American Journal of Health-System Pharmacy最新文献

{"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}

{"title":"Ceftobiprole: A therapeutic update.","authors":"Emily M Hitt, Dana R Bowers","doi":"10.1093/ajhp/zxaf006","DOIUrl":"10.1093/ajhp/zxaf006","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this therapy update is to highlight new clinical studies comparing ceftobiprole to current therapies and provide evidence for its suggested role in therapeutic management of selected infectious diseases.</p><p><strong>Summary: </strong>Antimicrobial resistance continues to be a global health problem, and newer targeted antimicrobials are necessary to combat increasing rates of problematic infections. More specifically, targeted antimicrobials against methicillin-resistant Staphylococcus aureus are needed. Ceftobiprole has been marketed internationally for the treatment of complicated skin and skin structure infections, community-acquired pneumonia, and hospital-acquired pneumonia. While Food and Drug Administration approval was previously pursued for its use in acute bacterial skin and skin structure infections in the US, the Food and Drug Administration issued a complete response letter determining that study data were unreliable and recommended completion of additional studies. In April 2024, ceftobiprole was granted approval for 3 indications in the US based on updated clinical study data. Ceftobiprole is the second fifth-generation cephalosporin to be developed and approved for clinical use.</p><p><strong>Conclusion: </strong>Ceftobiprole has been shown to be safe and effective in treating specific infectious diseases such as bloodstream infections, acute bacterial skin and skin structure infections, and community-acquired bacterial pneumonia. Its use should be considered when targeting infections caused by methicillin-resistant S. aureus where other therapeutic options may be limited. However, additional real-world data on the efficacy of ceftobiprole should be continually monitored as experience in the US increases.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e489-e497"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027729","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 24-hour pharmacy call response on time to antibiotics in open fractures.","authors":"Bacil Kadi, Melanie Smith Condeni, Taylor Morrisette, Carolyn Bell, Aaron Hamby, Abby Pollander","doi":"10.1093/ajhp/zxae398","DOIUrl":"10.1093/ajhp/zxae398","url":null,"abstract":"<p><strong>Purpose: </strong>Open fractures are associated with significant morbidity after trauma, which is driven, in part, by infection. Current literature and guidelines recommend that this patient population receive antimicrobial prophylaxis within 1 hour of emergency department (ED) arrival to minimize the risk of infection. The primary aim of this study was to investigate whether the addition of a trauma response to a pharmacy resident on-call program resulted in antibiotic administration within 1 hour of presentation to a higher proportion of patients with open fractures.</p><p><strong>Methods: </strong>This was a retrospective, observational, quasi-experimental analysis that was conducted at an academic medical facility with a level 1 trauma center for patients presenting to the ED from January 2019 to December 2020 (preimplementation period) and from January 2021 to December 2022 (postimplementation period). Patients were included if they were 18 years of age or older and presented to the ED with an open fracture(s). Patients with independent fractures of fingers and those who died in route to or in the ED were excluded. The primary outcome was the proportion of patients with antibiotic administration within 1 hour of ED presentation for patients with open extremity fractures.</p><p><strong>Results: </strong>A total of 292 patients met the eligibility criteria (49% in the preimplementation group and 51% in the postimplementation group). Patients were predominantly male (61% vs 58%), with an overall median age of 46 years. Following implementation of the on-call pharmacy resident trauma response, a significantly higher proportion of patients received antibiotics within 1 hour of presentation (70% vs 83%; P = 0.019). The median (interquartile range) time to antimicrobial administration was also significantly shorter in the postimplementation group (31 [16-68] minutes vs 19 [10-50] minutes; P = 0.005).</p><p><strong>Conclusion: </strong>The addition of a 24-hour on-call pharmacy resident response in the ED was associated with improved antibiotic administration within 1 hour of presentation in patients with open fractures.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"S2915-S2921"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926049","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":"Drug information question responses by a drug information center and by ChatGPT: Correspondence.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1093/ajhp/zxae396","DOIUrl":"10.1093/ajhp/zxae396","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e487-e488"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869281","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":"Triplett et al reply.","authors":"Samantha Triplett, Genevieve Lynn Ness-Engle, Erin M Behnen","doi":"10.1093/ajhp/zxae397","DOIUrl":"10.1093/ajhp/zxae397","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e488"},"PeriodicalIF":2.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891397","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}