JAPhA Practice Innovations最新文献

{"title":"Blood pressure reduction in glucagon-like peptide-1 receptor agonist users in a family medicine clinic","authors":"Julia Mesawich,&nbsp;Tiffaney Threatt,&nbsp;David Mercer","doi":"10.1016/j.japhpi.2025.100083","DOIUrl":"10.1016/j.japhpi.2025.100083","url":null,"abstract":"<div><h3>Background</h3><div>Hypertension remains increasingly prevalent, affecting an estimated 45.4% of adults in the United States (Ostchega et al., 2017-2018; National Center for Health Statistics, 2020). It is a common comorbidity in individuals with both type 2 diabetes mellitus (T2DM) and obesity. Incretin-based therapies, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs), are an effective treatment for T2DM and obesity. Although some meta-analyses have shown that patients on GLP-1 RAs experience modest blood pressure lowering, there have not been any studies that look at this as a primary end point.</div></div><div><h3>Objective</h3><div>This study aimed to determine the blood pressure–lowering effect of GLP-1 RAs on systolic and diastolic blood pressure in adults within 1 year of initiation.</div></div><div><h3>Methods</h3><div>This study was single center, observational, and retrospective. Patients were identified for inclusion if they were prescribed a GLP-1 RA between December 1, 2020, and June 1, 2021. GLP-1 RA use was defined as at least 2 prescriptions for the same GLP-1 RA, authorized on different dates. Clinic-measured blood pressures from baseline to 1 year after the initiation of GLP-1 RA therapy were collected.</div></div><div><h3>Results</h3><div>A total of 77 participants were evaluated for change in blood pressure from baseline to 1 year after GLP-1 RA initiation. Most participants were prescribed semaglutide injection (33.77%) or dulaglutide injection (36.36%). For the primary outcome, there was a statistically significant change in systolic blood pressure from baseline to 1 year after initiation of GLP-1 RA therapy. There was no statistically significant change in diastolic blood pressure.</div></div><div><h3>Conclusion</h3><div>From baseline to 1 year, GLP-1 receptor agonists lowered blood pressure with statistical significance. Therefore, in someone with hypertension and another compelling indication, GLP-1 RAs may be a good option for comprehensive management of comorbidities.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100083"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding impact: Resident research advancing the future of pharmacy practice","authors":"Darin C. Ramsey PharmD, BCPS, BCACP","doi":"10.1016/j.japhpi.2026.100118","DOIUrl":"10.1016/j.japhpi.2026.100118","url":null,"abstract":"","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100118"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial factors influencing community pharmacist’s intention to counsel on medication-induced genitourinary adverse effects","authors":"Emma Brusio,&nbsp;Deanna Tran,&nbsp;Hyunuk Seung,&nbsp;Eric Kim,&nbsp;Tiffany Taliaferro-Roberts,&nbsp;Victoria Bulkin","doi":"10.1016/j.japhpi.2026.100117","DOIUrl":"10.1016/j.japhpi.2026.100117","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacist-led counseling is an important service that has been associated with improved clinical outcomes, increased quality of life, drug knowledge, and patient satisfaction.<span><span>²</span></span> Effective patient education that produces patient understanding of medication-induced adverse effects has shown to improve medication adherence.<span><span>⁸</span></span> To date, there are no studies regarding factors influencing community pharmacists’ intention to counsel on medication-induced genitourinary adverse effects (GAEs).</div></div><div><h3>Objectives</h3><div>The objectives of this study were to determine psychosocial and workflow factors that may influence a community pharmacist’s intention to counsel patients on medication-induced genitourinary adverse effects.</div></div><div><h3>Methods</h3><div>This study was an anonymous, online survey distributed to community pharmacists focusing on their intention to counsel patients on medication-induced GAEs. Inclusion criteria were licensed community pharmacists employed at Albertsons community pharmacies, primarily working with patients, aged 18 years or older, and able to read and write English. Survey items used the Theory of Planned Behavior (TPB) framework to assess factors such as attitudes, subjective norms, and perceived behavioral control and included demographic questions and ranking of workflow influences. Descriptive statistics were used to summarize survey data.</div></div><div><h3>Results</h3><div>Out of 276 survey respondents, 242 individuals provided usable responses. The majority of respondents agreed that both patients and providers expect them to provide counseling on GAEs (∼55%), although fewer respondents (∼48%) felt that patients are comfortable discussing these issues. Pharmacists who counseled more frequently reported significantly greater comfort discussing GAEs across age and gender differences.</div></div><div><h3>Conclusion</h3><div>Most Albertsons pharmacists were willing and comfortable discussing medication-induced GAEs with patients. Additional training may support consistent counseling in the presence of external workflow challenges.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100117"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of SGLT2 inhibitor effects on glycemic management in hospitalized non-critically ill patients","authors":"E.J. Marineau,&nbsp;Dennis Dubovetsky","doi":"10.1016/j.japhpi.2026.100111","DOIUrl":"10.1016/j.japhpi.2026.100111","url":null,"abstract":"<div><h3>Background</h3><div>Professional society guidelines provide discordant recommendations regarding the inpatient use of sodium–glucose cotransporter 2 inhibitors (SGLT2i) for glycemic management in non-critically ill patients with type 2 diabetes mellitus (T2DM). Although the American Diabetes Association supports continuation or initiation of SGLT2i in select hospitalized patients with heart failure, the Endocrine Society recommends against routine inpatient use.</div></div><div><h3>Objective</h3><div>This study evaluated real-world safety and glycemic outcomes associated with SGLT2i use in non-critically ill hospitalized patients with T2DM.</div></div><div><h3>Methods</h3><div>This single-center, observational, retrospective cohort study included adults with established T2DM admitted to a large tertiary care hospital between August 1 and December 7, 2024. Patients receiving an SGLT2i in combination with insulin therapy were compared with patients receiving insulin therapy alone. The primary outcome was median inpatient point-of-care blood glucose. Secondary outcomes included percentage of glucose readings within the target range (100–180 mg/dL), total daily insulin, 90-day all-cause readmissions, length of stay, inpatient mortality, acute kidney injury, hypoglycemia, and ketoacidosis.</div></div><div><h3>Results</h3><div>A total of 150 patients were included (75 per group). Median inpatient blood glucose was lower in the SGLT2i group compared with insulin alone (165 vs. 180 mg/dL; <em>P</em> &lt; 0.001). There was no difference in the percentage of glucose readings within target range. Patients receiving SGLT2i required a slightly lower median total daily insulin dose (15 vs. 16 units; <em>P</em> = 0.006) and had fewer 90-day all-cause readmissions (28% vs. 48%; <em>P</em> = 0.005). Rates of hypoglycemia, acute kidney injury, ketoacidosis, length of stay, and inpatient mortality were similar between groups.</div></div><div><h3>Conclusions</h3><div>In this real-world cohort of non-critically ill hospitalized patients with T2DM, SGLT2i use in combination with insulin was associated with comparable glycemic control and no increase in adverse safety outcomes. These findings support cautious continuation of SGLT2i during hospitalization in appropriately selected patients and underscore the need for prospective studies to better define inpatient use.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100111"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial factors influencing community pharmacist’s intention to counsel on medication-induced genitourinary adverse effects","authors":"Emma Brusio,&nbsp;Deanna Tran,&nbsp;Hyunuk Seung,&nbsp;Eric Kim,&nbsp;Tiffany Taliaferro-Roberts,&nbsp;Victoria Bulkin","doi":"10.1016/j.japhpi.2026.100117","DOIUrl":"10.1016/j.japhpi.2026.100117","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacist-led counseling is an important service that has been associated with improved clinical outcomes, increased quality of life, drug knowledge, and patient satisfaction.<span><span>²</span></span> Effective patient education that produces patient understanding of medication-induced adverse effects has shown to improve medication adherence.<span><span>⁸</span></span> To date, there are no studies regarding factors influencing community pharmacists’ intention to counsel on medication-induced genitourinary adverse effects (GAEs).</div></div><div><h3>Objectives</h3><div>The objectives of this study were to determine psychosocial and workflow factors that may influence a community pharmacist’s intention to counsel patients on medication-induced genitourinary adverse effects.</div></div><div><h3>Methods</h3><div>This study was an anonymous, online survey distributed to community pharmacists focusing on their intention to counsel patients on medication-induced GAEs. Inclusion criteria were licensed community pharmacists employed at Albertsons community pharmacies, primarily working with patients, aged 18 years or older, and able to read and write English. Survey items used the Theory of Planned Behavior (TPB) framework to assess factors such as attitudes, subjective norms, and perceived behavioral control and included demographic questions and ranking of workflow influences. Descriptive statistics were used to summarize survey data.</div></div><div><h3>Results</h3><div>Out of 276 survey respondents, 242 individuals provided usable responses. The majority of respondents agreed that both patients and providers expect them to provide counseling on GAEs (∼55%), although fewer respondents (∼48%) felt that patients are comfortable discussing these issues. Pharmacists who counseled more frequently reported significantly greater comfort discussing GAEs across age and gender differences.</div></div><div><h3>Conclusion</h3><div>Most Albertsons pharmacists were willing and comfortable discussing medication-induced GAEs with patients. Additional training may support consistent counseling in the presence of external workflow challenges.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100117"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating pharmacist-directed care for eligible patients of a large community-based pharmacy chain: An analysis of dietitian referral adoption rates","authors":"Avery Salcedo,&nbsp;Jamie Remines,&nbsp;Pramit Nadpara,&nbsp;Jean-Venable R. Goode","doi":"10.1016/j.japhpi.2026.100108","DOIUrl":"10.1016/j.japhpi.2026.100108","url":null,"abstract":"<div><h3>Background</h3><div>A large community-based pharmacy chain offers medical nutrition therapy (MNT) via secure dietitian telehealth virtual calls to eligible patients under a contracted benefit plan. This service supports chronic disease management, such as diabetes and cardiovascular conditions, through remote, personalized nutrition care. However, despite evidence of clinical benefit, patient engagement with MNT services through telehealth remains low. Pharmacists are well positioned to identify eligible patients, refer them to MNT services, and conduct outreach to promote attendance.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the impact of pharmacist-directed care, including pharmacist-led identification of eligible patients, referral to MNT, and follow-up telephone calls, on dietitian referral adoption rates and patient engagement.</div></div><div><h3>Methods</h3><div>In this prospective quality improvement study, 388 adult beneficiaries enrolled in a contracted benefit plan were identified as eligible for MNT through the Diabetes and Heart Health Welcome programs. Pharmacists conducted follow-up calls to educate patients and encourage MNT scheduling. Descriptive and univariate analyses were used to summarize outcomes.</div></div><div><h3>Results</h3><div>Pharmacists conducted outreach telephone calls to all 388 eligible patients (100%). The most frequent call outcome was voicemail (205 of 388, 52.8%). Only 25 patients scheduled an MNT appointment (25 of 388, 6.4%), and 6 ultimately attended (6 of 388, 1.5%). Among those who declined or expressed disinterest (70 of 388, 18.0%), 10 (10 of 70, 14.3%) reported no interest in nutritional counseling, and 6 (6 of 70, 8.6%) were already receiving care from another dietitian. Cost concerns were the most frequently cited barrier (33 of 388, 8.5%). Most calls (261 of 388, 67.3%) lasted less than 1 minute.</div></div><div><h3>Conclusion</h3><div>Phone-based pharmacist outreach alone yielded limited patient engagement in MNT. Although pharmacist-directed referral and follow-up are feasible, they were insufficient to meaningfully increase appointment scheduling or attendance. Future efforts should incorporate multimodal outreach strategies, clearer cost and benefit communication, and personalized engagement methods to better address patient barriers and improve adoption of dietitian services.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100108"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing lipid targets: A cross-sectional general internal medicine patient evaluation for optimal lipid-lowering outcomes","authors":"David Keister ((Robbie) III),&nbsp;Sarah Lorenzen,&nbsp;Marilee Clemons,&nbsp;Sarah Aldrich Renner,&nbsp;Brian Tasma","doi":"10.1016/j.japhpi.2025.100086","DOIUrl":"10.1016/j.japhpi.2025.100086","url":null,"abstract":"<div><h3>Background</h3><div>In 2022, heart disease and stroke caused nearly 875,000 deaths in the United States, with $216 billion in health care costs and $147 billion in lost productivity. Preventing and managing atherosclerotic cardiovascular disease (ASCVD) are crucial.</div></div><div><h3>Objectives</h3><div>This study evaluates the integration of lower low-density lipoprotein cholesterol (LDL-C) targets from the 2022 American College of Cardiology (ACC) and 2023 American Diabetes Association (ADA) guidelines into practice.</div></div><div><h3>Methods</h3><div>This retrospective chart review investigated adult patients with ASCVD receiving lipid-lowering therapy (LLT) seen at an internal medicine clinic between January 1 and July 31, 2023. LDL-C targets were assigned per the 2022 ACC and the 2023 ADA guidelines. The primary end point was assigned LDL-C target achievement. Secondary end points included analyzing whether LLT was assessed for efficacy, provider identification of LDL-C targets, and target-directed interventions. Data were analyzed using quantitative and qualitative statistics.</div></div><div><h3>Results</h3><div>Of 375 screened patients, 319 were included. Overall, 265 (83%) had a lipid panel drawn within a year of their provider visit, with 222 (70%) from January 1, 2023, or later. Only 91 (29%) met their assigned LDL-C target, leaving 228 (71%) suboptimally treated. Among these, only 18 (8%) had a provider-identified LDL-C target, with 11 of these targets (61%) being inappropriate. Providers intervened to improve lipid control in only 23 of the 228 patients (10%) not meeting their LDL-C target.</div></div><div><h3>Conclusions</h3><div>Most primary care patients (71%) did not meet newer LDL-C targets, highlighting gaps in guideline adoption. These findings will guide clinic pharmacists in enhancing practices and addressing patient care gaps.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100086"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing timely access to medication changes: The role of ambulatory care pharmacists in overcoming transitions of care challenges","authors":"Alison N. Van Dyke,&nbsp;Karen S. Williams,&nbsp;Jessica Carswell,&nbsp;Keith M. Hughes Jr","doi":"10.1016/j.japhpi.2026.100110","DOIUrl":"10.1016/j.japhpi.2026.100110","url":null,"abstract":"<div><h3>Background</h3><div>Transitions of care are high-risk periods marked by frequent medication-related problems. Up to 80% of patients discharged from hospitals and 98% of older adults experience medication discrepancies. These lapses, often because of delayed refills or fragmented coordination, contribute to unplanned healthcare encounters, increased costs, and provider strain. Pharmacists in ambulatory care settings can mitigate these by improving medication access continuity.</div></div><div><h3>Objective</h3><div>To evaluate the impact of medication access gaps on time for the first unplanned healthcare encounter among patients discharged with chronic maintenance prescription medication changes.</div></div><div><h3>Methods</h3><div>A retrospective cohort study of patients discharged from two hospital sites between June 1, 2023 and May 31, 2024, with changes to chronic maintenance prescription medication. Eligible patients were ≥18 years of age, discharged to home, and followed up with a system-affiliated primary care provider. Patients were categorized as having a “medication gap” if they experienced any lapse in medication coverage because of delayed refills or required intervention. Patients with “no medication gap” maintained continuous medication access, with timely refills coordinated at follow-up.</div></div><div><h3>Results</h3><div>Among 104 patients, those with a medication gap had a significantly shorter time to first unplanned healthcare encounter (adjusted HR, 1.61; 95% CI, 1.09–2.39; <em>P</em> = 0.017) and were nearly four times more likely to experience a medication-related encounter (IPTW-adjusted HR, 3.76; 95% CI, 2.00–7.06; <em>P</em> &lt; 0.001). Patients with a medication gap were associated with more days without medication, lower refill rates at follow-up (26.9% vs. 61.5%, <em>P</em> &lt; 0.001), and more frequent barriers, such as inadequate discharge education.</div></div><div><h3>Conclusions</h3><div>Medication access gaps following discharge were associated with earlier and more frequent unplanned healthcare encounters. These findings highlight the need for pharmacist involvement in post-discharge medication management to reduce preventable healthcare use and improve care transitions.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100110"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing lipid targets: A cross-sectional general internal medicine patient evaluation for optimal lipid-lowering outcomes","authors":"David Keister ((Robbie) III),&nbsp;Sarah Lorenzen,&nbsp;Marilee Clemons,&nbsp;Sarah Aldrich Renner,&nbsp;Brian Tasma","doi":"10.1016/j.japhpi.2025.100086","DOIUrl":"10.1016/j.japhpi.2025.100086","url":null,"abstract":"<div><h3>Background</h3><div>In 2022, heart disease and stroke caused nearly 875,000 deaths in the United States, with $216 billion in health care costs and $147 billion in lost productivity. Preventing and managing atherosclerotic cardiovascular disease (ASCVD) are crucial.</div></div><div><h3>Objectives</h3><div>This study evaluates the integration of lower low-density lipoprotein cholesterol (LDL-C) targets from the 2022 American College of Cardiology (ACC) and 2023 American Diabetes Association (ADA) guidelines into practice.</div></div><div><h3>Methods</h3><div>This retrospective chart review investigated adult patients with ASCVD receiving lipid-lowering therapy (LLT) seen at an internal medicine clinic between January 1 and July 31, 2023. LDL-C targets were assigned per the 2022 ACC and the 2023 ADA guidelines. The primary end point was assigned LDL-C target achievement. Secondary end points included analyzing whether LLT was assessed for efficacy, provider identification of LDL-C targets, and target-directed interventions. Data were analyzed using quantitative and qualitative statistics.</div></div><div><h3>Results</h3><div>Of 375 screened patients, 319 were included. Overall, 265 (83%) had a lipid panel drawn within a year of their provider visit, with 222 (70%) from January 1, 2023, or later. Only 91 (29%) met their assigned LDL-C target, leaving 228 (71%) suboptimally treated. Among these, only 18 (8%) had a provider-identified LDL-C target, with 11 of these targets (61%) being inappropriate. Providers intervened to improve lipid control in only 23 of the 228 patients (10%) not meeting their LDL-C target.</div></div><div><h3>Conclusions</h3><div>Most primary care patients (71%) did not meet newer LDL-C targets, highlighting gaps in guideline adoption. These findings will guide clinic pharmacists in enhancing practices and addressing patient care gaps.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100086"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of vitamin K on coagulopathy in patients with cirrhosis: An observational study","authors":"Parker Kaleo,&nbsp;Joshua Akinsanya,&nbsp;Tiffany Lyons,&nbsp;Drew A. Wells","doi":"10.1016/j.japhpi.2026.100099","DOIUrl":"10.1016/j.japhpi.2026.100099","url":null,"abstract":"<div><h3>Background</h3><div>Cirrhosis impairs the liver’s ability to synthesize vitamin K–dependent coagulation factors, contributing to coagulopathy. Elevated international normalized ratio (INR) in these patients often prompts intravenous (I.V.) vitamin K administration, despite limited evidence supporting its efficacy.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the impact of I.V. vitamin K administration on INR and identify factors that may predict response in patients with severe cirrhosis.</div></div><div><h3>Methods</h3><div>This single-center, retrospective, institutional review board–approved study included adult hospitalized patients with cirrhosis who received I.V. vitamin K. The primary outcome of this study was to evaluate the change in INR. Secondary analysis included the rate of bleeding events, in-hospital venous thromboembolism (VTE), and in-hospital mortality. Subgroup analysis and linear regression analysis were conducted.</div></div><div><h3>Results</h3><div>Among 134 patients, the median INR change from day 0 to day 3 was 0 [−0.4 to 0.2]. Bleeding events occurred in 19% of patients, in-hospital VTE in 3%, and mortality in 16%. Subgroup analysis showed a numerically greater INR reduction in patients with a baseline INR of greater than 2, but no differences based on Model for End-Stage Liver Disease scores or cirrhosis etiology. Multivariate analysis demonstrated that age older than 60 years and a decrease in INR of 0.5 from day 0 to 1 significantly predicted the overall change in INR.</div></div><div><h3>Conclusion</h3><div>Our research provides additional data to the existing literature, showcasing a lack of impact of I.V. vitamin K on INR in patients with cirrhosis. Notably, our study adds insight into the lack of benefit even in patients with more severe cirrhosis. Standardization of clinical practice recommendations to guide I.V. vitamin K use across the spectrum of cirrhosis is needed.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100099"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}