Journal of the American College of Clinical Pharmacy : JACCP最新文献

{"title":"Integrating standardized patient safety and quality competencies in pharmacy curriculum: Evaluation of the impact on student development and professional identity","authors":"Jennifer Chang Pharm.D.,&nbsp;Rachel G. Firebaugh Pharm.D., MPH,&nbsp;Curtis G. Jefferson Ed.D","doi":"10.1002/jac5.2000","DOIUrl":"https://doi.org/10.1002/jac5.2000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Improving patient safety and quality of care is a national healthcare priority. While changes in healthcare systems help to address some concerns in this area, the knowledge, skills, and attitudes of healthcare professionals play a role as well. Health professions education programs have a responsibility to ensure comprehensive patient safety and quality training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to evaluate the impact of integrating standardized safety and quality competencies from an evidence-based framework in a patient safety and quality course within a Doctor of Pharmacy program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A gap analysis was conducted using guidelines from the Canadian Patient Safety Institute (CPSI) to explore curricular coverage of the included concepts and competencies. The course was designed to address key competencies not addressed elsewhere in the curriculum. An adapted self-assessment survey tool was administered at the end of the course for students to retrospectively assess changes in perceived skills and attitudes. Mean retrospective pre- and post-scores were compared using the paired sample <i>t</i>-tests and Cohen <i>d</i> as a measure of effect size. Responses to an open-ended question regarding how students could impact patient safety were qualitatively analyzed for emergent themes. Student performance on the course final exam was analyzed using descriptive statistics to assess knowledge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-three students (80.8%) completed the survey and were included in the analysis. A statistically significant change was observed in 18 of the 24 self-assessment items, with effect sizes in the modest to moderate range. Key themes emerged regarding student professional identity development including error prevention, error management, reporting culture, learning culture, just culture, and teamwork. The mean individual student score on the final examination was 87.67% ± 4.87%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings suggest the new course using the CPSI framework had a positive impact on student knowledge, perceived skills, and attitudes in the area of patient safety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141968293","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":"Legal, safety, and practical considerations of compounded injectable semaglutide","authors":"Allison Spitery Pharm.D.,&nbsp;Mary J. Elder Pharm.D.,&nbsp;Nada Farhat Pharm.D.,&nbsp;Insaf Mohammad Pharm.D.,&nbsp;Alison Lobkovich Pharm.D.","doi":"10.1002/jac5.1999","DOIUrl":"https://doi.org/10.1002/jac5.1999","url":null,"abstract":"<p>The use of long-acting incretin-based therapies, such as semaglutide, has increased in recent years due to their benefits for glycemic control in diabetes, cardiovascular risk reduction, and weight management. Ongoing drug shortages have led clinicians and patients to seek alternative routes for accessing these therapies, including the use of non-United States Food and Drug Administration (FDA)-approved compounded incretin-based therapy. This review paper describes the legal, safety, and practical considerations of compounded injectable semaglutide for diabetes and weight management. While this paper is specific to injectable semaglutide, the concepts described apply to all compounded injectable incretin-based therapies. While there is a general recommendation against the use of non–FDA-approved compounded incretin analogs, if clinicians elect to use compounded incretin-based therapy, the potential harms and benefits for each patient must be considered, and patients must be properly educated on the correct administration of the product they receive.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142170364","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 analysis of the impact on total cost of care within a pharmacist-led comprehensive medication management program","authors":"Julie Anne Earby Pharm.D.,&nbsp;Tiffany Nicole Jenkins Pharm.D.,&nbsp;Abigail Marie Johnson Pharm.D.,&nbsp;Victoria Dianne Marchwinski Pharm.D.,&nbsp;Devin Marie Schmidt Pharm.D.","doi":"10.1002/jac5.2007","DOIUrl":"https://doi.org/10.1002/jac5.2007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The rise in health care expenditures continues to pose a significant concern regarding the longevity of the current health care system design. The literature has demonstrated a positive return on investment (ROI) when pharmacists perform medication management services. Building upon positive ROI literature, a clinically integrated network (CIN) in Michigan developed an approach to patient targeting for comprehensive medication management (CMM) services in existing alternative payment model (APM) Medicare Advantage, Medicaid, and Commercial contracts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The primary objective of this study was to examine the real-world impact of an advanced ambulatory care pharmacy model, inclusive of embedded clinic-based ambulatory pharmacists, centralized ambulatory pharmacists, centralized population health pharmacists, and specially trained pharmacy technicians, on the total cost of care (TCOC) within a large integrated health system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>For CMM dates of service occurring in calendar year 2022, pharmacy and medical claims were evaluated during the 6-month period prior to and following the initial CMM patient encounter. Upon completion of the study period, data were evaluated to assess TCOC and utilization trends for the study population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Statistically significant differences in median TCOC ($1427.84, <i>p</i> &lt; 0.001), prescription drug costs ($222.82, <i>p</i> &lt; 0.001), and medical costs ($462.26, <i>p</i> &lt; 0.001) were observed between the pre-CMM and post-CMM timeframes for the study population. A 16% reduction in hospital admissions was observed between the pre-CMM and post-CMM timeframes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This study further supports that pharmacist intervention as part of a CMM program can favorably affect health care costs. Criteria such as a population's benchmark costs and utilization, insurance product types, and core conditions present can help determine whether expanding or initiating CMM services could be beneficial in improving care and health care costs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.2007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142430263","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":"Perceptions and outcomes of a nationwide remote pharmacy mentorship program","authors":"Sarah E. Wheeler Pharm.D.,&nbsp;Katie Kiser Pharm.D.,&nbsp;Melissa Lipari Pharm.D.,&nbsp;Daniel Majerczyk Pharm.D., FCCP,&nbsp;R. Iain Pritchard Pharm.D.,&nbsp;Swati Bansal Pharm.D.,&nbsp;Deanna McDanel Pharm.D.","doi":"10.1002/jac5.2001","DOIUrl":"https://doi.org/10.1002/jac5.2001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Mentorship is crucial for professional development in health care. However, the outcomes of national remote mentorship programs in pharmacy remain largely unexplored. This study evaluates the perceptions and experiences of student pharmacists, residents, fellows, and nontrainee pharmacists in such a program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to assess the perceptions and outcomes of a nationwide remote pharmacy mentorship program designed for student pharmacists, residents, and fellows. It explores the efficacy, benefits, and barriers within a national pharmacy professional organization mentorship program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The mentor and mentee experiences in the American College of Clinical Pharmacy (ACCP) Ambulatory Care Practice and Research Network (PRN) from program years 2019–2022 were assessed using an anonymous online survey, employing a mixed-methods approach. The survey featured quantitative Likert scale and qualitative free-response questions. In addition, publicly available online sources provided data for postprogram placement outcomes of learner participants in the program. Summary statistics were computed from the quantitative data, and content analysis was applied to the qualitative data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 356 invited program participants, 48 mentors (32.7%) and 18 mentees (8.6%) responded to the survey. Most respondents agreed or strongly agreed on the program's effectiveness, contributing to a high postprogram placement rate in residencies and ambulatory care positions, emphasizing the program's success in supporting career progression. Respondents recognized significant benefits like career development and professional satisfaction. Notable demographic disparities, especially in age, gender, and race, were observed among participants. The study also identified logistical challenges that impeded the program's full potential.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite limitations, including a low number of responses, the study revealed that remote mentorship may positively affect professional development and well-being. The data supports the program-impacted respondent involvement and professional growth. Moreover, these findings suggest the need for further research to address the program barriers and disparities in participation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142430262","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":"Educational outcomes necessary to enter pharmacy residency training: 2023 update","authors":"Pamela L. Stamm Pharm.D., FCCP,&nbsp;Stuart T. Haines Pharm.D., FCCP,&nbsp;Krystal L. Edwards Pharm.D., FCCP,&nbsp;Nicholas M. Fusco Pharm.D., FCCP,&nbsp;Dawn E. Havrda Pharm.D., FCCP,&nbsp;Kelly C. Lee Pharm.D., MAS, FCCP,&nbsp;Jessica L. Papke Pharm.D.,&nbsp;Denise H. Rhoney Pharm.D., FCCP,&nbsp;Deborah A. Sturpe Pharm.D., M.A.,&nbsp;Gwendolyn Knowles Pharm.D.,&nbsp;Rachel D. Baggett Pharm.D.","doi":"10.1002/jac5.1994","DOIUrl":"https://doi.org/10.1002/jac5.1994","url":null,"abstract":"<p>The 2023 Educational Affairs Committee reviewed relevant position statements and publications to update the 2014 ACCP position statement on the educational outcomes (EOs) necessary for pharmacy students to enter postgraduate year 1 (PGY1) residency training. The committee initially aligned entry-level graduate outcomes with current PGY1 residency competencies achieved after postgraduate training. The committee then used these alignments to identify consistencies, insufficiencies, and gaps in preparation. This process revealed that the EOs and entrustable professional activities from curricular outcomes and entrustable professional activities and the North American Pharmacist Licensure Examination blueprint could serve as a partial list of outcomes necessary to enter postgraduate training; however, some of the outcomes necessary to enter residency were not consistently addressed. To improve residency readiness, the committee recommends that both academic programs and the individual learner evaluate and seek opportunities to address any curricular gaps in alignment. The findings also underscore the need for a single set of well-defined and mutually agreed-on educational competencies that evolve over time and embrace the knowledge, skills, and attitudes that demonstrate residency readiness.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142170286","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":"Empowering pharmacists with data: Steps toward proactive medication safety and quality improvement","authors":"Lara K. Ellinger Pharm.D.,&nbsp;Adam Bursua Pharm.D.,&nbsp;William Galanter M.D., Ph.D.,&nbsp;Gordon D. Schiff M.D.,&nbsp;Bruce L. Lambert Ph.D.","doi":"10.1002/jac5.2002","DOIUrl":"https://doi.org/10.1002/jac5.2002","url":null,"abstract":"<p>Pharmacists play a crucial role in medication safety and quality improvement in healthcare, yet face significant challenges due to limited data access, poor data quality, and insufficient data management skills. National pharmacy organizations emphasize the importance of pharmacists using data effectively to improve patient care. This paper suggests several strategies to overcome data challenges, including more widespread adoption of a Chief Pharmacy Informatics Officer (CPIO) role in healthcare institutions, the development and validation of medication safety metrics and dashboards, and the incorporation of data analysis and application skills into pharmacist education and training. The creation of the CPIO position is proposed to lead efforts in data management and use for medication safety. Additionally, establishing clear medication safety metrics and dashboards is recommended to monitor and improve safety practices. To support these roles and tools, enhancing pharmacist training in data analytics is deemed essential. Implementing these strategies aims to empower pharmacists to engage more effectively in proactive medication safety and quality improvement efforts. This approach is expected to address current gaps in data utilization and management, facilitating a more informed method for pharmacists to make healthcare safe for patients.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141968214","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":"Comparison of community pharmacy-measured blood pressure and ambulatory blood pressure monitoring: A pilot study","authors":"Christine Tran BA,&nbsp;Ibrahim S. Alhomoud Pharm.D.,&nbsp;Kristi Taylor B.S.,&nbsp;Tana Kaefer Pharm.D.,&nbsp;Roy Sabo Ph.D.,&nbsp;Dave L. Dixon Pharm.D., FCCP","doi":"10.1002/jac5.2004","DOIUrl":"https://doi.org/10.1002/jac5.2004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Blood pressure (BP) measured by 24-h ambulatory blood pressure monitoring (ABPM) is a better predictor of hypertension (HTN)-related end-organ damage than office BP; however, it is not always available nor tolerated by patients. Community pharmacy-measured blood pressure (CPBP) could serve as a potential alternative, although it is unknown whether CPBP is equivalent to BP measured using ABPM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The primary objective of this pilot study was to explore the equivalency of CPBP compared with awake ABPM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a pilot, single-arm, equivalency study of adults ≥21 years with HTN, taking ≥1 antihypertensive with no changes in the prior 2 weeks. Exclusion criteria included night shift workers, sleep apnoea, arrhythmia, on dialysis, pregnancy or an arm circumference &gt; 50 cm. Three unattended seated BP measurements were obtained in both arms at a community pharmacy and followed by 24-h ABPM. At the return visit, seated BP measurements were repeated; the mean across both visits served as the CPBP. The primary outcome was the equivalency of systolic BP measured at the community pharmacy to awake BP measured using ABPM. The continuous outcome (BP) was modelled against a binary fixed effect for the measurement device (CPBP vs. ABPM) and a subject-level random effect to account for the multiple BP readings arising from the same individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 25 participants had a mean (standard deviation [SD]) age of 65 (15) years, 80% were female, and 36% identified as Black or Latino. The mean (SD) systolic BP was 128.0 (20.2) and 129.1 (15.8) mmHg for CPBP and awake ABPM, respectively (<i>p</i> = 0.8409). No significant differences were found between the mean diastolic BP or heart rate for CPBP vs. 24-h ABPM or CPBP vs. daytime ABPM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The difference between CPBP and ABPM was not statistically significant; however, we cannot claim equivalence between the two approaches.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.2004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142170285","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":"Cross-sectional evaluation of a clinical decision support tool to identify medication-related problems at discharge from the acute care setting","authors":"Savanna DiCristina Pharm.D., MPH,&nbsp;Jacques Turgeon Ph.D.,&nbsp;Veronique Michaud Ph.D.,&nbsp;Luigi Brunetti Pharm.D., Ph.D.","doi":"10.1002/jac5.1998","DOIUrl":"https://doi.org/10.1002/jac5.1998","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There are many reported pharmacist-led transitions of care (TOC) programs to address medication-related problems (MRP) at discharge from the acute care setting. Most have identified time and labor resources as significant limitations. This study aims to assess the effectiveness of a medication risk score (MRS)-driven clinical decision support system (CDSS) in identifying actionable MRPs and improving medication safety in the acute care discharge TOC setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional analysis was conducted in a cohort of 481 subjects discharged from the acute care setting. The MRS-CDSS was utilized to identify MRPs and provide recommendations for risk reduction. The distribution of MRPs, recommendations, and their associations with MRS severity were analyzed. Additionally, the potential reduction in MRS per subject and its correlation with MRS severity were examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median MRS reduction per subject was 2 points, while high/severe-risk patients showed a median potential reduction of 7 points. Among the identified MRPs (<i>n</i> = 691), drug interaction, drug use without indication, and adverse drug reaction accounted for 89.7% of all MRPs. The top three recommendations, discontinue medication, change the time of administration, and start alternative therapy, represented 94.1% of all recommendations. Stratified analysis by MRS category revealed a significant increase in adverse drug reaction MRPs and recommendations to discontinue medications with higher MRS severity. The results were consistent with previous outpatient studies, supporting the MRS-CDSS's ability to enhance medication safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrates that the MRS-CDSS effectively identifies actionable MRPs and has the potential to substantially reduce overall pharmacotherapy regimen risk when applied during acute care discharge TOC. The findings support implementable recommendations directed at patient safety and the allocation of health care resources to high-risk patients for maximum benefit.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.1998","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141968193","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":"Integrating pharmacogenomic results in the electronic health record to facilitate precision medicine at a large multisite health system","authors":"Sarah A. Morris Pharm.D.,&nbsp;D. Grace Nguyen Pharm.D.,&nbsp;Victoria Morris M.Sc.,&nbsp;Kaitlyn Mroz B.S.,&nbsp;Simeon O. Kwange M.S.,&nbsp;Jai N. Patel Pharm.D.","doi":"10.1002/jac5.1996","DOIUrl":"https://doi.org/10.1002/jac5.1996","url":null,"abstract":"<p>Pharmacogenomics (PGx) results can potentially guide the prescribing of dozens of medications; however, use of such results is often limited by the prescriber's awareness of results and knowledge of drug–gene interactions. Integration of PGx results with corresponding clinical decision support (CDS) in the electronic health record (EHR) is critical to facilitate genotype-guided medication prescribing among all clinicians in an integrated health system. We describe our experience with developing an infrastructure to house PGx results and ensure actionable findings can be used at the point of care in real time using CDS. Upon transitioning to a new EHR, PGx-related CDS alerts for more than 50 medications were developed using a systematic and multidisciplinary process where clinical pharmacist input was key. Multiple strategies were required to enable the storage of PGx results as discrete data from any laboratory source to drive CDS. EHR features were leveraged to link results from external laboratories to CDS and a homegrown translational software platform was developed to integrate results from the in-house genomics laboratory directly into the EHR. These processes enabled PGx result integration for 2342 patients. As an example, among 356 patients who were genotyped for <i>CYP2C19</i> to guide voriconazole dosing as part of a standard protocol in bone marrow transplant, 114 (32%) had CDS alerts for medications other than voriconazole presented to a clinician. For 50 of these patients, alerts were presented to a clinician of a different specialty who likely was not aware the patient had PGx results. Clinical pharmacists at institutions performing PGx testing are encouraged to champion the integration of PGx results and CDS in the EHR to maximize clinician awareness and evidence-based use of PGx results.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.1996","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141967404","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":"Research and scholarly methods: Appraising the available literature to inform a research project","authors":"Blair J. MacDonald Pharm.D.,&nbsp;Erica H. Z. Wang Pharm.D.,&nbsp;Ricky D. Turgeon Pharm.D.","doi":"10.1002/jac5.1987","DOIUrl":"https://doi.org/10.1002/jac5.1987","url":null,"abstract":"<p>A literature review with an evaluation of existing evidence is often the first step in designing a research project. This article provides a systematic framework and guide for clinicians, researchers, and clinician-scientists to appraise the available literature to inform a clinical research project. The three-step approach outlined in this article starts with defining your research question using the Population Intervention Comparator Outcome-Design framework, followed by evaluation of the existing evidence and identification of gaps that could be addressed by a research project, and ends with guidance to refine the research question and start preparing a protocol.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.1987","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141584125","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}