Hospital Pharmacy最新文献

{"title":"Cefepime/Enmetazobactam.","authors":"Andrew R Staten, Danial E Baker","doi":"10.1177/00185787241269112","DOIUrl":"10.1177/00185787241269112","url":null,"abstract":"<p><p>Each month, subscribers to <i>The Formulary Monograph Service</i> receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of <i>The Formulary, Hospital Pharmacy</i> publishes selected reviews in this column. For more information about <i>The Formulary Monograph Service</i>, contact Wolters Kluwer customer service at 866-397-3433.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":"59 6","pages":"606-613"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11504107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499360","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":"In-Hospital Outcomes Associated With Initial Fibrinolysis Versus Primary Percutaneous Coronary Intervention Among Patients Residing in Rural Areas Presenting With ST-Segment Elevation Myocardial Infarction.","authors":"Whitney B Sussman, Conner E Johnson, Erin R Weeda","doi":"10.1177/00185787241303485","DOIUrl":"https://doi.org/10.1177/00185787241303485","url":null,"abstract":"<p><p><b>Background:</b> Fibrinolysis is more commonly used to manage ST-segment elevation myocardial infarction (STEMI) in rural versus urban areas. However, little is known about the outcomes associated with this treatment strategy in rural individuals. We sought to compare in-hospital outcomes associated with the use of fibrinolysis versus primary percutaneous coronary intervention (PCI) among patients residing in rural areas presenting with STEMI. <b>Methods:</b> We identified adult patients with STEMI between 2016 and 2021 using the United States National Inpatient Sample. The cohort was restricted to individuals residing in rural areas. Patients were divided into 2 cohorts based on the receipt of initial fibrinolysis versus primary PCI. In-hospital outcomes were compared between cohorts, with in-hospital mortality serving as the primary outcome and length of stay (LOS) serving as a secondary outcome. <b>Results:</b> We identified 13 475 rural STEMI encounters receiving either initial fibrinolytic therapy (n = 1095) or primary PCI (n = 12 380). The average age and number of comorbidities were similar between cohorts. In-hospital mortality occurred in 5.2% of patients, and mean LOS for initial fibrinolysis and primary PCI patients was 3.73 ± 3.739 days and 3.45 ± 3.974 days, respectively. After adjusting for covariates, initial fibrinolysis was not associated with higher in-hospital mortality (odds ratio [OR] = 0.913; 95% confidence interval [CI] = 0.679-1.228). Initial fibrinolysis was associated with a small increase in LOS compared to primary PCI (Mean difference = 0.079 days; 95%CI = 0.035-0.123). <b>Conclusions:</b> In this analysis of approximately 13 000 STEMI encounters among rural individuals, patient characteristics between those treated with initial fibrinolysis versus primary PCI were similar. Observed outcomes were not meaningfully different between cohorts. Fibrinolytic therapy should not be an overlooked treatment strategy in rural STEMI patients facing delays in receipt of primary PCI.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241303485"},"PeriodicalIF":0.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768174","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":"A Retrospective Study on the Continuation of Buprenorphine in the Perioperative Setting.","authors":"Morgan Lynn Dermody, Sandra Lemon, Lisa Kingdon, Laura Ruekert","doi":"10.1177/00185787241301348","DOIUrl":"https://doi.org/10.1177/00185787241301348","url":null,"abstract":"<p><p><b>Background and Aims:</b> The purpose of this study is to review the 2020 Substance Abuse and Mental Health Services Administration Guideline for Opioid Use Disorder recommendations to continue buprenorphine perioperatively by evaluating the total morphine milligram equivalents (MME) requirements in the first 24 hours postoperatively of patients who continued their buprenorphine therapy to those who discontinued their buprenorphine therapy perioperatively. <b>Methods:</b> This IRB approved study is a multicenter retrospective chart review of 80 surgical inpatients on buprenorphine prior to admission at participating sites from January 2015 to October 2022. The primary outcome is MME administered 24 hours postoperatively in patients who continued buprenorphine perioperatively versus those who discontinued buprenorphine perioperatively. Secondary efficacy outcomes included MME administered 48 and 72 hours postoperatively and daily average pain scores. Safety outcomes included rate of respiratory depression and mortality. <b>Findings:</b> Patients who continued buprenorphine perioperatively required significantly less MME in the first 24 hours postoperatively compared to those who discontinued buprenorphine perioperatively (median [IQR]; 23.25 [6-74.35] vs 93.38 [49.8-156.26]; <i>P</i> < .001). Secondary outcomes of MME administered at 48 hours (10.4 [0-40.5] vs 66.15 [27.94-143.5], <i>P</i> < .001) and 72 hours (0 [0-31.13] vs 66 [22.5-144], <i>P</i> < .001) postoperatively were also significantly less in those whose buprenorphine was continued versus those whose buprenorphine was discontinued perioperatively. Patients whose buprenorphine was continued perioperatively experienced significantly lower average pain scores at 48 (median [IQR]; 4.74 [2.9-7.08] vs 6 [4.93-7.4], <i>P</i> = .028) and 72 hours (3.78 [1.78-5.85] vs 5.75 [4.15-7.45], <i>P</i> = .002) postoperatively. <b>Conclusion:</b> Continuation of buprenorphine in the perioperative setting results in significantly lower utilization of MME in patients whose buprenorphine is continued compared to those whose buprenorphine is discontinued perioperatively.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241301348"},"PeriodicalIF":0.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768560","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 the Predictive Value of the SAMe-TT2R2 Score for Poor Anticoagulation Control in a Diverse Ethnic Population.","authors":"Sahimi Mohamed, Nik Najibah Nik Abdul Rahman, Jun Yuan Tan, Tarani Selvam, Hanis Hanum Zulkifly","doi":"10.1177/00185787241300293","DOIUrl":"https://doi.org/10.1177/00185787241300293","url":null,"abstract":"<p><p><b>Introduction:</b> In Asian countries, warfarin is still widely used for stroke prevention in non-valvular atrial fibrillation compared to non-vitamin K antagonist oral anticoagulants (NOACs) due to its affordability. A tool such as the SAMe-TT₂R₂ is needed to determine the probability of achieving and maintaining good anticoagulation control with warfarin therapy. However, it requires validation in the Malaysian cohort. Therefore, the objective of our study is to validate the SAMe-TT₂R₂ score in predicting poor anticoagulation control in Malaysia. A time in therapeutic range (TTR) < 65% was used to determine poor anticoagulation control. <b>Method:</b> This retrospective cohort study was conducted from July 2022 to July 2023. Patients were enrolled in 2020 from 49 facilities located across Malaysia resulting in a total of 957 included patients. TTR was calculated using Roseendaal's method. <b>Results:</b> The mean (SD) TTR and SAMe-TT₂R₂ score in the overall cohort is 65.2% (±24) and 5.5 (±0.9) respectively. Almost half of the population (43.7%) has the SAMe-TT₂R₂ score of 5. Having diabetes, ischemic heart disease, and increasing HAS-BLED and SAMe-TT₂R₂ score affects anticoagulation control on univariate analysis. However, after adjusting for demographics and clinical variables on multivariate analysis, only the SAMe-TT₂R₂ score as a continuous variable persists in predicting poor anticoagulation control. A SAMe-TT₂R₂ score cut-off point of >5 best predicts poor anticoagulation control with a sensitivity of 0.49 and a specificity value of 0.68. <b>Conclusion:</b> The SAMe-TT₂R₂ score, especially when exceeding 5, was associated with a higher likelihood of poor anticoagulation control, emphasizing its relevance in clinical assessment. However, its limited predictive capability, reflected by a C-statistic of 0.548, suggests the need for cautious interpretation and consideration of additional factors in anticoagulation management decisions. Continuous monitoring and personalized strategies are crucial for optimizing outcomes in this population.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241300293"},"PeriodicalIF":0.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768561","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":"Optimizing Inpatient Care for Patients With Parkinson Disease.","authors":"Joyce Generali","doi":"10.1177/00185787241299964","DOIUrl":"10.1177/00185787241299964","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241299964"},"PeriodicalIF":0.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768192","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":"Experience With the Use of Paromomycin Via Nasogastric Tube as Treatment for Cryptosporidium Infection: A Case Report.","authors":"Iván Cores Rodríguez, Eduardo Tejedor Tejada, Daniel Ortiz Del Olmo, Marta Bernárdez Domínguez, Maria Teresa Criado Illana","doi":"10.1177/00185787241299621","DOIUrl":"https://doi.org/10.1177/00185787241299621","url":null,"abstract":"<p><p>Cryptosporidiosis is an infectious disease caused by the Cryptosporidium parasite, primarily affecting the gastrointestinal tract of both humans and animals. Transmission occurs via fecal-oral route, mainly through ingestion of water or food contaminated with oocysts, the parasite's infectious form. Immunocompromised individuals are particularly susceptible to severe and prolonged symptoms. Current treatment strategies involve supportive measures and antiparasitic medications such as nitazoxanide and paromomycin, although patients with predisposing factors have an elevated risk of recurrence. There is currently no evidence supporting the use of paromomycin via nasogastric tube. Therefore, we present our experience with the use of an extemporaneous paromomycin solution and its clinical impact.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241299621"},"PeriodicalIF":0.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768562","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":"Study on Reliability in Healthcare Training and Critical Evaluation of ChatGPT AI Performance: Simulation of the Admission Test for the Hospital Pharmacy Specialization School in Turin, Italy.","authors":"Eleonora Castellana","doi":"10.1177/00185787241299039","DOIUrl":"10.1177/00185787241299039","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241299039"},"PeriodicalIF":0.8,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686862","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":"Pharmacist-led Transitions of Care: A Cohort Study on Admission Medication History Factors and Adjustments to the Discharge Medication List.","authors":"Tatianna N Pollak, Colleen M Renier, John P Curley, Irina V Haller","doi":"10.1177/00185787241298132","DOIUrl":"10.1177/00185787241298132","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt;Patients are at risk of experiencing medication errors during each transition of care (TOC), which can result in adverse drug events and readmissions. Implementing a pharmacist-led TOC service can optimize medication safety and patient outcomes by identifying and correcting medication discrepancies prior to hospital discharge. A pharmacist-led TOC service at a tertiary care center expanded services to review medications at discharge for all enrolled hospitalized patients, but data collection and review had yet to be performed. &lt;b&gt;Objective:&lt;/b&gt; The purpose of this study was to evaluate the number of patients with a medication discrepancy identified at hospital discharge in a pharmacist-led TOC service. &lt;b&gt;Methods:&lt;/b&gt; This was a single center, retrospective cohort study conducted at a tertiary care facility. Admission medication histories were completed by pharmacists in the emergency department and inpatient units. TOC discharge medication reconciliations were completed by pharmacists prior to hospital discharge. The study included hospitalized adult patients with a pharmacist-completed admission medication history and discharge medication reconciliation between July 1, 2021, to September 30, 2021. Patients readmitted within the study period were included more than once if study criteria were met. Patients who left against medical advice, discharged to hospice, or expired were excluded from the study. &lt;b&gt;Results:&lt;/b&gt; A total of 213 patients met inclusion criteria for this study, with 214 patient encounters included in the analysis after accounting for readmissions. More patients had a TOC medication discrepancy identified at discharge when admission medication histories were completed less than or equal to 24 hours after hospital admission versus greater than 24 hours after hospital admission (28.2% vs 23.6%, OR: 1.269, 95% CI: 0.658, 2.448). Fewer patients had a TOC discrepancy at discharge when fewer PTA medications were changed versus more PTA medications were changed during the admission medication history (0-1 medication changes vs ≥10 medication changes: 19% vs 29.4%, OR: 1.780, 95% CI: 0.730, 4.339). Fewer patients had a TOC discrepancy at discharge when admission medication histories were completed in the emergency department versus on the inpatient units (22.4% vs 28.6%, OR: 0.721, 95% CI: 0.366, 1.420). A similar number of patients had a TOC discrepancy at discharge regardless of the number of unit transitions throughout their hospital stay (1-2 transitions vs ≥4 transitions: 25.9% vs 25.5%, OR: 0.977, 95% CI: 0.456, 2.096). &lt;b&gt;Conclusions:&lt;/b&gt; One in four patients enrolled in the pharmacist-led TOC service had a medication discrepancy identified at discharge. This was irrespective of when the admission medication history was completed, how many changes were made, or how many times the patient transitioned units. Therefore, medication reconciliation at discharge should be a service provided to all admitted patie","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241298132"},"PeriodicalIF":0.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681714","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":"Respiratory Syncytial Virus Vaccine (mRNA).","authors":"Terri L Levien, Danial E Baker","doi":"10.1177/00185787241298140","DOIUrl":"10.1177/00185787241298140","url":null,"abstract":"<p><p>Each month, subscribers to <i>The Formulary Monograph Service</i> receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy and Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of <i>The Formulary, Hospital Pharmacy</i> publishes selected reviews in this column. For more information about <i>The Formulary Monograph Service</i>, contact Wolters Kluwer customer service at 866-397-3433.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241298140"},"PeriodicalIF":0.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681643","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":"Effects of Implementing a Heart Failure Order Set to Optimize Guideline-Directed Medical Therapy and Diuresis in Patients with Acute Heart Failure.","authors":"Eric D Johnston, Carmen B Smith, Joseph S Van Tuyl","doi":"10.1177/00185787241295983","DOIUrl":"10.1177/00185787241295983","url":null,"abstract":"<p><p><b>Background:</b> Utilization of guideline-directed medical therapy in patients hospitalized for acute heart failure is suboptimal during the hospitalization and after discharge. An inpatient heart failure order set may be a convenient and useful intervention to improve heart failure therapy in the inpatient setting. <b>Methods:</b> This is a retrospective study that assessed the use of an inpatient heart failure order set on pharmacologic therapy in patients hospitalized for acute heart failure from May to August 2022. Patients with heart failure with an ejection fraction less than 50% were included in the analysis. The co-primary endpoints were maintenance or optimization of guideline-directed medical therapy during the hospitalization. <b>Results:</b> Maintenance of guideline-directed medical therapy was significantly greater when providers used the heart failure order set (OR 2.35, 95% CI 1.03-5.33, <i>P</i> = .041). Optimization of guideline-directed medical therapy was also statistically greater with use of the order set (OR 11.31, 95% CI 4.37-29.31, <i>P</i> < .001). <b>Conclusions:</b> An inpatient heart failure order set may be an effective strategy to improve heart failure pharmacotherapy in patients hospitalized with acute heart failure.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241295983"},"PeriodicalIF":0.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619151","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}