13, 100397.

Abstract-Post-66 Medication Management and Sustainability

Attention Deficit Hyperactivity Disorder (ADHD): Drug Use In The Context of A Sars-Cov-2 Pandemic

Ismael Magalhães¹, Luís Nascimento^2,3, Joana Coelho^2,4,5

¹Instituto Politécnico de Bragança, Bragança, Portugal.²Departamento das Tecnologias de Diagnóstico e Terapêutica, Escola Superior de Saúde do Instituto Politécnico de Bragança, Bragança, Portugal.³CIMO- Centro de Investigação da Montanha, Bragança, Portugal.⁴Serviços Farmacêuticos da Unidade Hospitalar de Chaves da Unidade Local de Saúde Centro de Trás os-Montes e Alto Douro, E.P.E., Chaves, Portugal.⁵Centro Académico Clínico de Trás-os-Montes e Alto Douro (CACtmad) – Grupo de Cuidados Continuados e Paliativos, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal. Corresponding author: Joana Coelho - [e-mail]

Background: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood ^[1]. Pharmacological treatment, primarily with methylphenidate, is widely used ^[2,3]. This study evaluates ADHD drug consumption patterns before and during the SARS-CoV-2 pandemic. Objectives: To analyse the consumption of ADHD medicines in community pharmacies in Bragança before and during the SARSCoV-2 pandemic. Methods: A retrospective, observational, and quantitative study was conducted using data from eight pharmacies between 2018 and 2021. Data were collected through Sifarma and 4DigitalCare software and analysed using SPSS and Excel. Results: Medicine consumption was higher in the pre-pandemic period (2018–2019, 50.97%) than during the pandemic (2020–2021, 49.19%). However, 2021 recorded the highest annual consumption (27%). Ritalin© LA 20mg was the most dispensed medicine. The autumn season showed the highest usage. There was variability in dispensing volumes between pharmacies. Conclusions: The pandemic led to a temporary reduction in ADHD medicine use. Nevertheless, the increased consumption in 2021 suggests a possible delayed pharmacological response due to prolonged confinement. These findings underscore the impact of public health crises on the management of chronic conditions and highlight the need for consistent support for individuals with neurodevelopmental disorders.

Keywords: ADHD, COVID-19, methylphenidate

Acknowledgements

The authors would like to thank the Instituto Politécnico de Bragança for supporting the project, as well as all participants who responded to the survey. This abstract is presented on behalf of a research group.

References

1. Posner, J., Polanczyk, G. V., & Sonuga-Barke, E. (2020). Attention-deficit hyperactivity disorder. The Lancet, 395(10222), 450–462.

2. INFARMED – Autoridade Nacional do Medicamento e Produtos de Saúde, I.P. (2015). Medicamentos para a hiperatividade com défice de atenção: Análise da utilização.

3. Brant, L., & Carvalho, T. (2012). Metilfenidato: medicamento gadget da contemporaneidade. Interface - Comunicação, Saúde, Educação, 16(42), 623–636.

Abstract-Post-68 Medication Management and Sustainability

Home Medicine Storage: Assessment of Domestic Medication Storage Conditions In The Municipalities Of Bragança, Melgaço and Mondim De Basto

Ana Rei¹, Francisca Ribeiro¹, Márcia Pereira¹, Marta Daniela Ferreira¹, Sara Pereira¹, Joana Coelho^2,4,5, Luís Nascimento^2,3

¹Instituto Politécnico de Bragança, Bragança, Portugal.²Departamento das Tecnologias de Diagnóstico e Terapêutica, Escola Superior de Saúde do Instituto Politécnico de Bragança, Bragança, Portugal.³Research Centre for Active Living and Wellbeing (LiveWell), Instituto Politécnico de Bragança, Bragança.⁴Serviços Farmacêuticos da Unidade Hospitalar de Chaves da Unidade Local de Saúde Centro de Trás os-Montes e Alto Douro, E.P.E., Chaves, Portugal.⁵Centro Académico Clínico de Trás-os-Montes e Alto Douro (CACtmad) – Grupo de Cuidados Continuados e Paliativos, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal. Corresponding Author: Luís Nascimento - [e-mail]

Background: Medicines are often stored at home for emergencies or the treatment of acute and chronic conditions. However, improper storage—such as exposure to heat or humidity, or easy accessibility—can reduce efficacy and pose safety risks. These practices are frequently linked to limited health literacy and lack of pharmaceutical guidance. Objectives: This study aimed to evaluate household medication storage conditions in Bragança, Melgaço, and Mondim de Basto, examining the influence of sociodemographic variables and residents’ awareness of proper storage. Methods: A cross-sectional, quantitative, descriptive-correlational study was carried out using a structured online questionnaire with four sections: sociodemographic data, education, storage habits, and self-perceived knowledge. The questionnaire, while not formally validated, was based on existing literature. A non-probabilistic sample of 1126 residents aged ⩾18 years participated. Data were analysed using SPSS, with descriptive statistics and ANOVA to explore associations between storage practices and gender, age, and education. Results: Age, gender, and municipality did not significantly influence storage habits (p > 0.05), but education level was significant in Melgaço (p < 0.05). Participants stored medicines in diverse locations, such as kitchen or bathroom cabinets. Melgaço residents more often considered temperature and humidity. Examples of appropriate (e.g., keeping original packaging) and inappropriate (e.g., exposure to moisture) practices were reported. Conclusions: Educational level may influence medication storage practices. Tailored public health strategies and pharmaceutical counselling are essential to promote safe and rational medicine storage. Despite the absence of post-training evaluation, the findings highlight the need for awareness-raising interventions.

Keywords: Home medicine storage, pharmaceutical guidance, storage conditions

References

1. Huang, Y., Wang, L., Zhong, C., & Huang, S. (2019). Factors influencing attention to home medicine storage in China. BMC Public Health, 19, 1635.

2. Ocan, M., Bbosa, G. S., Waako, P., Ogwal-Okeng, J., & Obua, C. (2014). Factors predicting home storage of medicines in Northern Uganda. BMC Public Health, 14, 850.

3. Costa, A. M., Coelho, A., Graça, A., & Pedro, J. M. (2005). Uso racional do medicamento: Contributo da publicidade e da adequada conservação. Instituto Politécnico de Lisboa.

Abstract-Post-80 Medication Management and Sustainability

Safe Storage Of Medicines At Home: A Systematic Review

Ana Sousa¹, Ana Monteiro¹, Olivia Pereira¹, Sergio Teixeira¹, Xavier Costa¹

¹Instituto Politécnico de Bragança, Bragança, Portugal. Corresponding author: Olívia Pereira - [e-mail]

Background: Inadequate home storage of medicines compromises their stability and increases the risk of child access, storage of unused or expired medicines, and improper disposal [1-3]. Objectives: To evaluate, through a systematic review, home medicines storage practices, focusing on safety and associated risks. Methods: A systematic review was conducted in accordance with PRISMA guidelines, and the search was performed in the PubMed database between February and May 2025. The initial query retrieved 369,768 results for the keyword “safety”, which was reduced to 93 when combining “medicines” and “home storage.” After screening, 87 articles were excluded for not meeting the inclusion criteria: cross-sectional design, focus on household storage, involvement of community-based populations, last 15-year publication window. Six studies included in the final review. Results: Frequent inappropriate medicines storage locations, such as kitchens and bathrooms, was reported. In many cases, were stored within reach of children and expired and unused medicines were found in more than half of the households, and improper disposal practices were common. Higher levels of education and training in health-related fields were associated with safer storage and disposal practices. Conclusions: Improper storage and disposal of medicines are widespread among households. Educational interventions, public awareness campaigns, pharmacy-take back medicines programs, and greater involvement of healthcare professionals, are essential to promote safe use and proper disposal of medicines in household settings.

Keywords: safety, medicines, home storage

References

1. Samha, R., Wali, A., Kadri, S., Al-Assi, F., Al-Khalaf, A., Al-Deeb, A., et al. (2024). Knowledge and practices on home medication storage and disposal in Syria: A population-based, cross-sectional study. BMC Public Health, 24(1).

2. Louhisalmi, M., Lavikainen, P., Linden, K., Martikainen, J., & Timonen, J. (2024). Amount, type and storage of medicines in households: A survey for medicine users. Basic & Clinical Pharmacology & Toxicology, 134(1), 40–48.

3. Hendaus, M. A., Saleh, M., Darwish, S., Mostafa, O., Eltayeb, A., Al-Amri, M., et al. (2021). Parental perception of medications safe storage in the State of Qatar. Journal of Family Medicine and Primary Care, 10(8), 2969–2973.

Abstract-Post-83 Medication Management and Sustainability

Analysis of pharmaceutical waste management in bragança and são vicente

Marcos Fernandes, Marlen Sarmento¹, Olívia R. Pereira², Tânia Pires²

¹Instituto Politécnico de Bragança, Bragança, Portugal.²Research Centre for Active Living and Wellbeing (LiveWell), Instituto Politécnico de Bragança, Portugal. Corresponding author: Tânia Pires - [e-mail]

Background: Pharmaceutical waste is an increasing environmental concern, affecting water resources, soil, biodiversity, and public health, and contributing to the rise of antimicrobial resistance ^[1]. Objectives: To assess the knowledge, perception, and practices related to the disposal of pharmaceutical waste among students from the Polytechnic Institute of Bragança (IPB), in Portugal, and the University of Mindelo (UM), in Cape Verde. Methodology: A cross-sectional, descriptive study was conducted using a convenience and non-representative sample of students from IPB and UM. Data were collected via an online questionnaire structured around three dimensions: knowledge, perception, and disposal practices. Results: 118 students, 90 at IPB and 28 at UM, all aged 18 or older. Average age 23 (SD = 6.3); 78.8% female, 54.2% Health Sciences. 58% IPB students reported returning unused medicines to pharmacies. UM 32% reported proper disposal. Environmental awareness 58% IPB, 40% UM. Knowledge scores 8.51/10 IPB, 7.61/10 UM. 95.8% claimed to know disposal methods; 11.4% always followed. Conclusion: Results likely influenced by Portugal’s VALORMED system, with no equivalent in Cape Verde. Despite high awareness, proper disposal is limited. Opinions vary on the effectiveness of education, collection points, incentives, and legislation.

Keywords: Pharmaceutical waste disposal; Environmental awareness; Pharmaceutical waste management

Acknowledgements

This work is funded by national funds from FCT – Fundação para a Ciência e a Tecnologia, I.P., under the project/support UID/6157/2023.

Reference

1. Pereira de Andrade, E., Carvalho e Sousa, F., da Silva, R., & Silva Freitas, T. (2021). Impactos ambientais causados pelo descarte incorreto de medicamentos e sua relação com a saúde pública: Uma revisão literária. REVISTA DA FAESF: 5(3).

TOPIC: AI IN MEDICINES AND HEALTHCARE PRODUCTS

Abstract-Post-04 AI in Medicines and Healthcare Products

Who’s building the future of medicines? A global map of AI in drug discovery

Cristiana Midões¹

¹Polytechnic University of Guarda / BRIDGES - Biotechnology Research, Innovation and Design of Health Products, Guarda, Portugal. Corresponding author: Cristiana Midões - [e-mail]

Background: Artificial intelligence (AI) can accelerate drug development by increasing efficacy, reducing costs, and enabling faster and more precise discovery of new therapies ^[1]. By analyzing large amounts of information, predicting toxicity and pharmacokinetic profiles, and developing personalized therapies, AI holds promise for treating many diseases, reducing risks, and enhancing patient safety ^[2]. Objectives: To map and characterize companies that use artificial intelligence in drug development. Methods: An exploratory, qualitative, and descriptive study was conducted. Public information was collected and analyzed from company websites, scientific publications, and official communications. Additional data were gathered from business intelligence platforms such as Crunchbase and PitchBook, which provide insight into funding rounds, partnerships, and technological approaches. The companies were identified through targeted keyword searches (e.g., “AI in drug discovery”, “AI biotech startups”) and filtered based on their active involvement in the development of new drugs using artificial intelligence. Results: This study identified 33 companies utilizing AI for therapeutic development, with 45% (n = 15) based in Europe. A total of 144 projects were noted, including 30 in clinical trial phases I and/or II (20% of the total). Key focus areas include oncology, immunology, and rare diseases, with many projects aimed at drug repurposing and numerous partnerships with pharmaceutical firms. Conclusions: Artificial intelligence has great potential to accelerate and improve drug development, and its growing use indicates promising advances in the efficiency and precision of the pharmaceutical process. Therefore, AI can become an essential tool for safer, more efficient, and personalized medicine.

Keywords: Artificial Intelligence, Drug development, Patient safety

References

1. Patne, A. Y., Dhulipala, S. M., Lawless, W., Prakash, S., Mohapatra, S. S., & Mohapatra, S. (2024). Drug discovery in the age of artificial intelligence: Transformative target-based approaches. International Journal of Molecular Sciences, 25(22), 12233.

2. Kokudeva, M., Vichev, M., Naseva, E., Miteva, D. G., & Velikova, T. (2024). Artificial intelligence as a tool in drug discovery and development. World Journal of Experimental Medicine, 14(3), 96042.

Abstract-Post-46 AI in Medicines and Healthcare Products

E-Health strategies to promote treatment adherence in asthma and COPD: A scoping review

Helena Almeida¹, Olívia Gonçalves¹, Vânia Oliveira¹, Sara R. Fernandes^1,2, Marlene Santos^3,4, Fernando Moreira⁴, Ângelo Jesus⁴

¹Escola Superior de Saúde do Instituto Politécnico do Porto, Porto, Portugal.²LAQV, REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal.³Molecular Oncology & Viral Pathology, IPO-Porto Research Center (CI-IPOP), Portuguese Institute of Oncology, Porto, Portugal.0⁴LAQV/REQUIMTE, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal. Corresponding author: Olívia Gonçalves - [e-mail]

Background: The control of asthma and chronic obstructive pulmonary disease (COPD) depends on adherence to treatment, often administered via inhalation devices ^[1]. The digitalisation of healthcare has been suggested as a viable strategy to promote treatment adherence ^[2,3]. Objectives: This scoping review aimed to identify eHealth strategies promoting adherence to asthma and COPD treatment and to map the methodologies adopted in studies addressing this topic. Methods: A systematic search was conducted in PubMed and ScienceDirect to identify studies reporting the use of digital interventions applied to patients with asthma or COPD. Experimental and observational studies published between 2015 and 2025, in English or Portuguese, were included. Results: A total of 61 studies were identified, describing digital strategies with variable technology, interactivity, and integration with face-to-face healthcare services – 10 addressing the treatment of COPD, 47 for asthma treatment and four for both asthma and COPD. Most studies focused on mobile applications (n=31), followed by smart digital inhalers (n=13) and web-based platforms (n=12). Regarding outcomes, the assessment of the treatment adherence rates was performed in 85% of the studies, while 10% evaluated correct inhaler use. The heterogeneity of assessment methods (personalised feedback, automated reminders, and intake monitoring) limits direct comparison across studies. Conclusions: The use of digital strategies to enhance COPD and asthma treatment adherence has been consistently demonstrated. Effective integration of eHealth to improve treatment adherence in asthma and COPD requires personalized feedback, user-centered design, clinical follow-up, and equitable technology access.

Keywords: Digital Health, Treatment Adherence, Respiratory Diseases.

References

1. Zhang, S., King, D., Rosen, V. M., & Ismaila, A. S. (2020). Impact of Single Combination Inhaler versus Multiple Inhalers to Deliver the Same Medications for Patients with Asthma or COPD: A Systematic Literature Review. International Journal of Chronic Obstructive Pulmonary Disease, 15, 417–438.

2. Borghare, P. T., Methwani, D. A., & Pathade, A. G. (2024). A Comprehensive Review on Harnessing Wearable Technology for Enhanced Depression Treatment. Cureus, 16(8), e66173.

3. Miao, Y., Luo, Y., Zhao, Y., Liu, M., Wang, H., & Wu, Y. (2024). Effectiveness of eHealth Interventions in Improving Medication Adherence Among Patients with Cardiovascular Disease: Systematic Review and Meta-Analysis. Journal of Medical Internet Research, 26, e58013.

Abstract-Post-79 AI in Medicines and Healthcare Products

Artificial intelligence tools in community pharmacy: a literature review

Francisco Castro¹, Gonçalo Pires¹, Isabel Pinto¹, José Cunha¹, Luís Nascimento¹, Xavier Costa¹

¹Instituto Politécnico de Bragança, Bragança, Portugal. Corresponding Author: Isabel Pinto - [e-mail]

Background: Community pharmacies play a vital role in public health, serving as the first point of contact for many patients. With the increasing workload and complexity of care, artificial intelligence (AI) is being explored as a way to enhance pharmaceutical services ^[1-3]. Objective: This literature review aims to explore the current AI-based hardware and software technologies applied in community pharmacy, the barriers to their implementation, and their impact on pharmaceutical care. Methodology: A literature review was conducted using PubMed, focusing on articles from 2020 to 2025. Keywords included “artificial intelligence”, “community pharmacy”, “hardware”, “software” and “robots”. Inclusion criteria prioritized full-text studies of scoping reviews, systematic reviews or narrative reviews, about AI applications in community pharmacy. Results: The review identified a variety of AI tools, such as dispensing robots, decision-support systems, inventory management platforms, and chatbots. Benefits reported include improved medication adherence (up to +40%), reduced dispensing errors (up to -75%), and increased operational efficiency. Major implementation barriers are high costs, insufficient training, lack of technological infrastructure, and data privacy concerns. Conclusion: AI technologies offer promising opportunities to optimize processes and enhance patient safety in community pharmacy. However, successful integration requires strategic investment in training, infrastructure, and ethical safeguards to ensure safe and effective use.

Keywords: Artificial Intelligence, Community Pharmacy, Robots.

References

1. Jessica, H., et al. (2025). Applications of artificial intelligence in current pharmacy practice: A scoping review. Research in Social and Administrative Pharmacy, 21(3), 134–141.

2. Ranchon, F., et al. (2023). Development of artificial intelligence powered apps and tools for clinical pharmacy services: A systematic review. International Journal of Medical Informatics, 172, 104983.

3. Corey, L., et al. (2025). Effect of Uncertainty-Aware AI Models on Pharmacists’ Reaction Time and Decision-Making in a Web-Based Mock Medication Verification Task: Randomized Controlled Trial. JMIR Med Inform, 13, e64902.

TOPIC: REGULATORY STRATEGIES FOR DRUG RISK MANAGEMENT

Abstract-Post-01 Regulatory Strategies for Drug Risk Management

Handling of unconjugated monoclonal antibodies in oncology settings: recommendations and best practices

Maria Leonor Soares¹, Susana Sequeira^1,2

¹Escola Superior de Saúde da Universidade do Algarve, Faro, Portugal.²Unidade Local de Saúde do Algarve (Unidade Hospitalar de Faro), Faro, Portugal. Corresponding author: Maria Leonor Soares - [e-mail]

Background: The handling of unconjugated monoclonal antibodies (mAbs) in hospital settings is insufficiently regulated in Portugal. The absence of clear national guidelines puts healthcare professionals, particularly pharmacy technicians, at risk. Although not officially classified as hazardous drugs, unconjugated mAbs have inherent risk characteristics, including immunogenic potential, teratogenicity, and high bioactivity. Objectives: To identify gaps in the summaries of product characteristics (SmPCs) for 22 unconjugated mAbs identified during hospital training; to create an estimated risk table; to compare SmPC gaps with international guidelines; and to propose general and risk-adapted recommendations. Methods: A scoping review was conducted, including documentary analysis of SmPCs (Infomed), evaluation of international guidelines (European Commission, INRS, ISOPP, COSA), and a PubMed search. SmPCs were analyzed regarding aseptic technique, personal protective equipment (PPE), laminar flow cabinets, closed system drug-transfer devices (CSTDs), “do not shake” warnings, and handling by vulnerable professionals (e.g., pregnant, breastfeeding or planning a family). mAbs were also categorized as high, medium, or low risk based on therapeutic class, immunogenicity, teratogenicity, mutagenicity, and handling frequency. Results: Most SmPCs lacked recommendations on PPE, CSTDs, airflow cabinets or precautions for vulnerable groups. Based on the identified gaps and risk profiles, general and specific recommendations were developed. For example, the use of Class II biological safety cabinets was recommended for preparing all mAbs, regardless of risk level, an absent practice in most analyzed SmPCs. Conclusions: The findings support the urgent need for harmonized national recommendations to ensure safe handling of unconjugated mAbs in Portugal, aligned with international standards.

Keywords: monoclonal antibodies, safe handling, occupational safety

References

1. Alexander, M., et al. (2022). ISOPP Standards for the Safe Handling of Cytotoxics. Journal of Oncology Pharmacy Practice: Official Publication of the International Society of Oncology Pharmacy Practitioners, 28(3), S1–S126.

2. Ovensen JL, et al. (2024). NIOSH List of Hazardous Drugs in Healthcare Settings, 2024.

3. Ryan, M., Lam, N., Wright, K., & Siderov, J. (2023). Clinical Oncology Society of Australia Position Statement: 2022 update to the safe handling of monoclonal antibodies in healthcare settings. Asia-Pacific Journal of Clinical Oncology, 19(6), 723–730.

Abstract-Post-08 Regulatory Strategies for Drug Risk Management

The R.I.S.K. strategy: a one health-based approach to antimicrobial resistance from livestock and environmental sources

Cristiana Midões¹, Luísa Fernandes², Leonor Assude²

¹Polytechnic University of Guarda, Portugal/ BRIDGES - Biotechnology Research, Innovation and Design of Health Products, Guarda, Portugal.²Polytechnic University of Guarda, Portugal. Corresponding author: Cristiana Midões - [e-mail]

Background: Antimicrobial agents are essential for human, animal, and plant health and food safety. However, their intensive use in livestock production contributes to the acceleration of antimicrobial resistance (AMR) ^[1]. The One Health approach advocates for integrated actions to prevent infections and control resistance ^[2]. Objectives: This study aims to analyse scientific evidence linking the use of antibiotics in livestock to the emergence and spread of resistant bacteria, with implications for public health. Methods: Empirical studies published after 2020 in the PubMed and Science Direct databases, in English and Portuguese, were selected, excluding reviews. We used the key terms “agriculture,” “antibiotic,” “resistance,” and “human.” The R.I.S.K. analytical strategy—Resistance, Interconnection, Spread, and Knowledge—was developed to categorize and visualize findings across health sectors. Results: Seventeen articles met inclusion criteria. Ten studies focused on Resistance emergence (R); thirteen addressed Interconnection (I) between humans, animals, and the environment; eight examined Spread (S); and seven identified Knowledge gaps (K). Four studies examined specific antibiotic classes, covering almost all major groups. Transmission pathways were mainly through ingesting contaminated food and exposure to polluted water sources. Data confirmed presence of resistant bacteria in agroecosystems, impact on human and animal health, and environmental dissemination. Significant gaps persist in education, regulation, surveillance, and coordination across sectors. Conclusions: The R.I.S.K. strategy was relevant for organising complex evidence and highlighting critical AMR surveillance and control weaknesses. Strengthening integrated One Health responses is urgently needed to prevent further escalation of antimicrobial resistance and protect global health.

Keywords: Antimicrobial resistance, One Health, Public Health Safety.

References

1. World Health Organization, Food and Agriculture Organization of the United Nations, World Organisation for Animal Health, & United Nations Environment Programme. (2022). One health joint plan of action (2022–2026): Working together for the health of humans, animals, plants and the environment.

2. Guardabassi, L., Butaye, P., Dockrell, D. H., Fitzgerald, J. R., & Kuijper, E. J. (2020). One health: A multifaceted concept combining diverse approaches to prevent and control antimicrobial resistance. Clinical Microbiology and Infection, 26(12), 1604–1605.

Abstract-Post-29 Regulatory Strategies for Drug Risk Management

Implementation of safety strategies in the administration of Lasa and high-alert medications

Ângela Araújo¹, Cristiano Martins¹, Tânia Simões¹, Paulo Vieira¹, Pedro Oliveira²

¹Unidade Local de Saúde Barcelos/Esposende, EPE, Barcelos, Portugal.²Unidade Local de Saúde de Braga, Braga, Portugal. Corresponding author: Tânia Simões - [e-mail]

Background: Medication safety remains a challenge in clinical settings, requiring standardized practices and trained teams ^[1]. Guideline No. 008/2023 reinforces the need for a systematic approach to risk management throughout the medication-use process ^[2]. Additionally, DGS (2021) specifically addresses the risks associated with LASA medications, emphasizing the importance of clear identification and differentiation strategies ^[3]. Objective: To analyze Guideline N. 008/2023 and identify practical strategies for implementing safe medication practices, with a focus on look-LASA and high-alert medications (HAMs), promoting a patient-centered safety culture. Methods: An integrative literature review was conducted between 2018 and 2024 using Google Scholar, with the search terms “look-alike, sound-alike drugs”, “high-alert medications”, and “safety strategies”. Studies published in English and Portuguese were included, as well as guidelines issued by the DGS, addressing safety strategies in the administration of LASA and HAMs. A qualitative analysis identified key measures such as Tall Man lettering, physical segregation, electronic alerts, clinical decision support, staff training, and the promotion of a safety culture. Guideline No. 008/2023 was reviewed as the central normative reference. Results: Evidence highlights the importance of developing institutional lists of LASA and HAMs, using visual differentiation strategies, providing ongoing staff training, implementing incident reporting and analysis systems, conducting regular internal audits, and creating multidisciplinary safety workgroups. These measures contribute to error prevention and the strengthening of a safety culture. Conclusion: The implementation of standardized guidelines and procedures is essential to reduce adverse events and foster continuous improvement in healthcare quality and safety.

Keywords: Medication Safety, LASA Medications, Adverse Events

References

1. Fernandes Godinho, L., Carreira, C., & Martins, C. (2018). Medicamentos look-alike, sound-alike: Um velho conceito sempre em atualização look-alike, sound-alike drugs: An old concept always in update. Revista Da Sociedade Portuguesa de Anestesiologia, 27(3), 20–24.

2. Direção Geral da Saúde (2023). Medicamentos de alta vigilância.

3. Direção Geral da Saúde (2015). Medicamentos com nome ortográfico, fonético ou aspetos semelhantes.

TOPIC: OTHER

Abstract-Post-03 Other

The rational use of medicines in the treatment of vaginal fungal infections by the female population residing in Portugal

Tiago Oliveira¹, Ângelo Jesus², João Martins^1,3, Fernando Moreira²

¹Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal.²LAQV/REQUIMTE, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal.³CEAUL—Centro de Estatística e Aplicações, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal. Corresponding author: Tiago Oliveira - [e-mail]

Background: Vulvovaginal candidiasis is the second most common cause of vaginitis, affecting approximately 75% of women worldwide ^[1,2]. It can be classified as either uncomplicated or complicated vulvovaginal candidiasis ^[3]. Objectives: The aim of the present study is to assess the knowledge of the Portuguese female population regarding genitourinary infections and the appropriate selection of medicines for their treatment. Methods: This observational study included 519 female participants, aged 18 years or older, residing in Portugal, who responded anonymously to an online questionnaire, between 26 March and 10 April, 2024. The scientific validity of the questionnaire was assessed using Cronbach’s alpha, with a sample of 30 participants. Data were analysed using SPSS software, specifically employing Fisher’s exact test and the Kruskal–Walli’s test. Results: It was found that 78.1% of participants identified fewer than half of the risk factors for vulvovaginal candidiasis, while 64.16% incorrectly considered a malodour to be a characteristic symptom. Additionally, 93.3% were aware of fewer than half of the available medicines for the treatment of uncomplicated vulvovaginal candidiasis. Furthermore, 71.6% and 83.6% of participants reported lacking the autonomy to self-medicate in cases of uncomplicated and complicated vulvovaginal candidiasis, respectively. Conclusions: A knowledge gap was identified among Portuguese women regarding vulvovaginal candidiasis and its pharmacological treatment. Educational level and age were found to significantly influence women’s knowledge of condition. The study highlights a deficiency in literacy regarding vaginal fungal infections within the Portuguese female community.

Keywords: vulvovaginal candidiasis, women, antifungals

References

1. Anderson, M. R. (2004). Evaluation of Vaginal Complaints. JAMA, 291(11), 1368.

2. Workowski, K. A., Berman, S., & Centers for Disease Control and Prevention (CDC). (2010). Sexually transmitted diseases treatment guidelines, 2010. MMWR. Recommendations and Reports: Morbidity and Mortality Weekly Report. Recommendations and Reports, 59(RR-12), 1–110.

3. Achkar, J. M., & Fries, B. C. (2010). Candida infections of the genitourinary tract. Clin Microbiol Rev, 23(2), 253–273.

Abstract-Post-09 Other

Validation of a competency-based protocol for video simulation assessment in parenteral nutrition compounding

Sofia Vieira¹, Ângelo Jesus², Cristiano Matos³, Fernando Moreira²

¹Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal.²LAQV/REQUIMTE, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal.³Escola Superior de Tecnologia da Saúde de Coimbra, Instituto Politécnico de Coimbra, Coimbra, Portugal. Corresponding author: Sofia Vieira - [e-mail]

Background: Compounding PN is a complex and high-risk task for pharmacy professionals, with documented reports of serious injuries and even fatalities linked to errors in this process. Consequently, comprehensive training and rigorous assessment are crucial for pharmacy students and professionals involved in PN compounding. Objectives: This work aimed to develop and validate a protocol for an asynchronous assessment program specifically designed for compounding PN admixtures. Methods: The program is based on a video simulation, where individuals identify deliberately introduced errors in a simulated environment. We conducted a comprehensive literature search across PubMed and Web of Science (2004-2023) to identify the essential contents for a robust PN compounding assessment program. Concurrently, for a Delphi panel evaluated the assessment script. Results: A preliminary document outlining specific key competencies was developed. These competencies included: (i) meticulous aseptic technique, (ii) accurate volume measurement, (iii) understanding component compatibility, (iv) proficient use of puncture devices, and (v) correct manipulation of glass ampoules. The panel comprised 54 experts that met the inclusion criteria (minimum 5 years of experience in PN compounding and higher education in pharmacy). A consensus of 80% or higher was successfully achieved among the expert panel on the identified competencies. This significant agreement validates the proposed content for the assessment program. Conclusion: With this validation, it will be possible to create the video in accordance with the recommendations from the literature as well as expert opinions. This asynchronous health simulation is expected to enhance the assessment of pharmacy students and professionals in PN compounding.

Keywords: Parenteral Nutrition, Health Simulation, Pharmacy Assessment

References

1. Garnier, A., Vanherp, R., Bonnabry, P., & Bouchoud, L. (2023). Use of simulation for education in hospital pharmaceutical technologies: A systematic review. European Journal of Hospital Pharmacy, 30(2), 70.

2. Mirtallo, J. et al. (2004). Task Force for the Revision of Safe Practices for Parenteral Nutrition—Safe Practices for Parenteral Nutrition. Journal of Parenteral and Enteral Nutrition, 28(6).

3. Worthington, P. et al. (2017). When Is Parenteral Nutrition Appropriate? Journal of Parenteral and Enteral Nutrition, 41(3), 324–377.

Abstract-Post-20 Other

Sources of information used by the Portuguese population regarding generic drugs

Maria Maia¹, Clara Rocha¹, Jorge Balteiro¹

¹ESTeSC-Coimbra Health School, IPC, Coimbra, Portugal. Corresponding author: Maria Maia - [e-mail]

Background: By using Generic Drugs (GD), patients gain access to treatments at a lower cost and with a more favourable cost/benefit ratio. However, there remains some distrust regarding the safety and efficacy of GD. Pharmacy professionals and doctors play a key role in the decision-making process of patients, as they are considered credible and trustworthy sources of information^[1-3]. Objectives: Determine the sources of information used by the population to gain knowledge about GD. Methods: Observational and cross-sectional study. The sample size was calculated with a 95% confidence level and a 5% margin of error, resulting in a sample of 609 individuals. Data were collected through non-probability convenience sampling between February 2023 and May 2024, using a questionnaire administered at a community pharmacy and online. Results: Among the 609 respondents, 81.3% identified Pharmacy Professionals as their main source of information, followed by doctors (63.2%) and Healthcare Institutions (46.8%). Individuals with higher levels of education are more likely to use leaflets/magazines. Television/radio are most used by men and younger individuals. Family/friends/neighbors are the most cited sources by those with lower education levels and by older individuals. These associations are statistically significant (p<0.05). Conclusion: Results show that healthcare professionals are the most frequently used source of information, making patients more capable of making informed and responsible choices regarding the purchase of GD. It is of utmost importance to implement measures aimed at increasing knowledge about GD across the entire population.

Keywords: Generic Drugs, Sources of Information, Pharmacy Professionals

References

1. Oncu, S. et al. (2021). Knowledge, opinions and attitudes of primary care physicians about generic drugs: a cross-sectional study. Family Practice, 38(3), 272–279.

2. Hatem, G. et al. (2023). Knowledge, perception and acceptance of generic drugs in the general Lebanese population: A cross-sectional survey among adults. Journal of Medicine Access, 7.

3. Duque, M., Rocha, C., & Balteiro, J. (2014). Adesão dos utentes aos medicamentos genéricos. Revista Portuguesa de Saúde Pública, 32(2), 181–187.

Abstract-Post-21 Other

Imperfect apples with antimicrobial potential

Tatiana Ribeiro^1,2, Pablo Garcia³, Luisa Barreiros⁴, Patrícia Correia^1,2

¹Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal.²REQUIMTE/LAQV, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal.³Departamento de Ciências Farmacêuticas, Faculdade de Farmácia, Universidade de Salamanca, Salamanca, Spain. ⁴LAQV/REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal. Corresponding author: Tatiana Ribeiro - [e-mail]

Background: Apples are one of the most rejected fruits when they don’t have the appearance appreciated by the consumer ^[1]. The apple processing industry also generates a lot of waste. This fruit is rich in phytochemicals, but many are complex and have low bioavailability ^[2]. Fermentation is a metabolic process in which complex sugars are converted into small alcohols or organic acids, simpler compounds with greater oral and cutaneous bioavailability ^[3]. Objectives: Enhance, through fermentation, the microbial inhibition capacity of apple waste, combining the concept of circular and sustainable economy. Methods: The apples were supplied by the “Fruta Feia” cooperative, which aims to end food waste of fruits and vegetables due to their imperfect appearance. Different parts of the apple, prepared in different ways and adding sterile water, were fermented in flasks placed in an incubator at 30 °C. Samples were collected every 24 hours and the pH was measured. The fermented products were analyzed to evaluate the antimicrobial activity by measuring the inhibition halo for several species. Results: The tests using apple pulp resulted in a greater inhibition halo. It would be interesting to vary the state of fruit division, as well as to perform biostimulation and bioinoculation tests. Regarding the species tested, fermented apple pulp demonstrated greater activity in the sensitivity test for Staphylococcus aureus, Bacillus cereus, Pseudomonas aeruginosa and Staphylococcus epidermidis. Conclusions: Apples that are rejected by the commercial circuit can be valued through fermentation, showing promising antimicrobial activity for some bacterial species.

Keywords: apple, fermentation, antimicrobial activity.

References

1. Barreira, J., Arraibi, A. & Ferreira, I. (2019). Bioactive and functional compounds in apple pomace from juice and cider manufacturing: Potential use in dermal formulations. Trends Food Sci. Technol., 90, 76-87.

2. Ke˛dzia, M., Lewińska, A., Jaromin, A., Weselski, M., Pluskota, R. & Łukaszewicza, M. (2019). Fermentation parameters and conditions affecting levan production and its potential applications in cosmetics. Bioorganic Chemistry, 1-8.

3. Moon, K., et al. (2019). Development of systems for the production of plant-derived biopharmaceuticals. Plants, 9, 1-3.

Abstract-Post-22 Other

Mental health and anxiolytics in times of covid-19

Mafalda Machado¹, Jorge Balteiro¹, Clara Rocha¹

¹ESTESC-Coimbra Health School, IPC, Coimbra, Portugal. Corresponding author: Mafalda Machado - [e-mail]

Background: The COVID-19 pandemic has triggered not only a global health emergency but also a significant psychological impact ^[1]. Anxiety has emerged as one of the most prevalent psychiatric outcomes, often intensifying other mental health disorders and reducing overall quality of life ^[1,2]. This rise in anxiety has led to increased use of pharmacological treatments, particularly anxiolytics ^[1,2,3]. Objectives: To examine the relationship between the COVID-19 pandemic and the use of anxiolytic medications, focusing on anxiety levels within the adult Portuguese population. Methods: A descriptive, cross-sectional study was conducted using an online questionnaire distributed to Portuguese adults between January and February 2022. The Beck Anxiety Inventory was used to assess anxiety levels. The survey also gathered data on the use of pharmacological and non-pharmacological strategies for managing anxiety. Results: The findings indicated that 13.1% of participants exhibited severe anxiety, while 20.4% presented moderate anxiety. A notable increase in the consumption of anxiolytic medications was observed, with 81% of medicated participants reporting the use of anxiolytics. Furthermore, 70.8% had been using these medications for a duration exceeding three months. Additionally, 28.5% of respondents reported engaging in non-pharmacological methods to cope with anxiety symptoms. Conclusions: The COVID-19 pandemic was associated with increased anxiety levels and a greater reliance on anxiolytic medications among Portuguese adults. These findings highlight the urgent need for public health strategies aimed at preventing and managing anxiety through both pharmacological and alternative approaches.

Keywords: COVID-19; Mental Health; Anxiolytics.

References

1. Diez-Quevedo, C. et al. (2021). Mental disorders, psychopharmacological treatments, and mortality in 2150 COVID-19 Spanish inpatients. Acta Psychiatrica Scandinavica, 143(6), 526–534.

2. Alqudah, A. et al. (2021). About anxiety levels and anti-anxiety drugs among quarantined undergraduate Jordanian students during COVID-19 pandemic. International Journal of Clinical Practice, 75(7), e14112.

3. Sarangi, A., McMahon, T., & Gude, J. (2021). Benzodiazepine misuse: An epidemic within a pandemic. Cureus, 13(6), e15743.

Abstract-Post-25 Other

Beer raw materials: evaluation of antioxidant activity and potential skin benefits

Maria João Pereira¹, Diana Santos¹, Cláudia Pinho², Ana Isabel Oliveira²

¹Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal.²REQUIMTE/LAQV, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal. Corresponding author: Maria João Pereira - [e-mail]

Background: Malt and hop extracts have shown promising skin benefits, but scientific evidence is scarce ^[1]. Objectives: To evaluate, in vitro, the potential of aqueous extracts of malt and hops for antioxidant, photoprotective and metabolic activity in human keratinocytes (HaCaT cells). Methods: Experimental study, with the preparation of aqueous extracts of three malts (Chocolate, Munich and Vienna) and hops (Saaz, Citra and Mosaic), according to Silva et al. (2022) ^[2]. Total of phenolic compounds (TPC), antioxidant (hydrogen peroxide neutralization assay), photoprotective (sun protection factor- SPF), and metabolic activity of HaCaT cells (3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide -MTT assay) were evaluated. Data were analysed using the one-way ANOVA test and significant differences were considered for p < 0.05. Results: The aqueous extracts of hops showed higher TPC (54.20±1.56 - 90.02±0.48 mg GAE/g), antioxidant (1.88±0.11 < IC₅₀ < 3.81±0.15 μg/mL) and photoprotective activity (173.77±2.75 < SPF < 213.97±4.77), compared to malt extracts (10.97±0.48 < TPC < 21.18±0.40 mg GAE/g, 11.67±0.63 < IC₅₀ < 17.63±0.46 μg/mL and 21.22±0.12 < SPF < 79.53±0.93) (p < 0.05). Generally, cell viability was higher than 80% at the concentrations tested (1 - 500 μg/mL). The hop extracts had higher cell viabilities than the control (culture medium), showing greater potential for skin regeneration. Saaz hops have the highest TPC and SPF (p < 0.05). Conclusions: The extracts show promising activities, mainly hops extracts, at the cutaneous level, but further studies are needed to corroborate the activities studied and the possibility of integrating them into cosmetic formulation.

Keywords: Malt, Hop, Skin

Acknowledgements

This work received financial support from the PT national funds (FCT/MECI, Fundação para a Ciência e Tecnologia and Ministério da Educação, Ciência e Inovação) through the project UID/50006 -Laboratório Associado para a Química Verde - Tecnologias e Processos Limpos.

References

1. Censi, R., Peregrina, D. V., Gigliobianco, M. R., Pruccoli, L., Tarozzi, A., Martino, P. D., Lupidi, G., & Angeloni, C. (2021). New antioxidant ingredients from brewery by-products for cosmetic formulations. Cosmetics, 8(96).

2. Silva, S., Oliveira, A. I., Cruz, A., Oliveira, R. F., Almeida, R., & Pinho, C. (2022). Physicochemical properties and antioxidant activity Portuguese craft beers and raw materials. Molecules, 27(8007).

Abstract-Post-36 Other

Efficacy versus effectiveness. what is the impact of these parameters on the process of evaluating a medication?

Ana Deus¹, Maria Penha¹, Sílvia Carrilho¹, Sónia Silva¹

¹Escola Superior de Tecnologia da Saúde de Lisboa – Instituto Politécnico de Lisboa, Portugal. Corresponding author: Ana Deus - [e-mail]

Background: This narrative review explores the distinction between efficacy and effectiveness in medication evaluation. While efficacy reflects a medicine’s performance under controlled, ideal conditions, effectiveness relates to its impact in real-world clinical settings. Understanding this difference is crucial for accurate drug assessment and informed clinical, regulatory, and policy decisions. Objective: The purpose of this article is to present a narrative review on the impact of the parameter’s efficacy and effectiveness in the process of evaluating a medicine. Methods: The review was carried out in three databases: PubMed, Scopus and Web of Science. The search strategy involved the construction of a Boolean combination for each of the databases used. The definition of inclusion criteria is based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) model. The inclusion criteria were articles written in English, containing terms such as efficacy and effectiveness, as well as comparison of results, and published between 2004 and 2024. This review took place in November of 2024. Results: 83 records were initially obtained. From these 83 records, 11 articles were selected to prepare this article, taking into account the eligibility criteria. The studies showed different results depending on whether they analyzed effectiveness and/or efficacy. Conclusion: The parameters of efficacy and effectiveness have a significant impact on the evaluation of a medicine, as a drug may have high efficacy, but if it is not effective in the real world, its impact on public health remains limited.

Keywords: Efficacy, Effectiveness, Evaluation of a medicine.

References

1. Clark, W., Jobanputra, P., Barton, P., & Burls, A. (2004). The clinical and cost-effectiveness of anakinra for the treatment of rheumatoid arthritis in adults: a systematic review and economic analysis. Health Technology Assessment, 8(18).

2. Derchi, G., & Forni, G. L. (2005). Therapeutic Approaches to Pulmonary Hypertension in Hemoglobinopathies: Efficacy and Safety of Sildenafil in the Treatment of Severe Pulmonary Hypertension in Patients with Hemoglobinopathy. Annals of the New York Academy of Sciences, 1054(1), 471–475.

3. Dodick, D., Brandes, J., Elkind, A., Mathew, N., & Rodichok, L. (2005). Speed of Onset, Efficacy and Tolerability of Zolmitriptan Nasal Spray in the Acute Treatment of Migraine. CNS Drugs, 19(2), 125–136.

Abstract-Post-42 Other

Towards harmonisation: mapping pharmacy technician roles and skills across European EQF levels

Carolina Valeiro¹, Vitor Silva², João Joaquim³, Ângelo Jesus⁴, Simon Tee-Carter⁵, Tao Zhang⁵, Sean a Hogan⁵, Gemma Kinsella⁵, Christine O’Connor⁵, Isabel Elguero Claramunt⁶, M. Jesús Aparicio Cabezas⁶, Alejandra Reyes Moreno⁶, Antonio Rodrigo Díaz⁶, Cristiano Matos¹

¹European Association of Pharmacy Technicians, Brussels, Belgium.²Centro Hospitalar e Universitário de Coimbra - Unidade Local de Saúde de Coimbra, Coimbra, Portugal.³Escola Superior de Tecnologia da Saúde de Coimbra, Instituto Politécnico de Coimbra, Coimbra, Portugal. ⁴Escola Superior de Saúde do Instituto Politécnico do Porto, Porto, Portugal.⁵Pharmacy Technician Studies Team, Technological University Dublin, Dublin, Ireland.⁶Formación Profesional Colegio Tres Olivos, Madrid, Spain. Corresponding author: Carolina Valeiro – [e-mail]

Background: Pharmacy Technicians (PTs) play vital roles in European healthcare systems. However, their qualifications, responsibilities, and skillsets vary significantly across countries, influenced by differences in educational systems, national regulations, and assigned European Qualifications Framework (EQF) levels ^[1]. Objective: Map and compare roles, responsibilities, and skills across EQF Levels 4, 5, and 6, identify key differences and progression pathways to inform education, policy, and workforce development strategies. Methods: A qualitative comparative analysis was conducted based on national professional profiles, curricula, and institutional documentation related to PT roles and qualifications, across Portugal, Ireland, Spain, and Belgium. The study focused on EQF Levels 4 to 6, exploring PTs responsibilities, professional competencies, and transferable skills across community and hospital pharmacy settings. Results: EQF Level 4 PTs perform foundational tasks such as medication dispensing, stock management, pharmacovigilance support, and non-sterile compounding. At EQF Level 5, PTs demonstrate greater autonomy and scientific understanding, contributing to microbiological processes, vaccine programmes, and reimbursement systems. EQF Level 6 PTs, seen only in Portugal, take on advanced clinical and managerial roles, including protocol development, clinical risk assessments, quality assurance, and evidence-based practice. Progression reflects increasing complexity, responsibility, and the development of transferable skills such as leadership, communication, and critical thinking. Conclusions: There is a clear skills and responsibility gradient across EQF levels for PTs. Harmonising qualifications and expectations at the European level could support professional mobility, ensure consistent professional standards, and better prepare PTs for their expanding role in modern healthcare systems.

Keywords: Pharmacy Technicians, European Qualifications Framework, Competency Mapping

Acknowledgements

This work was developed as part of the Erasmus+ KA2 project PharmTech Mobility: Enhancing European Pharmacy Technician Exchange and Mobility (2024-1-IE01-KA210-VET-000245362) funded by the European Commission.

Reference

1. European Union. (2025). Description of the eight EQF levels.

Abstract-Post-51 Other

Impact of the covid-19 pandemic on the consumption of immunological supplements among higher education students

Ânnia Graça¹, Giovanni Afonseca¹, Levinior Delgado¹, Cristiana Midões², Luís Nascimento³

¹Instituto Politécnico de Bragança, Bragança, Portugal.²Instituto Politécnico da Guarda / BRIDGES - Biotechnology Research, Innovation and Design of Health Products, Guarda, Portugal.³Centre for Active Living and Wellbeing (LiveWell), Instituto Politécnico de Bragança, Bragança, Portugal. Corresponding author: Luís Nascimento - [e-mail]

Background: Scientific evidence has shown that supplementation with micronutrients, including vitamins C, D, and E, as well as zinc and selenium, plays a key role in supporting immune function, thereby helping to reduce susceptibility to infections, including respiratory infections ^[1]. In addition, recent analyses have shown that the use of nutritional supplements, particularly antioxidants and vitamins, can be beneficial during the post-COVID-19 recovery process, promoting an improvement in overall health and reducing persistent chronic inflammation ^[2]. Objectives: To characterize the consumption of immune supplements before and after the start of the COVID-19 pandemic among students at the Health School of the Polytechnic University of Bragança. Methods: Descriptive-correlational study, based on an online survey with 19 questions, applied to health students enrolled in 2021/2022 (⩾18 years old). The sample (n=320) was calculated based on a 95% confidence interval and 5% margin of error. Results: The majority of students (77%) reported awareness of immune supplements, and 63.5% stated they used them to support immune health. Consumption increased in 71.7% of cases after the start of the pandemic, with 85.4% indicating use only during specific periods. The most commonly used supplement contained vitamin C. Decisions to use supplements were primarily personal (40.4%) or based on informal advice. Notably, 56.3% began supplementation after the pandemic began. Conclusion: The findings reveal lasting changes in the health behaviours of higher education students, with a high perceived usefulness of immune-related food supplements even after the peak of the pandemic.

Keywords: Immune supplements, Health students, COVID-19

References

1. Gombart, A. F., Pierre, A., & Maggini, S. (2020). A review of micronutrients and the immune system–working in harmony to reduce the risk of infection. Nutrients, 12(1), 236.

2. Jamali, M., Jalali, M., Parvizian, N., Sadeghi, A., Behnoush, A. H., & Poustchi, H. (2024). The effect of macronutrient and micronutrient supplements on COVID-19: An umbrella review. Journal of Health, Population and Nutrition, 43(1), 2.

Abstract-Post-52 Other

The therapeutic potential of Punicalagin in the prevention and treatment of covid-19

Inês Sousa¹, Vera Rodrigues¹

¹Instituto Politécnico de Coimbra, Escola Superior de Tecnologia da Saúde, UCP Farmácia, Coimbra, Portugal. Corresponding Author: Inês Sousa - [e-mail]

Background: COVID-19 was first identified in China in December 2019. It is a single-stranded, positive-sense RNA virus whose entry into the host cell is mediated by the Spike protein, through interaction with ACE. Antiviral repositioning and prophylactic measures have been adopted strategies. Recent evidence points to the pharmacological potential of punicalagin, a polyphenol presents in the pomegranate peel, revealing it as a promising approach in supporting the prevention and treatment of COVID-19 ^[1-3]. Objectives: This review aims to gather information on punicalagin and its impact on the mechanism of action of SARS-CoV-2 infection, identifying possible therapeutic targets for this compound. Methods: A search for scientific articles in PubMed, Scielo, and Google Scholar included 15 articles, including 9 systematic reviews, 4 experimental studies conducted in vitro and in silico, 1 conducted in humans, and 1 cross-sectional study. The included studies were published between 2019 and 2024. Results and Discussion: Studies demonstrate that punicalagin effectively inhibits Spike-ECA binding and 3CL protease activity. These effects are dose-dependent and exhibit low cellular toxicity. Other studies identify potential promising therapeutic targets, such as RdRp-Nsp12, HE protein, and the RBD domain of the spike [1-3]. Conclusion: Punicalagin appears to be a promising compound due to its interaction with some SARS-CoV-2 structures. Despite its therapeutic potential, further clinical studies are needed to demonstrate its efficacy and safety in humans.

Keywords: Punicalagin; COVID-19; Therapeutic Potential

References

1. Chen, H. F. et al. (2023). The natural tannins oligomeric proanthocyanidins and punicalagin are potent inhibitors of infection by SARS-CoV-2. ELife, 12.

2. Saadh, M. J. et al. (2021). Punicalagin and zinc (II) ions inhibit the activity of SARS-CoV-2 3CL-protease in vitro.

3. Suručić, R. et al. (2021). Pomegranate peel extract polyphenols attenuate the SARS-CoV-2 S-glycoprotein binding ability to ACE2 Receptor: In silico and in vitro studies. Bioorganic Chemistry, 114.

Abstract-Post-63 Other

Valorisation of pomegranate surpluses by fermentation and evaluation of its antioxidant activity

Beatriz Dourado¹, Tatiana Ribeiro^1,2, Luisa Barreiros^1,3, Patrícia Correia^1,2

¹Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal.²REQUIMTE/LAQV, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal ³REQUIMTE/LAQV, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal. Corresponding author: Tatiana Ribeiro - [e-mail].

Background: Fruits are antioxidants’ natural sources, having numerous therapeutic properties ^[1]. Pomegranate (Punica granatum) stands out for its high antioxidant activity ^[2]. Nevertheless, its consumption and processing generate by-products such surpluses of whole fruit or isolated parts. This waste can be valued by microbial fermentation, that improves bioavailability and functional properties ^[3], allowing its reutilization for food purposes, as dietary supplements and cosmetic products. Objectives: This study aimed at evaluating the antioxidant activity of the products resulting from pomegranate fermentation. Methods: Four fermentation assays were carried out on pomegranate surpluses collected in the market, using the fruit autochthonous microorganisms and several isolated or mixed fruit parts (peels, seeds, membranes and pulp). Each assay was performed in duplicate and monitored until a reduced and stable pH value was attained. The antioxidant activity was assessed using the Folin-Ciocalteu method, Cupric Reducing Antioxidant Capacity method, and the total antioxidant capacity using 2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) method. Results: Analysing the results of the three methods, pomegranate by-products were found to have antioxidant activity under all the conditions tested. Samples with peel and membranes showed the highest antioxidant activity (213.08-607.79 µmol/g), followed by the mixture of pulp, seeds and membranes (7.77-30.51 µmol/g), and the lowest activity was observed with only pulp (1.91-7.03 µmol/g). Conclusions: This study promotes a sustainable approach to use surpluses resulting from food waste and fruit processing industries, indicating the possibility of economically valuing them as functional resources in the pharmaceutical and food industry.

Keywords: Pomegranate, fermentation, antioxidant activity.

References

1. Rahaman, M. M., Hossain, R., Herrera-Bravo, J., Islam, M. T., Atolani, O., Adeyemi, O. S., Owolodun, O. A., Kambizi, L., Daştan, S. D., Calina, D., & Sharifi-Rad, J. (2023). Natural antioxidants from some fruits, seeds, foods, natural products, and associated health benefits: An update. Food Science & Nutrition, 11(4), 1657.

2. Chan, L. P., Tseng, Y. P., Liu, C., & Liang, C. H. (2022). Fermented pomegranate extracts protect against oxidative stress and aging of skin. Journal of Cosmetic Dermatology, 21(5), 2236–2245.

3. Erskine, E., Ozkan, G., Lu, B., & Capanoglu, E. (2023). Effects of Fermentation Process on the Antioxidant Capacity of Fruit Byproducts. ACS Omega, 8(5), 4543–4553.

Abstract-Post-64 Other

Innovative transdermal therapy: ibuprofen ionic liquids for inflammatory bowel disease

Jéssica Vitoriano¹, Rui Pinto², Inês Silva^2,3

¹Faculdade de Farmácia, Universidade de Lisboa, Lisboa, Portugal.²iMed.ULisboa, Faculdade de Farmácia, Universidade de Lisboa, Lisboa, Portugal.³H&TRC-Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisboa, Portugal. Corresponding author: Inês Silva - [e-mail]

Background: Inflammatory bowel disease is a chronic gastrointestinal condition with increasing incidence and prevalence. Current treatments are primarily palliative and often leads to severe adverse effects and refractory cases. Ionic liquids allied with transdermal delivery offer an alternative to oral ibuprofen, harnessing its anti-inflammatory effect while reducing toxicity by bypassing direct gastrointestinal tract exposure. Objectives: The aim of this study is to evaluate the efficacy and safety of transdermal ibuprofen-based ionic liquids, [N1,1,6,2OH1][Ibu] and [N1,1,8,2OH1][Ibu]. Methods: The human immortalized keratinocyte cell line, HaCaT, was treated for 24 hours with 20 µg/mL and 40 µg/mL of [N1,1,6,2OH1][Ibu] and [N1,1,8,2OH1][Ibu]. Several assays were performed to evaluate cellular proliferation, viability, and cytotoxicity. Chronic colitis was induced in female CD-1 mice by weekly intrarectal administrations of 1% 2,4,6 trinitrobenzenesulfonic acid (TNBS) for 5 weeks. Mice were treated for 14 consecutive days with transdermal patches containing either [N1,1,6,2OH1][Ibu] or [N1,1,8,2OH1][Ibu], at doses of 20 mg/kg/day or 40 mg/kg/day. Physiological, biochemical, and histological parameters were evaluated; Results: Ibuprofen-based ionic liquids exhibit no toxicity towards HaCaT cells and demonstrated in vivo anti-inflammatory effect through the reduction of fecal hemoglobin, fecal calprotectin, alkaline phosphatase, tumor necrosis factor alpha, and interleukin-10. Macroscopic score confirmed the absence of gastric mucosa lesions; Conclusions: These findings support transdermal ibuprofen-based ionic liquids as a non-invasive, safe and effective strategy for the future management of inflammatory bowel disease.

Keywords: Ibuprofen-based Ionic Liquids, Transdermal Delivery, Inflammatory Bowel Disease

References

1. Mishra, R., Dhawan, P., Srivastava, A. S., & Singh, A. B. (2020). Inflammatory bowel disease: Therapeutic limitations and prospective of the stem cell therapy. World journal of stem cells, 12(10), 1050–1066.

2. Santos, M. M. et al. (2019). Ionic Liquids and Salts from Ibuprofen as Promising Innovative Formulations of an Old Drug. ChemMedChem, 14(9), 907–911.

3. Ren, G. (2019). Improved transdermal permeability of ibuprofen by ionic liquid technology: Correlation between counterion structure and the physicochemical and biological properties. Journal of Molecular Liquids, 283, 399–409.

Abstract-Post-73 Other

A review of in vitro and in vivo studies on the therapeutic potential of piperine in breast cancer

Carla Pereira¹, Cláudia Pinho^1,2, Patrícia Correia^1,2

¹Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal.²REQUIMTE/LAQV, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal. Corresponding Author: Patricia Correia - [e-mail]

Background: Breast cancer is the most prevalent neoplasm among Portuguese women. Therefore, more effective and less toxic therapeutic approaches are necessary. Piperine, an alkaloid found in black pepper (Piper nigrum), exhibits cytotoxic and chemoprotective properties ^[1]. Objectives: To discuss the in vitro and in vivo effects of piperine on breast cancer cell lines and mice models. Methods: Literature review using the PubMed®, Science Direct® and Directory of Open Access Journals® databases and keywords “piperine”, “Piper nigrum”, ”breast cancer”, “cytotoxicity”, “cancer therapy”, “tumor growth inhibition”. In vitro and in vivo studies exploring the role of piperine in breast cancer were included; articles using analogues and plant extracts with compounds other than piperine were excluded. Results: A total of 16 studies were included using different cancer cell lines (e.g. MDA-MB-231, MDA-MB-468, 4T1, MCF-7, T-47D) and mice models. Piperine exerts an antitumor activity by inhibiting cell proliferation, inducing apoptosis and negatively modulating cell cycle regulatory proteins. When combined with conventional therapies, piperine may help reduce chemotherapy doses by overcoming drug resistance and minimizing chemotherapy-associated side effects ^[2,3]. A reduction in tumor size was observed with the intraperitoneal co-administration of piperine (0.1 to 50 mg/kg/day) and other drugs. Conclusions: Piperine may act both as an isolated cytotoxic agent and in combination with other therapeutics. However, the methodological heterogeneity of studies, along with the scarcity of clinical trials, underscores the need for further investigation to validate its clinical applicability and contribute to less invasive approaches.

Keywords: Piperine, Piper nigrum, Breast Cancer

Acknowledgements

This work received financial support from the PT national funds (FCT/MECI, Fundação para a Ciência e Tecnologia and Ministério da Educação, Ciência e Inovação) through the project UID/50006 -Laboratório Associado para a Química Verde - Tecnologias e Processos Limpos.

References

1. Naeem, A. et al. (2022). Natural Products as Anticancer Agents: Current Status and Future Perspectives. Molecules, 27(23), 8367.

2. Hakeem, N. et al. (2024). Piperine enhances doxorubicin sensitivity in triple-negative breast cancer by targeting the PI3K/Akt/mTOR pathway and cancer stem cells. Scientific Reports, 14(1), 18181.

3. Rather, R. A., & Bhagat, M. (2018). Cancer Chemoprevention and Piperine: Molecular Mechanisms and Therapeutic Opportunities. Frontiers in Cell and Developmental Biology, 6.

Abstract-Post-74 Other

Occupational stress in community pharmacy professionals: a cross-sectional study

Daniela Pinto¹, Kayabí Oliveira¹, Marta Almeida¹, Luís Nascimento¹, Xavier Costa¹

¹Polytechnic Institute of Bragança, Bragança, Portugal. Corresponding Author: Xavier Costa - [e-mail]

Backgound: The study of mental health in health professionals, including community pharmacy professionals, is relevant due to their continuous exposure to emotionally stressful situations ^[1]. Work-related stress, burnout and intense routine significantly affect the quality of life ^[2,3]. Objective: To assess the stress levels of pharmacy professionals in the Bragança and Lisbon districts, different regions from Portugal, analysing the influence of sociodemographic and professional variables. Methods: Quantitative, cross-sectional, descriptive and correlational study with 127 community pharmacy professionals’ participants. Data were collected through a questionnaire with two parts: one for sociodemographic variables (gender, age, marital status, number of children, professional role, chronic illness, physical activity, and salary), and the second for assessing stress using the QSO-VG scale. Results: Stress levels were similar between Bragança (1.78) and Lisbon (1.82). The main reported causes of stress included lack of time with family and friends, work overload, inadequate salary, and negative attitudes from users. Only gender showed a statistically significant association with stress: men reported higher stress levels in Bragança (2.04), while women reported higher levels in Lisbon (1.92). No significant associations were found with the other sociodemographic variables studied. Conclusion: There was no significant stress level’s difference between different regions from Portugal. However, stress levels are significant in these regions, and it is necessary to improve working conditions and reduce the workload of the pharmacy professional’s community.

Keywords: Community pharmacy; occupational stress; pharmacy professionals.

References

1. Mendes, D., Leal, V., Rocha, M. C., Cruz, R. S., & Amaral, A. P. (2018). Estudo sobre burnout e estilos de vida em profissionais de farmácia comunitária. In I. Leal, S. von Humboldt, C. Ramos, A. F. Valente, & J. L. Pais Ribeiro (Eds.), Actas do 12º Congresso Nacional de Psicologia da Saúde (pp. 279–286). ISPA – Instituto Universitário.

2. Vilela, S. et al. (2015). Fatores de risco para estresse e transtornos mentais em farmacêuticos e auxiliares de farmácia. Saúde, Ética & Justiça, 20(2), 77–83.

3. Shao, S.-C. et al. (2020). Workload of pharmacists and the performance of pharmacy services. PLOS ONE, 15(4), e0231482.

Abstract-Post-75 Other

Aromatic and medicinal galactagogue plants: analysis of labelling information from online dietary supplements

Bruna Santos¹, Marta Lomba¹, Patrícia Correia^1,2, Cláudia Pinho^1,2

¹Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal.²REQUIMTE/LAQV, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal. Corresponding author: Claúdia Pinho - [e-mail]

Background: Breast milk provides both physical and psychological benefits for the mother and the infant. In cases of insufficient milk production, plants with galactagogue properties are considered an option, with traditional reports supporting their use [1,2]. Objectives: To collect and analyze dietary supplements (DS) containing plants, sold online, with galactagogue indications. Methods: A descriptive, cross-sectional study was conducted, using Google® platform to collect galactagogue DS in January 2025. Included criteria were DS for human use, DS with isolated or combined plants, stores selling DS. Labelling information, including active ingredients, indications for use, adverse reactions, interactions, and contraindications, was collected from the analysed DS. Results: A total of 16 DS from 14 websites were included in the study (ten containing mixtures of plants and six containing a single plant). In total, 21 different plants were identified. Fennel (Foeniculum vulgare) (seven DS) and fenugreek (Trigonella foenum-graecum) (six DS) were the most commonly used. Information on contraindications, such as not recommended for pregnant women, children, or individuals with allergies (to fish, fish oil, or soy), or in cases of known hypersensitivity to some ingredient, was included in 12 DS (75.0%). Only three DS (18.8%) provided details on adverse reactions and two DS on potential interactions (12.5%). Conclusions: The DS analyzed exhibited variations in their composition. Standardized studies are needed to demonstrate the efficacy and safety of these supplements, as well as to validate the effectiveness of the formulations and the potential synergistic effects between the plants.

Keywords: Galactagogue plants, milk production, dietary supplements

Acknowledgements

This work received financial support from the PT national funds (FCT/MECI, Fundação para a Ciência e Tecnologia and Ministério da Educação, Ciência e Inovação) through the project UID/50006 -Laboratório Associado para a Química Verde - Tecnologias e Processos Limpos.

References

1. Foong, S. C., et al. (2020). Oral galactagogues (natural therapies or drugs) for increasing breast milk production in mothers of non-hospitalised term infants. The Cochrane Database of Systematic Reviews, 5(5), CD011505.

2. Zheng, T., et al. (2020). The prevalence, perceptions and behaviors associated with traditional/complementary medicine use by breastfeeding women living in Macau: A cross-sectional survey study. BMC Complementary Medicine and Therapies, 20(1), 122.

Abstract-Post-76 Other

Dietary supplements and cosmetics with cannabis sativa l. and/or cannabidiol: analysis of labelling information and cannabinoid quantification methods

Ana Batalha¹, Sandra Regalo¹, Ana Isabel Oliveira^1,2, Cláudia Pinho^1,2, Patrícia Correia^1,2

¹Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal. ²REQUIMTE/LAQV, Escola Superior de Saúde, Instituto Politécnico do Porto, Portugal. Corresponding author: Patrícia Correia - [e-mail]

Background: The growing interest in the potential benefits of Cannabis sativa L. (CS) and cannabidiol, has boosted the marketing of dietary supplements (DS) and cosmetic products (CP). However, legal compliance and labelling information lack raises concerns about consumer safety ^[1]. Objectives: Analyse labelling information on DS and CP containing CS and/or cannabidiol, available online, and review cannabinoid quantification analytical methods (CQAM). Methods: A descriptive, cross-sectional study was conducted from August to October 2024 to collect DS and CP from websites (e.g. pharmacies, herbal stores) containing CS and/or cannabidiol, isolated or in mixtures. The labelling information was analysed (uses, ingredients, interactions, adverse reactions). A literature review was conducted in December 2024 using PubMed® to gather studies about CQAM, using the keywords “Chemistry Techniques, Analytical” [Mesh], “Cannabis sativa”, “Cannabinoids”. Results: A total of 60 products (22 DS; 38 CP) were identified. The most common ingredient was seed oil, present in 73% of DS and 59% of CP. The main indications were associated with skin hydration (16 CP), and as a complement in nervous system problems (18 DS). The literature review resulted in 16 studies. Two high-performance liquid chromatography methods were found the best for cannabinoid quantification, demonstrating good linearity, precision and accuracy. Conclusions: Ingredients, such as CS seed oil and cannabidiol, showed inconsistencies with current Portuguese legislation. Collected DS and CP may differ in CS and other contents, highlighting the importance of quality control and regulatory monitoring, using the validated CQAM identified in this study.

Keywords: Cannabis sativa L., cannabidiol, labelling information.

Acknowledgements

This work received financial support from the PT national funds (FCT/MECI, Fundação para a Ciência e Tecnologia and Ministério da Educação, Ciência e Inovação) through the project UID/50006 -Laboratório Associado para a Química Verde - Tecnologias e Processos Limpos.

Reference

1. McRae, G., & Melanson, J. E. (2020). Quantitative determination and validation of 17 cannabinoids in cannabis and hemp using liquid chromatography-tandem mass spectrometry. Analytical and Bioanalytical Chemistry, 412(27), 7381–7393.

Abstract-Post-81 Other

Potential activity of withanolides in breast cancer treatment: a systematic review

Ana Margarida Moreira¹, Rita Ferraz Oliveira^1,2, Cláudia Pinho^1,2, Patrícia Correia^1,2

¹Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal. ²REQUIMTE/LAQV, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal. Corresponding author: Cláudia Pinho - [e-mail]

Background: Portuguese female population data from 2021 indicate that 31.6% of all tumours were breast cancer (BC), with 8,714 new cases reported ^[1]. Withanolides, a group of steroidal lactones found in plants such as Withania somnifera, Physalis peruviana, and Tubocapsicum anomalum, exhibit potential anticancer activity and are considered promising compounds for the treatment of BC ^[2]. Objectives: Discuss the effectiveness and the potential mechanisms of action of withanolides in the treatment of BC. Methods: Following PRISMA guidelines, a systematic review was conducted to evaluate in vitro and in vivo activity of natural/synthetic withanolides in BC, using original articles published in English (until December 2024) found in ScienceDirect® and Pubmed® databases and using the keywords “withanolides” and “breast cancer”. Results: A total of 34 studies were analysed (24 in vitro, three in vivo, seven combining both type of approaches), with withaferin A being the predominant compound. The effectiveness of withanolides was evaluated using different approaches, such as cell viability/cell proliferation assays and analysis of apoptosis. The doses of withanolides used in studies and cancer cell lines (e.g., MCF-7, MDA-MB-231) ranged typically from 2 to 5 μM (in vitro studies) and from 4 to 8 mg/kg (in vivo studies). The mechanisms of action included cell cycle arrest (e.g., at the G2/M phase), modulation of oxidative stress, induction of apoptosis, inhibition of cell proliferation. Conclusions: Further studies are needed to confirm the results in clinical trials and to assess the potential of this group of steroidal lactones.

Keywords: Withania somnifera, withaferin A, breast cancer

Acknowledgements

This work received financial support from the PT national funds (FCT/MECI, Fundação para a Ciência e Tecnologia and Ministério da Educação, Ciência e Inovação) through the project UID/50006 -Laboratório Associado para a Química Verde - Tecnologias e Processos Limpos.

References

1. Registo Oncológico Nacional (2024). Registo Oncológico Nacional de Todos os Tumores na População Residente em Portugal, em 2019. Instituto Português de Oncologia do Porto FG, EPE (IPO Porto).

2. Khan, A. et al. (2024). Withaferin A decreases glycolytic reprogramming in breast cancer. Scientific Reports, 14(1), 23147.

Abstract-Post-82 Other

Access to community pharmacies by rural populations in northeastern portugal

Carolina Costa¹, Diana Pires¹, Olívia R. Pereira^1,2, Isabel C. Pinto^1,2

¹Department of Diagnostic and Therapeutic Technologies, School of Health, Polytechnic Institute of Bragança, Bragança, Portugal. ²Research Centre for Active Living and Wellbeing (LiveWell), Instituto Politécnico de Bragança, Portugal Corresponding Author: Isabel Pinto - [e-mail]

Background: Rural populations face challenges in accessing medicines and healthcare due to depopulation and geographic isolation. Community pharmacies play a vital role as the main point of care in these regions (1,2,3). Objectives: This study aims to explore the accessibility of community pharmacies in rural areas, understand the satisfaction and identify challenges. Methods: This is an observational, descriptive and cross-sectional study, with a non-probability convenience sample of 168 people living in two villages in the municipality of Alfândega da Fé, Bragança District, in northeastern Portugal. An online and paper self-completion questionnaire built to respond to the objectives of the present study was used, with 3 parts: sociodemographic, pharmacies accessibility and satisfaction with accessibility. Statistical analysis was conducted using Microsoft Excel, including absolute and relative frequencies, as well as measures of central tendency and dispersion. Results: Most of the participants were female (52.2%; 91), with ages between 70 and 79 years (20.8%; 35), with secondary education as qualifications (45; 26.8%) and a monthly income between 500 and 1000 euros (108; 64.3%). 42.3% (71) of the participants had stopped going to the pharmacy because of the challenges they faced, such as distance, the time needed to get to the pharmacy and the lack of transport. In addition, the majority of participants (78%; 131) feel unsatisfied with the accessibility of community pharmacies. Conclusions: Rural population is unsatisfied with access to community pharmacies and faces several difficulties and accessibility challenges. Policies must be created to facilitate access to community pharmacies for rural regions.

Keywords: Pharmacies accessibility, rural populations, accessibility satisfaction.

Acknowledgment

This work is funded by national funds from FCT – Fundação para a Ciência e a Tecnologia, I.P., under the project/support UID/6157/2023

References

1. Jagadeesan, C. T., Wirtz V. J. (2021). Geographical accessibility of medicines: a systematic literature review of pharmacy mapping. J Pharm Policy Pract. Mar 4;14-28.

2. World Health Organization. (2021). Primary health care on the road to universal health coverage: 2019 global monitoring report. World Health Organization.

3. Franco, C. M., Lima, J. G., Giovanella, L. (2021). Primary healthcare in rural areas: access, organization, and health workforce in an integrative literature review. Cad Saude Publica. 2021 Jul 7;37(7): e00310520.

Abstract-Post-87 Other

Quality control of an origanum vulgare l. oil cream for veterinary use: validation method

João Cabaço¹, Mário Pádua², Pedro Martinho³, Miguel Zegre², Rita Cotrim¹, Mafalda Silva¹, Gonçalo Silva¹, Alexandra Machado⁴, Ana Costa-Veiga^3,5

¹Pharmacy Degree. Escola Superior de Tecnologia da Saúde de Lisboa, Lisboa, Portugal. ^[2] H&TRC - Health & Technology Research Center, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa; Lisboa, Portugal. ³Unidade Local de Saúde de Santa Maria, Lisboa, Portugal. ⁴Centre for Ecology, Evolution and Environmental Changes (CE3C) & Global CHANGE and Sustainability Institute, Faculdade de Ciências da Universidade de Lisboa, Lisboa, Portugal. ⁵CHRC - Comprehensive Health Research Centre, Lisboa, Portugal. Corresponding Author: Ana Costa-Veiga - [e-mail]

Background: The increasing interest in phytotherapeutic alternatives in veterinary medicine requires robust analytical methods to characterize bioactive compounds ^[1]. Objectives: Validate a high-performance liquid chromatography coupled with diode-array detector (HPLC-DAD/UV) method to use in quality control. Identify and quantify carvacrol and thymol molecules in a 2% (v/v) water-in-oil (W/O) cream formulation containing Origanum vulgare L. essential oil. Methods: The method used a reverse-phase C18 column and an isocratic mobile phase of methanol:acetonitrile:water (60:15:25), coupled with a diode-array detector and quantification by UV at 275 nm and room temperature. The method simultaneously quantifies carvacrol and thymol extracted from the cream. Calibration curves for both analytes were prepared with external standards, and linearity was confirmed within the range of 0–6 µg per 10 µL injection, with high correlation coefficients (R² > 0.990). Other validation parameters were performed as intra and inter-assay precision and accuracy. Selectivity and specificity were assessed through comparison with standard absorption spectra. Results: The method showed intra and inter assay precision below 5% RSD. LOD and LOQ of 0.14 and 0.43 µg (in 10µL injection) for thymol and 6.4 and 19.5 ng for carvacrol were found. Prior to HPLC-DAD/UV analysis, 100 mg of cream samples were extracted in triplicate with acetonitrile, with recoveries of 90 and 100% for the two formulations, when compared with the negative control ^[2]. Conclusions: This method validation confirms its reliability for quantifying key bioactive compounds in complex topical formulations and supports its future application in quality control and efficacy studies of veterinary phytopharmaceuticals.

Keywords: HPLC-DAD/UV, essential oils, analytical method validation.

Acknowledgements

This research was funded by Concurso de Investigação, Desenvolvimento, Inovação e Criação Artística (IDI&CA) from Instituto Politécnico de Lisboa, grant number IPL/IDI&CA2024/PLANT-VET_ESTeSL

References

1. Machado, A.M., Lopes, V., Barata, A.M., Póvoa, O., Farinha, N., Figueiredo, A.C. (2023). Essential Oils from Origanum vulgare subsp. virens Ietsw. Grown in Portugal: Chemical Diversity and Relevance of Chemical Descriptors. Plants, 12(3), 621.

2. Gama, R. G. M., & Chaves, M. H. da C. (2019). Good practices for high performance liquid chromatography: an approach to pharmaceutical quality control. Scientia Chromatographica, 11(3):108-125.

Abstract-Post-91 Other

Orphan drugs and patient safety: focus on pharmacovigilance strategies

Cátia Resende¹, Elsa Alves¹, Mara Custódio¹, Matilde Gaspar¹, Sandra Ventura^1,2, Fátima Roque^1,2

¹Health Sciences School, Polytechnic Institute of Guarda, Guarda, Portugal. ²BRIDGES – Biotechnology Research, Innovation and Design for Health Products, Polytechnic Institute of Guarda, Guarda, Portugal. Corresponding author: Cátia Resende - [e-mail]

Background: Orphan drugs are essential for treating rare diseases, although their approval often relies on limited clinical evidence due to small patient populations. Orphan drugs safety data remains scarce and inconsistent while serious adverse reactions (ADRs) are being reported. This creates uncertainty underscoring the need for pharmacovigilance strategies specifically on those medicines ^[1]. Objective: To review the scientific literature on pharmacovigilance related to orphan drugs and identify strategies that support improved post-authorisation safety monitoring. Methods: A literature search was conducted in PubMed using the terms “orphan (drugs OR medicines)” AND pharmacovigilance. Thirty-four free full-text articles published in the last ten years were retrieved. Twelve articles were selected based on methodological quality, relevance and focus on pharmacovigilance in orphan drugs. The remaining articles were excluded for lacking discussion of post-marketing safety or not addressing orphan drugs. Results: Most publications reported inconsistencies in pharmacovigilance practices, lack of unified approaches, gaps in monitoring, and low levels of active surveillance. These studies proposed several strategies, including artificial intelligence for signal detection, bibliometric analyses to identify research gaps, post-authorisation study designs, regulatory reviews advocating harmonisation, adapting statistical algorithms for signal detection and creation of pharmacovigilance platforms specific for orphan drugs. Active patient participation in ADR reporting was also highlighted as key to improving real-world monitoring. Conclusion: Pharmacovigilance for orphan drugs remains fragmented and underdeveloped. Strengthening post-marketing safety strategies, promoting international regulatory alignment, and improving data sharing are essential steps to ensure the safe and effective use of these drugs.

Keywords: Orphan drugs; pharmacovigilance; rare diseases.

References

1. Xu, M., Li, G., Li, J., Xiong, H., & He, S. (2023). Pharmacovigilance for rare diseases: a bibliometrics and knowledge-map analysis based on web of science. In Orphanet Journal of Rare Diseases (Vol. 18, Issue 1). BioMed Central Ltd.

2. Chan, A. Y. L. et al. (2020). Access and Unmet Needs of Orphan Drugs in 194 Countries and 6 Areas: A Global Policy Review with Content Analysis. Value in Health, 23(12), 1580–1591.

3. Singh, V., Kapoor, S., & Gupta, S. K. (2024). An application of information technology in adaptive leadership of Ministry of Ayush during pandemic of Covid 19: A case study. In Mathematics and Computer Science (Vol. 2, pp. 77–89).