CONSULTANT PHARMACIST最新文献

{"title":"Atypical Antipsychotics in Late-Life and Treatment-Resistant Depression.","authors":"Trista Askins Bailey,&nbsp;Sehrish Panjwani","doi":"10.4140/TCP.n.2018.83","DOIUrl":"https://doi.org/10.4140/TCP.n.2018.83","url":null,"abstract":"<p><p>As persons age, their risk of developing late-life depression increases. Older adults not only have an increased risk of late-life depression, but they also have an increased risk of suicidal ideation. Because of these increased risks, it is vital that clinicians be aware of the options available to assist these persons to achieve remission of their symptoms, as well as prevent relapse. Atypical antipsychotics have been considered an augmentation option in younger adults with depression. However, because of the black box warning associated with atypical antipsychotics in older adults with dementia, clinicians often exercise caution when using these agents to help treat late-life depression. This article explores the various studies conducted for the use of atypical antipsychotics in older adults and their safety and efficacy in this population.</p>","PeriodicalId":45985,"journal":{"name":"CONSULTANT PHARMACIST","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4140/TCP.n.2018.83","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35800632","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":"Pharmacists Catch the Wave.","authors":"Micaela Leblanc","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":45985,"journal":{"name":"CONSULTANT PHARMACIST","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35800631","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":"CMS Proposes Sweeping Medicare Rule.","authors":"Paul Baldwin","doi":"10.4140/TCP.n.2018.56","DOIUrl":"https://doi.org/10.4140/TCP.n.2018.56","url":null,"abstract":"","PeriodicalId":45985,"journal":{"name":"CONSULTANT PHARMACIST","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4140/TCP.n.2018.56","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35738844","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":"Evaluation of Hypoglycemia and Potential Risk Factors in a Veterans Affairs Community Living Center.","authors":"Marissa L Ostroff,&nbsp;Kristin Aloi,&nbsp;William Bryan,&nbsp;Jason Moss,&nbsp;Lindsay Garris,&nbsp;Richard Sloane,&nbsp;Jennie Hewitt,&nbsp;Carrie Thomas,&nbsp;Janine Bailey","doi":"10.4140/TCP.n.2018.37","DOIUrl":"https://doi.org/10.4140/TCP.n.2018.37","url":null,"abstract":"<p><strong>Objectives: </strong>To describe hypoglycemic events in a Veterans Affairs (VA) community living center (CLC) population and to determine predictive risk factors associated with hypoglycemia.</p><p><strong>Design: </strong>Retrospective, exploratory, observational chart review.</p><p><strong>Setting: </strong>Tertiary-care VA Healthcare System CLC.</p><p><strong>Patients: </strong>Residents residing in a VA CLC with at least one active order for insulin between June 1, 2009, and June 30, 2013, were evaluated over a 90-day study period.</p><p><strong>Main outcome measures: </strong>The primary outcome was the number of days to the first hypoglycemic event as described by the survival curve analysis. The secondary outcomes included the overall incidence of hypoglycemia, the association of potential risk factors on the proportion of hypoglycemic events, and the association of potential risk factors on the development of an additional hypoglycemic event.</p><p><strong>Results: </strong>There was a 49% incidence of a hypoglycemic event in the 90-day study period with a 24% incidence within the first 7 days of resident admission, representing approximately half of all events that occurred. The only statistically significant risk factor for having a hypoglycemic event was the number of units of insulin/kg/day (hazard ratio = 1.008, 95% confidence interval 1.001, 1.015; P = 0.0317) that a resident was prescribed.</p><p><strong>Conclusions: </strong>Residents are at increased risk for hypoglycemia within the first seven days of admission to a CLC. It is imperative that providers closely monitor and reevaluate antidiabetic regimens at this time of transition.</p>","PeriodicalId":45985,"journal":{"name":"CONSULTANT PHARMACIST","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4140/TCP.n.2018.37","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35738842","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":"Medications Are Risky Business.","authors":"H Edward Davidson","doi":"10.4140/TCP.n.2018.7","DOIUrl":"https://doi.org/10.4140/TCP.n.2018.7","url":null,"abstract":"","PeriodicalId":45985,"journal":{"name":"CONSULTANT PHARMACIST","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4140/TCP.n.2018.7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35738397","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":"Streamlining the Medication Review Process by Use of a New Review Tool: CHART.","authors":"Quincy Ostrem,&nbsp;Stephen Carlson,&nbsp;Brady Hamilton","doi":"10.4140/TCP.n.2018.33","DOIUrl":"https://doi.org/10.4140/TCP.n.2018.33","url":null,"abstract":"<p><strong>Objective: </strong>The Carlson-Hamilton Adult Medication Review Tool (CHART) represents an effort to improve the approach to geriatric care by streamlining the medication review process and identifying potential medication issues that may be relevant to patient's cognitive presentation and impact clinical decision making.</p><p><strong>Setting: </strong>CHART was created at a behavioral health facility. The most common primary diagnoses on this unit include new onset psychosis and recent mental status changes.</p><p><strong>Practice description: </strong>This facility contains 155 beds divided into six units. The geriatric unit has an average census of 10 patients, with an average length of stay of 10 to 12 days.</p><p><strong>Practice innovation: </strong>This site is working to improve geriatric patient care by simplifying and streamlining the medication review process.</p><p><strong>Main outcome measurements: </strong>The pharmacy team evaluated change in medication burden and change in medication review requests.</p><p><strong>Results: </strong>Following implementation, this facility saw both a decreased medication burden and an increase in medication review requests.</p><p><strong>Conclusion: </strong>CHART is a tool that allows pharmacists and student pharmacists to streamline the review of medications and make recommendations.</p>","PeriodicalId":45985,"journal":{"name":"CONSULTANT PHARMACIST","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4140/TCP.n.2018.33","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35738841","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":"Controlling Diabetes: Continuous Glucose Monitoring for the Older Adult.","authors":"Caren McHenry Martin,&nbsp;Catherine Travis","doi":"10.4140/TCP.n.2018.16","DOIUrl":"https://doi.org/10.4140/TCP.n.2018.16","url":null,"abstract":"<p><p>Obtaining and maintaining adequate blood glucose control in the older adult with diabetes offers unique challenges. Intensive blood glucose control can increase the risk of hypoglycemia, which can be particularly risky in the older adult. Adding and adjusting diabetes medications in elderly patients with multiple comorbidities and numerous other medications can also be challenging. The use of professional continuous glucose monitors-which are worn by the patient for up to two weeks and record blood sugars every 5 to 15 minutes-provides pharmacists and other health care professionals with valuable data for managing the care of the older adult with diabetes.</p>","PeriodicalId":45985,"journal":{"name":"CONSULTANT PHARMACIST","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4140/TCP.n.2018.16","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35738839","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":"Clinical Research That Matters: Designing Outcome-Based Research for Older Adults to Qualify for Systematic Reviews and Meta-Analyses.","authors":"Jeannie K Lee,&nbsp;Susan M Fosnight,&nbsp;Erica L Estus,&nbsp;Paula J Evans,&nbsp;Victoria B Pho,&nbsp;Shannon Reidt,&nbsp;Jeffrey C Reist,&nbsp;Christine M Ruby,&nbsp;Stephanie L Sibicky,&nbsp;Janel B Wheeler","doi":"10.4140/TCP.n.2018.24","DOIUrl":"https://doi.org/10.4140/TCP.n.2018.24","url":null,"abstract":"<p><p>Though older adults are more sensitive to the effects of medications than their younger counterparts, they are often excluded from manufacturer-based clinical studies. Practice-based research is a practical method to identify medication-related effects in older patients. This research also highlights the role of a pharmacist in improving care in this population. A single study rarely has strong enough evidence to change geriatric practice, unless it is a large-scale, multisite, randomized controlled trial that specifically targets older adults. It is important to design studies that may be used in systematic reviews or meta-analyses that build a stronger evidence base. Recent literature has documented a gap in advanced pharmacist training pertaining to research skills. In this paper, we hope to fill some of the educational gaps related to research in older adults. We define best practices when deciding on the type of study, inclusion and exclusion criteria, design of the intervention, how outcomes are measured, and how results are reported. Well-designed studies increase the pool of available data to further document the important role that pharmacists have in optimizing care of older patients.</p>","PeriodicalId":45985,"journal":{"name":"CONSULTANT PHARMACIST","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4140/TCP.n.2018.24","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35738840","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":"Use of 2015 Beers Criteria Medications by Older Medicare Beneficiaries.","authors":"Rajul Patel,&nbsp;Leona Zhu,&nbsp;Dilraj Sohal,&nbsp;Elena Lenkova,&nbsp;Nichole Koshki,&nbsp;Joseph Woelfel,&nbsp;Carly Ranson,&nbsp;Cynthia S Valle-Oseguera,&nbsp;Edward L Rogan","doi":"10.4140/TCP.n.2018.48","DOIUrl":"https://doi.org/10.4140/TCP.n.2018.48","url":null,"abstract":"<p><strong>Objective: </strong>To examine the prevalence of potentially inappropriate medications (PIMs) in community-dwelling Medicare beneficiaries based on the updated 2015 American Geriatrics Society Beers criteria.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Thirteen mobile Medicare clinics were held throughout Northern and Central California during the fall of 2015.</p><p><strong>Patients, participants: </strong>Noninstitutionalized Medicare beneficiaries 65 years of age and older taking one or more medications.</p><p><strong>Interventions: </strong>Pharmacy students under direct supervision of licensed pharmacists performed medication therapy management (MTM). Drug and disease state data were collected and used to identify PIMs based on the 2015 Beers criteria.</p><p><strong>Main outcome measures: </strong>Number of beneficiaries who are taking a PIM, have a potential drug-drug or drug-disease interaction, and common factors associated with receiving a PIM.</p><p><strong>Results: </strong>MTM services were provided to 703 beneficiaries 65 years of age or older taking 1 or more medications. In total, 204 (29%) beneficiaries were taking 1 or more PIM. Drug-drug interactions were found in 54 beneficiaries, and 12 beneficiaries were found to have a significant drug-disease interaction. PIM prescribing was associated with certain chronic conditions (e.g., pain and insomnia). The prevalence of PIM use was significantly higher in women compared with men, whites compared with non-whites, and low-income beneficiaries compared with high income.</p><p><strong>Conclusion: </strong>Prescribers and pharmacists should work in concert to minimize PIM use in older adults. Practitioners knowledgeable about the updated 2015 Beers criteria may monitor drug use more closely, hopefully minimizing potentially harmful drug and/or disease-state problems, and preventing avoidable health-related sequelae.</p>","PeriodicalId":45985,"journal":{"name":"CONSULTANT PHARMACIST","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4140/TCP.n.2018.48","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35738843","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":"Don Bastain: Becoming a Consultant Pharmacist.","authors":"","doi":"10.4140/TCP.n.2017.723","DOIUrl":"https://doi.org/10.4140/TCP.n.2017.723","url":null,"abstract":"","PeriodicalId":45985,"journal":{"name":"CONSULTANT PHARMACIST","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4140/TCP.n.2017.723","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35850498","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}