INNOVATIONS in pharmacy (Iip - E-Journal)
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A Student-Initiated, Integrated Pharmacotherapeutics Learner-Centered Course
Get PDFObjective: To evaluate a learner-centered, elective course complementing pharmacotherapeutic instruction.
Design: A one credit-hour elective as developed. Enrolled students were responsible for article selection and to lead in-class discussions. A content-validated discussant rubric was use to peer review each discussant.
Assessment: Enrolled students kept current on the literature and nurtured an obligation to themselves and their peers to be prepared on a weekly basis to discuss the selected article. Discussion demonstrated varied opinions and provided ample opportunity for students to use technical/clinical language. Also, the course allowed for thinking at a higher level, discussing complex ideas/issues, and developing oral communication skills.
Conclusions: This learner-centered approach allowed the enrolled students to take ownership of their learning and complement their learning from the traditional mode of learning in two pharmacotherapeutic courses. It encouraged the students to investigate the clinical literature as a means to complement and enhance their knowledge.
Type: Not
Pharmacovigilance Programme of India
Get PDFPharmacovigilance is defined as "the pharmacological science relating to the detection, assessment, understanding and prevention of adverse effects, principally long term and short term adverse effects of medicines." It is an important and integral part of clinical research. India is the world's second most populated country with over one billion potential drug consumers. Although, India is participating in the Uppsala monitoring center program, its contribution to that database is relatively small. This problem is essentially due to the absence of a robust ADR monitoring system and also the lack of awareness of reporting concepts among Indian health care professionals. The specific aims of pharmacovigilance are to advance patient care and safety in relation to the use of medicines and all medical and paramedical interventions, contribute to the assessment of benefit, harm, effectiveness, and risk of medicines, promising their safe, rational, and more effective use, promote indulgent, education, and clinical training in pharmacovigilance and its effective communication to the public. Pharmacovigilance methods must also be capable to designate which patients are at risk of developing an adverse drug reaction. A suitably working pharmacovigilance system is important if medicines are to be used prudently. It will be advantageous for healthcare professionals, regulatory authorities, pharmaceutical companies and consumers to monitor medicines for risk.
Type: Commentar
Pharmacist Contributions to the U.S. Health Care System Reported in the 2009 and 2014 National Pharmacist Workforce Surveys
Get PDFType: Original Researc
Pharmacokinetic Analysis of Meropenem and Piperacillin in Critically-Ill Patients Requiring Continuous Ven-Venous Hemodiafiltration
Get PDFBackground: Literature has demonstrated proper antibiotic selection and prompt initiation of antibiotics are associated with lower morbidity and mortality. Septic patients have altered pharmacokinetics and often require continuous renal replacement therapy which contributes to altered drug clearance and metabolism. The current study evaluates the pharmacokinetics of meropenem and piperacillin/tazobactam in critically-ill patients requiring continuous veno-venous hemodiafiltration.
Purpose: This observational, prospective, single-center, nonrandomized study evaluated the pharmacokinetics of meropenem and piperacillin/tazobactam in critically-ill patients requiring continuous veno-venous hemodiafiltration.
Methods: Plasma drug concentrations were determined via high-performance liquid chromatography using three post-dose blood samples after steady-state antimicrobial agent administration.
Results: Meropenem peak drug concentrations ranged from 35.9 to 61 mcg/mL, while trough concentrations ranged from 3.9 to 16.7 mcg/mL. Piperacillin peak drug concentrations ranged from 240 to 331.8 mcg/mL, while trough concentrations ranged from 152.7 to 194.9 mcg/mL. Both drugs examined displayed peak concentrations relatively consistent with those expected from the literature, but observed trough concentrations for meropenem and piperacillin were uniformly high.
Conclusions: Intravenous doses of meropenem and piperacillin result in peak drug concentrations similar to those previously reported and trough concentrations significantly greater than those in the literature. While concentrations above an organism’s MIC are desirable given the time-dependent nature of these beta-lactam antibiotics, decreased renal clearance of patients maintained on CVVHDF therapy while receiving higher doses of antimicrobials creates a situation in which drug accumulation and toxicity may occur. Given the complex nature of ICU patient care, increased pharmacovigilance and therapeutic drug monitoring are necessary in this unique population.
Type: Original Researc
Discharge Medication Counseling and its Correlation with Reducing Readmissions for Patients with Chronic Obstructive Pulmonary Disease Exacerbations
Get PDFObjective: To determine the impact of pharmacist-provided discharge medication counseling on 30 and 90 day hospital readmissions and ED visits in patients admitted with COPD exacerbation.
Methods: A hospital-wide improvement was initiated, where COPD patients received discharge medication counseling and follow up phone call by a pharmacist. A pilot study was implemented, and data on readmission rates at 30- and 90-days were collected and compared to a hand-matched, retrospective control group that had not received discharge counseling by a pharmacist. Differences in readmission rates were analyzed using Chi-squared tests.
Results: A total of 28 patients received discharge counseling by the pharmacist and were compared to 28 retrospective patients. Differences in 30-day and 90-day readmission rates were not significant (p=1.000 and p=0.589, respectively). After thirty days, 7 (25%) intervention and 7 (25%) retrospective group patients had been readmitted. After ninety days, 11 (39.3%) intervention and 13 (46.4%) non-intervention patients had been readmitted. Since a small cohort of patients received discharge counseling, the study did not meet power.
Conclusions: Although not statistically significant, patients who received discharge medication counseling provided by a pharmacist had lower 90-day readmission rates post discharge. As regulations are implemented that penalize hospitals for readmissions that occur within 30 days of discharge, it is imperative that health care systems develop new strategies aimed at reducing readmission rates. Further studies that are adequately powered are needed to assess the impact pharmacists can have on readmission rates.
Type: Original Researc
Technology in the Pharmacy Learning Environment: Surveys of Use and Misuse
Get PDFThe use of technology in the classroom may have positive and negative effects on learning. The purpose of this investigation was twofold: to identify the effect technology is having on the pharmacy learning environment; and, to assess students' use of technology during class time for non-academic purposes. This study included a national cross-sectional survey as well as a single, college-specific survey. The national survey had a faculty response rate of 71.2%. Of the responders, approximately 61% identified significant problems related to students' use of technology in the pharmacy learning environment. Cell phones were a recognized concern and more than 90% of programs have chosen to restrict cell phone use in the classroom. The single college survey examining technology use during class for non-academic purposes had a student response rate of 87% and faculty response rate of 100%. Students and faculty members disagreed regarding the negative effects of technology use during class for non-academic purposes. Notably, 16% of students acknowledged their in-class use of technology for non-academic purposes had been disruptive to their learning, as compared to 95.7% of faculty. According to students, common reasons for off-task technology use included checking e-mail/text messages (75.1%), lack of engagement (58.1%), multitasking (56.2%), and accessing social media sites (33%). Faculty and students were asked about enforcement of technology policy. More faculty than students supported policy enforcement by faculty (65.2% versus 22.8%, respectively; p<0.001) as well as policy enforcement by students (78.3% versus 31.9%, respectively; p<0.001). Overall, technology use during class for non-academic purposes was common. Many schools and colleges of pharmacy are developing approaches to address these evolving issues by revising their technology use policies.
Type: Original Researc
Improving Blood Pressure Control in Over-the-Road Truck Drivers: Is Provision of Medication Therapy Management by Pharmacists Feasible?
Get PDFPurpose This pilot sought to determine feasibility of studying the impact on hypertension in over-the-road truck drivers who met with pharmacists for Medication Therapy Management (MTM) compared to those who did not.
Design/methodology/approach Drivers were randomly assigned to control or treatment (MTM) group for 52 weeks. Drivers assigned to the MTM arm could receive services in person or via secure videoconferencing technology located in a private space at the trucking company. All subjects were provided education and received a blood pressure monitor and log for recording daily blood pressures.
Findings Eleven drivers enrolled and seven drivers completed the study. The primary barriers to participation included unpredictable driver schedules and lack of access to MTM provider while on the road.
Research limitations/implications This pilot study was limited by small sample size. Pharmacists were not available to meet with truckers "on demand." Therefore, researchers are encouraged to test alternate opportunities to increase enrollment of drivers in studies and access to MTM services while drivers are on the road.
Practical implications Hypertension is the second highest health-related cost burden, and over-the-road truck drivers have unique challenges that can make it difficult to attain blood pressure control. Pharmacist-provided MTM has been shown to improve blood pressure control. Improving access to MTM, perhaps using a national network of pharmacists or technology from the road, may decrease morbidity and mortality in drivers.
Originality/value This paper fulfills an identified need to study how to improve driver access to care to reduce cardiovascular-related morbidity and mortality.
Type: Clinical Experienc
Method validation in pharmaceutical analysis: from theory to practical optimization
Get PDFThe validation of analytical methods is required to obtain high-quality data. For the pharmaceutical industry, method validation is crucial to ensure the product quality as regards both therapeutic efficacy and patient safety. The most critical step in validating a method is to establish a protocol containing well-defined procedures and criteria. A well planned and organized protocol, such as the one proposed in this paper, results in a rapid and concise method validation procedure for quantitative high performance liquid chromatography (HPLC) analysis.
Type: Commentar
A Profile of Retirement Age Pharmacists in Illinois
Get PDFIntroduction: This manuscript describes the unexpected results from a routine state survey of pharmacist workforce patterns. It describes the background characteristics, practice activities, working conditions, compensation, and fringe benefits among registered Illinois pharmacists of typical retirement age (≥ 65 years old) still active in practice.
Methods: A 4-page self-administered questionnaire was mailed to a random sample of 500 registered pharmacists residing in Illinois in early 2013. A reminder postcard was mailed to the whole sample at two weeks from the initial correspondence. Data collection concluded three months after the initial mailing.
Results: Response rate was 44.8%. Half of all respondents reported to be active in practice (n =119, 54.1%); most of these pharmacists reported working part-time (n= 92, 41.8%). Further inspection revealed that all respondents were age 65 or older. The average respondent could be characterized as a married, Caucasian male of typical retirement age. Respondents wanted significantly less time spent in medication dispensing (63.4%) and more time providing patient care services (27.5%). As expected, most work-related characteristics were significantly different between part-time and full-time respondents with one exception: there were no major differences in hourly wages observed.
Conclusion: Based on data from this survey, there is a substantial number of retirement age pharmacists in Illinois who continue to practice past the age of 65. A better understanding of pharmacist retirement trends is of importance to the profession as it has potential implications for pharmacy employers, educational institutions, and other stakeholders.
Type: Original Researc
Knowing Your Pharmacist's Name
Get PDFPharmacists are the most accessible health care providers to the general public. Pharmacists are experts in helping patients get the most out of today’s complicated medications. Pharmacists ensure safe and effective use of medications. The American Pharmacists Association pitched a campaign, “Know your medicine, know your pharmacist.” Before one can know their medicine, one must know their pharmacist. This study was conducted to see whether older or younger and male verse female patients knew their pharmacist’s name better in the Philadelphia area, as a pilot study.
Type: Commentar