American Journal of Health-System Pharmacy最新文献

{"title":"Impact of oncology pharmacy services on the management of chemotherapy-induced nausea and vomiting: A systematic review and meta-analysis.","authors":"Yejin Shin, Sangyoon Shin, Heejeong Ryu, Jooyi Lee, Eunkyung Euni Lee","doi":"10.1093/ajhp/zxae237","DOIUrl":"10.1093/ajhp/zxae237","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of oncology services rendered by clinical pharmacists on reducing chemotherapy-induced nausea and vomiting (CINV) and improving overall treatment experiences.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted using studies retrieved from PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Research Information Sharing Service (RISS). The incidence and severity of CINV were evaluated as primary outcomes. Secondary outcomes were patient adherence, patient satisfaction, quality of life (QoL), emergency department (ED) visits, hospitalizations, and costs.</p><p><strong>Results: </strong>A total of 12 studies were selected for systematic review, with 8 studies eligible for meta-analysis. We found that clinical pharmacy services contributed to preventing and alleviating CINV as well as improving patient's medication adherence, treatment satisfaction, and QoL, reducing hospital visits, and achieving cost savings. In the meta-analysis, pharmacists' interventions were notably effective in reducing the incidence of nausea (odds ratio [OR], 1.917; 95% CI, 1.243-2.955; P = 0.003) and vomiting (OR, 2.491; 95% CI, 1.199-5.177; P = 0.014) during overall treatments periods relative to results in control groups. In addition, the impact of clinical pharmacy services on CINV control was greater during the delayed phase compared to the acute phase.</p><p><strong>Conclusion: </strong>This study demonstrated the important role of clinical pharmacy services in controlling CINV and enhancing the overall treatment experience for patients with cancer. Further studies with standardized pharmacists' services and outcome measures are needed to validate our findings.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e131-e147"},"PeriodicalIF":2.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142085856","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":"Development of a pharmacy technician training program and advanced pharmacy technician roles: A health system's journey amidst an evolving national practice landscape.","authors":"Amisha Arya, Sandy Trueba, Anthony B Ricchiuti, Kenny Yu","doi":"10.1093/ajhp/zxae291","DOIUrl":"10.1093/ajhp/zxae291","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e108-e112"},"PeriodicalIF":2.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455882","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":"Bridging the continuity: Practice-enhancing publications about the ambulatory care medication-use process in 2022.","authors":"Nicholas P Gazda, Tyler A Vest, Grayson K Peek, Suzanne Francart, Stephen F Eckel","doi":"10.1093/ajhp/zxae338","DOIUrl":"10.1093/ajhp/zxae338","url":null,"abstract":"<p><strong>Purpose: </strong>This article identifies, summarizes, and prioritizes literature on the ambulatory care medication-use process (ACMUP) published in 2022 that can describe ambulatory pharmacy practice. The medication-use process (MUP) is the foundational system that provides the framework for safe medication utilization within the healthcare environment and was reimagined to focus on new innovations and advancements in ambulatory pharmacy practice. The ACMUP is defined in this article as having the following components: transitions of care, prescribing, access, dispensing, adherence, and evaluating. Articles evaluating at least one step of the ACMUP were assessed for their usefulness toward practice improvement.</p><p><strong>Summary: </strong>A PubMed search for articles published in 2022 was conducted in January 2023 using targeted Medical Subject Headings (MeSH) keywords and the table of contents of selected pharmacy journals, providing a total of 4,125 articles. A thorough review identified 49 potentially practice-enhancing articles: 6 for transitions of care, 9 for prescribing, 5 for access, 2 for dispensing, 6 for adherence, and 21 articles for evaluating. Trends from the impact articles are described.</p><p><strong>Conclusion: </strong>It is important to routinely review the published literature and to incorporate significant findings into daily practice. This article continues a series of articles defining and evaluating the currently published literature around the ACMUP. As healthcare continues to advance and care shifts to ambulatory settings, the ACMUP will continue to be a crucial process to evaluate.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e182-e189"},"PeriodicalIF":2.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612265","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":"Postintubation hypotension following rapid sequence intubation with full- vs reduced-dose induction agent.","authors":"Alicia E Mattson, Caitlin S Brown, Benjamin J Sandefur, Kristin Cole, Brandon Haefke, Daniel Cabrera","doi":"10.1093/ajhp/zxae217","DOIUrl":"10.1093/ajhp/zxae217","url":null,"abstract":"<p><strong>Purpose: </strong>Rapid sequence intubation (RSI) is a common emergency department (ED) procedure with an associated complication of postintubation hypotension (PIH). It has not been clearly established whether the selection and dose of induction agent affect risk of PIH. The objective of this study was to determine the incidence of PIH in patients receiving full-dose compared to reduced-dose induction agent for RSI in the ED.</p><p><strong>Methods: </strong>This was a health system-wide, retrospective cohort study comparing incidence of PIH based on the induction medication and dose given for RSI in the ED. Patients were included if they underwent RSI from July 1, 2018, through December 31, 2020, were 18 years of age or older, and received etomidate or ketamine. A reduced dose was defined as a ketamine dose of 1.25 mg/kg or less and an etomidate dose of 0.2 mg/kg or less.</p><p><strong>Results: </strong>A total of 909 patients were included in the final analysis, with most receiving etomidate (n = 764; 84%) and a smaller number receiving ketamine (n = 145; 16%). Patients who received ketamine had a higher mean pre-intubation shock index (full dose, 1.08; reduced dose, 1.04) than those who received etomidate (full dose, 0.89; reduced dose, 0.92) (P ≤ 0.001). Reduced doses of induction agent were observed for 107 patients receiving etomidate (14.0%) and 60 patients receiving ketamine (41.4%). Patients who received full-dose ketamine for induction had the highest rate of PIH (n = 31; 36.5%), and the difference was statistically significant compared to patients receiving reduced-dose ketamine (16.7%; P = 0.021) and full-dose etomidate (22.8%; P = 0.010).</p><p><strong>Conclusion: </strong>We observed that full-dose ketamine was associated with the highest rate of PIH; however, this group had the poorest baseline hemodynamics, confounding interpretation. Our results do not support broad use of a reduced-dose induction agent.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e148-e156"},"PeriodicalIF":2.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756565","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":"Bridging the continuity: Practice-enhancing publications about the ambulatory care medication-use process in 2023.","authors":"Nicholas P Gazda, Tyler A Vest, Grayson K Peek, Suzanne J Francart, Stephen F Eckel","doi":"10.1093/ajhp/zxaf012","DOIUrl":"https://doi.org/10.1093/ajhp/zxaf012","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>This article identifies, summarizes, and prioritizes published literature on the ambulatory care medication-use process (ACMUP) from 2023 that can describe ambulatory pharmacy practice. The medication-use process is the foundational system that provides the framework for safe medication utilization within the healthcare environment. The ACMUP is defined in this article as having the following components: transitions of care, prescribing, access, dispensing, adherence, and evaluating. Articles evaluating at least one step of the ACMUP were assessed for their usefulness toward practice improvement.</p><p><strong>Summary: </strong>A PubMed search was conducted in January 2024 for the publication year 2023 using targeted Medical Subject Headings (MeSH) keywords and the table of contents of selected pharmacy journals, providing a total of 2,903 articles. A thorough review identified 52 potentially practice-enhancing articles: 6 for transitions of care, 11 for prescribing, 5 for access, 6 for dispensing, 8 for adherence, and 16 articles for evaluating. Trends gleaned from the highest-impact articles are described.</p><p><strong>Conclusion: </strong>It is important to routinely review the published literature and to incorporate significant findings into daily practice. This article continues a series of articles defining and evaluating the currently published literature around the ACMUP. As healthcare continues to advance and care shifts to ambulatory settings, the ACMUP will continue to be a crucial process to evaluate.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027726","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 layered learning practice model: Ensuring accomplishment of both practice and pharmacy education.","authors":"Kazuhiko Kido, James C Lee, Daniel O'Neil, Stephen F Eckel","doi":"10.1093/ajhp/zxae231","DOIUrl":"10.1093/ajhp/zxae231","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e207-e210"},"PeriodicalIF":2.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970417","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: Comparison of clevidipine vs nicardipine in the treatment of hypertensive urgency and emergency in critically ill patients.","authors":"","doi":"10.1093/ajhp/zxae402","DOIUrl":"https://doi.org/10.1093/ajhp/zxae402","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031772","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 pharmacist's guide to mitigating sleep dysfunction and promoting good sleep in the intensive care unit.","authors":"Mona K Patel, Kristi Soyoung Kim, Lydia R Ware, Jeremy R DeGrado, Paul M Szumita","doi":"10.1093/ajhp/zxae224","DOIUrl":"10.1093/ajhp/zxae224","url":null,"abstract":"<p><strong>Purpose: </strong>To review causes, risk factors, and consequences of sleep disruption in critically ill patients; evaluate the role of nonpharmacological and pharmacological therapies for management of sleep in the intensive care unit (ICU); and discuss the role of pharmacists in implementation of sleep bundles.</p><p><strong>Summary: </strong>Critically ill patients often have disrupted sleep and circadian rhythm alterations that cause anxiety, stress, and traumatic memories. This can be caused by factors such as critical illness, environmental factors, mechanical ventilation, and medications. Methods to evaluate sleep, including polysomnography and questionnaires, have limitations that should be considered. Multicomponent sleep bundles with a focus on nonpharmacological therapy aiming to reduce nocturnal noise, light, and unnecessary patient care may improve sleep disorders in critically ill patients. While pharmacological agents are often used to facilitate sleep in critically ill patients, evidence supporting their use is often of low quality, which limits use to patients who have sleep disruption refractory to nonpharmacological therapy. Dedicated interprofessional teams are needed for implementation of sleep bundles in the ICU. Extensive pharmacotherapeutic training and participation in daily patient care rounds make pharmacists vital members of the team who can help with all components of the bundle. This narrative review discusses evidence for elements of the multicomponent sleep bundle and provides guidance on how pharmacists can help with implementation of nonpharmacological therapies and management of neuroactive medications to facilitate sleep.</p><p><strong>Conclusion: </strong>Sleep bundles are necessary for patients in the ICU, and dedicated interprofessional teams that include pharmacists are vital for successful creation and implementation.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e117-e130"},"PeriodicalIF":2.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905571","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 two dimensions of pharmacy artificial intelligence tools.","authors":"Steven Smoke","doi":"10.1093/ajhp/zxae293","DOIUrl":"10.1093/ajhp/zxae293","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e113-e116"},"PeriodicalIF":2.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455945","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":"Development and assessment of an abbreviated medication regimen complexity index (the A-MRCI).","authors":"Rebekah P Scrivens, Ina Liu, Joshua D Niznik, Evan W Colmenares, Mary-Haston Vest, Jennifer Jacobson, Zachariah M Deyo","doi":"10.1093/ajhp/zxae208","DOIUrl":"10.1093/ajhp/zxae208","url":null,"abstract":"<p><strong>Purpose: </strong>Adaptation of the Medication Regimen Complexity Index (MRCI) for automation in an electronic medical record has the potential to improve medication optimization and patient outcomes. The purpose of this study was to develop and evaluate an abbreviated medication regimen complexity index (A-MRCI) and compare its associations with patient-level factors to those of the MRCI.</p><p><strong>Methods: </strong>The MRCI was modified via several rounds of review with an expert panel of clinical pharmacists and outcomes researchers. Medication data from 138 electronic health records were abstracted to calculate MRCI and A-MRCI scores for dosage form, dosing frequency, and additional directions. Comparison between indices was performed using inferential statistics for a 1-month sample of patients admitted to a cardiology or advanced heart failure service in 2017.</p><p><strong>Results: </strong>A-MRCI scores were higher than MRCI scores (mean difference of 3.97, P < 0.0005; 95% CI, 2.21-5.71). A significant association was observed between the A-MRCI score and both length of stay (P = 0.0005) and polypharmacy (P < 0.0005), whereas an association between MRCI score and the patient-level factors examined was not demonstrated.</p><p><strong>Conclusion: </strong>On average, A-MRCI scores were higher and more likely to be associated with several patient-level factors. Internal analyses show the potential for integration into an electronic health record for automation. However, further exploration of the A-MRCI in a larger external validation sample is warranted.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e190-e206"},"PeriodicalIF":2.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733293","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}