Journal of Pharmacy Technology最新文献_第8页

Comparison of Two Intravenous Insulin Titration Methods in Hyperglycemic Crisis 两种静脉滴注胰岛素治疗高血糖危重症的比较

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Journal of Pharmacy Technology Pub Date : 2017-04-01 DOI: 10.1177/8755122517690749

E. Rohrbach, Kelli N Webb, T. Costello

{"title":"Comparison of Two Intravenous Insulin Titration Methods in Hyperglycemic Crisis","authors":"E. Rohrbach, Kelli N Webb, T. Costello","doi":"10.1177/8755122517690749","DOIUrl":"https://doi.org/10.1177/8755122517690749","url":null,"abstract":"Background: Glycemic control using intravenous insulin infusions is an important component of hyperglycemic crisis treatment. Literature supports the use of standardized titration protocols; however, comparisons of specific methods are limited. Objective: Compare the safety and efficacy of 2 insulin infusion titration methods used in hyperglycemic crisis. Methods: A retrospective chart review was conducted including adults admitted to an inpatient facility from August 1, 2013, to August 1, 2015, who were treated for at least 4 hours with an intravenous insulin infusion. Primary efficacy outcomes of time to anion gap closure and time to goal blood glucose was studied in patients meeting criteria for diabetic ketoacidosis (n = 79), while the primary safety outcome of rates of hypoglycemia were compared among all study patients (n = 200). Results: The fixed-rate titration method had statistically shorter time to blood glucose <200 mg/dL compared to the multiplier titration group (6.1 [4.0] vs 8.8 [4.4], respectively; P = .018; mean time in hours [standard deviation]); however, no statistically significant difference was seen in the other primary efficacy and safety outcomes. Statistical improvements were found in secondary outcomes of intensive/progressive care units, length of stay, and infusion duration in the fixed-rate titration method, while less deviation from titration recommendations was found in the multiplier titration group. Conclusions: Significant differences seen in time to a goal blood glucose, deviation prevalence, and holds of the infusion for low blood glucose have identified areas for optimization, additional study, and staff education.","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"34 1","pages":"72 - 77"},"PeriodicalIF":1.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75615726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Syphilis Screening 梅毒筛查

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Journal of Pharmacy Technology Pub Date : 2017-04-01 DOI: 10.1177/8755122517691308

M. Goza, Benjamin D. Kulwicki, J. Akers, M. Klepser

{"title":"Syphilis Screening","authors":"M. Goza, Benjamin D. Kulwicki, J. Akers, M. Klepser","doi":"10.1177/8755122517691308","DOIUrl":"https://doi.org/10.1177/8755122517691308","url":null,"abstract":"Objective: To provide a review on the use, percent positive agreement (PPA), percent negative agreement (PNA), and utilization of Syphilis Health Check for syphilis screening in community pharmacies (in coordination with public health departments) in an effort to increase overall syphilis screening in high-risk populations. Data Sources: PubMed was searched for the following keywords: syphilis, sexually transmitted diseases, diagnosis, public health, point-of-care tests. The search included all dates up to December 2016. Study Selection: Data from studies including the use of the Syphilis Health Check Rapid Immunochromatographic Test were included. Data Synthesis: There are many existing tests to aid in the diagnosis of syphilis. The Syphilis Health Check was compared with these assays using PPA and PNA, where it demonstrated a high level of accuracy in the detection of syphilis antibodies. Conclusion: The Syphilis Health Check Rapid Immunochromatographic Test is a Clinical Laboratory Improvement Amendments–waived assay that has been shown to be easy to use and produces results in minutes. As one of the most accessible health care providers, pharmacists have an opportunity to join the fight against syphilis, and in collaboration with public health departments, screen a vast number of high-risk patients and deliver follow-up care as needed.","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"2 1","pages":"53 - 59"},"PeriodicalIF":1.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82026801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Drug Therapy Problems Identified by Pharmacists Through Comprehensive Medication Management Following Hospital Discharge 药师通过出院后综合用药管理发现的药物治疗问题

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Journal of Pharmacy Technology Pub Date : 2017-03-27 DOI: 10.1177/8755122517698975

Sarah M Westberg, Sarah K. Derr, E. Weinhandl, T. Adam, A. Brummel, J. Lahti, S. Reidt, Brian Sick, Kyle Skiermont, W. S. St. Peter

{"title":"Drug Therapy Problems Identified by Pharmacists Through Comprehensive Medication Management Following Hospital Discharge","authors":"Sarah M Westberg, Sarah K. Derr, E. Weinhandl, T. Adam, A. Brummel, J. Lahti, S. Reidt, Brian Sick, Kyle Skiermont, W. S. St. Peter","doi":"10.1177/8755122517698975","DOIUrl":"https://doi.org/10.1177/8755122517698975","url":null,"abstract":"Background: Pharmacists influence health care outcomes through the identification and resolution of drug therapy problems (DTPs). Objective: The objectives of this study were to describe number, type, and severity of DTPs based on clinical significance and likelihood of harm in patients transitioning from hospital to home as assessed during a comprehensive medication management (CMM) visit with a pharmacist. Secondary objectives were to assess intrarater reliability in severity ratings and assess likelihood of harm for adverse drug reactions (ADR) by drug classes. Methods: Retrospective review of 408 patients having a face-to-face, telephonic, or virtual CMM visit within the Fairview Health System. Teams of 3 investigators reviewed each DTP from the electronic medical record for each of the 408 patients and assigned a severity score (0-10) for clinical significance and likelihood of harm. Main Results: The highest severity DTP classes were adherence and ADR. The lowest severity DTP class was unnecessary drug therapy. An average of 2.5 DTPs was found per patient at the index CMM visit following hospital discharge. The most common DTP classes were needs additional therapy and dose too low. There were statistically significant differences in DTP severity scoring between reviewer types, though differences were <5%. Drug classes with the highest severity ADR included diabetes, cardiovascular, and anticoagulant/antiplatelet agents. Conclusions: The DTP severity ratings indicated that reviewers found ADR and adherence DTPs were potentially the most severe. There were differences in DTP ratings between reviewer types, though clinical significance of these differences is unclear.","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"1079 1","pages":"107 - 96"},"PeriodicalIF":1.0,"publicationDate":"2017-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76698957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 29

Evaluation of the Appropriateness of Direct Oral Anticoagulant Selection and Monitoring in the Outpatient Setting 门诊直接口服抗凝剂选择与监测的适宜性评价

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Journal of Pharmacy Technology Pub Date : 2017-03-23 DOI: 10.1177/8755122517698976

K. Rieser, E. Rosenberg, Katherine Vogel Anderson

{"title":"Evaluation of the Appropriateness of Direct Oral Anticoagulant Selection and Monitoring in the Outpatient Setting","authors":"K. Rieser, E. Rosenberg, Katherine Vogel Anderson","doi":"10.1177/8755122517698976","DOIUrl":"https://doi.org/10.1177/8755122517698976","url":null,"abstract":"Background: Direct oral anticoagulants (DOACs) share many indications with warfarin but require less frequent follow-up and monitoring. There is limited data available on the prescribing of DOACs and appropriate laboratory monitoring in a real-world clinical setting. Objective: To determine if patients receiving care at 2 University of Florida (UF) Health Internal Medicine clinics are prescribed DOACs according to Food and Drug Administration (FDA)–approved labeling. Secondary objectives were to determine the percentage of patients receiving appropriate baseline laboratory tests prior to DOAC initiation and the frequency of laboratory monitoring. Methods: This retrospective chart review evaluated patients enrolled at 2 UF Health Internal Medicine practices within the UF Health system who were prescribed a DOAC between April 2014 and April 2015. Adherence to FDA-approved dosing recommendations and baseline laboratory tests were compared to previously published data. This study was approved by the UF Institutional Review Board. Results: A total of 194 patients met inclusion criteria. Ninety-six patients (49.5%) were on a DOAC prior to data collection; 98 patients (50.5%) started a DOAC during data collection. Of the 194 patients, 155 (79.9%) were prescribed DOACs per FDA-approved labeling (P = .0005); 79 (40.8%) obtained a complete blood count, serum creatinine, and liver function tests prior to DOAC initiation. Conclusions: Prescribing practices were significantly better than published data; however, 1 in 5 patients were not prescribed a DOAC according to FDA-approved labeling. Less than half of the patients started on a DOAC obtained the recommended labs prior to medication initiation.","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"3 1","pages":"108 - 113"},"PeriodicalIF":1.0,"publicationDate":"2017-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88398447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Preference and Frequency of Mobile Phone App Use for Drug Information Among Student Pharmacists 药学专业学生使用手机App获取药品信息的偏好及频率

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Journal of Pharmacy Technology Pub Date : 2017-03-15 DOI: 10.1177/8755122517698164

Sharon K. Park, Miriam C. Purnell, M. K. Freeman, Racquel V. Reese, S. Varga

{"title":"Preference and Frequency of Mobile Phone App Use for Drug Information Among Student Pharmacists","authors":"Sharon K. Park, Miriam C. Purnell, M. K. Freeman, Racquel V. Reese, S. Varga","doi":"10.1177/8755122517698164","DOIUrl":"https://doi.org/10.1177/8755122517698164","url":null,"abstract":"Background: Health care professionals commonly use mobile devices to retrieve drug information (DI) in clinical practice. The preference and frequency of such use by student pharmacists are not well understood. Objective: To investigate the preference and frequency of mobile phone application (app) use for retrieving DI among student pharmacists. Methods: DI specialists from 3 pharmacy schools generated a 13-question survey relating to students’ preference and frequency of DI app use via their mobile phone. The survey was tested and electronically disseminated to all current P1 through P4 students from all 3 schools. Data were collected for student demographics, availability of mobile phone and DI apps, frequency of using DI apps, and whether DI apps were purchased. Data were analyzed descriptively and statistically. Results: About 74% (n = 221) of students reported using their mobile phone apps for retrieving DI. About 95% of the students used 1 to 3 apps for DI purposes and more than 85% used them a few times a week or more. About 17.6% of the students reported purchasing apps for the purpose of finding DI and that purchased apps are more accurate (27.6%), more comprehensive (36.2%), and more current (26.2%), compared with free apps. Conclusions: Student pharmacists used 1 to 3 mobile apps, at least a few times a week for DI. Some students purchased apps for DI use in addition to free subscriptions from their school. Students perceived purchased DI apps being more accurate, more comprehensive, and more up to date than the free apps.","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"93 11","pages":"87 - 95"},"PeriodicalIF":1.0,"publicationDate":"2017-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72616143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Unavailability of Outpatient Medications: Examples and Opportunities for Management 门诊药物不可用:管理的例子和机会

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Journal of Pharmacy Technology Pub Date : 2017-03-12 DOI: 10.1177/8755122517697072

M. McLaughlin, J. Lin, R. Nguyen, Pratixa Patel, E. Fox

引用次数: 3

Reveiwers Summary Reveiwers总结

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Journal of Pharmacy Technology Pub Date : 2017-02-01 DOI: 10.1177/8755122516687493

引用次数: 0

Development of Novel Formulas to Determine Hospital and Pharmacy Opportunities to Reduce Extended Length of Stay 开发新配方，以确定医院和药房的机会，以减少延长的住院时间

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Journal of Pharmacy Technology Pub Date : 2017-02-01 DOI: 10.1177/8755122516677081

Kevin N. Hansen, Kathryn A. Morbitzer, Kayla M. Waldron, Lindsey B. Amerine

{"title":"Development of Novel Formulas to Determine Hospital and Pharmacy Opportunities to Reduce Extended Length of Stay","authors":"Kevin N. Hansen, Kathryn A. Morbitzer, Kayla M. Waldron, Lindsey B. Amerine","doi":"10.1177/8755122516677081","DOIUrl":"https://doi.org/10.1177/8755122516677081","url":null,"abstract":"Background: Hospital length of stay (LOS) is an important measure to determine resource utilization and efficiency of care for inpatients. No existing objective methodology is available to determine where and how pharmacy departments can have maximal impact on reducing extended LOS. Objective: An objective methodology to guide decisions by hospital pharmacy departments on reducing extended LOS is described. Methods: University of North Carolina Medical Center’s LOS was compared to hospitals with similar inpatient bed size and case mix index. Objective methodology using pharmacy intensity weight, LOS index, and relative number of cases overall and by hospital service was developed to identify targets of impacting LOS for a pharmacy department. Results: The novel Pharmacy Opportunity Length of Stay (POLOS) formula was developed to prioritize each Medicare Severity Diagnosis Related Group (MSDRG) based on the overall impact pharmacy can have on reducing extended LOS at an individual institution. An additional novel formula, Service Specific POLOS (SSPOLOS), was created to strategically target hospital services, as opposed to MSDRGs, allowing for effective deployment of targeted pharmacy interventions to decrease extended LOS. Conclusion: POLOS and SSPOLOS are novel formulas to guide pharmacy departments in objectively prioritizing and targeting resources to reduce extended LOS. The novel formulas can be used to quantify LOS performance at the hospital and pharmacy specific levels, in addition to providing a hospital service approach to launch LOS initiatives at health care institutions. To our knowledge, this represents the first opportunity for hospital pharmacy departments to objectively target and reduce extended LOS.","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"20 1","pages":"15 - 22"},"PeriodicalIF":1.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86911515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Impact of Pharmacist Follow-up Intervention on Patient Return to a Community Pharmacy From a Convenient Care Clinic 药师随访干预对便民门诊患者返回社区药房的影响

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Journal of Pharmacy Technology Pub Date : 2017-02-01 DOI: 10.1177/8755122516678266

Michelle N. Schroeder, J. Potter, K. DiDonato, Aaron J. Lengel, M. F. Powers

{"title":"Impact of Pharmacist Follow-up Intervention on Patient Return to a Community Pharmacy From a Convenient Care Clinic","authors":"Michelle N. Schroeder, J. Potter, K. DiDonato, Aaron J. Lengel, M. F. Powers","doi":"10.1177/8755122516678266","DOIUrl":"https://doi.org/10.1177/8755122516678266","url":null,"abstract":"Background: Convenient Care Clinics (CCCs) located within the same facility as a retail pharmacy offer the opportunity for immediate fill of prescriptions from the CCC and may also provide a source of new customers for the pharmacy. Objective: To assess the impact of a follow-up intervention on new patients seen at a CCC returning to the pharmacy for subsequent prescription fills compared to the control group. Methods: New patients who filled a prescription from the CCC in November and December 2015 received an initial follow-up telephone call or letter, respectively, from the pharmacist within 10 days of their prescription fill date. The primary end point of the percentage of patient return was assessed for 3 months following the initial fill date. Secondary end points included number of prescriptions transferred and customer satisfaction scores. Results: Thirty-four out of 214 patients in the control group returned to the pharmacy for subsequent prescription fills (15.9%). Fourteen out of 52 patients in the telephone group returned to the pharmacy for additional prescription fills following a telephone call from the pharmacist. (26.9%, P = .063) Sixteen out of 77 patients in the letter group returned to the pharmacy after their first prescription. (20.8%, P = .329). Conclusions: Following-up with new patients to the pharmacy in the form of a personalized telephone call increases the likelihood of patients continuing to utilize the pharmacy for their prescription needs.","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"44 1","pages":"23 - 30"},"PeriodicalIF":1.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89955875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Hospital-Based Clinical Pharmacy Services to Improve Ambulatory Management of Chronic Obstructive Pulmonary Disease 以医院为基础的临床药学服务改善慢性阻塞性肺疾病的门诊管理

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Journal of Pharmacy Technology Pub Date : 2017-02-01 DOI: 10.1177/8755122516675635

Amber L. Smith, Valerie Palmer, Nada M Farhat, J. Kalus, K. Thavarajah, B. Digiovine, Nancy Macdonald

{"title":"Hospital-Based Clinical Pharmacy Services to Improve Ambulatory Management of Chronic Obstructive Pulmonary Disease","authors":"Amber L. Smith, Valerie Palmer, Nada M Farhat, J. Kalus, K. Thavarajah, B. Digiovine, Nancy Macdonald","doi":"10.1177/8755122516675635","DOIUrl":"https://doi.org/10.1177/8755122516675635","url":null,"abstract":"Background: No systematic evaluations of a comprehensive clinical pharmacy process measures currently exist to determine an optimal ambulatory care collaboration model for chronic obstructive pulmonary disease (COPD) patients. Objective: Describe the impact of a pharmacist-provided clinical COPD bundle on the management of COPD in a hospital-based ambulatory care clinic. Methods: This retrospective cohort analysis evaluated patients with COPD managed in an outpatient pulmonary clinic. The primary objective of this study was to assess the completion of 4 metrics known to improve the management of COPD: (1) medication therapy management, (2) quality measures including smoking cessation and vaccines, (3) patient adherence, and (4) patient education. The secondary objective was to evaluate the impact of the clinical COPD bundle on clinical and economic outcomes at 30 and 90 days post–initial visit. Results: A total of 138 patients were included in the study; 70 patients served as controls and 68 patients received the COPD bundle from the clinical pharmacist. No patients from the control group had all 4 metrics completed as documented, compared to 66 of the COPD bundle group (P < .0001). Additionally, a statistically significant difference was found in all 4 metrics when evaluated individually. Clinical pharmacy services reduced the number of phone call consults at 90 days (P = .04) but did not have a statistically significant impact on any additional pre-identified clinical outcomes. Conclusion: A pharmacist-driven clinical COPD bundle was associated with significant increases in the completion and documentation of 4 metrics known to improve the outpatient management of COPD.","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"20 1","pages":"14 - 8"},"PeriodicalIF":1.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90069726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 13