Reconsidering Strategies for Insulin Intensification

March 11, 2016

Basal, prandial, NPH, ultra-long, inhaled, 70/30, 75/25, 50/50, U-100, U-200, U-300, and U-500 insulin … the list of options for patients with diabetes requiring insulin continues to expand. Current guidelines for glycemic management of patients with type 2 diabetes provide specific recommendations for the initiation of insulin therapy, but not insulin intensification. The recently published LanScape study provides a foundation for making evidence-based clinical decisions.


TEXT ME — Text Messaging to Promote Behavior Change

February 26, 2016
With over 75% of people using mobile phones worldwide, text messaging might be a simple, cost-effective platform to encourage lifestyle changes. Several healthcare-related applications and mobile phone text messaging systems have already been designed; yet, very few have undergone rigorous testing to confirm clinical benefit.  The investigators of the Tobacco, Exercise, and Diet Messages (TEXT ME) trial designed a text message-based intervention to encourage lifestyle modifications and evaluated its impact on cardiovascular risk in patients with established CHD. The TEXT ME study provides robust findings to support a simple, inexpensive intervention to modify cardiovascular risk … at least over the short term.

Pulling Ahead After a SPRINT – Evidence for Lower Blood Pressure Goals

February 10, 2016

The debate over the intensity of blood pressure (BP) lowering for patients with hypertension has been going on for decades.  Additional fuel to the fire was recently added with the early halt and publication of the Systolic Blood Pressure Intervention Trial (SPRINT).  So “how low should you go” for patients with high BP? Do lower BP goals reduce CV outcomes and death, particularly in patients at high risk?  Do they cause greater adverse effects? Or perhaps even worsen CV outcomes? These questions were examined in SPRINT.


How Long Is Long Enough? Extending OAC After Unprovoked PE

October 16, 2015

The recommended treatment duration for a first episode of unprovoked venous thromboembolism (VTE) is, at a minimum, 3 months with extended anticoagulation favored for those who are not at high risk for bleeding.  However, the optimal duration of anticoagulation therapy remains unknown.

The Prolonged Anticoagulation Treatment for a First Episode of Idiopathic Pulmonary Embolism (PADIS-PE) study examines this question but, most importantly, provides insights about patient outcomes after anticoagulation treatment is discontinued


Managing Direct Oral Anticoagulants – What’s Our Role?

September 18, 2015

Many clinicians are questioning the role pharmacists play in anticoagulation therapy management as direct oral anticoagulants (DOACs) increasingly replace warfarin for a variety of indications. A recent study examined medication adherence and therapy management practices at Veterans Health Administration (VHA) patient care sites. Although this study does not have all the answers, it does reveal the importance of patient selection and ongoing patient monitoring – potentially key roles for pharmacists.


Short-Course Dexamethasone for Asthma Exacerbations in Children

August 24, 2015

To treat acute asthma exacerbations in children, how about a single dose of dexamethasone and your done!  Sounds simple, easy, and convenient.  But is it too good to be true?


Dressed for Success? Professional Attire and Patient Perceptions

July 18, 2015

Every health professional takes an oath to service patients. To fulfill this covenant, patient trust must be earned. Without trust, patients are unlikely to share sensitive, personal information, hindering the provision of optimal care. Gaining trust is influenced by many factors. What influence does attire have on patients’ perceptions of their healthcare providers?