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

{"title":"Evaluation of an initiative to address polypharmacy in hospitalized older adults","authors":"Calvin J. Meaney Pharm.D., FCCP,&nbsp;Natalie Tjota M.D.,&nbsp;Kevin Pham,&nbsp;Gina Prescott Pharm.D., FCCP,&nbsp;Fred Doloresco Pharm.D., M.S.,&nbsp;Michael Ott Pharm.D.,&nbsp;Robert Wahler Pharm.D.,&nbsp;Zachary Wikerd M.D.","doi":"10.1002/jac5.1978","DOIUrl":"https://doi.org/10.1002/jac5.1978","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Polypharmacy contributes to medication-related harm in older adults. Deprescribing interventions are often employed in the outpatient setting, potentially missing patients with limited healthcare access. Hospitalization represents a unique touch point to address polypharmacy in older adults with a multidisciplinary team.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study examined the feasibility and effectiveness of a polypharmacy intervention in hospitalized older adults. The intervention was developed by a multidisciplinary team with a quality improvement framework and implemented by clinical pharmacists on an academic teaching service. Adults aged 65 years and older were included. Pharmacists completed a comprehensive medication review with the identification of medication therapy problems (MTPs), with additional evaluation for polypharmacy (five or more chronic medications) and potentially inappropriate medications (PIMs) using validated tools (Beers and STOPP/START criteria), with recommendations implemented during hospitalization. Descriptive statistics were used to describe the intervention and its outcomes. Reporting followed the SQUIRE statement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The polypharmacy intervention was provided to 155 patients. Polypharmacy occurred in 98.7% of older adults, whereas 82.6% received at least one PIM (261 total). This demonstrates a significant need for an intervention to address polypharmacy and PIMs during hospitalization. A median of two MTPs was identified per patient (total 287), the most common being adverse drug reaction (present in 52.3% of patients), medication without indication (47.7%), and indication without medication (31%). Opioids were the most common PIM (present in 36.1% of patients), followed by benzodiazepines (10.3%) and skeletal muscle relaxants (8.4%). A total of 40.6% of PIMs were successfully deprescribed at discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Polypharmacy is ubiquitous in hospitalized older adults. A multidisciplinary approach to deprescribing can reduce PIMs during hospitalization.</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":"2024-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141968191","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":"Ambulatory care hematology/oncology pharmacy services: A comprehensive review by the Saudi Oncology Pharmacy Assembly","authors":"Nada Alsuhebany Pharm.D.,&nbsp;Nora Alkhudair Pharm.D.,&nbsp;Mohammed Alzahrani Pharm.D.,&nbsp;Fouad Alnajjar Pharm.D., MSPharm, MBA,&nbsp;Abdullah M. Alrajhi Pharm.D.,&nbsp;Maha Aldoughaim Pharm.D.,&nbsp;Mohammed Alnuhait Pharm.D., MBA,&nbsp;Atika Alharbi Pharm.D.,&nbsp;Majed Alshamrani Pharm.D., MBA,&nbsp;Omar Alshaya Pharm.D.","doi":"10.1002/jac5.1960","DOIUrl":"https://doi.org/10.1002/jac5.1960","url":null,"abstract":"<p>Saudi Vision 2030 has driven significant changes in ambulatory care pharmacy services in the Kingdom of Saudi Arabia (KSA), transitioning pharmaceutical care from inpatient to outpatient settings. With a growing need to address non-communicable diseases, particularly cancer, ambulatory care oncology pharmacy services are of paramount importance. This study aims to evaluate the potential benefits and challenges of establishing such services in the KSA and offers recommendations for clinical pharmacists. A comprehensive literature search was conducted using PubMed, MEDLINE, EMBASE, and Google Scholar, encompassing research from inception to September 2023. The search focused on English language studies related to ambulatory care oncology/hematology pharmacy services. Among the 1351 studies found, those assessing the impact of clinical pharmacists on patient outcomes in outpatient oncology clinics were included. The review of the literature highlights the substantial impact of clinical pharmacists in outpatient hematology/oncology settings. A selection of several studies revealed their role in improving patient care, reducing health care costs, and enhancing treatment outcomes. Notable findings include a high acceptance rate of pharmacist interventions with significant cost savings, increased pharmacist involvement in patient encounters, and reduced emergency department visits and inpatient admissions due to pharmacist interventions. These results showed the valuable contributions of clinical pharmacists in the international outpatient oncology setting. Establishing ambulatory care hematology/oncology pharmacy services in Saudi Arabia is critical, considering the rising cancer burden. The value of specialized oncology clinical pharmacists in the outpatient setting is emphasized by various studies conducted in the United States. This review proposes a framework for patient-centered oncology practices, serving as a valuable resource for the strategic development of ambulatory care oncology pharmacy services in Saudi Arabia. These efforts align with Saudi Vision 2030's broader goals of enhancing health care quality and patient care.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141425128","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":"Pharmacist administered parenteral medications: A descriptive report of an inpatient training program","authors":"Ryan C. Dillon Pharm.D.,&nbsp;Carmen Leffler Pharm.D.,&nbsp;Ryan F. Schell Pharm.D.,&nbsp;Kristen C. Sherlin Pharm.D.,&nbsp;L. Montana Fleenor Pharm.D.,&nbsp;Linda B. McLaughlin Pharm.D.","doi":"10.1002/jac5.1977","DOIUrl":"https://doi.org/10.1002/jac5.1977","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Parenteral medication administration is a crucial aspect of in-hospital patient care and has been historically managed by nurses and physicians. Despite pharmacists' extensive training in the medication use process, their underutilization in medication administration stems from various factors, including the lack of formalized training, limited awareness by other healthcare professionals, and unclear legal guidance. This report discusses the implementation and outcomes of a pharmacist medication administration program at a large academic medical center.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The initiative began by revising hospital policies, enabling pharmacists to administer medications during emergencies. Documentation and communication protocols were established. Training included an online module and hands-on sessions covering various topics with a focus on parenteral medication administration and medication safety. Following completion of the program, competency of pharmacists was assessed by pharmacists experienced in intravenous administration using simulated patient case scenarios. Following implementation, the frequency and characteristics of pharmacist administered medications were captured and described.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty pharmacists, including 11 residents, participated. Seven pharmacists administered 349 doses of medications to 284 patients in emergency situations. Administrations by pharmacists included 227 titratable infusions, 72 intermittent or continuous infusions, 49 intravenous pushes, and 1 intranasal naloxone. Classes of medications included high risk products such as vasopressors, sedatives, antiarrhythmics, and thrombolytics. No extravasations or infiltrations were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Implementation of the pharmacist medication administration program signifies significant progress in strengthening the pharmacists' role in patient care at the bedside specifically highlighting the competency of pharmacists to administer parenteral products during emergency situations. The absence of adverse events highlights the feasibility and safety of integrating pharmacists into the bedside team. As the landscape of health-system pharmacy evolves, embracing standardized training programs like ours reemphasize pharmacists' essential contributions to the multidisciplinary healthcare teams, ultimately enhancing patient care and 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":"2024-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.1977","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142170361","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 a feedback strategy in a series of communication-focused patient care simulations","authors":"Hindu Rao Pharm.D.,&nbsp;Richard Beuttler Psy.D., M.S.,&nbsp;Madeline Dintzner Ph.D.,&nbsp;Reza Taheri Pharm.D., MBA,&nbsp;Albert T. Bach Pharm.D.,&nbsp;Neeloufar Fakourfar Pharm.D.","doi":"10.1002/jac5.1959","DOIUrl":"10.1002/jac5.1959","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Patient care simulations (PCS) and objective structured clinical examinations (OSCE) allow pharmacy students to practice communication. Feedback can help improve communication, but the impact over time is not well understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study investigated the impact of a feedback strategy on pharmacy students' communication skills over three PCS. It also evaluated the alignment between students' self-scoring and faculty scoring.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pharmacy students participated in three sessions (PCS1, OSCE, and PCS3) that were focused on the affective domain. Individualized numerical and narrative feedback was provided to students on their performance after PCS1. Students' communication was scored by faculty graders out of an 18-point validated rubric. Students self-scored their communication with the same rubric. Faculty and student scores were compared using a linear mixed effects model, and an intraclass correlation coefficient was used to measure agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In PCS1, 82 students scored an average of 15.41 ± 2.14 for faculty scores and 16.06 ± 1.55 for self-graded scores (0.36, <i>p</i> &lt; 0.001). In the OSCE, 81 students had an average of 15.93 ± 1.86 for faculty scores and 16.45 ± 1.35 for self-graded scores (0.1, <i>p</i> = 0.18). In PCS3, 74 students scored an average of 15.22 ± 2.15 for faculty scores and 16.25 ± 1.44 for self-graded scores (0.14, <i>p</i> = 0.08). A correlation between faculty and student scores was seen for PCS1. Over the three sessions, no significant differences were found between student self-graded scores (<i>p</i> = 0.08), but faculty scores did differ, with the OSCE having higher scores than PCS3 (<i>p</i> &lt; 0.01). Many students with faculty-graded scores greater than 1 standard deviation below the mean scored themselves higher than faculty did.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Feedback after PCS1 did not significantly improve scores. Students with low faculty-graded scores frequently scored themselves higher indicating low self-awareness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140981037","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":"Effect of pharmacist-led interventions on hypertension-related knowledge, medication adherence, and blood pressure control: A multi-center, randomized, controlled trial in Vietnam","authors":"Bon Huu Huynh M.Sc.,&nbsp;Ha Thi Vo Ph.D.,&nbsp;Anh Thi Kim Pham M.Sc.,&nbsp;Pramote Tragulpiankit Ph.D.,&nbsp;Nam Huu Huynh M.D., M.Sc.,&nbsp;Nhut Lien Nguyen M.D.,&nbsp;Lien Thi Nguyen M.Sc.,&nbsp;Tham Hong Pham M.Sc.,&nbsp;Surakit Nathisuwan Pharm.D.","doi":"10.1002/jac5.1955","DOIUrl":"10.1002/jac5.1955","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Hypertension is the single most important leading cause of morbidity and mortality in the Vietnamese population and remains poorly controlled by the current conventional care model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate whether pharmacist-led interventions can improve hypertension knowledge, medication adherence, and blood pressure (BP) control in Vietnamese patients with hypertension.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multi-center, randomized, controlled trial was conducted in three hospitals in Vietnam from October 2021 to May 2022. The educational interventions included direct counseling, printed material, and educational videos for smartphones. The primary outcome was hypertension knowledge assessed by the Hypertension Knowledge-Level Scale (HK–LS). Secondary outcomes were medication adherence as assessed by the Morisky Green Levine Adherence Scale (MGL) and changes in systolic (SBP) and diastolic BP (DBP) at week 12.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 381 patients were included in the study, with 190 and 191 patients in the intervention and control groups, respectively. At week 12, patients in the intervention group had a significantly higher mean HK–LS than the control group (18.97 ± standard deviation [SD] 2.10 vs. 14.98 ± SD 3.55, respectively; <i>p</i> &lt; 0.001). Significantly higher medication adherence was observed in the intervention group than in the control group (MGL score of 3.76 ± 0.52 vs. 3.20 ± 0.87, respectively; <i>p</i> &lt; 0.001). Patients in the intervention group had a significant reduction in mean SBP/DBP (−6.15/−2.58 mmHg) compared with the control group (−0.98/−0.92 mmHg; <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pharmacist-led interventions resulted in a significant improvement in disease knowledge, medication adherence, and BP control in the Vietnamese context of practice and health system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141000848","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":"Decoding pharmacogenomic test interpretation and application to patient care","authors":"Roseann S. Donnelly Pharm.D., FCCP,&nbsp;Larisa H. Cavallari Pharm.D., FCCP,&nbsp;Jeannine S. McCune Pharm.D., Ph.D., FCCP,&nbsp;Jennifer Trofe-Clark Pharm.D., FCCP,&nbsp;Christine M. Formea Pharm.D.,&nbsp;Glenda Hoffecker Pharm.D.,&nbsp;Molly M. Csere BSPharm,&nbsp;Keri C. Anderson Pharm.D.,&nbsp;Shubha Bhat Pharm.D., M.S., FCCP,&nbsp;Scott A. Mosley Pharm.D.,&nbsp;Qing Ma Pharm.D., Ph.D.,&nbsp;Ariel Ferdock Pharm.D.,&nbsp;James M. Hoffman Pharm.D., M.S.,&nbsp;J. Kevin Hicks Pharm.D., Ph.D., FCCP,&nbsp;Kelly E. Caudle Pharm.D., Ph.D., FCCP","doi":"10.1002/jac5.1958","DOIUrl":"10.1002/jac5.1958","url":null,"abstract":"<p>Pharmacogenomics is a growing area of medicine, and pharmacists across clinical practice settings have the opportunity to individualize medication selection and dosing using genetic data. However, many practicing pharmacists may feel ill-equipped to interpret pharmacogenomic test results because of insufficient education and training. Evidence-based, updated, and freely available resources such as the Clinical Pharmacogenetics Implementation Consortium guidelines can help pharmacists interpret and apply pharmacogenomic test results to patient care. Although gaps for the application of pharmacogenomic information exist, this commentary aims to demystify the interpretation of pharmacogenomic test results and empower pharmacists to apply genetic data alongside other clinical variables to optimize medication-related outcomes for their patients. An “ABCD” framework is proposed to guide pharmacists through the steps: (1) Actionability—Are the gene(s) clinically relevant for the patient? (2) Be Mindful of Limitations—What are the caveats with pharmacogenomic test results and reports? (3) Clinical Practice Guidelines—How do you use pharmacogenomic test results to guide clinical decision-making? and (4) Document and Discuss—How do you educate the patient about their pharmacogenomic test results and document the results for future use? Key concepts are illustrated using a psychiatric patient case example.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.1958","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140999698","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":"Remuneration for clinical education: Understanding the costs and considerations","authors":"Daniel S. Longyhore Pharm.D., Ed.D., FCCP,&nbsp;Nicole Woll M.Ed., Ph.D.","doi":"10.1002/jac5.1952","DOIUrl":"https://doi.org/10.1002/jac5.1952","url":null,"abstract":"","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140895294","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":"Building a robust pharmacy research program: Reflections from a large healthcare system not affiliated with a college of pharmacy","authors":"Joseph R. Herges Pharm.D.,&nbsp;Erin D. Wieruszewski Pharm.D.,&nbsp;Jason N. Barreto Pharm.D., M.Sc.,&nbsp;Jodi L. Taraba Pharm.D.,&nbsp;Erin F. Barreto Pharm.D., M.Sc.,&nbsp;Lance J. Oyen Pharm.D., MBA, FCCP,&nbsp;Andrea M. Nei Pharm.D.,&nbsp;Patrick M. Wieruszewski Pharm.D.,&nbsp;Kristina M. Thurber Pharm.D.,&nbsp;Garrett E. Schramm Pharm.D., FCCP,&nbsp;Christine M. Formea Pharm.D., MHI, FCCP,&nbsp;Maria I. Rudis Pharm.D.","doi":"10.1002/jac5.1957","DOIUrl":"10.1002/jac5.1957","url":null,"abstract":"<p>Professional standards for academic health care system pharmacy departments and clinical pharmacists advocate for research and scholarly activities. Developing and sustaining a research program in a clinical pharmacy department is challenging. Over the span of a decade, a robust pharmacy research program was developed in an academic medical center not affiliated with a college of pharmacy. The aim of this manuscript is to provide a framework suitable for scaling research in pharmacy departments within an academic medical center. Objectives to accomplish the aim includes describing the structure and evolution of the clinical pharmacy department research program, listing measurable outputs and achievements of the pharmacists and the program and describing the barriers encountered and solutions that were enacted to overcome them. Elements critical to building and sustaining a research program in the pharmacy department included long-term commitment from within the department, a departmental research infrastructure, support from institutional leadership, research funding from the institution, and a growth mindset in accordance with company initiatives to support evolving research needs. A research curriculum was developed for pharmacy residents and pharmacists, created electronic tools for research proposal scientific reviews and allocation of funds, and established departmental research career development awards that allowed for protected time to pursue research and professional development. Over the first 10 years of the program, publication rates grew more than three-fold, faculty appointments and promotions increased approximately five-fold, and pharmacist investigators obtained extramural federal funding. Further offsetting clinical workload relative to dedicated research time remains a challenge. The experience and success at this academic medical center suggest it is feasible to develop a robust, sustainable clinical pharmacy department research program.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141005323","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":"Early evaluation of a novel alert within cardiac procedural areas to facilitate genotype-guided antiplatelet therapy","authors":"Joel Van Heukelom Pharm.D., MBA,&nbsp;Max Weaver M.S.,&nbsp;Carson Max B.S.,&nbsp;Jordan F. Baye Pharm.D., M.A.,&nbsp;Ashley Peterson AAS,&nbsp;Andrii Maryniak M.D.,&nbsp;Tomsaz P. Stys M.D.,&nbsp;Amanda Massmann Pharm.D.","doi":"10.1002/jac5.1956","DOIUrl":"10.1002/jac5.1956","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Clopidogrel remains widely utilized in patients undergoing percutaneous coronary intervention despite compelling evidence that genetic variation impacts patient response to clopidogrel. Clinical decision support (CDS) is frequently used to aid in precision medicine; however, limitations within the electronic medical record can hinder reliable CDS. Procedural areas where standard order entry is not utilized create a barrier to CDS implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aimed to evaluate the implementation of a novel alerting mechanism on genotype-guided antiplatelet prescribing within the cardiac catheterization laboratory procedural setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted to assess the rate of antiplatelet ordering in patients with one or two loss-of-function cytochrome P450 2C19 (<i>CYP2C19</i>) alleles before and after alert implementation. Pharmacogenomic congruence was measured before and after the alert via chart abstraction that included the <i>CYP2C19</i> genotype and antiplatelet medications ordered within that encounter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 236 patients were included in analyses, 127 encounters within the cohort before alert implementation and 136 encounters in the cohort after alert implementation. Prior to alert implementation, 40.9% (<i>n</i> = 127) were prescribed clopidogrel compared with 25.7% (<i>n</i> = 136) post implementation. After implementing a genotype-guided alert within the cardiac catheterization laboratory procedural setting, providers were 2.22 times more likely to prescribe an alternative antiplatelet (<i>p</i> = 0.024). Clopidogrel-naïve patients were 9.75 times more likely to receive a genotype-guided antiplatelet order following alert implementation (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Providers were responsive to a novel alert within the cardiac catheterization laboratory procedural setting. Genotype-guided antiplatelet prescribing significantly increased following the alert implementation.</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":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141015274","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":"A multistep approach and executive summary assessing and addressing workforce satisfaction and retention of the oncology pharmacy workforce","authors":"Alison M. Gulbis Pharm.D.,&nbsp;Zahra Mahmoudjafari Pharm.D., MBA,&nbsp;Kamakshi Rao Pharm.D.","doi":"10.1002/jac5.1954","DOIUrl":"10.1002/jac5.1954","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Hematology/oncology pharmacists work in various roles in healthcare systems and represent a highly skilled and valuable resource. There remains a significant challenge in the recruitment and retention of these well-trained pharmacists. We sought to identify key factors and propose solutions to impact the ability to recruit, promote, and retain pharmacists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An initial survey in 2021 assessed the status of the oncology pharmacist workforce with regard to job satisfaction and attrition risk. Based on the top 5 factors identified in the Initial Survey, a Follow-Up Survey was conducted in 2022 to further understand top dissatisfiers in the workplace. To address these factors, an in-person collaborative workshop was conducted in 2023 with a focus on creating action plans around the practice model, professional development, well-being, and metrics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 392 individuals participated in the Follow-Up Survey. Most were 31–40 years of age (56%), female (70%), Caucasian (78%), and from academic medical centers (68%). Of the 367 individuals who responded to factors contributing to dissatisfaction at work, 51 of the respondents selected all five factors. The most common factor was the practice model (77%), followed by burnout/well-being (74%), leadership (62%), professional development (56%), and metrics (32%). At the workshop, teams worked collaboratively to review detailed data, evaluate root causes, define a goal future state, and build recommendations for incremental steps to pursue progress in each of these areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Utilizing key information learned from both the Initial and Follow-Up Survey, the Oncology Pharmacy Workforce Collaborative demonstrated that the key themes are interconnected and institutional support is essential in modernizing practice models, revamping professional development, creating better measures of direct and indirect patient care activities, and ensuring effective support for well-being.</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":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141017120","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}