Pub Date : 2020-02-21DOI: 10.1177/8755122520906291
Adam Root, Robert D. Raiff, T. Ortel, Kimberly L. Hodulik
Objective: To report the utilization of emicizumab in a patient with severe hemophilia A with inducible inhibitors and the reduction of drug costs related to decreased on-demand recombinant factor VIIa use. Case Summary: A 65-year-old African American man with established hemophilia A with an inducible factor VIII inhibitor presented with a bleeding hematoma from the right posterior thigh. The patient was historically managed on frequent administration of recombinant factor VIIa to achieve hemostasis and was started on every 2-hour dosing during this admission. Emicizumab, a new therapy for hemophilia A, became available during this admission, and the patient discontinued recombinant factor VIIa and transitioned to weekly emicizumab injections. The patient did not require any recombinant factor VIIa during the following 12 months resulting in substantial drug cost savings. Discussion: After initiation of emicizumab therapy, the patient no longer required on-demand treatment with recombinant factor VIIa for bleeds. Through this reduction in recombinant factor VIIa, there was a large decrease in inpatient drug costs and inpatient admissions for bleeding events. Conclusion: The potential reduction in drug costs and inpatient admissions should be considered when determining if emicizumab therapy is appropriate for hemophilia A patients with inhibitors. Further research is needed to confirm that continued long-term use of emicizumab remains associated with a reduction in on-demand treatment.
{"title":"Initiation of Emicizumab Therapy in an Adult Patient With Hemophilia A With Inhibitors and Associated Drug Cost Savings","authors":"Adam Root, Robert D. Raiff, T. Ortel, Kimberly L. Hodulik","doi":"10.1177/8755122520906291","DOIUrl":"https://doi.org/10.1177/8755122520906291","url":null,"abstract":"Objective: To report the utilization of emicizumab in a patient with severe hemophilia A with inducible inhibitors and the reduction of drug costs related to decreased on-demand recombinant factor VIIa use. Case Summary: A 65-year-old African American man with established hemophilia A with an inducible factor VIII inhibitor presented with a bleeding hematoma from the right posterior thigh. The patient was historically managed on frequent administration of recombinant factor VIIa to achieve hemostasis and was started on every 2-hour dosing during this admission. Emicizumab, a new therapy for hemophilia A, became available during this admission, and the patient discontinued recombinant factor VIIa and transitioned to weekly emicizumab injections. The patient did not require any recombinant factor VIIa during the following 12 months resulting in substantial drug cost savings. Discussion: After initiation of emicizumab therapy, the patient no longer required on-demand treatment with recombinant factor VIIa for bleeds. Through this reduction in recombinant factor VIIa, there was a large decrease in inpatient drug costs and inpatient admissions for bleeding events. Conclusion: The potential reduction in drug costs and inpatient admissions should be considered when determining if emicizumab therapy is appropriate for hemophilia A patients with inhibitors. Further research is needed to confirm that continued long-term use of emicizumab remains associated with a reduction in on-demand treatment.","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"4 1","pages":"110 - 113"},"PeriodicalIF":1.0,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85284382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-17DOI: 10.1177/8755122520905582
Bianca Mayzel, Sandra S. Axtell, Carolyn M. Richardson, N. Link
Background: Studies are needed to evaluate medication-related problems (MRPs) to assess the effect of a pharmacist on managing medications postdischarge. Objective: To assess the ability of pharmacist-led medication review and reconciliation to reduce the number of MRPs found in transitional care medicine (TCM) visits, leading to medication optimization. Methods: This study involved a retrospective chart review of standard TCM procedure at a family/internal medicine clinic and a prospective, team-based TCM visit in the same clinic. Inclusion criteria included patients discharged from any hospital within our institution and seen in the clinic. The primary outcome was the difference in the proportion of MRPs found between the prospective and retrospective groups. Secondary outcomes included the number and specific type of MRPs found, classified by the Pharmaceutical Care Network Europe tool, and further subdivided by patient aware or unaware of MRP, only in the prospective group, as well as 30-day readmission rate. Results: Patients in the prospective group (n = 50) had an average age of 67.9 years versus 65.5 years in the retrospective group (n = 50). Four times as many patients in the prospective group were found to have MRPs than the retrospective group. The most common MRP was due to a patient-related factor, meaning the cause is related to a patient’s behavior. Patients were unaware of the MRP in a majority of these cases. Thirty-day readmission rate did not differ between the groups. Conclusion: Team-based TCM visits that included a pharmacist-led medication reconciliation uncovered more MRPs than patients who did not have a pharmacist perform a medication reconciliation.
{"title":"The Impact of Face-to-Face Pharmacist Transitional Care Management Visits on Medication-Related Problems","authors":"Bianca Mayzel, Sandra S. Axtell, Carolyn M. Richardson, N. Link","doi":"10.1177/8755122520905582","DOIUrl":"https://doi.org/10.1177/8755122520905582","url":null,"abstract":"Background: Studies are needed to evaluate medication-related problems (MRPs) to assess the effect of a pharmacist on managing medications postdischarge. Objective: To assess the ability of pharmacist-led medication review and reconciliation to reduce the number of MRPs found in transitional care medicine (TCM) visits, leading to medication optimization. Methods: This study involved a retrospective chart review of standard TCM procedure at a family/internal medicine clinic and a prospective, team-based TCM visit in the same clinic. Inclusion criteria included patients discharged from any hospital within our institution and seen in the clinic. The primary outcome was the difference in the proportion of MRPs found between the prospective and retrospective groups. Secondary outcomes included the number and specific type of MRPs found, classified by the Pharmaceutical Care Network Europe tool, and further subdivided by patient aware or unaware of MRP, only in the prospective group, as well as 30-day readmission rate. Results: Patients in the prospective group (n = 50) had an average age of 67.9 years versus 65.5 years in the retrospective group (n = 50). Four times as many patients in the prospective group were found to have MRPs than the retrospective group. The most common MRP was due to a patient-related factor, meaning the cause is related to a patient’s behavior. Patients were unaware of the MRP in a majority of these cases. Thirty-day readmission rate did not differ between the groups. Conclusion: Team-based TCM visits that included a pharmacist-led medication reconciliation uncovered more MRPs than patients who did not have a pharmacist perform a medication reconciliation.","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"64 1","pages":"101 - 95"},"PeriodicalIF":1.0,"publicationDate":"2020-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84149533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-30DOI: 10.1177/8755122518814935
Ahmet Emre Eyler, Rachel F. Faley, Jan M. Kim, Myeong Gyu Knockel, Brooke Stultz, Jeremy Swanson, Joseph M. Takieddine, S. Tanoshima, Reo Tawil, Samah Terrell, Jamie M. Thiboutot
Abeyta, Agnieszka Ackerbauer, Kimberly Adams, Alex Adeola, Mobolaji Akers, Julie Alalawi, Mai Allen, Bryan Alvarez-Risco, Aldo Anders, Stephanie Anderson, Shawn D. Asal, Nicole Bain, Kevin Baker, Michelle Bandy, Veronica T. Barenholtz Levy, Hedva Barros, Michael C. Bishop, Bryan Black, Robin Boisvert, Louis Bright, David Brown, Jacob Bruce, Susan Buchman, Christina Buckel, Whitney Burgess, Sarah Burghardt, Kyle Burka, Abigail Byerly, Wesley Bystrak, Tamara Carter, Chris Cates, Marshall E. Childs-Kean, Lindsey Chiu, Ada Chong, Christopher Colmenares, Evan Colucci, Vincent J. Conway, Stephanie L. Cook, Elizabeth Covington, Elizabeth Cowart, Kevin Coz-Yataco, Angel Dash, Ranjeet D’Astoli, Joseph Dawwas, Ghadeer Dean, Stacey R. Deen, Beth Deming, Paulina Dharia, Sheetal Diec, Sandy DiScala, Sandra Ditch, Kristen Dougherty, John A. Eaves, Shannon Eljaaly, Khalid Enderby, Cher Eskazan, Ahmet Emre Eyler, Rachel F. Faley, Brian Farinola, Nicholas Felix, Daniel Fleming, James Gibson, Mara Gónzalez Álvarez, Isabel Gören, Jessica Hashida, Tohru Hashmi, Furqan Hellenga, Nadia Hockman, Rebecca Haynes Hoke, Kathleen House, Naomi Huang, Yen-Ming Hughes, Jonathan Jackson, Kristy Janzen, Kristin Jellinek-Cohen, Samantha P. Johannesmeyer, Herman Kane, Brenna Keeshin, Susana Keresztes, Jan M. Kim, Myeong Gyu Knockel, Laura Kopcza, Kathleen B. Krantz, Erica Krichbaum, Michelle Krikorian, Susan A. Leffler, Michaela Leo, Andrea Levine, Alexander Liao, Siyun Lilliston, Andrea Michelle Liu, Wenxi Lyles, Adraine Lawrence MacDonald, Nancy C. Macedo, Kelly Mahan, Rebecca Malone, Patrick Mathew, Sheryl Mercuro, Nicholas Merrey, Jessica Molino, Suzanne Mospan, Cortney Muir, Justin Okeahialam, Basil Patel, Hansita Pattie, Stacey Baker Pektezel, Mehmet Petite, Sarah Powers, Mary Redfern, Roberta Rein, Leanne Rhalimi, Mounir Rose, Christina Rosselli, Jennifer Russak, Edward Salerno, David Scherrer, Leigh Seed, Sheila Selvi-Sabater, Pablo Skordallos, Sebastian Slugocki, Malgorzata Smith, Susan Snyder, Scott Spence, Nathan A. Spray, Jeffery Steinberg, Michael Steiner, Chris 814935 PMTXXX10.1177/8755122518814935Journal of Pharmacy Technology other2018
{"title":"Reviewer Acknowledgment","authors":"Ahmet Emre Eyler, Rachel F. Faley, Jan M. Kim, Myeong Gyu Knockel, Brooke Stultz, Jeremy Swanson, Joseph M. Takieddine, S. Tanoshima, Reo Tawil, Samah Terrell, Jamie M. Thiboutot","doi":"10.1177/8755122518814935","DOIUrl":"https://doi.org/10.1177/8755122518814935","url":null,"abstract":"Abeyta, Agnieszka Ackerbauer, Kimberly Adams, Alex Adeola, Mobolaji Akers, Julie Alalawi, Mai Allen, Bryan Alvarez-Risco, Aldo Anders, Stephanie Anderson, Shawn D. Asal, Nicole Bain, Kevin Baker, Michelle Bandy, Veronica T. Barenholtz Levy, Hedva Barros, Michael C. Bishop, Bryan Black, Robin Boisvert, Louis Bright, David Brown, Jacob Bruce, Susan Buchman, Christina Buckel, Whitney Burgess, Sarah Burghardt, Kyle Burka, Abigail Byerly, Wesley Bystrak, Tamara Carter, Chris Cates, Marshall E. Childs-Kean, Lindsey Chiu, Ada Chong, Christopher Colmenares, Evan Colucci, Vincent J. Conway, Stephanie L. Cook, Elizabeth Covington, Elizabeth Cowart, Kevin Coz-Yataco, Angel Dash, Ranjeet D’Astoli, Joseph Dawwas, Ghadeer Dean, Stacey R. Deen, Beth Deming, Paulina Dharia, Sheetal Diec, Sandy DiScala, Sandra Ditch, Kristen Dougherty, John A. Eaves, Shannon Eljaaly, Khalid Enderby, Cher Eskazan, Ahmet Emre Eyler, Rachel F. Faley, Brian Farinola, Nicholas Felix, Daniel Fleming, James Gibson, Mara Gónzalez Álvarez, Isabel Gören, Jessica Hashida, Tohru Hashmi, Furqan Hellenga, Nadia Hockman, Rebecca Haynes Hoke, Kathleen House, Naomi Huang, Yen-Ming Hughes, Jonathan Jackson, Kristy Janzen, Kristin Jellinek-Cohen, Samantha P. Johannesmeyer, Herman Kane, Brenna Keeshin, Susana Keresztes, Jan M. Kim, Myeong Gyu Knockel, Laura Kopcza, Kathleen B. Krantz, Erica Krichbaum, Michelle Krikorian, Susan A. Leffler, Michaela Leo, Andrea Levine, Alexander Liao, Siyun Lilliston, Andrea Michelle Liu, Wenxi Lyles, Adraine Lawrence MacDonald, Nancy C. Macedo, Kelly Mahan, Rebecca Malone, Patrick Mathew, Sheryl Mercuro, Nicholas Merrey, Jessica Molino, Suzanne Mospan, Cortney Muir, Justin Okeahialam, Basil Patel, Hansita Pattie, Stacey Baker Pektezel, Mehmet Petite, Sarah Powers, Mary Redfern, Roberta Rein, Leanne Rhalimi, Mounir Rose, Christina Rosselli, Jennifer Russak, Edward Salerno, David Scherrer, Leigh Seed, Sheila Selvi-Sabater, Pablo Skordallos, Sebastian Slugocki, Malgorzata Smith, Susan Snyder, Scott Spence, Nathan A. Spray, Jeffery Steinberg, Michael Steiner, Chris 814935 PMTXXX10.1177/8755122518814935Journal of Pharmacy Technology other2018","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"2013 1","pages":"45 - 46"},"PeriodicalIF":1.0,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82697409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-02-01DOI: 10.1177/8755122517744031
Sakra Saleh, Bandy, L. Jason, Barenholtz Levy, Hedva, Barros, C. Michael, Battaglia, Laura, Kopcza
Abazia, Daniel Adams, Alex Akins, Ronda Al-Shaer, Mohammad Ali, Saadia Alkim, Huseyin Alvarez-Risco, Aldo Bahmaid, Reem Balhareth, Sakra Saleh Bandy, Jason L. Barenholtz Levy, Hedva Barros, Michael C. Battaglia, Jessica N. Bergan, Jennifer Bernknopf, Allison Bonanno, Christina Borja-Hart, Nancy Bork, Sara Brenner, Allison C. Bright, David Britton, Emily Brown, Sherrill J. Bucher, Kasey Burgess, Sarah Burnett, Yvonne Byrnes, Holly Cates, Marshall E. Chaddha, Ashish Chong, Christopher Clements, Jennifer N. Cocchio, Craig Coletti, Daniel Cox, Laura McIntyre Cristofaro, Lisa Dault, Roxanne DeRemer, David DiMondi, Vincent Dunham, Marissa Dunn, Deanna Dutta Choudhury, Shubhasree Ellis, Mary Elsey, Rachel Evans, Shelby Eyler, Rachel F. Faley, Brian Fink, Joseph Fox, Lanae Fuji, Kevin Gillette, Michael Golchin, Negar Goldshtein, Inbal Hahn, Lindsay Hale, Charity Hansen, Kevin Hawks, Kelly Hein, Bradley E. Hill, Jordan Hohmeier, Kenneth Hui, Adrian Hutchison, Lisa Comer Jensen, Leon K. Jordan, Melanie Joseph, Merlyn Justis, Leanne Kang-Birken, Sunghe Lena Kaur, Upinder Keresztes, Jan M. Kliethermes, Mary Ann Knockel, Laura Kopcza, Kathleen B. Kouladjian O’Donnell, Lisa Krajewski, Kristin Lacher, Barbara Laskey, Dayne LaVance, Anne Leonard, Charles Li Ying, Huang Lin, Shin Yi Ling, Hua Lukasiewicz, Ronald H. Manzor Mitrzyk, Beatriz McCoy, Cheryl Merino-Bohórquez, Vicente Morin, Lucas Mruk, Allison Munsour, Emad Eldin Newman, Luke Papadopoulos, Nikolaos Park, Jiehye Patanwala, Asad Pegram, Angela Pervanas, Helen Peterson, Tim Pon, Tiffany Powers, Mary Priano, James Quinn, Andrea Renfro, Chelsea Rice, Kathryn Roberts, Gregory Robinson, Renee F. Rose, Adam J. Rosselli, Jennifer Sargin, Gokhan Scott, James D. Seed, Sheila Serlemitsos-Day, Maritsa Shea, Peter Shin, Maria Sirois, Caroline Skinner, Brian Spooner, Linda M. Stading, Julie A. Stevens, Brooke Stewart, Kyana Stultz, Jeremy Sullivan, Karyn Takieddine, Sheila Tawil, Samah Thompson, Alyssa Thornton, James Thurston, Maria Traeger, Jessica 744031 PMTXXX10.1177/8755122517744031Journal of Pharmacy Technology research-article2017
Abazia,丹尼尔·亚历克斯·亚当斯Akins任务Al-Shaer,穆罕默德·阿里,Saadia Alkim, Huseyin Alvarez-Risco, Aldo Bahmaid, Reem Balhareth Sakra萨利赫武器、杰森·L . Barenholtz Levy,巴罗斯,迈克尔·C .战斗,Jessica Hedva皮娜Bergan号,Jennifer Bernknopf,艾莉森,Christina Borja-Hart,南希的贡献,莎拉·布伦纳艾莉森,C .布莱特,大卫·艾米丽·布朗,Sherrill J . Bucher, Kasey伯吉斯,莎拉·马歇尔Burnett, Yvonne Byrnes,霍莉Cates Chaddha、克里斯托弗·克莱门茨Ashish Chong,,Jennifer Cocchio号,克雷格·Coletti,丹尼尔·考克斯,劳拉McIntyre Cristofaro, Lisa Dault, Roxanne DeRemer、大卫·DiMondi玛丽莎•邓恩,Deanna Vincent Dunham Dutta乔杜里Shubhasree Ellis,玛丽Elsey,蕾切尔·埃文斯,Eyler谢尔比,蕾切尔·F . Faley Brian Fink、约瑟夫·福克斯、Lanae富士、凯文·吉列迈克尔·Golchin剥夺他们Goldshtein,哈恩Inbal,林赛Hale,接生婆慈善Hansen,凯文·凯利Hawks, Hein, Bradley E . Hill,肯尼斯·乔丹Hohmeier詹森Adrian和记黄埔,Lisa Comer,杨辉Leon Merlyn Justis,梅勒妮·约瑟夫·K . Jordan, Leanne Kang-Birken,莉娜Sunghe Kaur, Upinder Keresztes, Jan M . Kliethermes, Mary Ann Knockel劳拉Kopcza、凯瑟琳·B . Kouladjian o ' donnell, Lisa Krajewski, Kristin Lacher,芭芭拉·Laskey, Dayne LaVance,安妮·伦纳德·查尔斯,李英,Huang Lukasiewicz Lin) Shin猫扑Ling,华,罗纳德·H . Manzor Mitrzyk, Beatriz McCoy,谢丽尔Merino-Bohórquez Vicente Morin, Lucas Mruk, Allison Munsour Emad Eldin Newman, Luke Nikolaos朴槿惠,帕帕佐普洛斯Jiehye Patanwala阿萨德Pegram,安吉拉Pervanas、海伦·彼得森,Tim在蒂鲍尔斯、玛丽Priano、詹姆斯·梅特·奎因,安德里亚·Renfro切尔西·凯瑟琳·康多莉扎•赖斯·罗伯茨(Renee ghert F . Rose,格雷戈里·罗宾逊(Mary Robinson)亚当·J . Rosselli,詹妮弗·萨金Gokhan斯科特先生,詹姆斯·D . Seed, Sheila Serlemitsos-Day, cbc Shea,彼得·斯金纳Shin玛丽亚·卡洛琳·Sirois Brian Spooner, Linda M . Stading朱莉。史蒂文斯,布鲁克·斯图尔特、Kyana Stultz,杰里米·沙利文,Karyn Takieddine Sheila Tawil、Samah汤普森Alyssa Thornton, James Thurston, Maria Traeger, Jessica 744040pmtxxx10
{"title":"Reviewer Acknowledgment","authors":"Sakra Saleh, Bandy, L. Jason, Barenholtz Levy, Hedva, Barros, C. Michael, Battaglia, Laura, Kopcza","doi":"10.1177/8755122517744031","DOIUrl":"https://doi.org/10.1177/8755122517744031","url":null,"abstract":"Abazia, Daniel Adams, Alex Akins, Ronda Al-Shaer, Mohammad Ali, Saadia Alkim, Huseyin Alvarez-Risco, Aldo Bahmaid, Reem Balhareth, Sakra Saleh Bandy, Jason L. Barenholtz Levy, Hedva Barros, Michael C. Battaglia, Jessica N. Bergan, Jennifer Bernknopf, Allison Bonanno, Christina Borja-Hart, Nancy Bork, Sara Brenner, Allison C. Bright, David Britton, Emily Brown, Sherrill J. Bucher, Kasey Burgess, Sarah Burnett, Yvonne Byrnes, Holly Cates, Marshall E. Chaddha, Ashish Chong, Christopher Clements, Jennifer N. Cocchio, Craig Coletti, Daniel Cox, Laura McIntyre Cristofaro, Lisa Dault, Roxanne DeRemer, David DiMondi, Vincent Dunham, Marissa Dunn, Deanna Dutta Choudhury, Shubhasree Ellis, Mary Elsey, Rachel Evans, Shelby Eyler, Rachel F. Faley, Brian Fink, Joseph Fox, Lanae Fuji, Kevin Gillette, Michael Golchin, Negar Goldshtein, Inbal Hahn, Lindsay Hale, Charity Hansen, Kevin Hawks, Kelly Hein, Bradley E. Hill, Jordan Hohmeier, Kenneth Hui, Adrian Hutchison, Lisa Comer Jensen, Leon K. Jordan, Melanie Joseph, Merlyn Justis, Leanne Kang-Birken, Sunghe Lena Kaur, Upinder Keresztes, Jan M. Kliethermes, Mary Ann Knockel, Laura Kopcza, Kathleen B. Kouladjian O’Donnell, Lisa Krajewski, Kristin Lacher, Barbara Laskey, Dayne LaVance, Anne Leonard, Charles Li Ying, Huang Lin, Shin Yi Ling, Hua Lukasiewicz, Ronald H. Manzor Mitrzyk, Beatriz McCoy, Cheryl Merino-Bohórquez, Vicente Morin, Lucas Mruk, Allison Munsour, Emad Eldin Newman, Luke Papadopoulos, Nikolaos Park, Jiehye Patanwala, Asad Pegram, Angela Pervanas, Helen Peterson, Tim Pon, Tiffany Powers, Mary Priano, James Quinn, Andrea Renfro, Chelsea Rice, Kathryn Roberts, Gregory Robinson, Renee F. Rose, Adam J. Rosselli, Jennifer Sargin, Gokhan Scott, James D. Seed, Sheila Serlemitsos-Day, Maritsa Shea, Peter Shin, Maria Sirois, Caroline Skinner, Brian Spooner, Linda M. Stading, Julie A. Stevens, Brooke Stewart, Kyana Stultz, Jeremy Sullivan, Karyn Takieddine, Sheila Tawil, Samah Thompson, Alyssa Thornton, James Thurston, Maria Traeger, Jessica 744031 PMTXXX10.1177/8755122517744031Journal of Pharmacy Technology research-article2017","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"1 1","pages":"37 - 38"},"PeriodicalIF":1.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84963011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-08-11DOI: 10.1177/8755122517725327
Kenya Ie, Maria A. Felton, S. Springer, Stephen A. Wilson, S. Albert
Background: Prescription-related problems among older adults have been of great interest. However, few data are available regarding the prevalence of these problems in US family medicine residency practices (FMRPs). Objective: The aim of this research was to examine the prevalence of multimorbidity, polypharmacy, and potentially inappropriate medications (PIMs) use among older adults who visited 5 FMRPs more than once a year. Methods: A cross-sectional hospital record review for patients 65 years or older who visited 1 of the 5 university-affiliated FMRPs at least twice during January 1 to December 31, 2014, was conducted. The prevalence of multimorbidity (24 chronic index conditions), polypharmacy, and PIMs use was examined. Results: A total of 1084 patients were included in the analyses. The most common chronic conditions were hypertension (87.8%), hyperlipidemia (69.7%), and osteoarthritis (56.1%). The mean number of chronic conditions was 5.3 (SD 2.6). The prevalence of multimorbidity (≥2 chronic conditions) was 95.6%. Among these multimorbid older adults (N = 1036), the mean number of medication orders was 9.04 (SD 4.36) and 1.57 (SD 0.92) for PIMs, 86.1% met polypharmacy standards (≥5 medications), and 33.4% were prescribed one or more PIMs. The proportion of patients with fewer prescriptions at the last visit was 45.4% in the polypharmacy group and 38.0% in the PIMs group. Conclusion: Our results suggest a high level of morbidity and complexity among older adults receiving care in FMRPs. Improving the continuity of care as well as promoting interdisciplinary collaboration would have potential to reduce these prescription-related problems. Further research and education to address polypharmacy and PIMs among this population at FMRPs are required.
{"title":"Multimorbidity and Polypharmacy in Family Medicine Residency Practices","authors":"Kenya Ie, Maria A. Felton, S. Springer, Stephen A. Wilson, S. Albert","doi":"10.1177/8755122517725327","DOIUrl":"https://doi.org/10.1177/8755122517725327","url":null,"abstract":"Background: Prescription-related problems among older adults have been of great interest. However, few data are available regarding the prevalence of these problems in US family medicine residency practices (FMRPs). Objective: The aim of this research was to examine the prevalence of multimorbidity, polypharmacy, and potentially inappropriate medications (PIMs) use among older adults who visited 5 FMRPs more than once a year. Methods: A cross-sectional hospital record review for patients 65 years or older who visited 1 of the 5 university-affiliated FMRPs at least twice during January 1 to December 31, 2014, was conducted. The prevalence of multimorbidity (24 chronic index conditions), polypharmacy, and PIMs use was examined. Results: A total of 1084 patients were included in the analyses. The most common chronic conditions were hypertension (87.8%), hyperlipidemia (69.7%), and osteoarthritis (56.1%). The mean number of chronic conditions was 5.3 (SD 2.6). The prevalence of multimorbidity (≥2 chronic conditions) was 95.6%. Among these multimorbid older adults (N = 1036), the mean number of medication orders was 9.04 (SD 4.36) and 1.57 (SD 0.92) for PIMs, 86.1% met polypharmacy standards (≥5 medications), and 33.4% were prescribed one or more PIMs. The proportion of patients with fewer prescriptions at the last visit was 45.4% in the polypharmacy group and 38.0% in the PIMs group. Conclusion: Our results suggest a high level of morbidity and complexity among older adults receiving care in FMRPs. Improving the continuity of care as well as promoting interdisciplinary collaboration would have potential to reduce these prescription-related problems. Further research and education to address polypharmacy and PIMs among this population at FMRPs are required.","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"114 1","pages":"219 - 224"},"PeriodicalIF":1.0,"publicationDate":"2017-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79333268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-13DOI: 10.1177/8755122517720293
S. Durham, M. J. Wingler, Lea S. Eiland
Background: Ceftriaxone is a third-generation cephalosporin commonly utilized as an empiric antibiotic treatment option in the emergency department (ED). Overuse can lead to decreased susceptibility and emergence of multidrug-resistant pathogens, increased costs, and unnecessary adverse effects. Objective: The purpose of this project was to determine the appropriateness of ceftriaxone usage in the ED of a veteran’s health care system. Methods: This retrospective chart review included all veterans who received at least one dose of ceftriaxone in the ED between June 1, 2014, and June 1, 2015. The primary outcome was the percentage of appropriate ceftriaxone use. Usage appropriateness was determined on a case-by-case basis by examining current published guidelines and local recommendations based on the institutional antibiogram. Results: Ceftriaxone was prescribed for a wide variety of indications and was determined to be inappropriately prescribed in 164 patients (53%). The most common reason for inappropriate prescribing was lack of a first-line indication for ceftriaxone (64%). Only 120 patients (38.5%) exhibited systemic signs of infection based on vital signs and laboratory parameters, and 25 patients (8%) likely did not require antibiotic therapy at all. Conclusions: Ceftriaxone was used inappropriately in more than half of the patients who received the drug in the ED. The literature on the prescribing habits for ceftriaxone is limited in the United States, but these results are similar to studies conducted in other countries. Attempts should be made to educate prescribers on appropriate indications for the use of ceftriaxone.
{"title":"Appropriate Use of Ceftriaxone in the Emergency Department of a Veteran’s Health Care System","authors":"S. Durham, M. J. Wingler, Lea S. Eiland","doi":"10.1177/8755122517720293","DOIUrl":"https://doi.org/10.1177/8755122517720293","url":null,"abstract":"Background: Ceftriaxone is a third-generation cephalosporin commonly utilized as an empiric antibiotic treatment option in the emergency department (ED). Overuse can lead to decreased susceptibility and emergence of multidrug-resistant pathogens, increased costs, and unnecessary adverse effects. Objective: The purpose of this project was to determine the appropriateness of ceftriaxone usage in the ED of a veteran’s health care system. Methods: This retrospective chart review included all veterans who received at least one dose of ceftriaxone in the ED between June 1, 2014, and June 1, 2015. The primary outcome was the percentage of appropriate ceftriaxone use. Usage appropriateness was determined on a case-by-case basis by examining current published guidelines and local recommendations based on the institutional antibiogram. Results: Ceftriaxone was prescribed for a wide variety of indications and was determined to be inappropriately prescribed in 164 patients (53%). The most common reason for inappropriate prescribing was lack of a first-line indication for ceftriaxone (64%). Only 120 patients (38.5%) exhibited systemic signs of infection based on vital signs and laboratory parameters, and 25 patients (8%) likely did not require antibiotic therapy at all. Conclusions: Ceftriaxone was used inappropriately in more than half of the patients who received the drug in the ED. The literature on the prescribing habits for ceftriaxone is limited in the United States, but these results are similar to studies conducted in other countries. Attempts should be made to educate prescribers on appropriate indications for the use of ceftriaxone.","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"42 1","pages":"215 - 218"},"PeriodicalIF":1.0,"publicationDate":"2017-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86575394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-25DOI: 10.1177/8755122517716472
Maryann R. Cooper, Bassem Almalki, Kristine C. Willett
Objective: To review nivolumab for the treatment of classical Hodgkin lymphoma (cHL). Data Sources: Literature searches were conducted in Medline (1946 to May week 3 2017), EMBASE (1974 to 2017 week 22), and Google Scholar using the terms Hodgkin lymphoma AND nivolumab. Study Selection and Data Extraction: Two clinical trials (phase I and phase II) were identified. Data Synthesis: Nivolumab inhibits programmed death receptor-1 allowing for increased T-cell mediated immune surveillance of tumors. Nivolumab was evaluated in cHL patients after failure of autologous stem cell transplantation and brentuximab vedotin consolidation. Patients received nivolumab 3 mg/kg every 2 weeks. In the phase I trial, the objective response rate was 87% (95% confidence interval [CI] = 66-97) and the rate of progression-free survival (PFS) at 24 weeks was 86% (95% CI = 62-95). The most common adverse events (AE) included rash (22%) and decreased platelet count (17%). Following extended follow-up at a median of 86 weeks, 50% of the initial responders maintained a durable response. In the phase II clinical trial, 53 patients (66.3%, 95% CI = 54.8-76.4) achieved an objective response and PFS at 6 months was 76.9% (95% CI = 64.9-85.3). The common AE were fatigue (25%), infusion-related reactions (20%), and rash (16%). After further follow-up at a median of 15.4 months, 12-month overall survival was 94.9% (median overall survival not reached). Conclusions: Nivolumab is an effective option in treating patients with relapsed/refractory cHL with an acceptable safety profile. Further studies are needed to investigate the role of nivolumab for the treatment of cHL.
目的:综述纳武单抗治疗经典霍奇金淋巴瘤(cHL)的疗效。数据来源:在Medline(1946年至2017年5月第3周)、EMBASE(1974年至2017年第22周)和谷歌Scholar中使用霍奇金淋巴瘤和尼武单抗进行文献检索。研究选择和数据提取:确定了两个临床试验(I期和II期)。数据综合:Nivolumab抑制程序性死亡受体-1，允许增加t细胞介导的肿瘤免疫监视。在自体干细胞移植和brentuximab vedotin巩固失败后的cHL患者中评估Nivolumab。患者每2周接受纳武单抗3mg /kg治疗。在I期试验中，客观缓解率为87%(95%置信区间[CI] = 66-97)， 24周无进展生存率(PFS)为86% (95% CI = 62-95)。最常见的不良事件(AE)包括皮疹(22%)和血小板计数下降(17%)。在中位数为86周的延长随访后，50%的初始应答者维持了持久的应答。在II期临床试验中，53名患者(66.3%，95% CI = 54.8-76.4)获得了客观缓解，6个月的PFS为76.9% (95% CI = 64.9-85.3)。常见的AE是疲劳(25%)、输液相关反应(20%)和皮疹(16%)。进一步随访中位时间为15.4个月，12个月总生存率为94.9%(中位总生存率未达到)。结论:Nivolumab是治疗复发/难治性cHL患者的有效选择，具有可接受的安全性。需要进一步的研究来调查纳武单抗在治疗cHL中的作用。
{"title":"Nivolumab for the Treatment of Classical Hodgkin Lymphoma","authors":"Maryann R. Cooper, Bassem Almalki, Kristine C. Willett","doi":"10.1177/8755122517716472","DOIUrl":"https://doi.org/10.1177/8755122517716472","url":null,"abstract":"Objective: To review nivolumab for the treatment of classical Hodgkin lymphoma (cHL). Data Sources: Literature searches were conducted in Medline (1946 to May week 3 2017), EMBASE (1974 to 2017 week 22), and Google Scholar using the terms Hodgkin lymphoma AND nivolumab. Study Selection and Data Extraction: Two clinical trials (phase I and phase II) were identified. Data Synthesis: Nivolumab inhibits programmed death receptor-1 allowing for increased T-cell mediated immune surveillance of tumors. Nivolumab was evaluated in cHL patients after failure of autologous stem cell transplantation and brentuximab vedotin consolidation. Patients received nivolumab 3 mg/kg every 2 weeks. In the phase I trial, the objective response rate was 87% (95% confidence interval [CI] = 66-97) and the rate of progression-free survival (PFS) at 24 weeks was 86% (95% CI = 62-95). The most common adverse events (AE) included rash (22%) and decreased platelet count (17%). Following extended follow-up at a median of 86 weeks, 50% of the initial responders maintained a durable response. In the phase II clinical trial, 53 patients (66.3%, 95% CI = 54.8-76.4) achieved an objective response and PFS at 6 months was 76.9% (95% CI = 64.9-85.3). The common AE were fatigue (25%), infusion-related reactions (20%), and rash (16%). After further follow-up at a median of 15.4 months, 12-month overall survival was 94.9% (median overall survival not reached). Conclusions: Nivolumab is an effective option in treating patients with relapsed/refractory cHL with an acceptable safety profile. Further studies are needed to investigate the role of nivolumab for the treatment of cHL.","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"47 1","pages":"237 - 244"},"PeriodicalIF":1.0,"publicationDate":"2017-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78708252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-04DOI: 10.1177/8755122517702171
Surbhi Shah, John A. Galdo, Elizabeth D. Cox, M. Moreno, H. Young
Background: Adherence to long-term pharmacotherapy is problematic in the United States. Bubble packaging of medications has been touted to improve patients’ use of medications. Scant research has assessed bubble packaging’s impact on adherence to multiple medications. Objective: To compare medication adherence between patients receiving medications to address cardiovascular disease risk factors in bubble packages to those receiving medications in pill bottles. Methods: This retrospective cohort study utilized prescription dispensing records from an independent pharmacy. Patients receiving statins, β-blockers, angiotensin-converting enzyme inhibitors, or oral hypoglycemic agents were identified and grouped into those who received medications in bubble packages and those received medications in pill bottles. Adherence was assessed with medication possession ratios. Patients were classified as adherent if their medication possession ratio was 80% or more. Results: Receiving medications in bubble packaging was significantly associated with greater adherence compared to pill bottles (P < .001). In adjusted models, greater numbers of medications filled (P = .024) and increasing patient age (P = .018) were significantly associated with low adherence, while bubble packaging was not (P = .13). Stratified analyses revealed that bubble packaging was significantly associated with greater adherence when 4 or fewer medications are filled (P = .012) and for patients between 18 and 44 years of age (P = .023). Conclusion: Bubble packages can improve medication adherence. However, they may not resolve complex issues contributing to the problem of nonadherence, especially for older patients and those prescribed multiple medications.
{"title":"Impact of Bubble Packaging on Adherence to Long-Term Oral Medications Used to Prevent Cardiovascular Disease","authors":"Surbhi Shah, John A. Galdo, Elizabeth D. Cox, M. Moreno, H. Young","doi":"10.1177/8755122517702171","DOIUrl":"https://doi.org/10.1177/8755122517702171","url":null,"abstract":"Background: Adherence to long-term pharmacotherapy is problematic in the United States. Bubble packaging of medications has been touted to improve patients’ use of medications. Scant research has assessed bubble packaging’s impact on adherence to multiple medications. Objective: To compare medication adherence between patients receiving medications to address cardiovascular disease risk factors in bubble packages to those receiving medications in pill bottles. Methods: This retrospective cohort study utilized prescription dispensing records from an independent pharmacy. Patients receiving statins, β-blockers, angiotensin-converting enzyme inhibitors, or oral hypoglycemic agents were identified and grouped into those who received medications in bubble packages and those received medications in pill bottles. Adherence was assessed with medication possession ratios. Patients were classified as adherent if their medication possession ratio was 80% or more. Results: Receiving medications in bubble packaging was significantly associated with greater adherence compared to pill bottles (P < .001). In adjusted models, greater numbers of medications filled (P = .024) and increasing patient age (P = .018) were significantly associated with low adherence, while bubble packaging was not (P = .13). Stratified analyses revealed that bubble packaging was significantly associated with greater adherence when 4 or fewer medications are filled (P = .012) and for patients between 18 and 44 years of age (P = .023). Conclusion: Bubble packages can improve medication adherence. However, they may not resolve complex issues contributing to the problem of nonadherence, especially for older patients and those prescribed multiple medications.","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"61 1","pages":"114 - 120"},"PeriodicalIF":1.0,"publicationDate":"2017-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75292559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-01DOI: 10.1177/8755122516683519
Timothy P. Frost, A. Adams
Objective: The benefit of a tech-check-tech (TCT) practice model in institutional settings has been well documented. To date, few studies have explored TCT beyond institutional settings. This article summarizes the existing evidence in community pharmacy–based TCT research with respect to dispensing accuracy and pharmacist time devoted to direct patient care. Data Sources: A literature review was conducted using MEDLINE (January 1990 to August 2016), Google Scholar (January 1990 to August 2016), and EMBASE (January 1990 to August 2016) using the terms “tech* and check,” “tech-check-tech,” “checking technician,” and “accuracy checking tech*”. Bibliographies were reviewed to identify additional relevant literature. Study Selection and Data Extraction: Studies were included if they analyzed TCT and were conducted in a community pharmacy practice site, inclusive of chain, independent, mass merchant, supermarket, and mail order pharmacies. Studies were excluded if the TCT practice model was conducted in an institutional or long-term care setting. Survey data on theoretical models of TCT in community pharmacy practice settings were also excluded. Data Synthesis: Over the past 14 years, 4 studies were identified indicating TCT has been performed safely and effectively in community settings. The studies demonstrate that trained community technicians perform as accurately as pharmacists and that TCT increased the amount of pharmacist time devoted to clinical activities. In the 2 studies that reported accuracy rates, pharmacy technicians performed at least as accurately as pharmacists (99.445 vs 99.73%, P = .484; 99.95 vs 99.74, P < .05). Furthermore, 3 of the studies reported gains in pharmacist time, with increases between 9.1% and 19.18% of pharmacist time for consultative services. Conclusions: The present studies demonstrate that TCT can be safe and effective in community pharmacy practice settings, with results similar to those found in institutional settings. It is anticipated more states will explore TCT in community settings in the years ahead as a strategy to improve patient care.
目的:一个技术检查技术(TCT)实践模式在机构设置的好处已经得到了很好的记录。迄今为止，很少有研究在机构环境之外探索TCT。本文总结了基于社区药房的TCT研究中关于调剂准确性和药剂师用于直接患者护理的时间的现有证据。数据来源:使用MEDLINE(1990年1月至2016年8月)、Google Scholar(1990年1月至2016年8月)和EMBASE(1990年1月至2016年8月)进行文献综述，使用术语“技术*和检查”、“技术-检查-技术”、“检查技术员”和“准确性检查技术*”。查阅参考书目以确定其他相关文献。研究选择和数据提取:如果研究分析了TCT，并在社区药房实践现场进行，包括连锁，独立，大型商家，超市和邮购药房，则纳入研究。如果TCT实践模型在机构或长期护理环境中进行，则排除研究。社区药房实践环境中TCT理论模型的调查数据也被排除在外。数据综合:在过去14年中，确定了4项研究，表明在社区环境中安全有效地进行了TCT。这些研究表明，训练有素的社区技术人员的表现与药剂师一样准确，TCT增加了药剂师用于临床活动的时间。在报告准确率的两项研究中，药学技术人员的工作至少与药剂师一样准确(99.445 vs 99.73%， P = .484;99.95 vs 99.74, P < 0.05)。此外，其中3项研究报告了药剂师时间的增加，药剂师咨询服务的时间增加了9.1%到19.18%。结论:目前的研究表明，TCT在社区药房实践环境中是安全有效的，其结果与在机构环境中发现的结果相似。预计未来几年，更多的州将在社区环境中探索TCT，作为改善患者护理的一项战略。
{"title":"Tech-Check-Tech in Community Pharmacy Practice Settings","authors":"Timothy P. Frost, A. Adams","doi":"10.1177/8755122516683519","DOIUrl":"https://doi.org/10.1177/8755122516683519","url":null,"abstract":"Objective: The benefit of a tech-check-tech (TCT) practice model in institutional settings has been well documented. To date, few studies have explored TCT beyond institutional settings. This article summarizes the existing evidence in community pharmacy–based TCT research with respect to dispensing accuracy and pharmacist time devoted to direct patient care. Data Sources: A literature review was conducted using MEDLINE (January 1990 to August 2016), Google Scholar (January 1990 to August 2016), and EMBASE (January 1990 to August 2016) using the terms “tech* and check,” “tech-check-tech,” “checking technician,” and “accuracy checking tech*”. Bibliographies were reviewed to identify additional relevant literature. Study Selection and Data Extraction: Studies were included if they analyzed TCT and were conducted in a community pharmacy practice site, inclusive of chain, independent, mass merchant, supermarket, and mail order pharmacies. Studies were excluded if the TCT practice model was conducted in an institutional or long-term care setting. Survey data on theoretical models of TCT in community pharmacy practice settings were also excluded. Data Synthesis: Over the past 14 years, 4 studies were identified indicating TCT has been performed safely and effectively in community settings. The studies demonstrate that trained community technicians perform as accurately as pharmacists and that TCT increased the amount of pharmacist time devoted to clinical activities. In the 2 studies that reported accuracy rates, pharmacy technicians performed at least as accurately as pharmacists (99.445 vs 99.73%, P = .484; 99.95 vs 99.74, P < .05). Furthermore, 3 of the studies reported gains in pharmacist time, with increases between 9.1% and 19.18% of pharmacist time for consultative services. Conclusions: The present studies demonstrate that TCT can be safe and effective in community pharmacy practice settings, with results similar to those found in institutional settings. It is anticipated more states will explore TCT in community settings in the years ahead as a strategy to improve patient care.","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"1 1","pages":"47 - 52"},"PeriodicalIF":1.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89984027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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