Innovations in pharmacy最新文献

{"title":"Practice Patterns for N-acetylcysteine Dosing for Acetaminophen Toxicity in the United States.","authors":"Michael C Thomas, Christopher J Edwards, Amanda Dunlap","doi":"10.24926/iip.v15i4.6459","DOIUrl":"10.24926/iip.v15i4.6459","url":null,"abstract":"<p><p><i>Background:</i> Although the FDA approved acetaminophen toxicity dosing regimen for intravenous n-acetylcysteine (NAC) is a three-bag regimen, alternate regimens have been published which are generally simpler, and decrease errors and adverse effects. It is not clear how pervasive alternative regimens are used in hospitals in the US and reasons for a change from the FDA regimen. <i>Objective:</i> Characterize practice patterns for treating acetaminophen toxicity. <i>Methods:</i> A pilot-tested, electronic survey containing demographic and practice pattern questions for acetaminophen toxicity management was sent to residency program directors. The survey was open for 4 weeks with several reminder e-mails sent to non-responders. Descriptive statistics were used to summarize the data. <i>Results:</i> There were 119 responses (9.2% response rate). Responses were representative of all geographic areas in the US and were most commonly from community hospitals (67.2%) and those with 300 or more beds (72.2%). Nearly two-thirds used the FDA approved NAC regimen, whereas others used an alternate regimen. Reasons for making the change were for simplicity, to decrease errors or adverse events, or based on local poison center recommendations. More than one-third of respondents reported not using a maximum dosing weight. <i>Conclusions:</i> N-acetylcysteine is usually administered intravenously using the FDA approved regimen for acetaminophen toxicity. The weight for dosing was commonly capped at 100 kg, but some institutions did not use a maximum. Alternative intravenous regimens have been implemented at some institutions with the impetus for change being safety and simplicity.</p>","PeriodicalId":501014,"journal":{"name":"Innovations in pharmacy","volume":"15 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Study of Hemoglobin A1C Levels in Patients with Type 2 Diabetes after Creation of a Patient Assistance Program Enrollment Committee at a Student-Run Free Clinic.","authors":"John D Salvemini, Gregory R Vance, Amanda Pham, Garner Fincher, Johnny Yang, Harshin Sanjanwala, Leonna Conley, Alan Penman, James Pitcock","doi":"10.24926/iip.v15i4.6435","DOIUrl":"10.24926/iip.v15i4.6435","url":null,"abstract":"<p><p><i>Background:</i> Our student-run free clinic (SRFC) treats uninsured patients with type 2 diabetes (T2D) in a medically underserved region. Mississippi has the second highest diabetes prevalence in the nation. Increasing access for patients with diabetes to affordable medication is challenging. Some studies provide encouraging results for lowering hemoglobin A1C and increasing medication adherence through patient assistance programs (PAP). None have examined a student-run PAP committee's impact on diabetes outcomes. <i>Objective:</i> To compare A1C levels for patients with diabetes enrolled in PAPs by our committee with those not enrolled and to describe clinical outcomes. <i>Methods:</i> A retrospective review of patients with T2D at our SRFC between 2015 and 2023 was performed. The primary outcome was change in A1C within a 4-9 month follow-up window. Secondary outcomes were emergency department (ED) visits and hospital admissions. <i>Results:</i> Twenty-five patients with T2D were enrolled in PAPs, while 77 were not. The PAP group had a higher baseline A1C (10.9% vs. 8.7%). The difference in A1C between groups was not statistically significant (P=0.68), even with adjustment for covariates (P=0.59). ED visit and hospital admission frequency was similar between groups. Neuropathy was the most common diabetic complication. ED visits and hospital admissions for heart attacks occurred only in the non-PAP group. <i>Conclusion:</i> While patients enrolled in PAPs showed a greater average reduction in A1C, the difference was not statistically significant. The higher baseline A1C in the PAP group carries greater reduction potential. A prospective study is necessary to better evaluate PAP enrollment outcomes for uninsured patients with diabetes.</p>","PeriodicalId":501014,"journal":{"name":"Innovations in pharmacy","volume":"15 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Call to Action: Lead Pharmacy into the Next Decade.","authors":"Kerry K Fierke, Gardner Lepp, Bridget McGugan, Marta J Brooks","doi":"10.24926/iip.v15i4.6262","DOIUrl":"10.24926/iip.v15i4.6262","url":null,"abstract":"<p><p><i>Introduction:</i> The pace of change in healthcare and throughout the world will only continue to escalate. This evolution of continuously changing information requires us to be responsive and innovative. There are more ways than ever to share information, and more need than ever to share best practices for leadership related to pharmacy. In keeping with the mission of <i>INNOVATIONS in pharmacy</i> (Iip), we invite you to share creative and dynamic scholarly leadership work. <i>Methods:</i> The traditional written manuscript is an author-centric form of scholarly output; the format, process, expediency, and familiarity of written manuscripts benefit authors, but may not be as easily consumed as more user-centric forms of information. The Iip leadership section team investigated alternative ways to disseminate the results of research work that don't include a traditional written manuscript. <i>Findings:</i> We reached out to leaders across a variety of pharmacy work and practice settings to understand the importance of leadership today and the importance for leadership in pharmacy. Responses were common across pharmacy professionals in all settings; nearly every response mentioned that leadership is important to help motivate a team toward a shared goal or vision and to be a role model. Pharmacy leaders feel that leadership is needed to make decisions, take accountability and, especially in an area as highly regulated as healthcare, ensure regulations and procedures are followed and standards are upheld. At the same time, our current environment requires attention to new challenges such as a multigenerational workforce and artificial intelligence. <i>Call to Action</i>: Through our work as scholars, we can provide evidence-based, pertinent, timely solutions to address these issues, in ways that make it easily transferable to broad audiences. The future of pharmacy leadership is in our hands and awaits our unique insights. Traditional written manuscripts are valuable but may not fully connect with some people. The evolving landscape of healthcare leadership demands novel perspectives, creative applications, and open-minded evaluations. Join us on this transformative journey. Submit your Innovative scholarly works to Iip.</p>","PeriodicalId":501014,"journal":{"name":"Innovations in pharmacy","volume":"15 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Call to Action: Lead Pharmacy into the Next Decade.","authors":"Kerry K Fierke, Gardner Lepp, Bridget McGugan, Marta J Brooks, Gregory Zumach","doi":"10.24926/iip.v15i4.6264","DOIUrl":"10.24926/iip.v15i4.6264","url":null,"abstract":"","PeriodicalId":501014,"journal":{"name":"Innovations in pharmacy","volume":"15 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Hospitalization on Continuation of SGLT2 Inhibitors and GLP-1 Receptor Agonists for Comorbidities in Patients with Type 2 Diabetes.","authors":"Bethany L Murphy, Simran Chahal, Elleigh Shepherd, Nicole Taylor, Austin Camp","doi":"10.24926/iip.v15i4.6432","DOIUrl":"10.24926/iip.v15i4.6432","url":null,"abstract":"<p><p><i>Purpose</i>: In the treatment of type 2 diabetes mellitus (T2DM), select sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists are recommended based on comorbidities such as chronic kidney disease (CKD), heart failure (HF), and atherosclerotic cardiovascular disease (ASCVD). Because guidelines typically recommend insulin for inpatient treatment of T2DM, there is potential that these therapies may be negatively impacted by hospitalization. This study aimed to assess the effect of hospitalization on outpatient T2DM therapy. <i>Methods</i>: In this retrospective study, patients were included if they had a diagnosis of T2DM plus a comorbidity (CKD, HF, ASCVD) for which they were prescribed an SGLT2 inhibitor or GLP-1 receptor agonist and had a recent hospitalization and follow-up appointment at an outpatient clinic. Electronic medical records were reviewed to determine if these therapies were continued during transitions of care. Data was analyzed with basic descriptive statistics. <i>Results</i>: Thirty-six patients on SGLT2 inhibitor therapy met inclusion criteria. Four (11%) patients were never restarted on therapy outpatient following hospitalization, three of which did not have an appropriate reason for discontinuation. Twenty-two patients on GLP-1 receptor agonist therapy met inclusion criteria. Four (18%) were never restarted on therapy outpatient following hospitalization, two of which did not have an appropriate reason for discontinuation. <i>Conclusion</i>: Five out of 58 patients (8.6%) included in the study experienced an inappropriate discontinuation of therapy throughout the transitions of care process. While most patients had their T2DM medication restarted, this study shows hospitalization can impact guideline-directed outpatient therapy.</p>","PeriodicalId":501014,"journal":{"name":"Innovations in pharmacy","volume":"15 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of an Independent Patient Centered Medical Home Clinic Experience during Residency Training on Post-Residency Confidence.","authors":"Emily J Miretti, Kellie A Kippes, Amy N Thompson","doi":"10.24926/iip.v15i4.5646","DOIUrl":"10.24926/iip.v15i4.5646","url":null,"abstract":"<p><p><i>Description of the problem:</i> While previous studies have described the impact of incorporating a postgraduate year two (PGY2) Ambulatory Care resident on clinical outcomes and revenue, the impact of an independent Patient Centered Medical Home (PCMH) experience from the resident perspective has not been reported. The purpose of this study was to determine the impact of an independent PCMH rotation on resident confidence. <i>Description of the innovation:</i> A longitudinal, independent PCMH rotation has been part of a PGY2 Ambulatory Care residency since program inception. To determine the impact of this experience on resident confidence, a 23-item survey was developed and distributed electronically to all previous PGY2 Ambulatory Care residents who completed this experience. <i>Critical Analysis:</i> All invited residents (n=15) responded. Following PGY2 completion, 46.7% of respondents worked as a clinical pharmacist specialist at an academic medical center. Most (86.7%) practiced in primary care and/or population health. The majority responded that the independent PCMH clinic rotation resulted in a positive impact on their confidence in ownership of practice (100%), providing clinical care (93.3%), and pharmacist-patient interactions (86.7%). <i>Implications:</i> An independent PCMH rotation during PGY2 Ambulatory Care training can have a positive impact on post-residency clinical confidence.</p>","PeriodicalId":501014,"journal":{"name":"Innovations in pharmacy","volume":"15 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Call to Action: Lead Pharmacy into the Next Decade.","authors":"Gregory Zumach, Kerry K Fierke, Gardner Lepp, Bridget McGugan, Marta J Brooks, Anthony Olson, Andrew Bartlett, Nilushi Karunaratne, Betty Exintaris","doi":"10.24926/iip.v15i4.6265","DOIUrl":"10.24926/iip.v15i4.6265","url":null,"abstract":"","PeriodicalId":501014,"journal":{"name":"Innovations in pharmacy","volume":"15 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Student IPEC Competency Using Observer-Based Evaluation in Didactic Interprofessional Education Activities.","authors":"Jacqueline M Zeeman, Kimberly A Sanders, Tia M Belvin, Philip T Rodgers","doi":"10.24926/iip.v15i4.5840","DOIUrl":"10.24926/iip.v15i4.5840","url":null,"abstract":"<p><p><i>Introduction</i>: IPE competency requires multiple developmental experiences across diverse educational environments, including didactic and experiential learning. While literature outlines various IPE activities, gaps exist regarding IPE evaluation strategies with most published tools relying on self-evaluation. This study describes an observer-based assessment of individual student IPEC Competency development for students participating in didactic-IPE activities, and compares observer-based ratings with student self-evaluation ratings. <i>Innovation</i>: The IPEC Competency Assessment Tool of Individual Students (I-CATIS) was piloted in an IPE case collaboration activity involving pharmacy and dental students. Faculty were trained on the I-CATIS and evaluated pharmacy students on thirteen predetermined IPEC sub-competencies. Students evaluated their self-efficacy on the selected IPEC sub-competencies, which was compared with I-CATIS results. <i>Findings</i>: Sixty-three pharmacy students across 12 groups were evaluated by six faculty facilitators. Across all observed competencies, 26% of students were rated as \"Minimal\" and 64% as \"Developing\" on a competency compared to 10% rated as \"Competent.\" Students' self-evaluation ratings were higher on all sub-competencies compared to observer-evaluation ratings. Facilitators indicated the I-CATIS tool was easy to use, but challenging to complete while concurrently facilitating interprofessional teams. <i>Conclusions</i>: The I-CATIS enabled observer-based evaluation of individual student's IPEC Competency development in the didactic-IPE activity. I-CATIS can supplement and advance student self-evaluation data and inform didactic IPE curriculum development to ensure graduates are prepared and competent to practice in a collaborative healthcare environment.</p>","PeriodicalId":501014,"journal":{"name":"Innovations in pharmacy","volume":"15 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Pharmacy Learner Self-Reflection and Preceptor Evaluations Using a Single-Point Rubric during Experiential Rotations.","authors":"Jennifer A Nowak, Carrie N Baker, Riley D Bowers","doi":"10.24926/iip.v15i4.5733","DOIUrl":"10.24926/iip.v15i4.5733","url":null,"abstract":"<p><p><i>Background:</i> Development of successful, practice-ready pharmacists includes ensuring learners are self-aware and able to reflect on knowledge, skills, and abilities. Though evidence indicates reflective practices are important in pharmacy education, there is a general lack of structure for implementation of reflective practices. The primary objective of this study was to compare learner self-evaluations to preceptor and pharmacy resident evaluations for scored learning activities completed on experiential rotations to assess consistency of student self-reflections. <i>Methods:</i> This study compared learner self-evaluations to preceptor and pharmacy resident evaluations using a single-point rubric for three types of assignments completed during experiential rotations at a community teaching hospital. These assignments included clinical presentations, patient counseling, and written drug information responses. Data were collected via retrospective review of completed, de-identified evaluations. The primary endpoint was differences in overall scores between students and evaluators, analyzed via paired T-test. <i>Findings:</i> A total of 68 learner evaluations were reviewed, with a majority (89.7%) completed by students on Advanced Pharmacy Practice Experiences. Overall, no significant differences emerged between student and preceptor evaluator scores, indicating that students were able to consistently self-reflect. <i>Conclusion:</i> Pharmacy students on experiential rotations demonstrated consistency in self-scoring and evaluation with preceptors on assignments related to presentations, drug information responses, and patient counseling when using single-point rubrics to self-evaluate.</p>","PeriodicalId":501014,"journal":{"name":"Innovations in pharmacy","volume":"15 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Assessment of an Online, Asynchronous State-Specific Pharmacy Law Continuing Education Program for Multistate Pharmacy Jurisprudence Examination Preparation.","authors":"Apryl N Peddi, Lauren M Caldas, Evan M Sisson, Sofia Yousufzai, Laura M Frankart","doi":"10.24926/iip.v15i4.6128","DOIUrl":"10.24926/iip.v15i4.6128","url":null,"abstract":"<p><p><i>Description of the Problem:</i> The Multistate Pharmacy Jurisprudence Examination (MPJE) is a licensure requirement for pharmacists. National pass rates for this exam are variable and have recently been decreasing nationally. Current support for graduates in pharmacy law courses and MPJE test preparation tools varies between states and institutions. <i>Description of the Innovation:</i> The Virginia Commonwealth University School of Pharmacy created an online, asynchronous continuing education (CE) course that provides content specific to Virginia pharmacy laws and regulations. The course is divided into six modules, aligned with MJPE competency statements. <i>Critical Analysis:</i> Of the 158 recent graduates and practicing pharmacists transferring to the state who have taken the CE, 26 responded to the survey (response rate = 16.5%) on pass rate success and resources used in preparation for MJPE. The majority (96%) of those who completed the CE passed their next attempt on the MJPE with 20 participants taking it for the first time. Qualitative feedback was collected and evaluated, revealing response categories of practice scenarios, alignment to MPJE, program structure, and overall satisfaction. This limited cross-sectional data reports descriptive preliminary findings. <i>Implications:</i> The institution will continue to offer this CE. The CE creates a revenue stream for the institution and provides a resource for passing the Virginia MPJE. There is limited generalizability.</p>","PeriodicalId":501014,"journal":{"name":"Innovations in pharmacy","volume":"15 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}