Senior Care Pharmacist最新文献_第6页

Impact of Pharmacist Transitions of Care on 30-Day Readmissions Within a Primary Care-Based Accountable Care Organization. 药剂师转诊对基于基础医疗的责任医疗组织内 30 天再入院治疗的影响。

Senior Care Pharmacist Pub Date : 2024-05-01 DOI: 10.4140/TCP.n.2024.178

Tina Benny, Kajal Jain, Genevieve Marie Hale, Rucha Acharya, Cynthia Moreau, Elaina Rosario, Alexandra Perez

{"title":"Impact of Pharmacist Transitions of Care on 30-Day Readmissions Within a Primary Care-Based Accountable Care Organization.","authors":"Tina Benny, Kajal Jain, Genevieve Marie Hale, Rucha Acharya, Cynthia Moreau, Elaina Rosario, Alexandra Perez","doi":"10.4140/TCP.n.2024.178","DOIUrl":"https://doi.org/10.4140/TCP.n.2024.178","url":null,"abstract":"Previous studies in the ambulatory care setting have shown inconsistent results in regard to, or with respect to pharmacist telephonic transitions of care (TOC) encounters and reduction in 30-day readmission rates. No studies that have been completed within an accountable care organization (ACO) evaluating the impact of telephonic TOC encounters performed by a pharmacist have been identified. The objective of this study was to analyze the impact of clinical pharmacy telephonic TOC encounters on readmission rates within a primary care-based ACO. In this retrospective chart review, data for those who had a pharmacist telephonic TOC encounter and those who had an attempt were collected. The primary outcome of this study was all-cause 30-day readmission rate. Secondary outcomes included 30-day readmission rate for targeted disease states, time to readmission, and readmission reason the same as previous discharge reason. For subjects who received a telephonic TOC encounter, pharmacist intervention type and provider acceptance of intervention(s) were described. For the final analysis, 154 encounters were included, 83 encounters in the telephonic TOC encounter group, and 71 did not receive a telephonic TOC encounter. The 30-day readmission rates were similar among those who received a telephonic TOC encounter and those who did not: the difference was not significant (15.7% vs. 28.2%; P = 0.059). There was also no statistical difference in the secondary outcomes. Even so, the results of this study suggest that performing a pharmacist telephonic TOC encounter in a primary care-based ACO setting has the potential to reduce 30-day readmission rates and further research appears to be warranted in this important area of practice.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":"39 5","pages":"178-184"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859031","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

Recommendations for Next Steps in Our Understanding of Use of Antipsychotics Among Older People in the Post-Acute Long-Term Care Environments: Article 3 of 3. 对我们了解急性期后长期护理环境中老年人使用抗精神病药物情况的下一步建议：第 3 条，共 3 条。

Senior Care Pharmacist Pub Date : 2024-05-01 DOI: 10.4140/TCP.n.2024.169

Steven Levenson, Barbara Resnick, Paul Katz

{"title":"Recommendations for Next Steps in Our Understanding of Use of Antipsychotics Among Older People in the Post-Acute Long-Term Care Environments: Article 3 of 3.","authors":"Steven Levenson, Barbara Resnick, Paul Katz","doi":"10.4140/TCP.n.2024.169","DOIUrl":"https://doi.org/10.4140/TCP.n.2024.169","url":null,"abstract":"This article is the third installment of a multi-part series on the history and usage of antipsychotics in older people living in nursing and assisted living facilities. This article presents next steps and recommendations for appropriate usage of antipsychotics in the older population based on the lead author's early drafts, submitted to the editors prior to his untimely death, of this series and on his consultations with the coauthors. Dr Levenson emphasized in his focus on next steps related to antipsychotic use: that all providers should review the history of antipsychotic use and recognize clinically legitimate alternative explanations for the findings. His conclusions were that \"off label\" usage should not be a reason to exclude the appropriate use of antipsychotics. His overall recommendations to clinicians are to assess and diagnose the underlying cause of the problem, understand the treatment options and select the best one to address the clinical problem and/or the symptom if the problem cannot be fully resolved, and to focus on all medications, not just antipsychotics, in a patient's regimen to aid in a comprehensive understanding of the assessment and inform therapeutic recommendations.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":"39 5","pages":"169-172"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858347","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

Polypharmacy as Formal Training and a Model of Practice. 作为正式培训和实践模式的多药疗法。

Senior Care Pharmacist Pub Date : 2024-05-01 DOI: 10.4140/TCP.n.2024.173

Michael J Schuh, Sheena K Crosby

{"title":"Polypharmacy as Formal Training and a Model of Practice.","authors":"Michael J Schuh, Sheena K Crosby","doi":"10.4140/TCP.n.2024.173","DOIUrl":"https://doi.org/10.4140/TCP.n.2024.173","url":null,"abstract":"Traditional definitions of polypharmacy may largely not account for the market proliferation of herbal and dietary supplements, cannabis products, or incorporate the new science of pharmacogenomics (PGx). Polypharmacy is encountered by most pharmacists providing patient care in many settings. The \"polypharmacist\" can assist patients and providers with solving medication-related problems (MRPs) in this new and challenging environment of supplements and cannabis products by utilizing traditional pharmacology and pharmacokinetic principles, including PGx, broadly across many medical disciplines. One may encounter polypharmacy more in the geriatric population, though in an age of supplements and cannabis proliferation, polypharmacy is increasingly being encountered at younger ages. Not only is polypharmacy training at best fragmented in pharmacy curricula, but it may also not account for the above-mentioned products that may use the same metabolic pathways to increase drug interactions and adverse drug reactions (ADRs) regarding prescription medications. Polypharmacy being more formally prioritized in pharmacist training may better prepare pharmacists for commonly encountered polypharmacy and can be a viable model of practice.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":"39 5","pages":"173-177"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860623","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

Destination on the Horizon: The Prolonged Journey to Attain Pharmacists' Provider Status. 地平线上的目的地：获得药剂师提供者地位的漫长旅程。

Senior Care Pharmacist Pub Date : 2024-05-01 DOI: 10.4140/TCP.n.2024.202

Leigh Davitian

引用次数: 0

Responding to "Pharmacogenomics in Clinical Practice for Older People". 回应 "老年人临床实践中的药物基因组学"。

Senior Care Pharmacist Pub Date : 2024-05-01 DOI: 10.4140/TCP.n.2024.168

Tamara Ruggles

引用次数: 0

Preparation Times and Estimated Costs for Vancomycin Formulations: Does the Difference Matter? 万古霉素制剂的制备时间和估计成本：差异重要吗？

Senior Care Pharmacist Pub Date : 2024-05-01 DOI: 10.4140/TCP.n.2024.185

Merton Lee, Chad Worz, Dana Gaal, Nicole Brandt

{"title":"Preparation Times and Estimated Costs for Vancomycin Formulations: Does the Difference Matter?","authors":"Merton Lee, Chad Worz, Dana Gaal, Nicole Brandt","doi":"10.4140/TCP.n.2024.185","DOIUrl":"10.4140/TCP.n.2024.185","url":null,"abstract":"Objective Infections from methicillin-resistant Staphylococcus aureus are increasingly treated in longterm care facilities, but long-term care pharmacies face high costs in the provision of sterile vancomycin for intravenous administration. This study compares pharmaceutical costs of outsourced, compounded, and room temperature premixed vancomycin formulations in a long-term care pharmacy. Design This retrospective observational study reviewed 124 orders of vancomycin. Means for total pharmacy preparation time, pharmacist labor time, and extrapolated time over complete course of treatment were compared for three vancomycin preparations: outsourced, compounded by pharmacy, and room temperature premixed vancomycin formulations. Cost calculations were generated using ingredient costs as reported by the pharmacy and median pharmacist labor costs as published from national sources. Results Mean total preparation times and pharmacist preparation times were shortest for premixed vancomycin. Over full courses of treatment, mean pharmacy preparation time for compounded was 5 hours 3 minutes (mean of 28 treatments) and 2 hours 8 minutes for premixed (mean of 54 treatments). Data on pharmacist time in outsourced orders were not available. Total pharmacy costs were $993.94 for compounded vancomycin, $2220.34 for outsourced, and $809.36 for room temperature premixed vancomycin. Conclusion There were reduced preparation times for room temperature premixed vancomycin compared with compounded and outsourced formulations for skilled nursing facilities. As multiple drug-resistant organism infections are increasingly treated in long-term care, finding cost-effective approaches to medication provision from pharmacies is critical.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":"39 5","pages":"185-192"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865301","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

Pharmacogenomics in Clinical Practice for Older People. 老年人临床实践中的药物基因组学。

Senior Care Pharmacist Pub Date : 2024-04-01 DOI: 10.4140/TCP.n.2024.132

Syeda R Hashimi, Olajumoke Babatunde, Khalifa Alrajeh, Richard J Dixon, Aimalohi Okpeku, Elvin T Price

{"title":"Pharmacogenomics in Clinical Practice for Older People.","authors":"Syeda R Hashimi, Olajumoke Babatunde, Khalifa Alrajeh, Richard J Dixon, Aimalohi Okpeku, Elvin T Price","doi":"10.4140/TCP.n.2024.132","DOIUrl":"10.4140/TCP.n.2024.132","url":null,"abstract":"Older people are over-represented among individuals that experience adverse drug reactions (ADR) and adverse drug events (ADE). Furthermore, older people are over-represented among individuals that visit emergency departments and are hospitalized because of ADRs. Moreover, older people are overrepresented among those who suffer ADEs while hospitalized. Finally, older people are among those most likely to have an anaphylactic response to prescription medications. Therefore, older people are prime candidates for efforts aimed at optimizing pharmacotherapeutic outcomes. Pharmacogenomics is an approach of using genetic data to optimize pharmacotherapeutic outcomes. Over the last two decades, pharmacogenomics grew from research initiatives into the current environment of pharmacogenomics implementation. Specifically, implementing pharmacogenomics into clinical settings or within health care systems has proven beneficial in optimizing pharmacotherapeutic outcomes. Therefore, pharmacists focused on optimizing pharmacotherapeutic outcomes for older people should be aware of the approaches to and resources available for implementing pharmacogenomics. KEY WORDS: Drug labeling biomarkers, Genes, Older adults, Pharmacogenomics.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":"39 4","pages":"132-136"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289126","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

Chronic Pain Management in a CYP2D6 Poor Metabolizer: A Case Report for Oxycodone. CYP2D6 代谢不良者的慢性疼痛治疗：关于羟考酮的病例报告。

Senior Care Pharmacist Pub Date : 2024-04-01 DOI: 10.4140/TCP.n.2024.137

Deepa Pednekar, Joshua Russell, Chandni Bardolia, David Thacker, Nishita Shah Amin

{"title":"Chronic Pain Management in a CYP2D6 Poor Metabolizer: A Case Report for Oxycodone.","authors":"Deepa Pednekar, Joshua Russell, Chandni Bardolia, David Thacker, Nishita Shah Amin","doi":"10.4140/TCP.n.2024.137","DOIUrl":"10.4140/TCP.n.2024.137","url":null,"abstract":"The objective of this case report is to illustrate pharmacogenomics (PGx)-guided oxycodone treatment, given the conflicting data on the analgesic response from oxycodone in Cytochrome P450 (CYP)2D6 poor metabolizers (PMs). PGx-guided therapy can help improve treatment outcomes. This case report describes a 58-year-old patient who was prescribed oxycodone for chronic pain management. The patient presented with a history of inadequate pain control despite analgesic treatment with oxycodone (morphine milliequivalent [MME] = 22.5). Pharmacogenetic testing revealed that the patient was a CYP2D6 Poor Metabolizer (PM), which may shed light on the observed lack of analgesic response to oxycodone. The clinical pharmacist recommended switching to an alternative opioid not metabolized via the CYP2D6 pathway. The patient was subsequently switched to hydromorphone (MME = 16), resulting in improved pain control and fewer side effects. The newer hydromorphone dose accounted for a 30% MME dose reduction. The patient's initial average and worst pain score were 7 and 9 out of 10, respectively, per the numeric rating scale (NRS). Upon follow-up with the patient in two weeks, her average and worst pain scores improved to 3 and 3.5 out of 10, respectively, per the NRS. Further PGx testing results led to an overall positive outcome, such as her willingness to participate in physical therapy as a result of improved pain scores. This case highlights the importance of considering individual variability in drug metabolism when prescribing medications, particularly opioids such as oxycodone, to ensure optimal therapeutic outcomes and minimize the risk of adverse events in CYP2D6 PMs.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":"39 4","pages":"137-142"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289123","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

Making Drug Therapy Safer and More Effective Is a Primary Concern for Pharmacists Everywhere. 让药物治疗更安全、更有效是各地药剂师关注的首要问题。

Senior Care Pharmacist Pub Date : 2024-04-01 DOI: 10.4140/TCP.n.2024.127

Chris Alderman

引用次数: 0

Pharmacogenomics: Medical Advancement Caught in an Ethical and Policy Quagmire. 药物基因组学：陷入伦理和政策泥潭的医学进步。

Senior Care Pharmacist Pub Date : 2024-04-01 DOI: 10.4140/TCP.n.2024.159

Leigh Davitian

引用次数: 0