American Journal of Health-System Pharmacy最新文献

{"title":"Impact of pharmacy involvement on care gap closure in Managed Medicaid patients.","authors":"Ellen Montgomery, Tiffany Sherod-Harris, Marina Adkins, Molly Hinely","doi":"10.1093/ajhp/zxae328","DOIUrl":"10.1093/ajhp/zxae328","url":null,"abstract":"<p><strong>Purpose: </strong>A population health pharmacy team was developed to improve health and increase reimbursement for patients with value-based care plans. The purpose of this study was to evaluate the impact of pharmacy involvement on care gap closure in Managed Medicaid patients.</p><p><strong>Methods: </strong>This was a single-center, retrospective cohort study of Managed Medicaid patients seen at outpatient facilities. Patients had a pharmacy risk score (PRS) of 6 or greater and had not achieved the Medicaid quality measures for both glycated hemoglobin (HbA1c) and blood pressure (BP). The intervention group included patients reviewed by pharmacy, compared to a control group of patients not reviewed by pharmacy. The primary outcome was closure of at least one care gap by the end of 2022. Secondary outcomes were the number of each type of gap closed, the frequency at which recommendations were made by pharmacists, and the frequency at which pharmacist recommendations were implemented by providers.</p><p><strong>Results: </strong>Data were collected for 80 patients for the period from January through October 2022. The primary outcome occurred in 37 (74%) patients in the intervention group and 15 (50%) patients in the control group (odds ratio, 2.85; P = 0.032). The HbA1c gap was closed in 30 (60%) patients in the intervention group and 8 (27%) patients in the control group. The BP gap was closed in 24 (48%) patients in the intervention group and 11 (37%) patients in the control group. The frequency with which recommendations were made by a pharmacist was associated with gap closure (P = 0.012). No significant difference was found based on the frequency at which recommendations were implemented by providers (P = 0.4).</p><p><strong>Conclusion: </strong>Pharmacy intervention was associated with an almost 3-fold-higher likelihood of closing at least one care gap in Medicaid patients. HbA1c gap closure was achieved more frequently than BP gap closure due to pharmacy involvement. The frequency with which recommendations were made by pharmacy was associated with increased gap closure regardless of the frequency with which these recommendations were implemented by providers.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"S2894-S2899"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685845","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":"Summaries of safety labeling changes approved by FDA-Boxed warnings highlights, October-December 2024.","authors":"","doi":"10.1093/ajhp/zxaf002","DOIUrl":"10.1093/ajhp/zxaf002","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e218-e220"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363465","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":"Inavolisib.","authors":"","doi":"10.1093/ajhp/zxae364","DOIUrl":"10.1093/ajhp/zxae364","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e213-e215"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885229","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":"Neuromuscular monitoring: A tutorial for pharmacists.","authors":"Dustin D Linn, J Ross Renew","doi":"10.1093/ajhp/zxae287","DOIUrl":"10.1093/ajhp/zxae287","url":null,"abstract":"<p><strong>Purpose: </strong>To describe neuromuscular monitoring modalities and highlight the importance of neuromuscular monitoring to clinical pharmacy practice.</p><p><strong>Summary: </strong>A growing body of literature and clinical practice guidelines have highlighted the importance of neuromuscular monitoring practices to ensure patient safety during surgery and in the intensive care unit. Understanding neuromuscular monitoring modalities can allow pharmacists to enhance participation in institutional discussions and optimization of neuromuscular blocker administration and reversal practices. We have described the various modalities of neuromuscular monitoring and considerations for using different modalities.</p><p><strong>Conclusion: </strong>Neuromuscular monitoring should be performed whenever neuromuscular blocking agents are administered. This practice represents an evidence-based approach to minimizing the occurrence of residual neuromuscular blockade and its associated complications.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e242-e251"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455898","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":"Experience of a peer prereview service including a junior reviewer program in a professional association.","authors":"Susan E Smith, Laura M Andrick, Evelyn Akuamoah-Boateng, Kwame Akuamoah-Boateng, Chancey Carothers, Tiffany Everett, Lillian S Kao, Olivia Nicastro, Corey J Witenko, Brandon Hobbs","doi":"10.1093/ajhp/zxae298","DOIUrl":"10.1093/ajhp/zxae298","url":null,"abstract":"<p><strong>Purpose: </strong>Scientific journals have reportedly low acceptance rates. Peer review support services offering manuscript review before journal submission are uncommon but may increase success with the publication process. The purpose of this report is to describe the development and experience with a peer prereview (PPR) service offered by the Clinical Pharmacy and Pharmacology (CPP) section of the Society of Critical Care Medicine.</p><p><strong>Summary: </strong>The CPP PPR service provides comprehensive review on research manuscripts before submission to a scientific journal. A junior reviewer program provides an opportunity for mentorship and professional development of reviewers. After the review is complete, authors and reviewers complete a survey regarding their experience with the service. Authors are also contacted biannually to determine their manuscript's status. From the program's start in 2011 through June 2022, 64% of the 58 manuscripts reviewed were accepted or published in journals with impact factors ranging from 0.915 to 9.296. Of the 31 (82%) authors responding to the survey, 94% said that the service met or exceeded their expectations and 84% would recommend the service to a colleague. Of the 29 (76%) reviewers responding to the survey, 100% said that the service met or exceeded their expectations and 92% would be willing to review again.</p><p><strong>Conclusion: </strong>The majority of manuscripts that went through the CPP PPR service were accepted for publication, and both authors and reviewers were highly satisfied with their experience. The CPP PPR service can be used as a framework for other institutions to implement.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e300-e306"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455885","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":"Physicochemical and microbiological stability of 40 mg/mL amiodarone hydrochloride oral suspension.","authors":"Marine Cavelier, Henri Gondé, Damien Costa, Fabien Lamoureux, Tony Pereira, Rémi Varin, Charles Hervouët","doi":"10.1093/ajhp/zxae299","DOIUrl":"10.1093/ajhp/zxae299","url":null,"abstract":"<p><strong>Purpose: </strong>Amiodarone hydrochloride is an antiarrhythmic drug used to treat supraventricular tachycardia. However, there are currently no commercial pediatric forms available to treat young patients. Various oral formulations were previously reported in the literature, but the concentration was lower than the doses prescribed in clinical practice (a loading dose of 500 mg/m2/day for 7-10 days followed by a maintenance dose of 250 mg/m2/day). The objective of this study was to develop an oral liquid formulation of amiodarone hydrochloride at an optimal concentration for use in children and to evaluate its physicochemical and microbiological stability.</p><p><strong>Methods: </strong>No commercial suspension vehicle was used, allowing the choice of excipients. Compounding was performed using hydroxypropylmethylcellulose as thickener, potassium sorbate preservative, citric acid/sodium citrate buffer, sodium saccharin as sweetener, and a strawberry flavoring agent. A concentration of 40 mg/mL was selected based on a 5-year compilation of prescribed doses. Analyses performed were the following: visual and microscopic inspection, testing for antimicrobial preservation, osmolality and pH measurements, quantification of amiodarone hydrochloride by a stability-indicating liquid chromatography method, and a microbiological count.</p><p><strong>Results: </strong>At least 95% of the initial amiodarone hydrochloride remained stable during the 60-day study period under refrigeration. All other tested parameters remained stable at 5 °C. A targeted log reduction of the microorganism inoculum by day 14 and no microbial growth by day 28 were demonstrated in the test for antimicrobial preservation.</p><p><strong>Conclusion: </strong>The stability of 40 mg/mL amiodarone hydrochloride oral suspension was maintained under refrigeration for 60 days before opening bottles and for 1 month after opening bottles.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e274-e284"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455899","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":"Marstacimab-hncq.","authors":"","doi":"10.1093/ajhp/zxae365","DOIUrl":"10.1093/ajhp/zxae365","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e211-e212"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885230","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 clinical decision support alert to identify hepatic dysfunction and need for medication therapy adjustment in hospitalized patients.","authors":"Kevin B Nguyen, Scott Jacobs, Nissa Tasnim, John P Knorr","doi":"10.1093/ajhp/zxae327","DOIUrl":"10.1093/ajhp/zxae327","url":null,"abstract":"<p><strong>Purpose: </strong>To optimize the hepatic dysfunction alert tool at our institution to identify appropriate patients and minimize irrelevant alerts.</p><p><strong>Methods: </strong>This single-center, retrospective review included adults hospitalized over a 1-month period for whom a hepatic dysfunction alert fired for a medication order placed in the electronic health record. The existing alert determines hepatic dysfunction based on laboratory tests. The primary objective was to determine the proportion of patients with an alert that was deemed to be clinically relevant. Alerts were considered relevant if the patient had a Child-Pugh score in class B or C and were ordered a medication with a hepatic warning from FDA or LiverTox. The performance of 14 alternative models was evaluated.</p><p><strong>Results: </strong>A total of 1,541 alerts fired for 309 patients. Of these patients, 155 were randomly selected for the analysis, and the alert was deemed relevant in 86 patients (55%). Patients with relevant alerts were more likely to have documented liver disease and worsening measures on liver function tests. Of the alternative models evaluated, a model that excluded INR and albumin resulted in a 27% decrease in the number of alerts fired, of which 73% were relevant; however, it failed to identify 30% of patients with relevant hepatic dysfunction. None of the other models performed better.</p><p><strong>Conclusion: </strong>The existing hepatic dysfunction clinical decision support tool correctly identifies patients with relevant hepatic dysfunction only 55% of the time. Alternative models were able to improve the rate of relevant results, but not without missing patients with relevant hepatic dysfunction.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"S2885-S2893"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612274","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":"Implementing a risk stratification protocol for patients with migraine in a health-system specialty pharmacy setting.","authors":"Amanda Hickman, Andrew Wash, Sydney Kisala, Carly Giavatto, Casey Fitzpatrick, Hannah Kurtz, Jessica Mourani, Brandon Hardin, Ana I Lopez-Medina","doi":"10.1093/ajhp/zxae292","DOIUrl":"10.1093/ajhp/zxae292","url":null,"abstract":"","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e221-e223"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455897","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 implementation of autoverification standardization in the adult and pediatric emergency department.","authors":"Savanna Scott, Umbreen Murtaza, Sara Choi, Ian Watt, Juliana Chamless, Rosemary Duncan, Meghan Rowcliffe, Jacob Smith, Emily Pherson","doi":"10.1093/ajhp/zxae296","DOIUrl":"10.1093/ajhp/zxae296","url":null,"abstract":"<p><strong>Purpose: </strong>This project utilized the guidance of the American Society of Health-System Pharmacists (ASHP) autoverification toolkit to refine our health system's approach to autoverification and contribute to the literature regarding appropriate use of autoverification technology in a pediatric and adult emergency department (ED).</p><p><strong>Summary: </strong>This single-center quality improvement study was conducted in an academic medical center ED that has 33 pediatric beds and 77 adult beds. A team consisting of clinical pharmacy specialists in emergency medicine, medication safety and informatics personnel, operational managers, and pharmacy leadership was identified to develop and implement autoverification best practices in the ED utilizing practices outlined within the ASHP autoverification toolkit. Before implementation of best practices, defined as the \"preoptimization\" state, autoverification took place for most medications available in the automated dispensing cabinets (ADCs). By anchoring the autoverification rule on ADC inventory, it was challenging to optimize both inventory practices and autoverification best practices. This project focused on redesigning the autoverification rules in the electronic health record, defined as the \"postoptimization\" state. In the postoptimization state, autoverification in the ED was updated to better align with regulatory standards. Autoverification metrics and the percentage of orders that autoverified vs required pharmacist verification were analyzed in the preoptimization and postoptimization states.</p><p><strong>Conclusion: </strong>This project utilized the guidance from ASHP's autoverification toolkit to refine our health system's approach to autoverification. High-alert medications (eg, insulin, extended-release opioids, digoxin) were taken off autoverification following implementation. Optimization of autoverification rules allows more orders for high-alert medications to be reviewed by a pharmacist.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"e307-e314"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455880","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}