American Journal of Health-System Pharmacy最新文献

{"title":"Deprescribing in chronic kidney disease: An essential component of comprehensive medication management.","authors":"Marisa Battistella, Jo-Anne Wilson, Angelina Abbaticchio, Patrick Gee, Rasheeda Hall","doi":"10.1093/ajhp/zxaf051","DOIUrl":"10.1093/ajhp/zxaf051","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"745-752"},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802258","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":"Moving forward from Cockcroft-Gault creatinine clearance to race-free estimated glomerular filtration rate to improve medication-related decision-making in adults across healthcare settings: A consensus of the National Kidney Foundation Workgroup for Implementation of Race-Free eGFR-Based Medication-Related Decisions.","authors":"Wendy L St Peter, Andrew S Bzowyckyj, Tracy Anderson-Haag, Linda Awdishu, Michael Blackman, Andrew Bland, Ethan Chan, Christine Chmielewski, Cynthia Delgado, Rachel Eyler, Charles Foster, Joanna Hudson, Sandra L Kane-Gill, Mary Ann Kliethermes, Tuan Le, Rajanikanth Madabushi, Brianna Martin, W Greg Miller, Joshua J Neumiller, Ann M Philbrick, Glenda Roberts, Venita Schandorf, Andrew J Webb, Dennis Wu, Thomas D Nolin","doi":"10.1093/ajhp/zxae317","DOIUrl":"10.1093/ajhp/zxae317","url":null,"abstract":"<p><strong>Purpose: </strong>The goals of this paper are to (1) provide evidence and expert consensus to support a unified approach to estimating kidney filtration in adults with stable kidney function using race-free estimated glomerular filtration rate (eGFR) in place of Cockcroft-Gault estimated creatinine clearance (C-G eCrCL) for medical and medication-related decisions, and (2) demonstrate how adjusting eGFR results for an individual's body surface area (BSA) when it is higher or lower than 1.73 m2 will improve results for medication-related decisions.</p><p><strong>Summary: </strong>C-G eCrCL is predominantly used by US pharmacists to determine eGFR for the purposes of medication-related decisions, even though more accurate eGFR equations exist. Several driving factors make it the ideal time to shift clinical practice from using C-G eCrCL to eGFR. These factors include the following: (1) 2024 Food and Drug Administration (FDA) guidance for industry recommends eGFR over C-G eCrCL to evaluate the impact on pharmacokinetics in patients with impaired kidney function; (2) a joint National Kidney Foundation (NKF) and American Society of Nephrology task force recommends 3 race-free Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) eGFR equations for medical and medication-related decision-making; (3) the almost ubiquitous use of standardized serum creatinine assay methods in US clinical laboratories; and (4) increasing availability and use of serum cystatin C for eGFR assessment. This publication guides practitioners through the rationale for using race-free eGFR equations for medication-related decisions and how to implement this practice change.</p><p><strong>Conclusion: </strong>The NKF Workgroup for Implementation of Race-Free eGFR-Based Medication-Related Decisions suggests that health systems, health settings, clinical laboratories, electronic health record systems, compendia and data vendors, and healthcare practitioners involved with medication-related decision-making transition away from C-G eCrCL and towards the race-free eGFR equations for more accurate assessment of kidney filtration and consistency in medication and medical decision-making across the US.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"644-659"},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646685","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":"On the front lines of cardiovascular-kidney-metabolic syndrome: Review of GLP-1 and Dual GLP-1/GIP receptor agonists in CV and kidney health.","authors":"Lavinia Salama, Levi Sinn","doi":"10.1093/ajhp/zxaf053","DOIUrl":"10.1093/ajhp/zxaf053","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this review is to highlight the role of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists (GLP-1/GIP RAs) in managing cardiovascular-kidney-metabolic (CKM) syndrome, focusing on their cardiovascular (CV) and kidney-protective effects beyond glycemic control.</p><p><strong>Summary: </strong>In multiple randomized controlled trials, GLP-1 RAs were demonstrated to confer significant benefits in reducing CV events and preserving kidney function in patients with preexisting atherosclerotic cardiovascular disease (ASCVD) and those at high CV risk. Current guidelines, including those from the Kidney Disease: Improving Global Outcomes (KDIGO) initiative and the American Diabetes Association (ADA), underscore the therapeutic potential of these agents for managing chronic kidney disease (CKD), type 2 diabetes mellitus (T2DM), and metabolic syndrome. Additionally, emerging data suggests their utility beyond T2DM. This review summarizes the evidence supporting these guidelines, along with newer findings not yet fully integrated into clinical practice. It also examines the role of pharmacists and multidisciplinary teams, safety considerations, and practical strategies for managing common adverse effects.</p><p><strong>Conclusion: </strong>The integration of GLP-1 RAs and dual GLP-1/GIP RAs into clinical practice offers substantial benefits for patients, both with and without diabetes. Pharmacists play a pivotal role in recommending evidence-based treatments for those at high CV and kidney risk, educating patients, addressing social determinants of health, and bridging gaps across multidisciplinary care teams.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"693-709"},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802263","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 pharmacist as a key member of the kidney care team.","authors":"Christie Schumacher, Obidiugwu K Duru, Saugar Maripuri, Glenda Roberts, Elizabeth Van Dril","doi":"10.1093/ajhp/zxaf050","DOIUrl":"10.1093/ajhp/zxaf050","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"633-634"},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802266","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":"Perspectives of medication-related experiences in Black persons with kidney diseases: The patient voice.","authors":"Lisa A Hillman, Curtis Warfield, Wendy L St Peter","doi":"10.1093/ajhp/zxaf043","DOIUrl":"10.1093/ajhp/zxaf043","url":null,"abstract":"<p><strong>Purpose: </strong>Black persons comprise 13.4% of the US population but represent 36% of those with kidney failure. Medication-related disparities likely contribute to these outcomes. Patient perspective provides valuable insight into what they need and want from their medications and their care.</p><p><strong>Methods: </strong>We conducted five 1.25-hour online focus group sessions via a videoconferencing app between March 30 and June 27, 2022. Our nationally recruited sample consisted of 19 adults 37 to 72 years of age who represented a broad range of educational backgrounds, all with CKD (non-dialysis-dependent, dialysis-dependent, or post kidney transplant). Semistructured guides were constructed by our team and used by moderators. Inductive thematic analysis procedures were followed. Patients representative of our study population were integral members of our research team.</p><p><strong>Results: </strong>Our analysis includes 3 major themes and associated subthemes: (1) meet patients where they are (subthemes: patient autonomy and empowerment, experience with illness, home and community support, barriers to understanding, and barriers to access; (2) the patient journey with medications (subthemes: fears with medications, frustrations and burdens with medication use, adjusting to medications, desire for awareness and explanation, preferences with medications, and helpful tools and supports; and (3) significant interactions with healthcare professionals (subthemes: barriers to building trust, type of care and interactions desired, and care team communication).</p><p><strong>Conclusion: </strong>Recognizing the patient as an individual, addressing their frustrations and needs with medications, and attending to implicit biases and strategies to overcome barriers and empower Black persons with CKD are anticipated to reduce medication- related disparities and improve health outcomes experienced by this population.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"710-718"},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741835","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-led kidney transplant care leads the path to innovation in transitions of care and ambulatory care.","authors":"Alicia Lichvar, Amanda Condon-Martinez, Adam Diamond, Jillian Descourouez, Kevin Fowler, Monica Fox, Prince Anand, David Taber","doi":"10.1093/ajhp/zxaf052","DOIUrl":"10.1093/ajhp/zxaf052","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"728-737"},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741841","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":"AKHOMM initiative curriculum and learning and action collaborative.","authors":"Calvin J Meaney, Joanna Q Hudson, Brendan Bowman, Andrew Traynor","doi":"10.1093/ajhp/zxaf046","DOIUrl":"10.1093/ajhp/zxaf046","url":null,"abstract":"<p><strong>Purpose: </strong>The Advancing Kidney Health through Optimal Medication Management (AKHOMM) initiative was developed with the vision that every person with kidney disease receives optimal medication management through team-based care including a pharmacist to improve kidney health. Due to the need for education and clinical practice implementation strategies, the AKHOMM initiative designed 2 educational programs to help achieve our vision: a continuing education curriculum and a learning and action collaborative (LAC).</p><p><strong>Summary: </strong>The curriculum is online, interactive, and case based, with interprofessional accreditation, to provide baseline competency in comprehensive medication management (CMM) across chronic kidney disease and address health disparities in this population. The development process involved an interprofessional approach with input from persons with kidney disease and care partners. Modules have been well received based on postactivity surveys, with over 90% of respondents (970/1,044) indicating that the activity will improve their ability to treat and manage their patients. Ongoing quality assurance of existing modules, coupled with development of new modules in prioritized areas (cardiovascular-kidney-metabolic [CKM] syndrome, glomerular diseases) will continue to provide education to the pharmacy and broader healthcare communities. The LAC was designed using implementation science principles to facilitate pharmacist inclusion in patient care teams to provide CMM to patients with CKM. Site teams will include a pharmacist, provider champion, and others coupled with an implementation coach and field expert. Through a continuous quality improvement framework, the teams will work towards achieving their bold aim over a 12-month implementation period.</p><p><strong>Conclusion: </strong>The curriculum and LAC address the current void of pharmacist-based care in CKM.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"719-724"},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762797","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":"Using guideline-directed medical therapies to improve kidney and cardiovascular outcomes in patients with chronic kidney disease.","authors":"Thelma Barber, Joshua J Neumiller, Michelle A Fravel, Robert L Page, Katherine R Tuttle","doi":"10.1093/ajhp/zxaf045","DOIUrl":"10.1093/ajhp/zxaf045","url":null,"abstract":"<p><strong>Purpose: </strong>An estimated 37 million people currently live with chronic kidney disease in the US, which places them at increased risk for kidney disease progression, cardiovascular disease, and mortality. This review discusses current standard-of-care management of patients with chronic kidney disease, identifies key gaps in care, and briefly highlights how pharmacists can address gaps in care as members of the multidisciplinary care team.</p><p><strong>Summary: </strong>Recent advances in guideline-directed medical therapies for patients with chronic kidney disease, including agents from the sodium-glucose cotransporter, glucagon-like peptide-1 receptor agonist, and nonsteroidal mineralocorticoid receptor antagonist classes, can dramatically improve cardiovascular-kidney-metabolic care and outcomes. Unfortunately, gaps in screening, diagnosis, and implementation of recommended therapies persist. Team-based models of care-inclusive of the person with chronic kidney disease-have the potential to significantly improve care and outcomes for people with chronic kidney disease by addressing current gaps in care.</p><p><strong>Conclusion: </strong>As members of the multidisciplinary care team, pharmacists can play a critical role in addressing current gaps in care, including optimized use of guideline-directed medical therapies, in patients with chronic kidney disease.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"681-692"},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802268","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":"Cardiovascular-kidney-metabolic syndrome medications: A time to rebrand?","authors":"Rebecca Maxson, Joshua J Neumiller, Dan Aistrope, Melanie R Weltman, Sheryl Chow","doi":"10.1093/ajhp/zxaf042","DOIUrl":"10.1093/ajhp/zxaf042","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"738-744"},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762506","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":"Suzetrigine.","authors":"","doi":"10.1093/ajhp/zxaf054","DOIUrl":"10.1093/ajhp/zxaf054","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"635-637"},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959608","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}