Journal of pharmacy practice最新文献_第2页

Olmesartan-Induced Enteropathy: Case Reports and Insights From FDA Adverse Event Reporting System (FAERS). 奥美沙坦诱发的肠病：来自FDA不良事件报告系统（FAERS）的病例报告和见解。

IF 1.1

Journal of pharmacy practice Pub Date : 2025-09-06 DOI: 10.1177/08971900251376797

Ilaria Mariani, Giulia Mosini, Stefania Cheli, Sofia Dinegro, Andrea Vicenzi, Cecilia Bonino, Vera Battini, Carla Carnovale, Emilio Clementi, Sonia Radice

{"title":"Olmesartan-Induced Enteropathy: Case Reports and Insights From FDA Adverse Event Reporting System (FAERS).","authors":"Ilaria Mariani, Giulia Mosini, Stefania Cheli, Sofia Dinegro, Andrea Vicenzi, Cecilia Bonino, Vera Battini, Carla Carnovale, Emilio Clementi, Sonia Radice","doi":"10.1177/08971900251376797","DOIUrl":"https://doi.org/10.1177/08971900251376797","url":null,"abstract":"Olmesartan, an angiotensin II receptor blocker (ARB) approved in 2002, is used to treat hypertension, either alone or with other antihypertensive drugs. It has been frequently associated with sprue-like enteropathy, while few cases of colitis have been reported. Differentiating between sprue-like enteropathy and colitis is of clinical concern, since just the first condition is a well-documented adverse event of olmesartan. Diagnosis of these occurrences is difficult, as symptoms are unspecific namely diarrhoea, weight loss, fatigue, nausea, and abdominal discomfort, with laboratory findings showing anaemia, electrolyte imbalances, and vitamin deficiencies. Here, we report two cases of patients in treatment for hypertension with olmesartan in association with hydrochlorothiazide and amlodipine, who developed sprue-like enteropathy and colitis, respectively. We then conducted a disproportionality analysis of cases retrieved from the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) to assess the association level between these conditions and olmesartan. We found a strong association between olmesartan and sprue-like enteropathy (ROR 8499.53 (95% CI: 8402.05 - 16383.99)). Olmesartan resulted to be associated also with colitis (ROR 2.56 (95% CI: 2.28 - 2.88)). In light of the diagnostic challenges posed by nonspecific symptoms, these findings underscore the importance of distinguishing between the two conditions in patients exposed to olmesartan, to improve the spectrum of knowledge.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251376797"},"PeriodicalIF":1.1,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006229","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 Bleeding and Thrombotic Outcomes of Anticoagulation Strategies Upon Intensive Care Unit Admission for Patients with Atrial Fibrillation on Direct Oral Anticoagulants. 房颤患者直接口服抗凝剂入住重症监护病房时抗凝策略的出血和血栓结局评价。

IF 1.1

Journal of pharmacy practice Pub Date : 2025-09-06 DOI: 10.1177/08971900251376819

Priya J Patel, Mariah I Sigala, Corey V Dinunno, Laura M Blackburn, Kevin R Donahue

{"title":"Evaluation of Bleeding and Thrombotic Outcomes of Anticoagulation Strategies Upon Intensive Care Unit Admission for Patients with Atrial Fibrillation on Direct Oral Anticoagulants.","authors":"Priya J Patel, Mariah I Sigala, Corey V Dinunno, Laura M Blackburn, Kevin R Donahue","doi":"10.1177/08971900251376819","DOIUrl":"https://doi.org/10.1177/08971900251376819","url":null,"abstract":"Background: Critically ill adults are more commonly being admitted to intensive care units (ICU) with a recent history of direct oral anticoagulant (DOAC) use. No consensus guidance exists on optimal anticoagulation strategies in critically ill adults with non-valvular atrial fibrillation (NVAF) on DOAC's prior to ICU admission, and there is considerable variability in clinical practice. Objective: To evaluate rates of major bleeding and thrombosis between 2 anticoagulation strategies for NVAF upon ICU admission: package insert (continuation of oral or parenteral anticoagulation per manufacturer recommendations) vs non-package insert (prophylactic dosing or delayed therapeutic anticoagulation). Study design: This was a retrospective cohort study conducted from January 2019 to August 2023. Patients with NVAF and objective evidence of DOAC exposure within 48 hours of ICU admission were included. Those admitted to the ICU for a bleeding event or who received anticoagulation for indications other than NVAF were excluded. Results: A total of 353 patients met inclusion criteria (122 vs 231 in the package insert and non-package insert groups, respectively). There was no significant difference in the composite incidence of major bleeding and stroke or systemic embolism between groups (4.1% in package insert vs 6.1% in non-package insert; P = 0.437). Conclusion: This study demonstrated no difference in the incidence of major bleeding, in-hospital stroke, or systemic embolism with a package insert vs a non-package insert approach to anticoagulation in critically ill patients receiving DOAC therapy for atrial fibrillation. However, more studies are needed to develop evidence-based guidance on anticoagulation management in this population.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251376819"},"PeriodicalIF":1.1,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008390","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 Change in Medication Regimen Complexity-ICU (MRC-ICU) Score Following Implementation of a Virtual Intensive Care Model in a Multisite, Rural Health-System. 在多站点农村卫生系统中实施虚拟重症监护模式后药物治疗方案复杂性- icu （MRC-ICU）评分变化的评估

IF 1.1

Journal of pharmacy practice Pub Date : 2025-09-06 DOI: 10.1177/08971900251370888

David Mastro, Karen Williams, Joshua Campbell

{"title":"Evaluation of Change in Medication Regimen Complexity-ICU (MRC-ICU) Score Following Implementation of a Virtual Intensive Care Model in a Multisite, Rural Health-System.","authors":"David Mastro, Karen Williams, Joshua Campbell","doi":"10.1177/08971900251370888","DOIUrl":"https://doi.org/10.1177/08971900251370888","url":null,"abstract":"Background: Telehealth in the ICU (Tele-ICU) may improve patient outcomes and optimize utilization of high acuity intensive care unit (ICU) beds. However, the relationship between tele-ICU and medication regimen complexity-ICU (MRC-ICU) score is unexplored. Objective: To assess the effect of tele-ICU on MRC-ICU score and describe pharmacists' work. Methods: Adult ICU encounters lasting at least 24 h were retrospectively compared pre- and post- implementation of tele-ICU services in a rural, five-hospital system. The primary outcome was MRC-ICU score 24 h after ICU admission. Prospectively, pharmacist interventions during ICU encounters were captured. Encounters were categorized on exposure to clinical pharmacist review. Results: The difference in mean MRC-ICU score between pre- and post-intervention encounters was -0.2032 (95% CI,-0.8253, 0.4188, P = 0.5217). Post-intervention encounters had a higher rate of thromboembolism prophylaxis (64.5% vs 54.9%, P = 0.001), higher adherence to stress-ulcer prophylaxis (74.1% vs 60.9%, P < 0.001), and a lower presence of glycemic control agent(s) (39.8% vs 46.2%, P = 0.017) 24 h after ICU admission. Tele-ICU services did not significantly change ICU LOS (3.261 vs 3.166 days, P = 0.536), nor ICU mortality (11.1% vs 12.7%, P = 0.377). In the prospective period (n = 196 encounters), 189 interventions were recorded on 80 encounters. There was no difference in median MRC-ICU score at 24 h in encounters with clinical pharmacist review and intervention vs without scheduled clinical pharmacist review (9 vs 8, P = 0.0596). Conclusion: Implementation of Tele-ICU did not change the MRC-ICU score at 24 h, although some ICU bundled care metrics improved. Many encounters lack opportunity for meaningful pharmacy interventions.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251370888"},"PeriodicalIF":1.1,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006244","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

Glucagon-like Peptide-1 Receptor Agonists and Reproductive Health: Current Evidence and Clinical Implications. 胰高血糖素样肽-1受体激动剂与生殖健康：目前的证据和临床意义。

IF 1.1

Journal of pharmacy practice Pub Date : 2025-09-04 DOI: 10.1177/08971900251376795

Jordyn Kettner, Elizabeth Donnelly, Marina L Maes

{"title":"Glucagon-like Peptide-1 Receptor Agonists and Reproductive Health: Current Evidence and Clinical Implications.","authors":"Jordyn Kettner, Elizabeth Donnelly, Marina L Maes","doi":"10.1177/08971900251376795","DOIUrl":"https://doi.org/10.1177/08971900251376795","url":null,"abstract":"Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have experienced rapid growth in recent years as treatments for type 2 diabetes mellitus and obesity. These medications offer promising benefits, including weight loss and improved glycemic control; however, their implications for reproductive health warrant attention. While tirzepatide has been shown to impact absorption of oral contraceptives due to delayed gastric emptying, other GLP-1RAs do not appear to have clinically significant interactions with oral contraception. Fertility outcomes may improve with GLP-1RAs and dual GLP-1/GIP agonists due to weight loss and related metabolic benefits. Despite their widespread use, data on GLP-1RAs in pregnancy and lactation remain limited, leaving significant gaps in guidance for clinicians. This review synthesizes current literature on GLP-1RAs to highlight reproductive health considerations, including their potential impacts on contraception, fertility, pregnancy, and lactation. Greater awareness and understanding of these factors can support informed decision-making and optimize care for individuals using GLP-1RAs.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251376795"},"PeriodicalIF":1.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000853","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

Greater HIV Viral Load Suppression in Patients Using an Integrated Health System Specialty Pharmacy. 使用综合卫生系统专业药房的患者更大的HIV病毒载量抑制。

IF 1.1

Journal of pharmacy practice Pub Date : 2025-09-04 DOI: 10.1177/08971900251376796

Karen Salomon-Escoto, Martha Stutsky, George Reed, Monica Y Hinestroza Jordan, Jonathan Kay, Mireya Wessolossky

{"title":"Greater HIV Viral Load Suppression in Patients Using an Integrated Health System Specialty Pharmacy.","authors":"Karen Salomon-Escoto, Martha Stutsky, George Reed, Monica Y Hinestroza Jordan, Jonathan Kay, Mireya Wessolossky","doi":"10.1177/08971900251376796","DOIUrl":"https://doi.org/10.1177/08971900251376796","url":null,"abstract":"PurposeThis study assessed the impact of an integrated health system specialty pharmacy (HSSP) on viral load (VL) suppression in HIV patients, compared to patients utilizing non-health system specialty pharmacies (non-HSSPs).MethodsThis was a single-center, retrospective observational cohort study of patients ≥18 years with a HIV diagnosis and an encounter in the outpatient HIV clinic at an academic medical center associated with a HSSP, at least one order for an antiretroviral (ARV) medication, and at least one HIV-1 RNA VL result between January 2018 and May 2022. Outcomes included average rate of VL suppression and socio-demographic factors associated with VL suppression. Comparison of VL suppression between groups was tested using a generalized estimating equation logistic regression.ResultsFrom January 2018 to May 2022, 889 patients met the inclusion criteria; 326 provided VL results while filling at the HSSP and 681 had results while filling through a non-HSSP (118 patients provided results in both groups). Of the 5295 VL results, 90.6% reflected VL suppression, with the average rate of 91.0% in the HSSP group vs 86.0% in the non-HSSP group (adjusted OR = 1.89 95% CI: [1.40, 2.56]). Sex, ethnicity, and race were not associated with VL suppression. However, VL suppression decreased significantly with Charleson Comorbidity Index 1-3; increased with age; and increased over time from VL index date.ConclusionsHIV patients filling ARV therapy through a HSSP had a higher rate of VL suppression than those filling through non-HSSPs, highlighting the potential clinical benefit of this specialty pharmacy model.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251376796"},"PeriodicalIF":1.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000846","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

Beyond the Bedside: Utilization of an On-Call Pharmacist to Bridge Gaps in Clinical Coverage for Select Critically ill Populations. 超越床边：利用一个随叫随到的药剂师，以弥合差距，在临床覆盖的选择重症人群。

IF 1.1

Journal of pharmacy practice Pub Date : 2025-09-04 DOI: 10.1177/08971900251376800

Alyssa S Meester, Erica Caffarini, Mariela Cardona Gonzalez, Michael Young, Jordan DeWitt

{"title":"Beyond the Bedside: Utilization of an On-Call Pharmacist to Bridge Gaps in Clinical Coverage for Select Critically ill Populations.","authors":"Alyssa S Meester, Erica Caffarini, Mariela Cardona Gonzalez, Michael Young, Jordan DeWitt","doi":"10.1177/08971900251376800","DOIUrl":"https://doi.org/10.1177/08971900251376800","url":null,"abstract":"PurposeTo describe the utilization of an on-call critical care pharmacist to bridge gaps in clinical coverage for subspecialized critically ill populations.MethodsIn October 2022, a 24/7 on-call team of medical and cardiac ICU pharmacists was established to field questions regarding patients with mechanical circulatory support and pulmonary hypertension. On-call pharmacists were available via centralized telephone number Monday through Friday from 4:00 p.m. to 8:00 a.m., and at all hours on weekends. Information characterizing calls received was collected in an electronic database. A review of all database entries through March 2025 was conducted and descriptive statistics were used to quantify calls received, time spent, multidisciplinary team member engagement, and types of interventions.ResultsOn-call pharmacists received 207 calls and documented 218 interventions. Calls were most often received between the hours of 4:00 p.m. and 8:00 a.m., and the median time spent per call was 10 minutes (IQR 5-20 minutes). On-call critical care pharmacists received the most calls for ECMO patients (38.2%), followed by pulmonary hypertension (26.1%) and Impella® patients (20.8%). The majority of inquiries were from pharmacists (35.7%), followed by advanced practice providers (33.3%) and physicians (21.3%). Anticoagulation and hemostasis was the most commonly cited intervention category (56.4%).ConclusionIn the absence of an onsite critical care pharmacist, a 24/7 on-call critical care pharmacist was utilized by members of the multidisciplinary team to bridge gaps in clinical coverage. Further research is needed to determine the pharmacoeconomic and clinical impacts of on-call critical care pharmacists when onsite resources are unavailable.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251376800"},"PeriodicalIF":1.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992833","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 Retrospective Reappraisal of Labetalol's Hemodynamic Effects. 拉贝他洛尔血流动力学效应的回顾性再评价。

IF 1.1

Journal of pharmacy practice Pub Date : 2025-08-23 DOI: 10.1177/08971900251370870

Mary Margaret Rinker, Teresa Valadez, Renee Petzel Gimbar, Andrew Posen

{"title":"A Retrospective Reappraisal of Labetalol's Hemodynamic Effects.","authors":"Mary Margaret Rinker, Teresa Valadez, Renee Petzel Gimbar, Andrew Posen","doi":"10.1177/08971900251370870","DOIUrl":"https://doi.org/10.1177/08971900251370870","url":null,"abstract":"Background: Labetalol is an adrenergic antagonist used to manage blood pressure. Current package labeling and drug databases describe intravenous (IV) labetalol's hemodynamic effects to have an alpha-to-beta potency relationship of 1:7, denoting a predominantly negative cardiotropic effect, which differs from our clinical experience. Objective: The purpose of this study was to describe the hemodynamic effects of IV labetalol in clinical practice and compare those results to official references. Methods: This was a retrospective, observational cohort study of patients undergoing evaluation and management for acute ischemic stroke in the emergency department. We included patients who received IV labetalol and excluded those experiencing intracerebral hemorrhage. The primary outcome was labetalol's alpha-to-beta relative clinical potency (RCP), calculated as the median ΔSBP / ΔHR, using nadir values within one hour of labetalol's administration. Results: Forty-two patients met criteria for analysis, with median age of 66 years and majority female sex (71%). Following a median dose of 10 mg, the median ΔSBP was -35 mmHg and ΔHR -9 beats per minute. The median alpha-to-beta RCP was approximately 7:2. Out of 42 patients, 10 experienced excessive reductions in SBP. This cohort exhibited neither new-onset bradycardia nor reflex tachycardia. Conclusions and Relevance: We clinically observed IV labetalol's alpha-to-beta potency ratio to be 7:2, significantly differing from the 1:7 ratio stated in official references. While this study has limitations, our findings highlight an inconsistency between real-world experience and nongeneralizable experimental results. We recommend revision of the official references that intend to guide clinician use of IV labetalol.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251370870"},"PeriodicalIF":1.1,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958389","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

Interventions for Improved Time to Antibiotic Administration in Pediatric Patients With Febrile Neutropenia. 改善小儿发热性中性粒细胞减少症患者抗生素使用时间的干预措施。

IF 1.1

Journal of pharmacy practice Pub Date : 2025-08-08 DOI: 10.1177/08971900251364058

Kathleen M Villarama, Jessica Lise, Martha Hugger, Marvella Cephas, Nadia I Awad

{"title":"Interventions for Improved Time to Antibiotic Administration in Pediatric Patients With Febrile Neutropenia.","authors":"Kathleen M Villarama, Jessica Lise, Martha Hugger, Marvella Cephas, Nadia I Awad","doi":"10.1177/08971900251364058","DOIUrl":"https://doi.org/10.1177/08971900251364058","url":null,"abstract":"Background: For pediatric patients with suspected neutropenic fever in the emergency department, the gold standard antibiotic administration time is 60 min upon presentation. Unfortunately, this is difficult to achieve given operational delays and the lack of multidisciplinary collaboration. Objective: To implement quality improvement strategies to improve the time to antibiotic administration for pediatric patients with suspected neutropenic fever. Methods: Eligible participants included children with suspected febrile neutropenia. A chart review was conducted to determine if intravenous antibiotics were administered within 60 min from triage. Various process-driven and educational interventions were then implemented. The primary outcome was mean time to antibiotic administration from triage. Results: From January 2023 to September 2023, 72 patients were evaluated for the pre-interventions group. From October 2023 to April 2024, 93 patients were assessed for the post-interventions group. The mean time to antibiotic decreased from 92 to 39 min (95% confidence interval [CI], 31.42 to 64.11; P < .001), and the percentage of patients receiving antibiotics within 60 min increased from 35 to 88% (95% CI 0.57 to 0.72; P < .001). Prior to interventions, the major source of delay was the time between nurse triaging and physician ordering of the antibiotic. After interventions, the mean time from triaging to ordering decreased from 34 to 16 min (95% CI, 4.34-31.88; P = .0103). Conclusion: In pediatric patients with suspected neutropenic fever in the emergency department, a multidisciplinary approach and identification of delays in antibiotic delivery can be instrumental in reducing the time to antibiotics administration.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251364058"},"PeriodicalIF":1.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804366","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

Comparison of Two Empiric Extended-Infusion Dosing Approaches for Piperacillin-Tazobactam in Critically Ill Patients: 3.375 grams Versus 4.5 grams. 危重患者哌拉西林-他唑巴坦两种经验性延长输液给药方式的比较：3.375 g vs 4.5 g。

IF 1.1

Journal of pharmacy practice Pub Date : 2025-08-02 DOI: 10.1177/08971900251365827

Elizabeth A Feldman, Erica L Barbay, Robert W Seabury, Valerie M Amedeo, Wesley D Kufel

引用次数: 0

Optimizing Healthcare: Implementation of a Pharmacist-To-Pharmacist Transitions of Care Pilot Program. 优化医疗保健：从药剂师到药剂师护理过渡试点项目的实施。

IF 1

Journal of pharmacy practice Pub Date : 2025-08-01 Epub Date: 2024-12-19 DOI: 10.1177/08971900241309460

Jacqueline McDonnell, Karli Combs, Randi Dockery

{"title":"Optimizing Healthcare: Implementation of a Pharmacist-To-Pharmacist Transitions of Care Pilot Program.","authors":"Jacqueline McDonnell, Karli Combs, Randi Dockery","doi":"10.1177/08971900241309460","DOIUrl":"10.1177/08971900241309460","url":null,"abstract":"Background: Transitions of care (TOC) is defined as the movement of patients between healthcare practitioners, settings and home. Ineffective TOC can lead to hospital readmissions, increased costs, and patient dissatisfaction. Pharmacists have a unique opportunity to ensure that continuity of care, in regard to medication optimization and education, is continued throughout the transition between settings. With both inpatient and ambulatory pharmacists supporting smooth discharge for hospitalized patients, an opportunity was identified to implement a pharmacist-to-pharmacist TOC program at Ascension Genesys Hospital (AGH). Objective: Implement a pharmacist-to-pharmacist TOC program at AGH. Methods: This was a single-center pilot program in which a pharmacist-to-pharmacist TOC program was implemented at AGH between January 1st and April 30th, 2024. Patients were included if they were 18 years of age and older, managed by the family medicine (FM) team, and had at least 5 medications at discharge. The FM and ambulatory pharmacists provided recommendations and all medication related problems (MRPs) and interventions were documented. Descriptive analysis was conducted. Results: A total of 25 hospitalized patients and 10 follow-up patients were included. A total of 44 inpatient MRPs and 41 outpatient MRPs were recorded. The most common inpatient MRP was antibiotic stewardship. The most common clinic MRP was medication access barrier. Conclusion: Implementation of the pilot program occurred and results were reported. These results demonstrate the importance of pharmacist involvement in TOC.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"397-402"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864632","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