American Journal of Health-System Pharmacy最新文献

{"title":"Estimating measured creatinine clearance for critically ill trauma patients with presumed normal kidney function.","authors":"Roland N Dickerson, Delaney S Adams, Julie E Farrar, Joseph M Swanson, Sara Soule, Saskya Byerly, Dina M Filiberto, Joanna Q Hudson","doi":"10.1093/ajhp/zxaf028","DOIUrl":"10.1093/ajhp/zxaf028","url":null,"abstract":"<p><strong>Purpose: </strong>The intent of this study was to evaluate the predictive performance of two common methods for estimating kidney function in critically ill trauma patients with presumed normal kidney function.</p><p><strong>Methods: </strong>A retrospective analysis of 2 common methods for estimating kidney function, the Cockcroft-Gault (CG) and Chronic Kidney Disease Epidemiology Collaboration (2021 CKD-EPI) equations, was undertaken for adult trauma patients. Patients with a 24-hour urine collection for determination of measured creatinine clearance (mCrCl) within 4 to 14 days after admission were included in the study. Patients with a serum creatinine concentration of >1.5 mg/dL or who required dialysis were excluded.</p><p><strong>Results: </strong>The 200 patients included in the study had a median (IQR) mCrCl of 184 (141-233) mL/min; both the CG and CKD-EPI equations were biased towards underpredicting mCrCl, with median (IQR) values of 135 (100-177) mL/min and 135 (113-155) mL/min, respectively (P < 0.001). One hundred twenty-two patients had augmented renal clearance (ARC), defined as an mCrCl of >129 mL/min/1.73m2, and those patients had a median (IQR) mCrCl of 216 (188-265) mL/min; both the CG and CKD-EPI equations were biased towards underpredicting mCrCl in patients with ARC: the median (IQR) estimates were 160 (126-197) mL/min and 147 (129-164) mL/min, respectively (P < 0.001). For those without ARC (n = 78), the median (IQR) mCrCl was 125 (98-153) mL/min; both the CG and CKD-EPI equations underpredicted mCrCl, with median estimates of 98 (76-116) mL/min and 112 (92-132) mL/min, respectively (P < 0.001). The CKD-EPI equation outperformed the CG method for all markers of precision in patients without ARC (P < 0.003).</p><p><strong>Conclusion: </strong>Common predictive equations for assessing kidney function in critically ill patients with traumatic injuries underpredicted mCrCl, especially in those with ARC.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e498-e506"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254313","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":"The impact of change in regulations on buprenorphine prescribing for opioid use disorder.","authors":"Evon Ibrahim, Kaitlyn DeHoff, Eric Lambart, Molly Bray, Mary Marogi","doi":"10.1093/ajhp/zxaf035","DOIUrl":"10.1093/ajhp/zxaf035","url":null,"abstract":"<p><strong>Purpose: </strong>In December 2022, federal regulations in the US changed to increase access to buprenorphine for patients who need treatment for opioid use disorder (OUD), removing the requirement for prescribers to obtain a DATA waiver. This study's purpose was to evaluate the impact of these changes in regulations on buprenorphine prescribing for OUD at a community teaching hospital.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study investigated buprenorphine prescribing habits before and after the requirement for a DATA waiver was removed. The study focused on patients who had a diagnosis code for OUD or had buprenorphine with or without naloxone ordered for OUD from March 1 to December 20, 2022 (before the changes) and from March 1 to December 20, 2023 (after the changes). The primary outcome was the percentage of patients with OUD who received buprenorphine with or without naloxone before and after the changes in regulations.</p><p><strong>Results: </strong>Of the 386 patients for whom charts were reviewed, 162 patients met the inclusion criteria: 81 patients in the before group and 81 patients in the after group. Before the changes in regulations, 40% of patients with OUD had buprenorphine ordered in the inpatient setting, compared to 63% of patients after regulations were changed (P = 0.003). More patients had their home buprenorphine regimen continued in the inpatient setting in the after group than in the before group (53% vs 37%; P = 0.04).</p><p><strong>Conclusion: </strong>After removal of the DATA waiver requirement for buprenorphine prescribing, more patients with OUD were prescribed buprenorphine during hospitalization and at discharge.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"S2943-S2950"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555549","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":"Medication administration by inpatient pharmacists: Innovative interdisciplinary care teams.","authors":"Lisa Boothby, Emily Webb, Deborah Goodlett, Kellee Brown, Johlee Odinet","doi":"10.1093/ajhp/zxae374","DOIUrl":"10.1093/ajhp/zxae374","url":null,"abstract":"<p><strong>Purpose: </strong>Pharmacists traditionally provide clinical pharmacy services in acute care settings. Two hospitals within our system integrated medication administration pharmacists into inpatient interdisciplinary care teams. Goals of this interdisciplinary care model were to improve productivity, quality, safety, patient satisfaction, and team member engagement while decreasing waste in the medication-use process and reliance on external nursing agency support.</p><p><strong>Summary: </strong>The new pharmacy role of medication administration pharmacist (MAP pharmacist) was integrated into the inpatient interdisciplinary care team. This new pharmacy role was not responsible for order verification in the electronic medical record. MAP pharmacists administered 99% of medications for assigned patients, averaging 100 to 120 medication administrations per day. Pharmacists educated patients about medications, including their purpose and most common adverse effects, using the teach-back method. Patient satisfaction scores increased 37% for patients' ability to understand adverse effects of medications and 44% for understanding the purpose of their new medications. Annual nursing staff turnover decreased from 30% to 7%, with a $2 million decrease in external nurse agency spend from 2022 to 2023. Pharmacist team member satisfaction scores, as measured on a Press Ganey scale ranging from 1 (poor) to 5 (very good), remained high, at a mean of 4.00 for engagement, with \"progress,\" \"quality work, and \"knows what is expected\" cited as strengths (mean scores of 4.23-4.46). The mean Press-Ganey score for pharmacy well-being increased from 3.80 in 2022 to 3.99 in 2023. Pharmacy opportunities identified via survey include enhanced communication and continued professional development. Post implementation, all surveyed nurses requested medication administration pharmacists on the inpatient interdisciplinary care team moving forward.</p><p><strong>Conclusion: </strong>The interdisciplinary care team with pharmacists enhanced medication safety and quality indicators, improved nursing satisfaction with workflow, and had a positive impact on patient satisfaction. Increased nursing capacity allowed for expanded assignments and nurse-to-patient ratios, as well as decreased reliance on external nurse agency support. Due to the overwhelming success of the initiative, MAP pharmacists' role as part of the interdisciplinary care team is being expanded to additional hospital service lines throughout the healthcare system.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e523-e528"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827088","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: Outcomes in patients with spontaneous bacterial peritonitis utilizing first-line or alternative agents for secondary prophylaxis.","authors":"","doi":"10.1093/ajhp/zxaf031","DOIUrl":"10.1093/ajhp/zxaf031","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commission on Goals dives into evolving healthcare landscape.","authors":"-Kate Traynor","doi":"10.1093/ajhp/zxaf108","DOIUrl":"10.1093/ajhp/zxaf108","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e479-e480"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075430","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":"Pharmacist homicides in the United States: A retrospective review of NVDRS data from 2003 to 2020.","authors":"Kylee A Funk, Ciara Gonzales, Mary E Logeais, Ann M Philbrick, Jake A Woodruff, William N Robiner","doi":"10.1093/ajhp/zxae355","DOIUrl":"10.1093/ajhp/zxae355","url":null,"abstract":"<p><strong>Purpose: </strong>Workplace and work-related violence are growing concerns in the healthcare community and among healthcare professionals. A gap exists in our understanding of the most extreme form of violence, homicide, against pharmacists and the contributing factors leading to their tragic deaths. The objective of this study was to identify homicides of pharmacists and characterize potential patterns, including, but not limited to, the connection to pharmacists' work.</p><p><strong>Methods: </strong>Data from the Centers for Disease Control and Prevention's National Violent Death Reporting System (NVDRS) were analyzed to explore the number and characteristics of homicides of pharmacists that occurred between 2003 and 2020.</p><p><strong>Results: </strong>Between 2003 and 2020, 33 homicides of pharmacists were reported to the NVDRS. A slight majority (n = 17, 52%) of victims were female. Six (18%) were determined to be workplace or work-related homicides; only 2 homicides were related to the work of a pharmacist. Nearly two-thirds (n = 21, 64%) were perpetrated with a firearm. The suspects for most of these homicides were male (n = 28, 85%), and many were either a current or former partner of the decedent (n = 14, 42%).</p><p><strong>Conclusion: </strong>In the US, homicides of pharmacists occur infrequently relative to the general population. Homicides in pharmacists' workplaces are uncommon, and homicides of pharmacists appear to be tied most often to domestic violence and firearms.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e536-e543"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680570","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":"Well-being as a shared responsibility.","authors":"Christina Le","doi":"10.1093/ajhp/zxae386","DOIUrl":"10.1093/ajhp/zxae386","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e486-e487"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806049","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":"Prescribing errors in hospitalized patients on the ketogenic diet.","authors":"Cheng Yu Yen, Lauren Kronisch, Kayleen Whitley, Byronae Carew, Arturo Zaldana, Gloria Diaz-Medina, Akshat Katyayan, Jon A Cokley","doi":"10.1093/ajhp/zxaf036","DOIUrl":"10.1093/ajhp/zxaf036","url":null,"abstract":"<p><strong>Purpose: </strong>A ketogenic diet (KD) is recommended as a nonpharmacological treatment option in pediatric patients with epilepsy. Prescribing errors for these patients can result in inadvertent carbohydrate exposure, increasing the risk of loss of ketosis and breakthrough seizures. The objective of this study was to evaluate the incidence of inadvertent carbohydrate exposure in hospitalized children on the traditional KD.</p><p><strong>Methods: </strong>This was a retrospective cohort study of patients with epilepsy receiving KD therapy while admitted to the hospital. Patients 18 years of age or younger diagnosed with epilepsy and/or intractable epilepsy, receiving antiseizure medications on the traditional KD or KD total parenteral nutrition, or with GLUT-1 genetic disorder were included. The primary endpoint was the incidence of patient admissions with unintended orders for carbohydrate-containing medications during hospitalization.</p><p><strong>Results: </strong>A total of 42 patients accounting for 66 inpatient admissions were included in this study. The total incidence of admissions with an inadvertent carbohydrate-containing medication order placed was 52% for intravenous (IV) medications and 64% for oral medications. Patients averaged 2 carbohydrate-containing orders per admission for both IV and oral medications. The most commonly prescribed carbohydrate-containing medications were given at least once before being discontinued. Of the IV medications documented in this study, 6 were premix products diluted in carbohydrate-containing solutions and did not have an alternative file built to facilitate dilution in normal saline.</p><p><strong>Conclusion: </strong>Because of their restricted carbohydrate allowance and the possibility of carbohydrate-containing product excipients, patients on the KD are at increased risk for receiving inappropriate carbohydrate-containing medications during hospital admissions.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"S2937-S2942"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676643","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":"The dalbavancin dilemma: Establishment of a new formulary restriction workflow to balance access and stewardship.","authors":"Ryan W Stevens, Katie Bye, Sara Ausman, Anna Bartoo, Jake Noble, Josh Clement","doi":"10.1093/ajhp/zxae387","DOIUrl":"10.1093/ajhp/zxae387","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"517-521"},"PeriodicalIF":2.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806046","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":"Crinecerfont.","authors":"","doi":"10.1093/ajhp/zxaf017","DOIUrl":"10.1093/ajhp/zxaf017","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"505-507"},"PeriodicalIF":2.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555537","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}