Journal of the American College of Clinical Pharmacy : JACCP最新文献

Pharmacogenomics (PGx) results can potentially guide the prescribing of dozens of medications; however, use of such results is often limited by the prescriber's awareness of results and knowledge of drug–gene interactions. Integration of PGx results with corresponding clinical decision support (CDS) in the electronic health record (EHR) is critical to facilitate genotype-guided medication prescribing among all clinicians in an integrated health system. We describe our experience with developing an infrastructure to house PGx results and ensure actionable findings can be used at the point of care in real time using CDS. Upon transitioning to a new EHR, PGx-related CDS alerts for more than 50 medications were developed using a systematic and multidisciplinary process where clinical pharmacist input was key. Multiple strategies were required to enable the storage of PGx results as discrete data from any laboratory source to drive CDS. EHR features were leveraged to link results from external laboratories to CDS and a homegrown translational software platform was developed to integrate results from the in-house genomics laboratory directly into the EHR. These processes enabled PGx result integration for 2342 patients. As an example, among 356 patients who were genotyped for CYP2C19 to guide voriconazole dosing as part of a standard protocol in bone marrow transplant, 114 (32%) had CDS alerts for medications other than voriconazole presented to a clinician. For 50 of these patients, alerts were presented to a clinician of a different specialty who likely was not aware the patient had PGx results. Clinical pharmacists at institutions performing PGx testing are encouraged to champion the integration of PGx results and CDS in the EHR to maximize clinician awareness and evidence-based use of PGx results.

A literature review with an evaluation of existing evidence is often the first step in designing a research project. This article provides a systematic framework and guide for clinicians, researchers, and clinician-scientists to appraise the available literature to inform a clinical research project. The three-step approach outlined in this article starts with defining your research question using the Population Intervention Comparator Outcome-Design framework, followed by evaluation of the existing evidence and identification of gaps that could be addressed by a research project, and ends with guidance to refine the research question and start preparing a protocol.

This commentary provides an overview of the current literature and best practices for online learning and assessment within the didactic curriculum of pharmacy education, building on the 2022 ACCP commentary addressing remote experiential learning. Lessons learned from online delivery of curricula and best practices for programs to create the optimal online learning environment for students are reviewed. Although benefits of online learning have been found, such as flexibility, convenience, and efficient use of time, with similar short-term student performance, the potential long-term implications on pharmacy students are not fully known, particularly concerning board pass rates, job attainment, and knowledge/skills application in the workplace. This commentary reviews and recommends the types of teaching modalities that align best with an online format for knowledge acquisition and student satisfaction. The most challenging part of didactic curricula to teach remotely is skills development. Proficiency in skills (e.g., compounding preparations or physical assessment) is best evaluated in person to promote student self-confidence in pharmacy practice and patient care. This commentary reviews the needed components for designing quality online courses, all in the context of remembering the significance of instructor engagement. The commentary also discusses the importance of bidirectional feedback for the instructor and student and the deliberate use of formative assessments of learning to gauge student performance. A review of online summative and high-stakes assessments is included with a focus on ensuring academic integrity while also minimizing any impact on student performance and anxiety. As pharmacy education has learned from the experiences with the COVID-19 transition to online learning, consideration should be given to best practices regarding when and how to use online modalities to teach students and foster student learning. Regardless of the format, courses should engage the student and instructor and be evaluated routinely to promote achievement of learning outcomes.

Patel, N, Dannemiller, RE, Kovacevic, MP, Dube, KM, Lupi, KE, Blum, RC, Crowley, KE. Pharmacist-led intervention to reduce inappropriate continuation of targeted medications initiated in the acute care setting at hospital and ICU discharge. J Am Coll Clin Pharm. 2024; 7(4): 358–366. https://doi.org/10.1002/jac5.1924

In Table 3, the text “stimulants” was incorrectly spelled as “simulants.”

We apologize for this error.