Journal of Pharmacy Technology最新文献

{"title":"Creating Meaningful Alerts and Reducing Alert Fatigue: Strategies Implemented by Informatics Pharmacists to Optimize Dose Range Checking Alerts in a Multihospital Health System.","authors":"Jonathan F Choukroun,&nbsp;Kristina Lee,&nbsp;Aixa Rey","doi":"10.1177/87551225221117152","DOIUrl":"https://doi.org/10.1177/87551225221117152","url":null,"abstract":"<p><p><b>Background:</b> Among the many clinical decision support (CDS) mechanisms available in electronic health record (EHR) systems, dose range checking (DRC) is one of the most impactful safeguard tools integrated within most computerized provider order entry (CPOE) workflows. Unfortunately, improper configurations and lack of resources to maintain and monitor CDS systems can hinder and even disrupt daily clinical operations. <b>Objective:</b> This article seeks to highlight the impact that informatics pharmacists can make by implementing different strategies to decrease nuisance alerts and create clinically meaningful DRC alerts that guide clinicians in their practice. <b>Methods:</b> Following the activation of the DRC application for 3623 medication groupers (ie, generic drugs and all their dosage form variations), informatics pharmacists implemented strategies to monitor DRC alert output and decrease the number of inappropriate alerts. Such strategies included weekly monitoring of alerts, modification of order sentences (including dose, route, and age/weight filters), update to the rule triggering the alerts, and modifications of the preference settings. <b>Results:</b> From July to September 2018, an average of 70 DRC tables were reviewed by informatics pharmacists, reducing the number of overridden DRC alerts to 4796 in the first week of September-a 63% decrease in a 3-month period. <b>Conclusions:</b> By reducing the number of DRC nuisance alerts and improving the clinical content of DRC alerts, informatics pharmacists can contribute to lowering alert fatigue and improving providers' trust in CDS alerts.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9608100/pdf/10.1177_87551225221117152.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10018790","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":"Setmelanotide: A Novel Targeted Treatment for Monogenic Obesity.","authors":"Haley Pressley,&nbsp;Cyrille K Cornelio,&nbsp;Erin N Adams","doi":"10.1177/87551225221116010","DOIUrl":"https://doi.org/10.1177/87551225221116010","url":null,"abstract":"<p><p><b>Objective:</b> To review clinical data regarding the newly approved drug setmelanotide, an injectable melanocortin 4 receptor (MC4R) agonist, for chronic weight management in adults and children aged 6 years and older with monogenic obesity. <b>Data Sources:</b> A literature review was performed by searching MEDLINE, SCOPUS, and EMBASE for all relevant English-language articles published between January 1, 1996, and November 30, 2021, using search terms obesity, setmelanotide, Imcivree, and MC4R agonist. <b>Study Selection/Data Extraction:</b> This review included two phase 2, two phase 3, and one ongoing clinical trial evaluating the efficacy and/or safety of setmelanotide. <b>Data Synthesis:</b> Setmelanotide demonstrates statistically significant weight loss with at least a 10% decrease in body weight after 1 year and decreased appetite in phase 2 and phase 3 clinical trials. The most common adverse effects included injection site reaction (96%), skin hyperpigmentation (78%), nausea (56%), headache (41%), and diarrhea (37%). <b>Place in Therapy:</b> Setmelanotide is the first and only Food and Drug Administration-approved medication for the treatment of proopiomelanocortin, proprotein convertase subtilisin/kexin type 1, and leptin receptor deficiency in patients with obesity. It may be used in children and adults who have received genetic testing and exhibited extreme obesity before age five. Setmelanotide is a daily subcutaneous injection and may be difficult to afford for patients. <b>Conclusion:</b> Setmelanotide is an effective treatment in patients with obesity and indicated genetic disorders.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9608104/pdf/10.1177_87551225221116010.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10106291","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":"Interprofessional Collaboration Between a Clinical Pharmacist and Specialty Physicians to Treat Hepatitis C in an Interdisciplinary Medical Practice Setting.","authors":"Jennifer T Fix,&nbsp;Steven Hauf,&nbsp;Michael Herrera,&nbsp;Randy Martin,&nbsp;Mason Sweeden,&nbsp;Karl Meyer","doi":"10.1177/87551225221125428","DOIUrl":"10.1177/87551225221125428","url":null,"abstract":"<p><p><b>Objective:</b> Describes the activities of a clinical pharmacist in a gastroenterology (GI) clinic providing services to hepatitis C virus (HCV) patients, with a focus on practice management activities and tools. <b>Practice Description:</b> Located inside a GI specialty clinic in Fort Worth, Texas, the pharmacist provides comprehensive medication management under a collaborative practice agreement (CPA). Once referred by the GI physician, the pharmacist has face-to-face patient visits, develops the care plan, orders medications, and follows patients through sustained virologic response and the development of a hepatocellular carcinoma surveillance plan. <b>Practice Innovation:</b> The role of pharmacists in the management of HCV is important to understand. This article details a pharmacist-led clinic in an open GI medical practice. <b>Evaluation:</b> A retrospective chart review study was conducted to assess outcomes related to the integration of the clinical pharmacist. <b>Methods:</b> Completed by the study team, this study included manual chart reviews of patients with the ambulatory care pharmacist-driven HCV practice to pull data and information that were then tabulated using Qualtrics. <b>Results:</b> A total of 95 charts were surveyed, 78 records were created, and 49 patients were started on direct-acting antiviral (DAA) treatment by the pharmacist. Patients required multiple pharmacist communication actions. The minimum duration of the pharmacist service was 6 months and could extend more than 9 months depending on the time it took to get the patient started on medication. Pharmacist integration into the practice resulted in improved intake for the GI clinic, improved interprofessional interaction, and increased utilization of newer treatment modalities for HCV which feature cure rates up to 99% with limited side effects. <b>Conclusion:</b> Clinical pharmacists are well positioned to help navigate patients through the complexities of the medication use system, medication access, drug interactions and adverse effects, promote medication adherence, and allow patients to start and complete therapy.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9608105/pdf/10.1177_87551225221125428.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40655818","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":"Complications of Corticosteroid Therapy: A Comprehensive Literature Review.","authors":"Elliott J Koshi,&nbsp;Kurtis Young,&nbsp;Joshua C Mostales,&nbsp;Kristine B Vo,&nbsp;Lawrence P Burgess","doi":"10.1177/87551225221116266","DOIUrl":"https://doi.org/10.1177/87551225221116266","url":null,"abstract":"<p><p><b>Relevance to Patient Care and Clinical Practice:</b> Corticosteroids are among the most prescribed medications, particularly during the COVID-19 era. The literature has clearly highlighted the dangers of prolonged, high-dose corticosteroid use, which is important for clinicians to consider before treating patients in their clinical practices. <b>Objective:</b> The objective of this article is to review the literature on complications of corticosteroid use, review corticosteroid pharmacokinetics, and provide an updated reference on risks associated with corticosteroid therapy, especially at higher doses. <b>Data Sources:</b> A conventional literature search of PubMed was conducted without restrictions on publication date. Search terms included \"corticosteroids,\" \"avascular necrosis,\" \"gastrointestinal bleeding,\" and \"complications.\" <b>Study Selection and Data Extraction:</b> Pertinent systematic review/meta-analyses and randomized controlled trials were reviewed for study inclusion. <b>Data Synthesis:</b> Corticosteroids were associated with complications including avascular necrosis, gastrointestinal bleeding, myocardial infarction, heart failure, cerebrovascular events, diabetes mellitus, psychiatric syndromes, ophthalmic complications, tuberculosis reactivation, and bacterial sepsis. Increased daily and cumulative doses were associated with increased excess risk of complications. Cumulative doses greater than 430 mg prednisone equivalent were shown to increase the excess risk of avascular necrosis, with progressively higher rates with higher doses. Risk of gastrointestinal bleeding was significantly increased with corticosteroid usage in the in-patient but not out-patient setting. <b>Conclusion:</b> Since corticosteroids have been associated with the aforementioned severe complications and frequent medicolegal malpractice claims, counseling and informed consent should be performed when prescribing moderate-high dosages of corticosteroids. Further research is needed to characterize the long-term effects of corticosteroid usage in COVID-19 patients.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9608099/pdf/10.1177_87551225221116266.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10488383","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":"Ceftriaxone 1 g Versus 2 g Daily for the Treatment of Enterobacterales Bacteremia: A Retrospective Cohort Study.","authors":"Nadeem Baalbaki,&nbsp;Sharon Blum,&nbsp;Meredith Akerman,&nbsp;Diane Johnson","doi":"10.1177/87551225221121252","DOIUrl":"https://doi.org/10.1177/87551225221121252","url":null,"abstract":"<p><p><b>Background:</b> Ceftriaxone is a commonly used antibiotic for the treatment of susceptible Enterobacterales infections. There is currently limited clinical data on the optimal dose of ceftriaxone for Enterobacterales bacteremia. <b>Objectives:</b> To evaluate the rate of clinical failure of ceftriaxone 1 g versus 2 g daily in patients with Enterobacterales bacteremia. <b>Methods:</b> This was a retrospective cohort study of patients admitted to any of the 3 New York University Hospitals: Long Island, Tisch, or Brooklyn, with ceftriaxone-susceptible Enterobacterales bacteremia, receiving ceftriaxone 1 or 2 g daily from October 2019 to September 2020. The primary outcome was 90-day rate of clinical failure. Clinical failure was defined as escalation of therapy, relapse of infection, or all-cause mortality. <b>Results:</b> A total of 124 patients, 58% in the 1-g group and 42% in the 2-g group, were included. There was no statistically significant difference found in the primary outcome. The 90-day rate of clinical failure was 16.7% versus 9.6%, <i>P</i> = 0.260. There were no statistically significant secondary outcomes, although infection relapse rates at 90 days were numerically greater in the 1-g group (11.1% vs 1.9%, <i>P</i> = 0.078). Hypoalbuminemia was the only variable associated with an increased risk of clinical failure (odds ratio = 4.03; 95% confidence interval [CI] = 1.12-14.50, <i>P</i> = 0.033). <b>Conclusion:</b> In our exploratory findings, there was no statistically significant difference with the 90-day rate of clinical failure between ceftriaxone 1 g versus 2 g daily, although there was a numeric trend toward an increased rate of infection relapse within the 1-g group. Hypoalbuminemia was associated with an increased risk of clinical failure. Prospective studies are warranted to confirm these findings.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9608102/pdf/10.1177_87551225221121252.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10640842","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":"Tricyclic Antidepressant Overdose Manikin Simulation in Student Pharmacists.","authors":"Alex M Ebied,&nbsp;Jeremiah Jessee,&nbsp;Shaina Schwartz","doi":"10.1177/87551225221126613","DOIUrl":"10.1177/87551225221126613","url":null,"abstract":"<p><p><b>Background:</b> Pharmacists must be knowledgeable of medication use within the scope of both typical dosing and atypical dosing. In the United States, antidepressants are the fourth most common substance in overdose situations and are ranked first for serious exposures per year. <b>Objective:</b> The purpose of this study is to design, implement, and assess the efficacy of an antidepressant overdose simulation using a high-fidelity manikin. <b>Methods:</b> This was a single-center, prospective, observational, cross-sectional study of third-year student pharmacists in spring 2021. This study was determined to be exempt by the institutional review board. Students who did not participate in the manikin simulation or complete both the pre- and postsimulation surveys were excluded. Student pharmacists were expected to identify the type of overdose, identify probable offending agent, and evaluate the hemodynamic status. Primary objectives compared student pharmacist knowledge, confidence in recognizing overdose, and confidence in managing overdose pre- and post-antidepressant overdose manikin simulation. <b>Results:</b> Twenty-three students completed both surveys and participated in the simulation. The knowledge total score was 2.1 ± 1.3 in the presimulation and 2.9 ± 0.9 in the postsimulation (<i>P</i> < 0.001). The recognition confidence was 2.0 ± 1.3 in the presimulation and 3.7 ± 0.7 in the postsimulation (<i>P</i> < 0.001). The management confidence was 1.8 ± 1.0 in the presimulation and 3.5 ± 0.5 in the postsimulation (<i>P</i> < 0.001). Limitations in this study were small sample size, lack of rubric, and a case prompt. <b>Conclusion:</b> The outcomes were statistically significant postsimulation. Manikin simulations may have a larger impact on a pharmacy curriculum.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9608097/pdf/10.1177_87551225221126613.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40655819","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":"Enhanced Anticoagulant Effect of Warfarin When Co-administered With Quercetin.","authors":"Ruchit Patel,&nbsp;Allison Stine,&nbsp;Kimberly Zitko","doi":"10.1177/87551225221125667","DOIUrl":"10.1177/87551225221125667","url":null,"abstract":"A 79-year-old man on stable warfarin therapy for atrial fibrillation presented with an international normalized ratio (INR) of 7.5. The patient started quercetin supplementation several days prior to a routine INR monitoring appointment, taking 1 capsule daily. The supplement was made by Natural Factors and came in a dosage strength of 250 mg quercetin and 500 mg of Vitamin C. The patient previously had a stable INR between 2 and 3 for months, with an INR of 2.5 five days beforehand. The patient had no recent changes to contributing factors. The patient was taking stable amiodarone therapy for 4 months prior to this episode with no other critical INR values. No adverse bleeding events were reported by the patient. The patient had been taking 1 warfarin 7.5 mg tablet once daily with a weekly dose of 52.5 mg. After the INR of 7.5, the patient stopped taking the quercetin supplement indefinitely and restarted warfarin therapy after missing one day. Five days after the initial INR, the INR was found to be 2.5. The patient’s most recent labs were red blood cell (RBC) count of 4.48 103/ mm3, hemoglobin (HGB) of 13.7 g/dL, aspartate aminotransferase (AST) of 26 IU/L, alanine aminotransferase (ALT) of 18 IU/L, and a calculated creatinine clearance (CrCl) of 91 mL/min.","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9608098/pdf/10.1177_87551225221125667.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40655820","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":"Daridorexant: A New Dual Orexin Receptor Antagonist for Insomnia.","authors":"Erin St Onge,&nbsp;Bradley Phillips,&nbsp;Casey Rowe","doi":"10.1177/87551225221112546","DOIUrl":"https://doi.org/10.1177/87551225221112546","url":null,"abstract":"<p><p><b>Objective:</b> To review the safety, efficacy, and tolerability of daridorexant in treating insomnia characterized by difficulties with sleep onset and/or sleep maintenance in adult patients. <b>Data Sources:</b> A literature search was performed through PubMed using the following key terms: <i>daridorexant, ACT-541468, orexin, insomnia</i>, and <i>sleep</i>. <b>Study Selection and Data Extraction:</b> Selected articles included those which described clinical studies of the pharmacokinetics, efficacy, safety, or tolerability of daridorexant. <b>Data Synthesis:</b> Daridorexant works through antagonism of the dual orexin receptor. It is the third agent in this class of medications approved by the U.S. Food and Drug Administration (FDA). Daridorexant, at a dose of 25 mg to 50 mg, was shown to be effective in improving sleep parameters in phase 3 clinical studies and was well tolerated. Adverse event rates from phase 2 and 3 clinical trials were low with fatigue, nasopharyngitis, gait disturbance, somnolence, diarrhea, and headache most commonly reported. <b>Conclusions:</b> All currently available agents for treating insomnia have received a \"weak\" recommendation in the clinical practice guidelines, including the dual orexin receptor antagonist class of medications. Initial data suggest that with routine use daridorexant does not impair next day functioning, a common issue with other agents used to treat insomnia. In addition, daridorexant appears to be as safe and effective in treating insomnia in patients of all ages including those ≥65 years of age.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9420920/pdf/10.1177_87551225221112546.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10248843","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":"The Role of Clinical Pharmacist in Pediatrics' Adherence to Antiepileptic Drugs.","authors":"Suha Jarad,&nbsp;Amal Akour,&nbsp;Wael H Khreisat,&nbsp;Afrah K Elshammari,&nbsp;Saba Madae'en","doi":"10.1177/87551225221097619","DOIUrl":"https://doi.org/10.1177/87551225221097619","url":null,"abstract":"<p><strong>Background: </strong>Rate of nonadherence to antiepileptic drugs (AEDs) in children is about 33%. Engaging clinical pharmacists in the management of patients has proved to increase adherence to medications which will improve the outcomes of treatment.</p><p><strong>Objectives: </strong>To investigate the effect of a clinical pharmacist-led education on the adherence to AEDs in pediatric patients with epilepsy. Secondary outcomes include effectiveness and safety of AEDs, satisfaction with information about AEDs provided to the caregivers, and patients quality of life (QoL).</p><p><strong>Methods: </strong>This was an interventional study where pediatric patients were randomly assigned to the intervention (n = 41) or the control (n = 40) group. A 30-minute clinical pharmacist-led educational interview to the parent/caregiver was provided to the first group as add-on to standard medical care received by latter. Outcomes were measured at baseline and after 8-week follow-up.</p><p><strong>Results: </strong>The intervention group had an increase in mean adherence score from 6 ± 1.09 at baseline to 7.6 ± 0.9 at follow-up (<i>P</i> value < 0.001), while the control group had no significant change (<i>P</i> value > 0.05), the difference between the 2 groups at follow-up was significant (<i>P</i> value < 0.0001). No significant difference was observed between groups at follow-up with regard to effectiveness (<i>P</i> value > 0.05), and safety (<i>P</i> value = 0.08). While higher satisfaction with information (<i>P</i> value < 0.0001), and higher QoL (<i>P</i> value < 0.05) was observed in the intervention group.</p><p><strong>Conclusion and relevance: </strong>Clinical pharmacist-led education had a positive outcome on pediatric patients with epilepsy with regard to adherence, effectiveness, safety, satisfaction with information about AEDs, and QoL.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9420919/pdf/10.1177_87551225221097619.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9887990","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":"Effect of Antidepressants on Glucagon-Like Peptide-1 Receptor Agonist-Related Weight Loss.","authors":"Natalie Durell,&nbsp;Rachel Franks,&nbsp;Scott Coon,&nbsp;Kevin Cowart,&nbsp;Nicholas W Carris","doi":"10.1177/87551225221110850","DOIUrl":"https://doi.org/10.1177/87551225221110850","url":null,"abstract":"<p><strong>Background: </strong>Depression and obesity have a bidirectional relationship making the management of one, without the other, problematic. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a preferred medication class for diabetes and obesity treatment given their weight loss effect; however, it is not known how antidepressants impact this effect.</p><p><strong>Objective: </strong>To assess the impact of antidepressant use on GLP-1 RA-associated weight loss in patients with or without type 2 diabetes mellitus.</p><p><strong>Methods: </strong>This was a retrospective, propensity matched, cohort study conducted using TriNetX. The study identified patients initiating a GLP-1 RA being treated with citalopram/escitalopram, bupropion, or no antidepressant. Cohorts were propensity score matched to analyze the primary outcome of mean end-of-study (77-371 days) body weight.</p><p><strong>Results: </strong>An initial query identified 31 273 patients eligible for analysis (30 160 receiving no antidepressant, 311 receiving bupropion, and 802 receiving citalopram/escitalopram). After propensity score matching, the study found patients receiving citalopram/escitalopram were taking more antidiabetic therapies at baseline compared with patients not treated with an antidepressant. Patients in the antidepressant cohorts experienced less weight loss compared with their respective matched cohorts not receiving antidepressants (citalopram/escitalopram -0.73 kg versus -1.74 kg; bupropion -0.84 kg versus -3.46 kg). Only the bupropion cohort was significantly heavier at end-of-study versus the non-antidepressant cohort (108 kg versus 103 kg, <i>P</i> = 0.018).</p><p><strong>Conclusion and relevance: </strong>Antidepressants may diminish the weight loss effect of GLP-1 RAs. Additional research is needed to assess whether all GLP-1 RAs are affected similarly and the optimal weight loss strategies in patients receiving antidiabetic therapy with comorbid depression.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9420918/pdf/10.1177_87551225221110850.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9943093","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}