Journal of pharmacy practice最新文献

Eco-Sustainability in Hospital Pharmacy: A Pilot Survey on 'Going Green'. 医院药房的生态可持续性：医院药房的生态可持续性："走向绿色 "试点调查。

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Journal of pharmacy practice Pub Date : 2025-06-01 Epub Date: 2024-10-24 DOI: 10.1177/08971900241295285

Ariane Blanc, Delphine Moulin, Jameason Cameron

{"title":"Eco-Sustainability in Hospital Pharmacy: A Pilot Survey on 'Going Green'.","authors":"Ariane Blanc, Delphine Moulin, Jameason Cameron","doi":"10.1177/08971900241295285","DOIUrl":"10.1177/08971900241295285","url":null,"abstract":"Purpose: Between 2009 and 2015, the Canadian health care system was estimated to be responsible for 4.6% of national carbon emissions. Determine awareness of and describe eco-initiatives that the department of pharmacy can implement to aim to reduce the carbon footprint in hospital pharmacy in an effort to 'go green'. Methods: In a quality improvement initiative, pharmacy employees (i.e. pharmacists and pharmacy technicians) completed a cross-sectional survey designed to gauge willingness to 'go green' at work, to identify actionable areas of waste, and to assess commuting practices. Results: A total of 15 respondents completed the survey conducted March 14th -April 7th, 2022. Most respondents (73%) were willing to engage in more sustainable practices at work. The main barriers to implementing green practices at work were 'too time consuming' (20%), 'adds too much complexity' (20%), and 'cost' (16%). For commuting, 60% indicated the primary mode of transportation as 'personal vehicle', where 'subsidized transit' and was listed as the greatest incentive that could encourage a greener commute. The three largest areas of waste cited were 'single use plastic' (36%), 'limited of awareness of green practices' (15%), and 'lights left on in empty rooms' (12%). Conclusions: Pharmacy staff shared willingness to engage in more sustainable 'go green' practices but raised challenges to do so. With the knowledge that Canada has the second most climate intensive health system, there is a need for future research to describe how hospital pharmacies can contribute strategically to 'go green', advancing with implementing low carbon sustainable pharmacy practices.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"322-327"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502631","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: 0

Low Versus Standard Intensity Heparin Protocols in Adults Maintained on Extracorporeal Membrane Oxygenation: A Retrospective Cohort Study. 体外膜氧合维持治疗成人的低强度肝素方案与标准强度肝素方案：一项回顾性队列研究。

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Journal of pharmacy practice Pub Date : 2025-06-01 Epub Date: 2024-09-20 DOI: 10.1177/08971900241285248

Rachel C Robinson, Ashley N Taylor, Amy W Cato, Vijay S Patel, Jennifer L Waller, Nathaniel B Wayne

{"title":"Low Versus Standard Intensity Heparin Protocols in Adults Maintained on Extracorporeal Membrane Oxygenation: A Retrospective Cohort Study.","authors":"Rachel C Robinson, Ashley N Taylor, Amy W Cato, Vijay S Patel, Jennifer L Waller, Nathaniel B Wayne","doi":"10.1177/08971900241285248","DOIUrl":"10.1177/08971900241285248","url":null,"abstract":"Background: Patients maintained on extracorporeal membrane oxygenation (ECMO) often require systemic anticoagulation to prevent circuit clotting and systemic thromboembolic complications. The optimal intensity of anticoagulation to balance the risk of bleeding and prevention of thrombotic complications in this patient population is not well described. Objective: To compare bleeding events in patients on ECMO anticoagulated with standard vs low intensity heparin protocols. Methods: This single-center, retrospective cohort study included adult patients on VA- or VV-ECMO and anticoagulated with low or standard intensity heparin protocols. The primary outcome was the incidence of major bleeding; secondary outcomes included the incidence of minor bleeding, thrombotic complications, heparin-induced thrombocytopenia, in-hospital mortality, time in therapeutic range, anti-Xa correlation with aPTT, intensive care unit and hospital lengths of stay, oxygenator exchanges, and rate of protocol switching. Results: A total of 27 patients (14 low intensity, 13 standard intensity) were included. There were six major bleeding events in the low intensity group and four in the standard intensity group (P = 0.69); there were four minor bleeding events in the low intensity group and five in the standard intensity group (P = 0.69). Seven patients in the standard intensity group switched protocols; zero patients in the low intensity group switched protocols (P = 0.002). There were no differences in any other outcomes. Conclusions: There was no difference in the incidence of any bleeding or thrombotic events when using a low vs standard intensity heparin protocol in patients on ECMO. A low intensity heparin strategy for patients on ECMO may be feasible and safe.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"299-304"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289749","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: 0

Apixaban as a Secondary Prophylaxis Agent for Patent Foramen Ovale-Associated Stroke. 阿哌沙班作为卵圆孔未闭相关性脑卒中的二级预防用药。

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Journal of pharmacy practice Pub Date : 2025-06-01 Epub Date: 2024-09-24 DOI: 10.1177/08971900241287611

Rebecca M Khaimova, Yuliana Toderika, Justin Ramnarain, Claudette Donatien

{"title":"Apixaban as a Secondary Prophylaxis Agent for Patent Foramen Ovale-Associated Stroke.","authors":"Rebecca M Khaimova, Yuliana Toderika, Justin Ramnarain, Claudette Donatien","doi":"10.1177/08971900241287611","DOIUrl":"10.1177/08971900241287611","url":null,"abstract":"Background: The purpose of this case report is to describe a case of switching warfarin to apixaban in a patient on anticoagulant prophylaxis for a patent foramen ovale (PFO)-associated stroke. Case Summary: An 86-year-old Afro-Latina female with a past medical history of cerebrovascular accident (CVA) in 2012 secondary to PFO and diagnosed Atrial Fibrillation (AF). Patient was switched from warfarin to apixaban after 3 months of labile international normalized ratio (INR) levels. The patient's INR was monitored at a pharmacist-led anticoagulation clinic. As the patient's INR remained subtherapeutic while on warfarin, a shared decision was made to switch the patient to apixaban 2.5 mg twice daily due to consistently painful enoxaparin injections, inconsistent vitamin K intake, frequent clinic visits and unstable renal function. Patient tolerated the anticoagulant switch well and reported satisfaction with decreased clinic visits and variable vitamin K diet. At 12 months post-switch, the patient's complete blood count remains stable, no reported signs and symptoms of bleeding, and no new CVA or venous thromboembolism (VTE) events identified. Based on an improvement in renal function, the dose was increased to 5 mg twice daily.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"347-350"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348905","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: 0

Assessing Patient Feedback on the Feasibility of the YourRx Telepharmacy Mobile Application. 评估患者对 YourRx 远程药房移动应用程序可行性的反馈意见。

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Journal of pharmacy practice Pub Date : 2025-06-01 Epub Date: 2024-10-25 DOI: 10.1177/08971900241295286

Christine Veronica Misola, Zoe Nicolette Beatrice Oreta, Radha Kaur Lal, Maan Balt, Danica Resuello, Kevin Jace Miranda, Rogie Royce Carandang

{"title":"Assessing Patient Feedback on the Feasibility of the YourRx Telepharmacy Mobile Application.","authors":"Christine Veronica Misola, Zoe Nicolette Beatrice Oreta, Radha Kaur Lal, Maan Balt, Danica Resuello, Kevin Jace Miranda, Rogie Royce Carandang","doi":"10.1177/08971900241295286","DOIUrl":"10.1177/08971900241295286","url":null,"abstract":"Background: Telepharmacy is a method utilized in pharmacy practice that delivers pharmaceutical care services via telecommunication technology. In the Philippines, the current process for patients to avail of telepharmacy services utilizes a variety of existing applications or websites instead of a single application. Objectives: This study aimed to assess patient feedback on the feasibility of the newly developed telepharmacy mobile application, YourRx. Specifically, it evaluated the application's functionality, usability, security, and performance. Methods: The study had 3 phases: (1) the design and development phase, (2) the implementation phase, wherein the pharmacists and patients were oriented beforehand with the use of YourRx mobile application, and (3) the evaluation phase, where the mobile application was evaluated for its functionality, usability, security, and performance by the patients through the use of a survey questionnaire and an interview. Results: YourRx application was developed and evaluated successfully. It is available for Android users and has primary features, including video calls, sharing, and setting an appointment. A total of 46 patients used the YourRx. Most of the patients were very satisfied with the navigation, service acquisition, and overall design of the YourRx. They expressed convenience in acquiring telepharmacy services because the application was easy to understand, use, and navigate. Conclusion: YourRx is a pioneering telepharmacy mobile application in the Philippines. The results of this study substantiate that YourRx is a user-friendly platform that provides patients convenient access to telepharmacy services with less time and effort thus improving patient health outcomes.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"328-339"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502622","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: 0

Evaluation of Plasma-Lyte Versus Lactated Ringer's in Surgical Intensive Care Unit Trauma Patients as Fluid Resuscitation. 在外科重症监护室创伤患者的液体复苏中评估血浆-赖特与乳酸林格氏液的效果。

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Journal of pharmacy practice Pub Date : 2025-06-01 Epub Date: 2024-10-15 DOI: 10.1177/08971900241287854

Anna DeFrank, Shan Wang, Shahidul Islam, Kim Asmus, D'Andrea Joseph

{"title":"Evaluation of Plasma-Lyte Versus Lactated Ringer's in Surgical Intensive Care Unit Trauma Patients as Fluid Resuscitation.","authors":"Anna DeFrank, Shan Wang, Shahidul Islam, Kim Asmus, D'Andrea Joseph","doi":"10.1177/08971900241287854","DOIUrl":"10.1177/08971900241287854","url":null,"abstract":"In critically ill patients, fluid resuscitation with balanced crystalloids close to plasma osmolarity have a lower risk of electrolyte imbalances and demonstrated better clinical outcomes compared to normal saline (NS). While lactated ringer's (LR) has shown benefit over NS, plasma-lyte (PL) with a higher osmolarity and different electrolyte formulation is hypothesized to be superior. We performed a retrospective observational cohort study over 37 months at a tertiary hospital. Inclusion criteria were hospitalization in the surgical intensive care unit (SICU), trauma indication, ≥18 years old, and received either PL or LR. All PL administrations and every fifth patient with LR as resuscitation were included in order to match the sample size in each group. Primary outcomes were SICU length of stay (LOS), hospital LOS, and mortality. Secondary outcomes were biomarker changes from baseline. There were 113 patients in both PL and LR groups. The PL arm had higher APACHE II scores (16 vs 13, P = .033) and were more likely ventilated (39.3% vs 20.4%, P = .002) compared to LR. Median hospital LOS (12.0 vs 8.0, P < .001) and SICU LOS (6.0 vs 3.0, P < .001) are significantly longer in PL group compared to the LR group. However, there was no difference in in-hospital mortality (5.3% vs 3.5% P = .519) and SICU mortality (9.7% vs 5.3%, P > .208) between PL and LR. Overall, PL use was associated with prolonged hospital and SICU LOS. PL use did not demonstrate mortality benefit. However, patients were more critically ill in PL group based on higher APACHE II scores and higher rates of mechanical ventilation, which could be contributing to these unfavorable outcomes.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"314-321"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468339","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: 0

Standardized Clinical Infectious Diseases Pharmacy Care Delivery and Antimicrobial Stewardship Program Management Within a Large, Integrated Healthcare System. 大型综合医疗保健系统内的标准化临床传染病药房护理服务和抗菌药物管理计划管理。

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Journal of pharmacy practice Pub Date : 2025-06-01 Epub Date: 2024-12-12 DOI: 10.1177/08971900241308620

Stacy Lynn Harmon, Erik LaChance, Jessica L Miller, Sreya Patel, Amolee R Patel

{"title":"Standardized Clinical Infectious Diseases Pharmacy Care Delivery and Antimicrobial Stewardship Program Management Within a Large, Integrated Healthcare System.","authors":"Stacy Lynn Harmon, Erik LaChance, Jessica L Miller, Sreya Patel, Amolee R Patel","doi":"10.1177/08971900241308620","DOIUrl":"10.1177/08971900241308620","url":null,"abstract":"PurposeInfectious Diseases (ID) pharmacy expertise is crucial for the success of antimicrobial stewardship (AMS) efforts. As health systems expand due to mergers and acquisitions, ID pharmacy teams strive to deliver consistent care across the enterprise. This report describes the fusion of multiple AMS practice models during the integration of health systems to optimize and standardize care delivery.SummaryThe merger of two large, community hospital systems necessitated the recalibration of services of both legacy antimicrobial stewardship programs (ASPs). While there was agreement that ID pharmacists perform daily prospective audit and feedback of antimicrobials and respond to diagnostics and cultures, the prioritization of practices across the enterprise that retained allowances for individual hospital nuance was paramount. The result was a practice model dedicated to consistent patient care regardless of geographic location, socioeconomic status, or reliance on a single ID pharmacist's availability. Additionally, the team coordinates the system ASP, in collaboration with medical staff. This includes implementation of stewardship initiatives, formulary management and guideline and document control. Lastly, ID pharmacists serve as a resource for prescribers and pharmacy staff and leadership.ConclusionThe development of a standardized ID pharmacy practice model delivered through a hybrid of remote and in-person coverage addressed disparities in clinical services, education and ASP management. Complexities such as care gaps during leave are reconciled with this process while maintaining the minimum expectations of every ID pharmacist. This was especially crucial to establish consistent patient care across state lines with the rise of virtual services and inability to develop on-site rapport.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"340-346"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817897","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: 0

Why Bisoprolol? A Neglected Beta-Blocker in the U.S. 关于：为什么是比索洛尔？在美国被忽视的β-受体阻滞剂

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Journal of pharmacy practice Pub Date : 2025-06-01 Epub Date: 2024-12-15 DOI: 10.1177/08971900241308623

Kazuhiko Kido, Maya Guglin

引用次数: 0

Great Expectations: Semaglutide as Antidiabetic Weight Management in a Psychiatric Hospital. 美好的期望：塞马鲁肽作为精神病院的抗糖尿病体重管理药物

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Journal of pharmacy practice Pub Date : 2025-06-01 Epub Date: 2024-10-22 DOI: 10.1177/08971900241294122

Krysta Shannon, Grace Shyh

引用次数: 0

A Comparison of Vancomycin Area Under the Curve and Trough Concentration in Specific Populations. 比较万古霉素在特定人群中的曲线下面积和低浓度。

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Journal of pharmacy practice Pub Date : 2025-06-01 Epub Date: 2024-09-30 DOI: 10.1177/08971900241287274

Kadaajah L T Johnson-Louis, My-Linh Nguyen, Rosemary K Zvonar

{"title":"A Comparison of Vancomycin Area Under the Curve and Trough Concentration in Specific Populations.","authors":"Kadaajah L T Johnson-Louis, My-Linh Nguyen, Rosemary K Zvonar","doi":"10.1177/08971900241287274","DOIUrl":"10.1177/08971900241287274","url":null,"abstract":"Background: Vancomycin is an antibiotic known to cause nephrotoxicity, particularly when a vancomycin trough of 15 to 20 mg/L, a surrogate for an area under the curve (AUC) of at least 400 mgh/L, is targeted. Although monitoring vancomycin AUC is more resource intensive, it may especially benefit populations expected to be at higher risk of nephrotoxicity. Objective: To describe the proportion of discordance between vancomycin AUC and trough concentration in targeted high-risk populations. Methods: A prospective observational review was conducted on adults receiving intravenous vancomycin for more than 48 hours from May 9 to June 3, 2022. Patients included were elderly, obese, had renal dysfunction, and/or received 4 grams or more of vancomycin daily with a pending vancomycin trough concentration. A peak concentration was ordered by a project team member to calculate AUC to assess discordance. Results: A total of 47 patients were included with 87 vancomycin minimum concentration (Cmin)/AUC pairs analyzed. Discordance was observed in 52.9% of Cmin/AUC pairs in the entire cohort. The majority (79%) of the 43 Cmin levels <15 mg/L had an associated AUC >400 mgh/L and 57% of 21 Cmin levels within the 15 to 20 mg/L range had an AUC >600 mgh/L. Conclusion: A high degree of discordance between vancomycin Cmin and AUC was present in patients considered to be at high risk of nephrotoxicity. Monitoring vancomycin AUC in these patients may reduce the risk of nephrotoxicity.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"305-313"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348904","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: 0

A Pilot Project to Implement a Pharmacist-Managed Remote Blood Pressure Monitoring Service. 实施由药剂师管理的远程血压监测服务试点项目。

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Journal of pharmacy practice Pub Date : 2025-06-01 Epub Date: 2024-09-19 DOI: 10.1177/08971900241285943

Kaci Boehmer, Chris Johnson

{"title":"A Pilot Project to Implement a Pharmacist-Managed Remote Blood Pressure Monitoring Service.","authors":"Kaci Boehmer, Chris Johnson","doi":"10.1177/08971900241285943","DOIUrl":"10.1177/08971900241285943","url":null,"abstract":"Background: Clinicians often hesitate to adjust antihypertensive medications based solely on clinic blood pressure (BP) readings. Limitations to obtaining home readings include access to sphygmomanometers and ability to provide accurate, reliable readings upon follow-up. Objective: This study examined whether an online platform linked to remote BP monitoring improved BP management and facilitated effective clinical interventions by pharmacists. Methods: Thirty patients with uncontrolled hypertension were enrolled and provided a remote BP monitor for home use. BP data downloaded to an online platform were monitored by two clinic pharmacists. Daily BP checks were requested (up to twice daily), and pharmacists called patients approximately weekly for 6 months. Through approved protocols, pharmacists individualized interventions to improve patient care. Descriptive statistics were used for demographic and clinical data. Results: The average systolic BP reduction was 39 mmHg (IQR = 17-52.5) for the 21 patients included in analysis. A target BP <140/<90 was achieved by 67%, and 76% had improved BP control. Patients utilized the cuff 2-4 times (n = 10) or >5 times weekly (n = 11). Through 261 patient contact attempts, the pharmacists requested more BP checks (n = 62), changed medications (n = 57), or provided non-pharmacologic counseling (n = 24) most often. Medication changes commonly included dose increases (n = 35) and additional agents (n = 17) for BP control. Spironolactone (n = 5) and thiazide diuretics (n = 5) were the most added medications. Conclusions: Most patients were willing to check their BP when provided with devices. The majority achieved a clinically significant decrease in home BP readings, demonstrating that pharmacist-driven home-monitoring programs can improve the optimization of hypertension regimens.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"294-298"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289747","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: 0