American Journal of Health-System Pharmacy最新文献

{"title":"Cosibelimab.","authors":"","doi":"10.1093/ajhp/zxaf055","DOIUrl":"10.1093/ajhp/zxaf055","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"638-641"},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A student-led approach to completion of the Practice Advancement Initiative 2030 self-assessment tool with a state affiliate in North Dakota.","authors":"Madelyn J Johnson, Habiba Afifi, Amanda Meyer, Maari Loy","doi":"10.1093/ajhp/zxae367","DOIUrl":"10.1093/ajhp/zxae367","url":null,"abstract":"<p><strong>Purpose: </strong>To efficiently complete Practice Advancement Initiative (PAI) 2030 self-assessments, students aimed to overcome completion barriers and collect data to identify areas for improvement with pharmacy practice in the state of North Dakota.</p><p><strong>Summary: </strong>Pharmacy departments from hospitals and health systems face challenges when completing the self-assessment tool, and creativity must be kindled to develop an appropriate approach. Over the course of a 5-week advanced pharmacy practice experience rotation, 2 students generated an efficient, personal, and novel approach to completing the PAI 2030 self-assessment tool with pharmacy leaders across the state.</p><p><strong>Conclusion: </strong>The novel student-led approach achieved a completion rate greater than the goal suggested by the American Society of Health-System Pharmacists while providing the students with learning and networking opportunities. As a result, pharmacy leaders have baseline PAI 2030 self-assessment data for 26 hospitals across North Dakota, which can be used for further analysis and application.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e544-e550"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Pharmacotherapy of acute ST-elevation myocardial infarction and the pharmacist's role, part 2: Complications, postrevascularization care, and quality improvement.","authors":"","doi":"10.1093/ajhp/zxaf004","DOIUrl":"10.1093/ajhp/zxaf004","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e481"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of paralytic choice on postintubation sedation and analgesia in the emergency department.","authors":"Calvin Hwang, Benjamin Michaels, Kristen Park, Andrew Dang, Christine Vo, Stephen Lee, Zlatan Coralic","doi":"10.1093/ajhp/zxaf037","DOIUrl":"10.1093/ajhp/zxaf037","url":null,"abstract":"<p><strong>Purpose: </strong>We describe the timing of first-dose sedation and analgesia after rapid sequence intubation (RSI) in patients induced with etomidate and paralyzed with rocuronium or succinylcholine.</p><p><strong>Methods: </strong>This was a retrospective study of adult patients undergoing RSI in 3 emergency departments (EDs). We evaluated the time to administration of analgesia and sedation using a Cox proportional hazard model controlling for choice of paralytic, post-RSI hypotension (nadir systolic blood pressure of less than 100 mm Hg in the first hour), bedside presence of an ED pharmacist, and practice site. We also describe the first doses of post-RSI analgesia and sedation.</p><p><strong>Results: </strong>A total of 2,059 adult patients were included in the study, of whom 1,532 received rocuronium and 527 received succinylcholine. The median time to first dose of sedation was 12 minutes (interquartile range [IQR], 7-26 minutes) in patients given rocuronium and 10 minutes (IQR, 6-19 minutes) in those given succinylcholine. The median time to analgesia was 24 minutes (IQR, 10-78 minutes) and 21 minutes (IQR, 10-60 minutes), respectively. Administration of rocuronium was associated with lower rates of sedation (adjusted hazard ratio [aHR], 0.75; 95% confidence interval [CI], 0.67-0.85) and analgesia (aHR, 0.73; 95% CI, 0.62-0.87). Hypotension was also predictive of decreased sedation (aHR, 0.67; 95% CI, 0.54-0.80), while bedside presence of an ED pharmacist was associated with improvement (aHR, 1.14; 95% CI, 1.03-1.27). Overall, the median post-RSI initial propofol infusion rate was low at 20 μg/kg/min (IQR, 10-30 μg/kg/min).</p><p><strong>Conclusion: </strong>Use of rocuronium for RSI was associated with reduced likelihood of timely post-RSI sedation and analgesia. Coupled with low initial sedative dosing, our findings suggest that patients intubated with rocuronium are at increased risk of being awake during paralysis.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"S2929-S2936"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a novel framework for hepatitis C diagnosis and treatment in an academic health system.","authors":"Lindsey P Sheehan, Maribeth P Wright, Christian Rhudy, Thai Osborne, Thom Platt, Deborah L Duckworth","doi":"10.1093/ajhp/zxae373","DOIUrl":"10.1093/ajhp/zxae373","url":null,"abstract":"<p><strong>Purpose: </strong>Hepatitis C viral infection is a major public health concern and leading cause of chronic liver disease in the United States. Hepatitis C is primarily transmitted through blood exchange and is highly prevalent among people who inject drugs. Despite the availability of direct-acting antiviral (DAA) treatment, cost and barriers to access remain prohibitive for many patients.</p><p><strong>Summary: </strong>In 2018, University of Kentucky HealthCare (UKHC) began a screening program for patients admitted to its emergency department (ED). Despite identifying hepatitis C RNA-positive patients, connection to care proved challenging due to unavailability of follow-up clinic appointments, communication barriers, and lack of insurance coverage. In 2023, UKHC implemented a pharmacist-led hepatitis C screening, assessment, and treatment initiative in the ED following American Association for the Study of Liver Diseases (AASLD) simplified treatment guidelines. Pharmacists order needed laboratory assessments and complete imaging for liver fibrosis in eligible patients. Patients diagnosed with hepatitis C who meet simplified treatment criteria are prescribed DAA therapy by a hepatitis C advanced practice provider employed by the program. The UKHC specialty pharmacy then follows up with dispensing of DAA therapy and proactive refill management for subsequent fills.</p><p><strong>Conclusion: </strong>This holistic, interdisciplinary treatment model has allowed UKHC to increase treatment attachment rates for hepatitis C diagnoses in the ED from approximately 10% to 54%. This program has also reduced the median time to treatment of hepatitis C-infected individuals encountered in the ED from approximately 420 days to 17 days.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e551-e558"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective evaluation of a residency preparation checklist for PGY1 match success.","authors":"Alex N Isaacs, Dustin D Linn, Lindsay M Saum, Miller L Miller, Elizabeth Richardson, Yitao Li, Robert D Beckett","doi":"10.1093/ajhp/zxae354","DOIUrl":"10.1093/ajhp/zxae354","url":null,"abstract":"<p><strong>Purpose: </strong>The study objective was to determine whether scores on a residency preparation checklist differed for student pharmacists who matched with a postgraduate year 1 (PGY1) residency program and those who did not match.</p><p><strong>Methods: </strong>This was a multicenter, cross-sectional study with a voluntary survey administered before Match Day, between March 1 and 15, 2022, to student pharmacists in their final year of pharmacy school. Participants were from 3 institutions in Indiana. The survey consisted of 4 demographic items and the 33 items from a previously validated residency preparation checklist. Match data were obtained from each institution's administration and paired with survey results, and the data were then deidentified. The primary endpoint analyzed was the overall score for matched vs unmatched students, with secondary endpoints evaluating association of individual checklist items with matching through univariate analysis and forward logistic regression.</p><p><strong>Results: </strong>A total of 111 student pharmacists applying to residency programs completed at least part of the survey (72.5% response rate). Of these students, 95 (85.6%) matched during phase I or phase II. Students who matched had a median checklist score of 24, which was significantly higher than the score for students who did not match (median checklist score of 20). The median checklist score was also significantly higher in students offered interviews at 50% or more of the programs to which they applied in phase I than in participants who were offered interviews at less than 50% of programs. In the univariate analysis, 9 checklist items were significantly different for matched vs unmatched participants.</p><p><strong>Conclusion: </strong>A prospective evaluation of a validated residency checklist determined that candidates who matched with a PGY1 pharmacy residency program had a significantly higher score than those who did not. This tool can be used by pharmacy residency candidates and mentors throughout pharmacy school to help prepare for successful placement in a PGY1 pharmacy residency program.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e514-e522"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between medication regimen complexity and pharmacist engagement in fluid stewardship.","authors":"Susan E Smith, Logan T Smith, Andrea Sikora, Trisha N Branan, Christopher M Bland, W Anthony Hawkins","doi":"10.1093/ajhp/zxae369","DOIUrl":"10.1093/ajhp/zxae369","url":null,"abstract":"<p><strong>Purpose: </strong>The medication regimen complexity intensive care unit (MRC-ICU) score has previously been associated with pharmacist workload and fluid overload. The purpose of this study was to determine the relationship of MRC-ICU score with pharmacist-driven fluid stewardship recommendations as a means of establishing its role in risk stratifying critically ill patients for pharmacist intervention.</p><p><strong>Methods: </strong>Adult patients admitted to the medical ICU and followed by the academic pharmacy team were included in this retrospective, single-center cohort study. Patient and pharmacist data were collected via electronic medical record and surveillance tool, respectively. MRC-ICU and sequential organ failure assessment (SOFA) scores were captured at ICU admission. The primary outcome was correlation between MRC-ICU score and number of pharmacist-driven fluid stewardship recommendations. Secondary outcomes included the relationships between MRC-ICU score, accepted recommendations, and patient outcomes (fluid overload and length of stay [LOS]). Descriptive statistics were calculated for each variable. Spearman's rank-order correlation was used.</p><p><strong>Results: </strong>Of 168 patients, 22 (13%) experienced fluid overload. Median MRC-ICU and SOFA scores were 13 and 7, respectively, and were higher for patients experiencing fluid overload than for those without fluid overload. MRC-ICU had a weakly positive correlation with the number of pharmacist-driven fluid stewardship recommendations (ρ = 0.200; P = 0.010), fluid overload (ρ = 0.167; P = 0.030), and ICU LOS (ρ = 0.354; P < 0.001). These relationships remained true when looking at only the fluid stewardship recommendations that were accepted by the team.</p><p><strong>Conclusion: </strong>MRC-ICU displayed a weakly positive correlation with pharmacist workload, suggesting its potential use in identifying patients likely to benefit from pharmacist intervention.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e529-e535"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bluetooth Low Energy: A familiar technology for novel use in medication dispense tracking.","authors":"Jo Ann Leal, Alex Wiebe, Merissa Andersen, Dylan Kosaski","doi":"10.1093/ajhp/zxae392","DOIUrl":"10.1093/ajhp/zxae392","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e482-e485"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of obtaining prescriptions upon discharge on hospital readmissions in a large healthcare system.","authors":"Ethan Robarts, Brandy McGinnis, Brian Nguyen, Neil Pan, Emily Ong","doi":"10.1093/ajhp/zxae395","DOIUrl":"10.1093/ajhp/zxae395","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of a discharge pharmacy program on hospital readmission rates among adult patients.</p><p><strong>Methods: </strong>A multicenter, retrospective cohort study was conducted across 4 hospitals and their partnered discharge pharmacy for the period from July 2022 to July 2023. Adult patients aged 18 years or older who were discharged from an inpatient hospital unit and had their prescriptions sent to an Ascension Seton hospital-based discharge pharmacy before leaving the hospital were compared to those whose prescriptions were sent elsewhere. This comparison was conducted to assess the impact of an integrated healthcare delivery approach. Baseline characteristics, such as the number of discharge medications, index admission diagnoses, and discharge unit, were collected for comparison. The primary endpoint was the rate of 30-day hospital readmission, with secondary endpoints including the readmission rate within 31 to 60 days and reasons for 30-day readmission.</p><p><strong>Results: </strong>A total of 15,690 patients were included in the study (3,376 in the Ascension Seton hospital-based discharge pharmacy group and 12,314 in the control group). The rate of hospital readmission within 30 days from the index visit was 3.31% (95% confidence interval [CI], 2.99% to 3.63%) in the non-Ascension Seton pharmacy group compared to 2.10% (95% CI, 1.62% to 2.58%) in the Ascension Seton pharmacy group. The difference in 30-day hospital readmission rate was statistically significant (P = 0.01), with an absolute difference of 1.21%.</p><p><strong>Conclusion: </strong>A statistically significant decrease in 30-day hospital readmission rate was seen in the Ascension Seton hospital-based discharge pharmacy group compared to the study group that had their discharge prescriptions sent to a pharmacy other than an Ascension Seton hospital-based discharge pharmacy.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"S2922-S2928"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric learning experiences in PGY1 pharmacy residency training: A 5-year analysis.","authors":"Suzanne C Harris, Jolene R Bostwick, Marshall E Cates, Lisa Whittington Goldstone, Amy B Werremeyer, Charles F Caley","doi":"10.1093/ajhp/zxae334","DOIUrl":"10.1093/ajhp/zxae334","url":null,"abstract":"<p><strong>Purpose: </strong>A growing shortage of mental health providers and the increasing prevalence and severity of mental illness necessitate a qualified pharmacist workforce to increase access and care. Psychiatric learning experiences (PLEs) completed during pharmacy residency training are one way to address this need. The purpose of this study was to characterize PLEs offered by postgraduate year 1 (PGY1) programs and completed by PGY1 residents over a 5-year period.</p><p><strong>Methods: </strong>A retrospective review of data from PharmAcademic was conducted. All ASHP-accredited PGY1 programs from the 2016-2017 through 2020-2021 residency years were included in the descriptive analysis. PLE presence was identified using a keyword search of learning experience titles and descriptions. A post hoc analysis was conducted to compare yearly PLE completion rates during the study period and annual completion rates relative to presence or absence of a postgraduate year 2 psychiatric pharmacy residency.</p><p><strong>Results: </strong>Of 1,461 PGY1 programs, 511 programs (34.9%) offered a PLE. Most PLEs were elective (82%). During the study period, 20.8% of PGY1 residents completed a PLE despite 77% having access.</p><p><strong>Conclusion: </strong>PGY1 residents complete PLEs at low rates. The reasons for this are unclear and need to be further explored. The growing need for qualified pharmacists to care for patients with mental illness calls for strategies to increase mental health training, including greater completion of PLEs by PGY1 residents and an understanding of how PLEs are promoted to PGY1 residents.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e507-e513"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}