Journal of pharmacy practice最新文献_第7页

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。

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Journal of pharmacy practice Pub 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":"https://doi.org/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":"8971900241309460"},"PeriodicalIF":1.0,"publicationDate":"2024-12-19","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

Letter re: 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 : 2024-12-15 DOI: 10.1177/08971900241308623

Kazuhiko Kido, Maya Guglin

引用次数: 0

Pharmacist Impact in a Post Neuro Intensive Care Virtual Clinic (PREVAIL). 药剂师对后神经重症监护虚拟诊所的影响（占上风）。

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Journal of pharmacy practice Pub Date : 2024-12-13 DOI: 10.1177/08971900241308624

Grace M Conroy, Danielle M Marut, Joao A Gomes, Sarah Street, Julie Idoine, Christine Ahrens

{"title":"Pharmacist Impact in a Post Neuro Intensive Care Virtual Clinic (PREVAIL).","authors":"Grace M Conroy, Danielle M Marut, Joao A Gomes, Sarah Street, Julie Idoine, Christine Ahrens","doi":"10.1177/08971900241308624","DOIUrl":"https://doi.org/10.1177/08971900241308624","url":null,"abstract":"Background: Traditional Post-Intensive Care Recovery Clinics (PIRCs) often exclude neurocritical care patients. In 2020, a multidisciplinary team started Post Neuro Intensive Care Virtual Clinic (PREVAIL) that uses telemedicine to provide consultative care for patients with a primary neurologic injury who are at risk for post-intensive care syndrome. During clinic, critical care pharmacists perform medication reconciliations and provide drug therapy recommendations. Objectives: The objective of this observational review is to describe the pharmacists' interventions and role in a novel PIRC. Methods: A retrospective, observational review was conducted for patients who were seen in PREVAIL from December 2020 to January 2022. The pharmacist completed a medication reconciliation and provided drug therapy recommendations. Results: Amongst fifty-two PREVAIL patients, the most common neurologic diagnosis was intracerebral hemorrhage, seizures, and acute ischemic stroke. All patients were mechanically ventilated during their ICU stay, with a median ICU length of stay of 17 days [IQR 10-26]. After medication reconciliation, 93% of patients required adjustments to their medication list. After patient examination, 89% of patients required a drug therapy recommendation, with a median of three interventions per patient. Various medication classes were intervened on, most frequently antipsychotics, anti-seizure medications, antihypertensives, anticoagulants, neuromodulators, and antidepressants. Conclusion: This is the first study to evaluate pharmacist contributions at a consultative telemedicine PIRC that focuses on providing care for patients with a primary neurologic injury. PREVAIL pharmacists have a crucial role in the multidisciplinary team. Future research is required to determine the pharmacist's impact on clinical outcomes.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900241308624"},"PeriodicalIF":1.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822116","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 : 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":"https://doi.org/10.1177/08971900241308620","url":null,"abstract":"Purpose: Infectious 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.Summary: The 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.Conclusion: The 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":"8971900241308620"},"PeriodicalIF":1.0,"publicationDate":"2024-12-12","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

D-Penicillamine Induced Myelotoxicity: A Unique Case. d -青霉胺诱导骨髓毒性：一个独特的案例。

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Journal of pharmacy practice Pub Date : 2024-12-11 DOI: 10.1177/08971900241308626

Aliya Abdulla, Aryan Rezvani, Christopher Nelsen, Mariah I Sigala

{"title":"D-Penicillamine Induced Myelotoxicity: A Unique Case.","authors":"Aliya Abdulla, Aryan Rezvani, Christopher Nelsen, Mariah I Sigala","doi":"10.1177/08971900241308626","DOIUrl":"https://doi.org/10.1177/08971900241308626","url":null,"abstract":"Purpose: A case of D-penicillamine-related myelotoxicity in a patient with Wilson's disease is reported. Summary: There is a paucity of literature regarding D-penicillamine (DPA) induced myelotoxicity in the setting of Wilson's disease (WD). A 22-year-old male presented with a 1-week history of bleeding gums and dizziness. Four months prior, he had been diagnosed with Wilson's disease and started on a regimen of DPA. His blood counts demonstrated profound pancytopenia. Due to concern for suspected drug-induced myelotoxicity, DPA was discontinued. Parvovirus B19, Epstein-Barr virus, cytomegalovirus, and varicella zoster virus polymerase chain reaction studies were negative and there was no evidence of hematological malignancy. Bone marrow biopsy demonstrated hypocellularity and trilineage hypoplasia with corresponding aspirate flow cytometry confirming the absence of acute leukemia. The patient was started on subcutaneous granulocyte-colony stimulating factor, provided transfusion support with packed red blood cells and platelets. Despite these measures, his blood count failed to recover, and he was discharged on eltrombopag 150 mg daily with plans for outpatient transfusion support. DPA was permanently discontinued, and he was prescribed trientine 750 mg daily. Unfortunately, his myelotoxicity remained consistent, requiring regular transfusions. He is currently undergoing evaluation for bone marrow transplant. Conclusion: DPA-induced myelotoxicity is a rare clinical entity. Our case demonstrates a unique clinical presentation of this phenomenon. Guidelines to mitigate the risk of and treat this toxicity remain to be determined.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900241308626"},"PeriodicalIF":1.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813531","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

Real World Data of Viral Suppression With Darunavir/Cobicistat and Dolutegravir/Rilpivirine Among Treatment-Experienced Patients Living With Multidrug-Resistant HIV. 有治疗经验的耐多药 HIV 感染者使用 Darunavir/Cobicistat 和 Dolutegravir/Rilpivirine 抑制病毒的实际数据。

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Journal of pharmacy practice Pub Date : 2024-12-01 Epub Date: 2024-04-29 DOI: 10.1177/08971900241247618

Preethi S Samuel, Folake Olaleye, Maria Longo, Leonard Berkowitz

{"title":"Real World Data of Viral Suppression With Darunavir/Cobicistat and Dolutegravir/Rilpivirine Among Treatment-Experienced Patients Living With Multidrug-Resistant HIV.","authors":"Preethi S Samuel, Folake Olaleye, Maria Longo, Leonard Berkowitz","doi":"10.1177/08971900241247618","DOIUrl":"10.1177/08971900241247618","url":null,"abstract":"Background: Despite the effectiveness of the TRIO regimen in maintaining viral suppression, as seen in the ANRS 139 TRIO trial, one drawback is the high pill burden. However, with the development of newer antiretrovirals, this regimen can be simplified. The combination of both co-formulated darunavir/cobicistat and dolutegravir/rilpivirine keeps the integrity of the TRIO regimen while decreasing daily pill count from 12 to 2 tablets daily. The purpose of this case series is to demonstrate the efficacy of this regimen as there is a current lack of data. Methods: This case series included patients with no resistance to dolutegravir, rilpivirine, or darunavir, who were switched to the modified TRIO regimen between June 1st 2018 to June 1st 2022. The primary outcome was the proportion of patients with plasma HIV-RNA levels <50 copies/mL by 24 weeks. Results: At week 24, all patients (n = 9) had a HIV-RNA <50 copies/mL. At week 48, one patient did not have a VL available. However, out of the remaining 8 patients, all maintained an HIV-RNA of <50 copies/mL at week 48. Conclusion: HIV-RNA levels remained suppressed when patients were switched to the modified TRIO regimen. In addition, the pill burden was reduced which can add to overall patient satisfaction.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"1400-1404"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140849994","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

Management and Pharmacological Treatment of Peripheral Arterial Disease. 外周动脉疾病的管理和药物治疗。

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Journal of pharmacy practice Pub Date : 2024-12-01 Epub Date: 2024-05-01 DOI: 10.1177/08971900241250084

Samantha J Leatham, Karl R Winckel, Keshia R De Guzman

引用次数: 0

Evaluation of Sodium-Glucose Transport Protein 2 (SGLT2) Inhibitor Prescribing Patterns in Heart Failure Patients at Hospital Discharge. 评估心衰患者出院时钠糖转运蛋白 2 (SGLT2) 抑制剂的处方模式。

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Journal of pharmacy practice Pub Date : 2024-12-01 Epub Date: 2024-05-27 DOI: 10.1177/08971900241256772

Emily Wo, Cara Trulli, Jessica Wilczynski, Jimmy Gonzalez

{"title":"Evaluation of Sodium-Glucose Transport Protein 2 (SGLT2) Inhibitor Prescribing Patterns in Heart Failure Patients at Hospital Discharge.","authors":"Emily Wo, Cara Trulli, Jessica Wilczynski, Jimmy Gonzalez","doi":"10.1177/08971900241256772","DOIUrl":"10.1177/08971900241256772","url":null,"abstract":"Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) dapagliflozin and empagliflozin are indicated for heart failure with reduced ejection fraction (HFrEF) for cardiovascular death and heart failure hospitalization risk reduction. Due to the recent nature of these data, prescribing of SGLT2is may be suboptimal. Objective: This study sought to assess the prevalence of SGLT2i prescriptions at hospital discharge for HFrEF. Methods: A retrospective chart review was conducted on HFrEF patients discharged from April 1st to December 31st, 2021 from one academic medical center in the United States. The primary objective was to determine the percentage of eligible patients prescribed SGLT2i at discharge and the secondary objective was to characterize covariates impacting prescription. Results: Overall, 115 patients were included. The mean age was 72 ± 14.25 years. The majority were male (73.9%) and Caucasian (74.8%). At discharge, 15.7% of patients were prescribed an SGLT2i, although 94.8% were eligible. Baseline characteristics and concomitant medications did not differ significantly, although the mean number of discharge medications differed significantly between those prescribed an SGLT2i (15.78 ± 6.77) and those not (12.05 ± 5.28) (P = 0.023). Conclusions: SGLT2is are under-prescribed at discharge for HFrEF patients, despite many being eligible. Further studies should be done to elucidate factors that influence the under-prescription of SGLT2is.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"1318-1324"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158138","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

Impact of Risk Stratification in Patients With Diabetes Mellitus in a Health System Specialty Pharmacy Setting. 医疗系统专科药房对糖尿病患者进行风险分层的影响。

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Journal of pharmacy practice Pub Date : 2024-12-01 Epub Date: 2024-05-29 DOI: 10.1177/08971900241257293

Mackenzie Stout, Carly Giavatto, Nicholas McDonald, Lauren Bryant, Casey Ross, Casey Fitzpatrick, Jessica Mourani, Ana I Lopez-Medina

{"title":"Impact of Risk Stratification in Patients With Diabetes Mellitus in a Health System Specialty Pharmacy Setting.","authors":"Mackenzie Stout, Carly Giavatto, Nicholas McDonald, Lauren Bryant, Casey Ross, Casey Fitzpatrick, Jessica Mourani, Ana I Lopez-Medina","doi":"10.1177/08971900241257293","DOIUrl":"10.1177/08971900241257293","url":null,"abstract":"Background: Integrated pharmacist care into health systems results in significant A1c reduction and improved outcomes in patients with diabetes. However, little is known about the adoption of Health System Specialty Pharmacy (HSSP) chronic disease management (CDM) services within diabetes clinics. Risk stratification is proven to enhance care in various patient populations. Objective: The objective of this study is to describe how the implementation of risk stratification in the HSSP setting results in optimized patient outcomes in diabetes. Method: This is a retrospective descriptive study reporting the results of expanding the HSSP care model to implement risk stratified CDM services for patients with diabetes. A total of 285 patients were enrolled in the HSSP CDM pharmacy services and were stratified into high- or low-risk groups. Results: Eighty-eight patients were stratified as high-risk with an average baseline A1c of 11.47% and a most recent average of 8.84%. The remaining 285 patients were stratified into the low-risk group. Their average baseline A1c was 7.48% and the last recorded average A1c was 7.15%. Patients not enrolled in HSSP CDM services (N = 100) had a lower reduction in average A1c compared to patients enrolled in the program. Conclusion: Patients stratified into high- and low-risk groups had greater reductions in A1c compared to patients who did not use HSSP CDM services. These results showcase the success of risk stratification and demonstrate the impact HSSP has on patients needing CDM services and outlines a strategy to provide the greatest impact in a high-volume patient population.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"1325-1330"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141159831","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

The Use of Intraperitoneal Ampicillin in a Patient With Enterococcus faecalis Peritonitis. 在粪肠球菌腹膜炎患者中使用腹腔内氨苄西林

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Journal of pharmacy practice Pub Date : 2024-12-01 Epub Date: 2024-05-23 DOI: 10.1177/08971900241256726

Natalie Greer, Joanna Q Hudson, Anna Jacobs, Drew A Wells

{"title":"The Use of Intraperitoneal Ampicillin in a Patient With Enterococcus faecalis Peritonitis.","authors":"Natalie Greer, Joanna Q Hudson, Anna Jacobs, Drew A Wells","doi":"10.1177/08971900241256726","DOIUrl":"10.1177/08971900241256726","url":null,"abstract":"Introduction: Peritoneal dialysis (PD) - associated peritonitis is a serious complication of peritoneal dialysis (PD). The 2022 International Society of Peritoneal Dialysis (ISPD) guidelines do not recommend intraperitoneal (IP) ampicillin for treatment of Enterococcal PD - associated peritonitis. To date, there is no in vivo data to support use of IP ampicillin for the treatment of Enterococcus faecalis. Case Description: A 69-year-old man with a past medical history of end stage kidney disease (ESKD) requiring continuous cycling peritoneal dialysis (CCPD) was admitted to the hospital and treated for peritonitis with E. faecalis. The patient's CCPD prescription was 2.5% Dianeal with 5 total exchanges. IP ampicillin was added to the first 4 exchanges and additional ampicillin was added to the last fill. The patient successfully completed the treatment course with clinical cure. Discussion: The use of IP ampicillin for E. faecalis peritonitis is controversial and previously lacked compelling clinical evidence for or against its use. This case demonstrates treatment of peritonitis using a modified dosing strategy with ampicillin added to each CCPD exchange and last fill. The loss of ampicillin antimicrobial activity reported in vitro with E. faecalis was not supported by this case.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"1405-1409"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080339","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