American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists最新文献

{"title":"Drug dosing in patients with low body weight.","authors":"Brian L Erstad, Jeffrey F Barletta","doi":"10.1093/ajhp/zxag292","DOIUrl":"https://doi.org/10.1093/ajhp/zxag292","url":null,"abstract":"<p><strong>Purpose: </strong>To highlight important considerations when designing dosing regimens for patients with low body weight.</p><p><strong>Summary: </strong>Pharmacokinetic alterations that occur in patients with low body weight could lead to inappropriate drug concentrations and adverse effects if standard doses for patients with normal body habitus are used. In contrast to information on drug dosing in patients with obesity, there is a dearth of publications concerning drug dosing in patients with low body weight. Weight descriptors available for dosing patients with low body weight are the same as those used in obese patients but are not as well studied. However, there are general considerations regarding weight descriptors for weight-based drug dosing that are similar for patients with low or excess weight such as the lack of demonstrated usefulness of ideal body weight. The results of investigations that are available for drug dosing in patients with low body weight are primarily limited to antimicrobial and anticoagulant agents, which have well established forms of therapeutic drug monitoring or laboratory monitoring parameters. Of note, the antimicrobials and anticoagulants studied in patients with low body weight tend to be hydrophilic drugs that are eliminated by the kidneys. This has implications for pharmacokinetic parameters, including volume of distribution and clearance that may not be applicable for more lipophilic agents. There is little information on lipophilic drugs with larger volumes of distribution and often non-renal mechanisms of clearance.</p><p><strong>Conclusion: </strong>There is a paucity of information regarding drug dosing in patients with low body weight. The limited information suggests substantial variability in pharmacokinetic outcomes and clinical outcomes with standard doses in low weight patients. Nevertheless, this group should be considered a \"special population\" where individualized dosing approaches should be sought. More research is needed in this area particularly with respect to size descriptors useful for weight-based drug dosing and for lipophilic drugs that are not amenable to some form of therapeutic drug monitoring.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019456","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":"The Layered Learning Practice Model: Perspectives, Challenges, and Future Directions.","authors":"Jennifer N Wisniewski, Mary E Fredrickson, Anna Nogid, Emily P Jones, Kristy Brittain","doi":"10.1093/ajhp/zxag298","DOIUrl":"https://doi.org/10.1093/ajhp/zxag298","url":null,"abstract":"","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019084","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":"Pharmacy-led transition of care services with positive readmissions impact in an acute care hospital.","authors":"Rita Shane, Jackie Ho, Donna Leang, Sarah Stephens, Joshua Pevnick, Hai Tran, Vipul Patel, Steven M Simons","doi":"10.1093/ajhp/zxag291","DOIUrl":"https://doi.org/10.1093/ajhp/zxag291","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of pharmacy transitions of care (TOC) services on all cause 30-day readmission rates among Medicare Bundled Payment for Care Improvement Advanced Initiative (BPCI-A, referred to as Bundle) patients.</p><p><strong>Methods: </strong>This retrospective study included BPCI-A patients discharged from a large academic hospital between July 1, 2023, and June 30, 2024. Pharmacy TOC services included admission medication history, discharge medication review, and pharmacist-led PDFU conducted within 72 hours of discharge. Thirty-day readmission rates were compared between patients receiving comprehensive TOC services versus partial or no TOC, and between patients receiving PDFU versus no PDFU. Multivariable logistic regression and Cox proportional hazards models adjusted for demographic and clinical covariates.</p><p><strong>Results: </strong>Of 6,095 discharged patients, 5,122 were included in the analysis. Patients receiving comprehensive TOC services had lower 30-day readmission rates compared with controls (12.63% vs 17.06%; OR, 0.70; 95% CI, 0.60-0.82; p < 0.05). Patients receiving PDFU also had significantly lower readmissions (12.52% vs 22.54%; OR, 0.49; 95% CI, 0.41-0.59; p < 0.05). In adjusted analyses, both comprehensive TOC (HR, 0.71; 95% CI, 0.61-0.82) and PDFU (HR, 0.49; 95% CI, 0.41-0.58) were associated with reduced hazard of 30-day readmission (p < 0.001 for both). Non-English language and higher discharge medication count were associated with increased readmission risk.</p><p><strong>Conclusion: </strong>Pharmacist-managed TOC services, particularly PDFU, were associated with significantly reduced 30-day readmissions among BPCI-A patients, supporting pharmacist involvement in value-based care models.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019065","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":"\"At Your Service\" or Going the Extra Mile Personal Reflections.","authors":"Charles D Ponte","doi":"10.1093/ajhp/zxag299","DOIUrl":"https://doi.org/10.1093/ajhp/zxag299","url":null,"abstract":"","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019417","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":"Summarizing the evidence on health-system impacts of smart pump interoperability: A scoping review.","authors":"Elizabeth V Glashan, Linh Nguyen, Shi Yi Xiong, Janice Y Kung, Taryn Buoy, Cheryl A Sadowski","doi":"10.1093/ajhp/zxag286","DOIUrl":"https://doi.org/10.1093/ajhp/zxag286","url":null,"abstract":"<p><strong>Purpose: </strong>Smart pump interoperability integrates infusion pumps with a healthcare facility's electronic health record to reduce the risk of intravenous medication errors. The purpose of this scoping review was to summarize and characterize the literature regarding health-system impacts from implementation of smart pump interoperability and identify gaps in research.</p><p><strong>Summary: </strong>A literature search was designed in collaboration with a medical librarian. Articles that studied impacts from implementation of smart pump interoperability in the acute care setting were identified. The following databases were searched from inception to 2025: MEDLINE, Embase, PubMed, Cochrane Library, CINAHL, Scopus, and TRIP (Turning Research Into Practice). The first 200 results from Google Scholar and bibliographies from included articles were screened. A structured search for gray literature was performed in Google. Data relating to the research question was extracted from each included article using a standardized data charting tool. Extracted data was analyzed descriptively to characterize the literature. Using predefined eligibility criteria, 1,452 titles and abstracts were screened, and 82 articles were selected for full-text review. Thirteen articles were included in this review.</p><p><strong>Conclusion: </strong>Varying study designs and methods have been used to examine health-system impacts resulting from the implementation of smart pump interoperability. Outcomes relating to patient safety, organizational finances, workflow and staff perception, documentation, and infusion data have been studied. Implementation is complex. Challenges to implementation and corresponding solutions have been detailed in the literature. Long-term studies with large sample sizes would strengthen the evidence regarding health-system impacts from smart pump interoperability.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003305","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":"Parting thoughts on AI and the future of pharmacy practice.","authors":"Michael T Rupp","doi":"10.1093/ajhp/zxag289","DOIUrl":"https://doi.org/10.1093/ajhp/zxag289","url":null,"abstract":"","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957246","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":"An unfortunate choice.","authors":"Essilvo Sulejmani","doi":"10.1093/ajhp/zxag287","DOIUrl":"https://doi.org/10.1093/ajhp/zxag287","url":null,"abstract":"","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946564","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":"Integration of the medication regimen complexity - intensive care unit (MRC-ICU) score into an electronic health record and comparison to an institution-specific clinical monitoring score at a large, tertiary, community hospital.","authors":"Paige Putz, Andrea Sikora, Ryan Lamberg, Kelli Henry, Aaron Chase, Paul Huiras","doi":"10.1093/ajhp/zxag284","DOIUrl":"https://doi.org/10.1093/ajhp/zxag284","url":null,"abstract":"","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932329","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":"Guidelines for validating mass spectrometry-based analyses as stability indicating for AJHP.","authors":"Kevin R Tucker, Edward C Navarre, Marcelo J Nieto","doi":"10.1093/ajhp/zxag285","DOIUrl":"https://doi.org/10.1093/ajhp/zxag285","url":null,"abstract":"","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946575","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":"Quality indicators measuring pharmaceutical care for asthma and chronic obstructive pulmonary disease within primary care: a scoping review.","authors":"Claire D Visser, Henk-Jan Guchelaar, Martina Teichert","doi":"10.1093/ajhp/zxag277","DOIUrl":"https://doi.org/10.1093/ajhp/zxag277","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the growing emphasis on quality improvement, an overview of quality indicators (QIs) measuring pharmaceutical care in asthma and COPD remains limited. Numerous QIs have been developed for general respiratory care, yet often designed for physician-led hospital settings rather than pharmacist-led primary care. This scoping review provides an overview of existing QIs measuring pharmaceutical care for asthma and COPD within primary care, including an evaluation of their clinimetric properties.</p><p><strong>Methods: </strong>A systematic literature search was conducted across five electronic databases. The population included adult asthma and/or COPD patients; concept aimed at QIs measuring structures, processes, and outcomes; in the context of pharmaceutical care provided by pharmacists in primary care. Selected articles were categorized using a two-stage approach; a study-level classification followed by an indicator-level classification of identified QIs.</p><p><strong>Results: </strong>Of the 46 articles identified 23 articles (47.9%) focused on development, 16 articles (33.3%) on validation, and 9 articles on feasibility (18.8%). Overall, 188 QIs measuring pharmaceutical care for asthma and/or COPD were identified, categorized into five healthcare domains; 1) screening and diagnosis (10.6%), 2) guideline-based pharmacological treatment (21.8%), 3) self-management support (25.0%), 4) referral for expert advice (7.4%) and 5) disease control assessment (35.1%). Identified QIs included structure (1.6%), process (81.9%) and outcome (16.5%). 155 QIs (82.4%) were evaluated on development-related metrics, 46 QIs (24.5%) on validation and 42 QIs (22.3%) on feasibility.</p><p><strong>Conclusion: </strong>A vast overview of QIs have been identified for pharmaceutical care in asthma and COPD, noting their practical utility and validation depends on their applicability for internal clinical improvement or external 'pay-for-performance' schemes.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932342","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}