American Journal of Health-System Pharmacy最新文献

{"title":"An international, multicenter post hoc analysis comparing in-person and virtual medication management strategies in post-ICU recovery clinics.","authors":"Aeryana N Beaudrie-Nunn, Janelle O Poyant, Christine M Groth, Stephen H Rappaport, Rachel M Kruer, Emily Miller, Jessica A Whitten, Allyson M Mcintire, Cara M McDaniel, Kevin D Betthauser, Rima A Mohammad, Michael T Kenes, Rebecca Bookstavar Korona, Alexandra E Barber, Pamela MacTavish, Deepali Dixit, Siu Yan A Yeung, Joanna L Stollings","doi":"10.1093/ajhp/zxae244","DOIUrl":"10.1093/ajhp/zxae244","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the incidence of ICU pharmacist interventions in intensive care unit recovery center (ICU-RC) in-person and virtual clinic visits.</p><p><strong>Methods: </strong>This was a post hoc analysis of interventions implemented by ICU pharmacists among adult patients who were referred to 12 ICU-RCs across the United States and the United Kingdom between September 2019 and July 2021, as reported in the previously published study \"An International, Multicenter Evaluation of Comprehensive Medication Management by Pharmacists in ICU Recovery Centers.\" That study included patients who received a comprehensive medication review by an ICU pharmacist. Medication-related interventions performed by an ICU pharmacist during ICU-RC in-person clinic visits were compared to those performed during virtual clinic visits.</p><p><strong>Results: </strong>There were 507 patients referred to an ICU-RC, of whom 474 patients attended a clinic visit. Of those, 472 received a comprehensive medication review, with 313 patients attending in-person visits and 159 patients attending virtual visits. The incidence of medication-related interventions implemented was higher in the ICU-RC in-person clinic group compared to the virtual clinic group (86.5% vs 79.2%, P = 0.04). There was no difference in the median number of ICU pharmacist interventions per patient between the in-person and virtual clinic groups (2 vs 2, P = 0.13). An ICU admission diagnosis was an independent predictor of medication-related interventions among all patients.</p><p><strong>Conclusion: </strong>The incidence of ICU pharmacist interventions was higher at ICU-RC in-person clinic visits compared to virtual clinic visits. Pharmacists aid in meeting the complex pharmacologic challenges of post-intensive care syndrome in both settings.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e262-e273"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003390","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":"Oral history collection gives personal look at public health pharmacy.","authors":"Kate Traynor","doi":"10.1093/ajhp/zxaf003","DOIUrl":"https://doi.org/10.1093/ajhp/zxaf003","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":"82 5","pages":"e216-e217"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466621","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":"Clinical review of substitutions or alternatives for critical chemotherapy drug shortages in hematologic malignancies.","authors":"Jose Tinajero, Tanya Markary, Jason Chen, Vaibhav Agrawal, Dat Ngo","doi":"10.1093/ajhp/zxae239","DOIUrl":"10.1093/ajhp/zxae239","url":null,"abstract":"<p><strong>Purpose: </strong>Over the past decade, drug shortages have become increasingly more problematic for clinicians, with over 300 drug shortages reported in the first quarter of 2023. Shortages of chemotherapy drugs can have a negative impact on patient care, as omission or delay of treatment can lead to worse outcomes. Although many articles have been published on this topic, currently no review articles discuss strategies for using alternative regimens or substitutions in the event of severe chemotherapy drug shortages.</p><p><strong>Summary: </strong>In this article, we review the literature on antineoplastic agents used to treat hematologic malignancies that experienced a drug shortage from 2010 through 2023, providing recommendations for substitutions and alternative regimens in the event of a critical shortage. In particular, we discuss how shortages of fludarabine, cytarabine, daunorubicin, methotrexate, and platinum agents may be addressed, including supporting clinical evidence.</p><p><strong>Conclusion: </strong>Further publications assessing possible alternatives and substitutions for chemotherapy agents and examining the efficacy of previous strategies are needed to mitigate potentially devastating interruptions to care for patients with cancer during severe drug shortages.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e224-e241"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016090","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":"Fiercely collaborative: A discussion of teamwork, trust, and appreciation in pharmacy practice.","authors":"John S Clark","doi":"10.1093/ajhp/zxae347","DOIUrl":"https://doi.org/10.1093/ajhp/zxae347","url":null,"abstract":"<p><p>In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447997","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: Ultra-complex specialty medications: Meeting the challenges of significant medication requirements through an integrated specialty pharmacy model.","authors":"","doi":"10.1093/ajhp/zxae400","DOIUrl":"https://doi.org/10.1093/ajhp/zxae400","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424745","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":"Evaluation of a hazardous drug surface contamination surveillance program in a large community hospital.","authors":"Alexis Hayes-Porter, Blake Shay","doi":"10.1093/ajhp/zxaf022","DOIUrl":"https://doi.org/10.1093/ajhp/zxaf022","url":null,"abstract":"<p><strong>Disclaimer: </strong>In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.</p><p><strong>Purpose: </strong>Risks of occupational exposures to hazardous drugs (HDs) have been documented and identified as needing to be monitored. To decrease potential exposures in a community hospital, this project evaluated the impact of implementing a hazardous drug wipe sampling technology (BD HD Check system; BD, Franklin Lakes, NJ) and accompanying environmental procedures, risk level scoring assessment, and recordkeeping tools on identifying HD surface contamination.</p><p><strong>Methods: </strong>The 16-week evaluation focused on HD wipe sampling of locations (25 sites) within a cleanroom suite and infusion areas at the largest hospital of a multihospital community health system. Sites were determined through a risk stratification assessment to which areas were given a high, medium, or low-risk category to determine frequency of testing. HD wipe samples were tested for methotrexate, doxorubicin, and cyclophosphamide. Standard operating procedures (SOPs) were developed to address testing, decontamination, and retesting procedures.</p><p><strong>Results: </strong>A total of 238 samples were collected over 16-weeks across 25 sample sites. Fifteen of 25 sites resulted in at least 1 positive, totaling 37 initially positive results. Following initial positives, 92.5% of sites successfully tested negative following decontamination. Three sites that remained positive after decontamination underwent a corrective and preventative action (CAPA) analysis and were negative after a second round of decontamination.</p><p><strong>Conclusion: </strong>Sampling led to reduction in contamination and more transparency in HD monitoring. The HD wipe sampling technology (BD HD Check system) and accompanying procedures were shown to be helpful in establishing and refining SOPs for HD preparation, cleaning/decontamination, and wipe sampling.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424747","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 an enhanced medication access workflow within a health-system specialty pharmacy: Impact on patient and clinician experience.","authors":"Brandon Harkonen, Anthony Cuttitta, James Henderson, Valerie Gavrila, Jey Mckibbin, Sherrie Luttman, Wendy Benedict, Lindsey R Kelley, Scott A Flanders, Hae Mi Choe, Geoffrey D Barnes","doi":"10.1093/ajhp/zxaf023","DOIUrl":"https://doi.org/10.1093/ajhp/zxaf023","url":null,"abstract":"<p><strong>Disclaimer: </strong>In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.</p><p><strong>Purpose: </strong>The initiation of specialty medications is associated with patient access challenges and clinician burden. This evaluation assessed the impact on patient and clinician experience of an intervention to improve medication access by investing resources upstream of the prescribing step.</p><p><strong>Methods: </strong>The specialty pharmacy intervention was designed to improve medication access within 5 medical specialty clinics by utilizing an embedded medication access team assigned to patients and prescribers of targeted medications. Using a multimethods evaluative approach to quantitatively assess associations between the referral process and patient experience, we analyzed the emotional valence of patient portal messages using a retrospective cohort study within the event study framework of a nonrandomized, stepped wedge implementation design. Semistructured qualitative interviews provided an understanding of clinician experience.</p><p><strong>Results: </strong>The intervention was associated with an increase in the net positive emotional valence of patient portal messages (average marginal effect, 5.3; 95% CI, 3.8-6.8; P < 0.001). Except for patients seen by gastroenterologists for irritable bowel disease, patients cared for in all other specialties experienced statistically significant increases in net positive valence in the primary analysis. Regarding clinician experience, 4 major interrelated themes emerged from 17 qualitative interviews with prescribers and pharmacists: (1) decreased clinician burden, general praise, (2) improved experience and satisfaction, reduced anxiety and concerns, (3) rewarding praise for other prescribers/colleagues, and (4) excellent coordination, efficiency, and speed.</p><p><strong>Conclusion: </strong>Investing staff resources before, during, and after the prior authorization process greatly improved clinician experience. The positive valence of patient portal messages also increased, suggesting patient experience improvements.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397763","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":"Important antimicrobial dosing considerations for transitions of care: Focus on thrice-weekly dosing in hemodialysis.","authors":"Y Vivian Tsai, Caitlin Soto, Garrett Crawford, Kathryn Dzintars","doi":"10.1093/ajhp/zxae259","DOIUrl":"10.1093/ajhp/zxae259","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this clinical review is to evaluate current literature and propose optimal dosing strategies for thrice-weekly postdialytic administration of select antimicrobial agents in individuals receiving chronic intermittent hemodialysis (iHD).</p><p><strong>Summary: </strong>The optimization of outpatient parenteral antimicrobial therapy (OPAT) for patients receiving chronic iHD presents a prime opportunity for stewardship intervention. By utilizing the existing vascular hemodialysis access instead of inserting an additional peripheral catheter for antimicrobial administration, the risk for potential clinical complications (e.g. vein thrombosis, catheter-associated infections) can be minimized. In addition to vancomycin and aminoglycosides, literature evidence also supports the use of thrice-weekly cefazolin, ceftazidime, cefepime, ertapenem, and daptomycin given after dialysis sessions.</p><p><strong>Conclusion: </strong>Optimal dosing strategies of antimicrobials during transitions-of-care are imperative, especially in those receiving OPAT with iHD. While different dosing strategies may exist for each antimicrobial agent, other factors such as the modality of hemodialysis and site/severity of infection should be considered when choosing the optimal dosing regimen.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"203-210"},"PeriodicalIF":2.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339291","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":"Use of local treatment in managing infections: Focus on antimicrobial locks, beads, and cement.","authors":"Wesley D Kufel, Julia E Kufel","doi":"10.1093/ajhp/zxae264","DOIUrl":"10.1093/ajhp/zxae264","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this review is to describe important considerations with local antimicrobial therapies such as locks, beads, and cement for adjunctive infection management or prevention.</p><p><strong>Summary: </strong>Local delivery of antimicrobials with locks, beads, and cement has been used for infection management with retained devices in an effort to improve clinical success. However, their use has been controversial due to conflicting clinical data and logistical issues. Antimicrobial lock therapy (ALT) has been used for both adjunctive treatment and prevention of catheter-related bloodstream infections for certain pathogens and based on patient-specific scenarios. ALT has been a controversial method for sterilizing the catheter lumen by delivering high concentrations of antibiotics with or without heparin into the catheter for prolonged durations. Studies differ regarding the selection and concentrations of antibiotics, dwell duration, presence of heparin in the ALT, clinical outcomes/definitions, and use for prevention or treatment of catheter-related bloodstream infections. Antibiotic beads and cement have been used for various surgical procedures but are predominately considered in orthopedic surgeries. Despite the widespread use of the antibiotic-loaded bone cement in orthopedics, studies differ regarding the selection and concentrations of antibiotics, clinical outcomes/definitions, and use for prevention or treatment of infections.</p><p><strong>Conclusion: </strong>Although antimicrobial locks, beads, and cement are commonly used for adjunctive treatment or prevention of infections, more data are needed to support their use to provide clinical efficacy and safety with consistent antimicrobial selection and logistics.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"211-222"},"PeriodicalIF":2.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339303","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":"Pharmacists leading the way in infectious diseases education, research, and patient care.","authors":"Elizabeth Dodds Ashley, Kayla R Stover Hielscher, P Brandon Bookstaver","doi":"10.1093/ajhp/zxae361","DOIUrl":"10.1093/ajhp/zxae361","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"223-227"},"PeriodicalIF":2.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695016","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}