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Using shared decision-making tools: Are they worth it?

Using shared decision-making tools: Are they worth it?

November 13, 2020

There’s no denying that shared decision making (SDM) is an effective communication approach for making patient-centered medical decisions across a variety of health conditions. However, while tools for SDM are often useful during patient visits with practitioners, studies have yielded mixed results with regard to patient outcomes.  A new study explores the impact of a SDM tool for anticoagulation selection in patients with atrial fibrillation compared to standard care.

Guest Authors:  Ashley Meredith, PharmD, BCACP, BCPS, CDCES and Chandler Howell, PharmD

Music by Good Talk

Less Might Be Better: Deprescribing Antihypertensive Medications in Older Adults

Less Might Be Better: Deprescribing Antihypertensive Medications in Older Adults

October 30, 2020

Health care professionals often don’t think twice about adding a new medication when a patient is not at goal. But we’re reluctant to stop a medication for a chronic condition when the patient appears to be stable and doing well.  Polypharmacy in older adults is a significant problem.  It’s costly and increases the likelihood of adverse effects. Several observational studies have suggested that lower blood pressure and multiple antihypertensive medications may be harmful in the elderly. Is it possible to discontinue medications without causing serious harm?

Guest Authors: Keturah Weaver Pharm D, BCPS and Daniel Longyhore Pharm D, M.S., BCACP

Music by Good Talk

Extracting Data on CBD: Effects on Opioid Use and Quality of Life

Extracting Data on CBD: Effects on Opioid Use and Quality of Life

October 16, 2020

Sales of cannabinoid-containing products continue to rise. In 2020 it became a billion-dollar industry. With the increased use and popularity of CBD products, every clinician needs to critically appraise the evidence to determine if CBD should play a role in pain management and help educate patients about the potential risks.

Guest Author:  Alex R. Mills, PharmD, BCACP, AAHIVP

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I Screen, You Screen, We Should All Screen for Unhealthy Drug Use

I Screen, You Screen, We Should All Screen for Unhealthy Drug Use

October 2, 2020

Nearly 1 in 8 Americans older than 12 used illicit substances in 2018, including misuse of prescription medications. In addition, more than 80% of those who would benefit from substance use treatment in the past year did not receive it. Thus, the importance of identifying and offering treatment should be a priority — particularly in primary care settings. However, there are many barriers to implementing unhealthy substance use screening including pervasive stigma, lack of clinician comfort, logistics, and limited knowledge of or avenues for treatment when unhealthy drug use is uncovered. The US Preventative Services Task Force (USPSTF) recently published updated recommendations on drug use screening.

Guest Authors: Melissa C. Palmer, PharmD, BCPS, BCPP; Jordan Cooler, PharmD, BCPP; and Amanda Stahnke, PharmD, BCACP

Music by Good Talk

Implementing Comprehensive Medication Management – Ingredients for Success

Implementing Comprehensive Medication Management – Ingredients for Success

September 11, 2020

Pharmacists providing effective comprehensive medication management (CMM) services in interprofessional care settings can contribute to improved patient outcomes. Core components of a successful practice include a clearly articulated philosophy of practice, a systematically implemented process of care, and an effective practice management system.  Although much has been written about the first two components, less is known about what is required to create an effective practice management system.

Guest Authors:  Elizabeth Cook, PharmD, BCACP, AE-C, CDE and Leslie Walters, PharmD, BCACP

Music by Good Talk

Can VOYAGER Put PAD Patients Back on Their Feet?

Can VOYAGER Put PAD Patients Back on Their Feet?

August 28, 2020

Peripheral artery disease (PAD) impacts 8.5 million Americans age 40 years or older, often leading to acute limb ischemia, amputation, hospitalization, revascularization, major adverse cardiac events (MACE), and death. In addition to being at very high risk of MACE, more than 10% of PAD patients who had revascularization surgery are hospitalized for major adverse limb events, including acute limb ischemia leading to amputation. Could combination therapy, an antithrombotic regimen comprised of a direct oral anticoagulant and an antiplatelet agent, help prevent limb ischemia and cardiovascular (CV) events in these high-risk patients?

Guest Authors:  Navya Varshney, PharmD, BCPS and Rachel Lowe, PharmD, BCPS

Music by Good Talk

Will Bempedoic Acid provide SERENITY for Patients with Statin Intolerance?

Will Bempedoic Acid provide SERENITY for Patients with Statin Intolerance?

August 14, 2020

Current guidelines recommend statins for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) due to their well-established therapeutics benefits.  Unfortunately, many patients are unable to tolerate statins due to statin-associated muscle symptoms (SAMS), most commonly manifested as myalgias. Patients who are unable to tolerate a statin can be challenging to treat. Even if the patient is willing to try a lower dose or a different statin, the patient’s low-density lipoprotein cholesterol (LDL-C) may still be above the recommended threshold.  This puts patients unable to tolerate statins at increased risk of ASCVD or of a recurrent cardiovascular event. Is bempedoic acid a useful therapeutic option in patients with SAMS?

Guest Authors:  Kara Gurries, PharmD, BCACP and Janeen Ibarreta, PharmD

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No Provider Status, No Problem: CCM as a Revenue Source in Community Pharmacy

No Provider Status, No Problem: CCM as a Revenue Source in Community Pharmacy

July 31, 2020

Hypertension is poorly managed in the United States with only 25% of patients achieving optimal blood pressure (BP) control (BP less than 130/80 mmHg).  To achieve optimal control, patients require close follow-up and BP-lowering medication regimens need to be titrated and periodically adjusted. Community pharmacists are in a unique position to manage patients who have poorly controlled hypertension. However, significant barriers exist to implementing hypertension management services by community pharmacists including a lack of reimbursement. Is chronic care management (CCM) a viable payment model to support these services?

Guest Authors:  Kimberly Zitko, PharmD, BCACP, BCGP and Brittany Schmidt, PharmD, BCACP

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Powerful Placebos and Notorious Nocebos: Implications for Ambulatory Care

Powerful Placebos and Notorious Nocebos: Implications for Ambulatory Care

July 17, 2020

Imagine you have recommended statin therapy to a patient with diabetes. A few weeks later, the patient experiences leg pain and stops it. Was this patient’s leg pain caused by the statin? Or was it a nocebo effect? Muscle symptoms in placebo-controlled trials of statin therapy range from 3-5%, while rates in real-world observational studies are between 15-20%. Ambulatory care pharmacists have an important role in recognizing and managing placebo and nocebo effects. Understanding the placebo effect allows clinicians to harness the power of placebos. Reframing risks during patient education may decrease nocebo effects.

Guest Authors:  Sara Wettergreen, PharmD, BCACP and Joseph Nardolillo, PharmD

Music by Good Talk

An Incli-ng of Benefit? Efficacy and Safety of Inclisiran for Elevated LDL

An Incli-ng of Benefit? Efficacy and Safety of Inclisiran for Elevated LDL

July 6, 2020

Lipid management continues to be an essential component in the prevention and treatment of atherosclerotic cardiovascular disease (ASCVD).  For the past decade, clinical practice guidelines have gone back and forth about optimal treatment goals but guidelines all agree that statins should be used as the preferred initial therapy. However, there is still a lack of clarity about the optimal add-on therapies. The newest LDL-lowering therapy is inclisiran, a small interfering RNA (siRNA) that targets the PCSK9 pathway.

Guest Authors:  Joshua O. Holmes, PharmD, MS and Amanda Schartel, PharmD, BCACP

Music by Good Talk

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