JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY最新文献

{"title":"Factors associated with attaining a pharmacy residency interview: A scoping review","authors":"Suzanne Whitten, Beth Bryles Phillips, S. Osae, R. Stone, Chelsea A. Keedy, Blake R. Johnson, Amber Prentiss, Devin L. Lavender","doi":"10.1002/jac5.1929","DOIUrl":"https://doi.org/10.1002/jac5.1929","url":null,"abstract":"Postgraduate pharmacy residencies are essential in preparing graduates for pharmacy careers. Residencies are highly competitive and despite efforts to increase the number of residency programs in the United States, the demand still outweighs the supply. Attaining a residency interview is a critical step in securing a residency position. The objective of this scoping review is to describe the published literature on factors associated with attaining a pharmacy residency interview. The updated Arksey and O'Malley scoping review framework was followed for this scoping review. The review is reported according to The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Extension for Protocols and Scoping Reviews (PRISMA‐ScR). The search strategy contained a combination of medical subject headings (MeSH) and keywords from a review of article title and abstracts. The inclusion and exclusion criteria were created a priori. English language studies describing pharmacy residency interview, selection, rubrics, and descriptive, quantitative, or qualitative data were included. Title and abstracts were independently reviewed, followed by independent full‐text reviews. Covidence©, an online systematic review platform, was used in the screening, review, and selection process. Thirteen studies assessing factors associated with a residency interview met inclusion criteria. The majority of these studies (n = 7) analyzed data from residency program director (RPD) surveys. Most of these studies found that RPDs highly value letters of recommendation when evaluating a candidate's application. Three studies analyzed retrospective data. Several studies focused on letters of recommendation. The studies described letters of recommendation, letters of intent, grade point average, and leadership experience as factors associated with attaining a residency interview. Most studies had limitations in generalizability, study design, and heterogeneous data.","PeriodicalId":360695,"journal":{"name":"JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139836366","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}

{"title":"Impact of internal medicine pharmacists on antimicrobial stewardship","authors":"Ashley Rizzo, S. Suchindran, B. Albrecht, Nicole L. Metzger","doi":"10.1002/jac5.1926","DOIUrl":"https://doi.org/10.1002/jac5.1926","url":null,"abstract":"Increased demands on infectious diseases (ID) pharmacists and providers may result in targeted antimicrobial stewardship (AMS) interventions. Internal medicine (IM) pharmacists frequently intervene on antimicrobials for their patients during general clinical care, although little is known regarding their overall impact on AMS.Characterize AMS interventions made by IM pharmacists to identify areas of AMS that can be expanded to patients not covered by ID teams.This was a prospective, dual‐center, cross‐sectional study where IM pharmacists, and their trainees were recruited to document routinely made AMS interventions that happened during daily patient care activities. These interventions were classified based on infection source, stewardship intervention type, whether recommendations were accepted or rejected by providers, and any barriers incurred during the implementation of interventions.Four IM pharmacists documented 386 interventions from February 2021 through May 2021. Physicians accepted pharmacist interventions 95.6% of the time. The most common interventions were for respiratory (n = 87, 22.5%), genitourinary (n = 80, 20.7%), and skin and skin structure infections (n = 65, 16.8%). The antimicrobials that IM pharmacists most frequently intervened on were vancomycin (n = 89, 23.1%) and ceftriaxone (n = 68, 17.6%). The most common interventions that were made were dose adjustment (n = 105, 27.2%), shortened duration of therapy (n = 86, 22.3%), and intravenous (IV) to oral (PO) conversions (n = 38, 9.8%). Of the 17 interventions not accepted, the most common barrier to implementation was physician concerns (n = 11, 52.4%), which were primarily associated with IV to PO recommendations (n = 7, 63.6%).IM pharmacists participate in AMS for their patients and intervene frequently to adjust dosing for antimicrobials, shorten duration of therapy, and facilitate IV to PO conversions. IM pharmacists could serve as AMS extenders where additional AMS coverage is needed.","PeriodicalId":360695,"journal":{"name":"JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY","volume":"52 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139779482","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}

{"title":"Implementation of a pharmacist‐driven chronic obstructive pulmonary disease transitions of care service at a large academic medical center","authors":"Maggie M. Lycouras, Nicole E. Cieri‐Hutcherson, Brian P. Kersten, Collin M. Clark","doi":"10.1002/jac5.1933","DOIUrl":"https://doi.org/10.1002/jac5.1933","url":null,"abstract":"Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality in the United States, and one in five COPD hospitalizations result in a readmission within 30 days. Pharmacists have been identified as key members of interdisciplinary teams to improve transitions of care.The objective of this study was to develop, implement, and evaluate outcomes for a pharmacist‐driven COPD transitions of care bundle at an academic medical center.A COPD care bundle was implemented for patients presenting with a COPD exacerbation from December 1, 2021 to February 28, 2022. A historical control group was created from patients who were discharged between December 1, 2020 and February 28, 2021. Patient characteristics, pharmacist‐driven interventions, and time required for the intervention were assessed descriptively. Inhaler technique was assessed before and after pharmacist education utilizing standardized rubrics. The percentage change in inhaler scores was assessed with a Wilcoxon signed‐rank test. Readmission outcomes were analyzed using a chi‐squared test.There were 30 patients in the intervention group and 46 in the control group. There were 104 interventions requiring provider collaboration, of which 84 (81%) were accepted. A median (interquartile range, IQR) of 46 (37–55) min was spent per patient in the intervention group. At baseline, patients scored a median of 84.6% (75–100) of steps correctly across all inhaler device types. After pharmacist education, patient scores increased to a median of 100% [92.3–100] (p < 0.0001). There were eight (26.7%) 30‐day all‐cause readmission rates in the intervention group and 15 (32.6%) in the control group (p = 0.58).Most pharmacist recommendations were accepted by providers. Medication education led to improved understanding of inhaler technique, but there was no difference in 30‐day readmission rates. Further development of this service is warranted based on these findings.","PeriodicalId":360695,"journal":{"name":"JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY","volume":"83 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139781234","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}

{"title":"Pharmacist‐led intervention to reduce inappropriate continuation of targeted medications initiated in the acute care setting at hospital and ICU discharge","authors":"Nandini Patel, Robert E. Dannemiller, Mary P. Kovacevic, Kevin M. Dube, Kenneth E. Lupi, Rachel C. Blum, Kaitlin E. Crowley","doi":"10.1002/jac5.1924","DOIUrl":"https://doi.org/10.1002/jac5.1924","url":null,"abstract":"Pharmacist‐led interventions may reduce the inappropriate continuation of acid‐suppressive agents and antipsychotics temporarily initiated in the intensive care unit (ICU), but limited data exist for other medications. This study evaluated the impact of a pharmacist‐led intervention on the number of medications inappropriately continued upon ICU and hospital discharge. This was a single‐center, pre‐post intervention analysis conducted in the medical and surgical ICUs at a tertiary academic medical center. The pre‐ and post‐intervention groups included adults who were newly initiated on medications used for stress ulcer prophylaxis, delirium, agitation, wakefulness, sedation, and insomnia from December 1, 2021 to January 31, 2022 and December 12, 2022 to February 13, 2023, respectively. In the post‐intervention group, pharmacists identified patients who were newly initiated on a medication of interest and documented in patients' charts via an electronic handoff tool utilizing a standardized template. The appropriateness of those medications was assessed daily, and pharmacists intervened when necessary. The number of medications inappropriately continued at ICU and hospital discharge and ICU and hospital lengths of stay were compared. Overall, 399 encounters were included in the final analysis, and a total of 459 medications were newly initiated in the ICU. There was no significant difference in the number of medications inappropriately continued at hospital discharge [22 (8.4%) vs. 10 (5.1%); p = 0.17]. Significantly fewer medications were inappropriately continued at ICU discharge in the post‐intervention group [85 (32.3%) vs. 37 (18.9%); p < 0.01]. The median ICU length of stay was significantly greater in the post‐intervention group [4 (2–8) vs. 2 (1–6) days; p < 0.01]. No significant difference was found in the median hospital length of stay [14 (7–26.5) vs. 16 (9–33.75) days; p = 0.08]. Use of an electronic handoff tool was associated with a significant reduction in the number of medications inappropriately continued at ICU discharge.","PeriodicalId":360695,"journal":{"name":"JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY","volume":"78 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139850975","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}

{"title":"Solid organ transplant residency research publication rates and characteristics associated with successful publication","authors":"J. Melaragno, Danielle Kovac, Stephanie Witek, Matt Harris, Karen Khalil, Melissa R. Laub, David Quan, Alicia B. Lichvar","doi":"10.1002/jac5.1925","DOIUrl":"https://doi.org/10.1002/jac5.1925","url":null,"abstract":"Publication rates, characterization, and assessment for predictors of publication in post‐graduate year 2 (PGY2) solid organ transplant (SOT) are lacking.This study was conducted to determine the publication rate of PGY2 SOT pharmacy resident projects, understand practices surrounding resident research, and assess characteristics of published manuscripts.An electronic survey of PGY2 SOT residency programs was distributed. Invitation for participation was sent by email to residency program directors (RPDs), and information related to the PGY2 SOT program, RPDs, research mentors/preceptors, residents, and each research project was gathered for residents graduating between 2016 and 2019. Characteristics influencing publication success were assessed with multivariate logistic regression modeling.Thirty‐eight RPD responses were analyzed (67.8% response rate). All PGY2 SOT programs were American Society of Health‐System Pharmacists (ASHP) accredited, 92% were at academic medical centers, and more than 80% were active over 6 years with a median of 10 (interquartile range [IQR] 5–13) graduated residents. In total, 35/97 (36.1%) of SOT PGY2 research projects were published, 22.7% intend to submit or have a manuscript under revision, and 39.2% will not pursue publication. Of published projects, 81% were in medical journals. Median impact factor was 2.9 (IQR 1.5–2.9). Programs active more than 10 years (odds ratio [OR] 4.0, 95% confidence interval [CI] 1.41–11.17, p = 0.009) and utilization of additional resources (OR 4.2, 95% CI 1.23–14.37, p = 0.022), including availability of a biostatistician/epidemiologist or pharmacy student, were independently predictive of publication. Fifty percent of RPDs rated their programs as either “effective” or “extremely effective” in enabling publication. Perceived barriers to publication, most often continuity of PGY2 SOT involvement after residency, were identified.Overall, 36.1% of PGY2 SOT pharmacy resident research projects achieved publication over a 4‐year period at the time of the survey. Years of PGY2 SOT program activity and having additional resources were independently associated with publication.","PeriodicalId":360695,"journal":{"name":"JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY","volume":"85 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139794890","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}

{"title":"Post‐Acute Coronavirus Disease‐2019 Syndrome: Review of the Literature and Role of the Pharmacist","authors":"Shahristan R. Kokoy, J. Stollings","doi":"10.1002/jac5.1866","DOIUrl":"https://doi.org/10.1002/jac5.1866","url":null,"abstract":"Severe acute respiratory syndrome coronavirus (SARS‐CoV‐2) has resulted in over 500 million confirmed cases of coronavirus disease‐2019 (COVID‐19) worldwide, causing over 6 million deaths. A wide disease spectrum has been described for COVID‐19 infections with a newer focus on the long‐term impacts termed Post‐Acute COVID‐19 Syndrome (PACS). PACS is not formally defined but occurs 4 weeks to 6 months after the acute infection impacting the neurologic, cardiovascular, respiratory, gastrointestinal, endocrine, renal, dermatologic, and hematologic organ systems to varying degrees. Nearly one third of patients will experience a neuropsychiatric manifestation within 6 months of a COVID‐19 diagnosis with anxiety, depression, and post‐traumatic stress disorder (PTSD) being the most common symptoms. There is much similarity between PACS and Post‐Intensive Care Syndrome (PICS). Long‐term follow‐up is necessary to ensure intensive care unit (ICU) survivors are cared for appropriately. The development of PICS clinics across the world has set a groundwork for better managing PACS. The inclusion of clinical pharmacists in these clinics has repeatedly improved outcomes. Implementation of the ABCDEF Bundle prevents the occurrence of PICS and PACS, making it an important discussion point for the entire health care team. Epidemiologic data is still emerging with the National Institute of Health (NIH) Researching COVID to Enhance Recovery (RECOVER) research initiative contributing to our understanding of PACS and how to best manage it. The purpose of this review paper is to characterize PACS and recommend prevention, potential monitoring, and treatment, as well as to highlight the role of the clinical pharmacist in the management of this population.This article is protected by copyright. All rights reserved.","PeriodicalId":360695,"journal":{"name":"JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117619249","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}