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Using CRP in COPD to Guide Treatment Decisions During Exacerbations

Using CRP in COPD to Guide Treatment Decisions During Exacerbations

October 11, 2019

Patients frequently present to outpatient clinics and community pharmacies with acute exacerbations of chronic obstructive pulmonary disease and clinicians have an important decision to make. Should they prescribe antibiotics? Patients may seek antibiotics as a quick fix to their symptoms, but many AECOPD are not caused by bacterial infection. Prescribing unnecessary antibiotics exposes patients to adverse effects and can increase antimicrobial resistance.  But not prescribing antibiotics could delay recovery if the exacerbation is of bacterial origin … or worse, result in an avoidable hospitalization and death. Could a simple, bedside test empower patients and prescribers to use antimicrobials more selectively?

Guest Author:  Brittany Schmidt, PharmD, BCACP

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Addressing the Adherence Problem: Do Med Sync Programs Really Work?

Addressing the Adherence Problem: Do Med Sync Programs Really Work?

September 27, 2019

The “silent killer” that impacts every ambulatory care practice is medication non-adherence.  Today, medication non-adherence is estimated to cause 125,000 preventable deaths every year and costs all of us $300 billion. It is no surprise that pharmacists have an important roll to play tackling this critical issue. Many pharmacies have now implemented medication synchronization or med sync programs to proactively address medication adherence.  While some have called med sync a “golden ticket,” research is clearly needed.

Guest Authors: Michael Kachmarsky, PharmD, BCACP and Daniel Longyhore, PharmD, MS, BCACP

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The Importance of a Healthy Mind in Patients with an Unhealthy Heart

The Importance of a Healthy Mind in Patients with an Unhealthy Heart

September 13, 2019

Patients who have had acute coronary syndromes (ACS) are more likely to suffer from major depression than the general population with rates of clinically relevant symptoms of depression as high as 45%. Unfortunately, even if patients are routinely screened for depression with a PHQ-2 and PHQ-9 in primary care settings, appropriate treatments are often not initiated. Depression causes psychological stress which activates the sympathetic nervous system which leads to increased cortisol levels, inflammation, and platelet activation that can contribute to atherosclerosis and accelerate plaque formation. Thus, untreated depression may worsen cardiac outcomes.

Guest Authors: Hansita B. Patel, PharmD and Abigail L. Hulsizer, PharmD

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Addressing the Concerns and Needs of Transgender Persons

Addressing the Concerns and Needs of Transgender Persons

August 30, 2019

The transgender/gender nonconforming (TGNC) community faces a variety of challenges including access to healthcare, societal stigma, and discrimination. As a profession, pharmacy is well-positioned to reduce and address the barriers to care faced by TGNC individuals and to provide them with positive experiences within the healthcare system. However, formal instruction about this patient population’s social and medical needs is lacking in most pharmacy school curricula.

Guest Authors: Justin Bachman, PharmD and Abby Frye, PharmD, BCACP

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The Power of Pharmacist-to-Pharmacist Handoffs During Transitions of Care

The Power of Pharmacist-to-Pharmacist Handoffs During Transitions of Care

August 16, 2019

Hospital readmissions are often medication-related and potentially preventable. Pharmacists can play a vital role in improving medication outcomes during transitions of care (TOC). Although numerous TOC practice models have been described, it remains unclear what practices will promote optimal continuity of care. A recently published study in the Journal of the American Pharmacists Association (JAPhA) examined the impact of pharmacist-to-pharmacist handoffs using electronic communications to reduce hospital readmissions in high-risk patients.

Guest Authors: Jessica Wooster, PharmD, BCACP and Laressa Bethishou, PharmD, BCPS

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Improving Access to Naloxone - Yes, Pharmacists (Nar)CAN!

Improving Access to Naloxone - Yes, Pharmacists (Nar)CAN!

August 2, 2019

The opioid overdose epidemic, primarily driven by potent synthetic opioids, has rapidly intensified in recent years.  Overdose education and naloxone distribution (OEND) efforts appear to have a positive impact on opioid-overdose mortality. As many states continue to expand naloxone access through various legislation efforts, it’s important to identify which laws have the greatest impact on reducing fatal opioid overdoses. 

Guest Authors:  Scott Coon, PharmD, BCPS, BCACP and Matthew Thomas, PharmD

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Making the GRADE: It’s time to AGREE on better CPGs

Making the GRADE: It’s time to AGREE on better CPGs

June 21, 2019

Staying abreast of the constant changes to clinical practice guidelines (CPGs) and determining their quality is difficult.  The general consensus in the medical community is that CPGs reduce inappropriate care and improve treatment quality and patient safety. However, concerns have been raised about the reliability, quality, and validity of CPGs. A recently published systematic review critically appraised the quality of published CPGs for the treatment of chronic diseases in primary care.

Guest Authors:  Frank Yu, Pharm.D. and Takova Wallace-Gay, Pharm.D., BCACP

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If Your Heart’s Not into It, Do You Really Need to Take Your Meds?

If Your Heart’s Not into It, Do You Really Need to Take Your Meds?

June 10, 2019

Dilated cardiomyopathy is the leading cause of sudden cardiac death and heart failure (HF) and the chief indication for cardiac transplantation. However, approximately 40% of patients see a significant improvement in left ventricular ejection fraction and reduction in the left ventricle size over time with pharmacologic treatment. As deprescribing becomes an increasingly important part of our clinical practice, we need more data about how deprescribing impacts outcomes, particularly in chronic diseases such as heart failure.  The recently published TRED-HF is attempted to address this important question: Is the burden of lifelong therapy with medications necessary or worth it in patients with "recovered" dilated cardiomyopathy?

Guest Author:  Jennifer Pruskowski, PharmD, BCPS, BCGP, CPE

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Should We Hold Our Breath for Vitamin D in COPD?

Should We Hold Our Breath for Vitamin D in COPD?

May 23, 2019

Chronic obstructive pulmonary disease (COPD) exacerbations contribute to mortality, disease progression, worsening quality of life, and increased health care costs. Respiratory tract infections are a common cause of COPD exacerbations.  While prophylactic antibiotics may play a role, vitamin D supplementation is an attractive option by stimulating innate and adaptive immune responses. Although severe vitamin D deficiency (25(OH)D <10 ng/mL) has been associated with more frequent exacerbations and hospitalizations in patients with COPD, it is unclear if supplementation actually reduces exacerbation frequency. A recent meta-analysis provides some data regarding the potential benefits of vitamin D supplement to prevent COPD exacerbations.

Guest Authors:  Jennifer Clements, PharmD, BCPS, BCACP and Lisa Gibbs, PharmD

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Breaking Up is Hard to Do: Are E-Cigarettes the Solution Tobacco Cessation?

Breaking Up is Hard to Do: Are E-Cigarettes the Solution Tobacco Cessation?

May 10, 2019

While there are several proven smoking cessation medications available over-the-counter and by prescription, e-cigarettes are being increasingly used for smoking cessation despite the lack of data or official FDA approval for this indication. To appropriately advise our patients, it is important to understand the safety and efficacy of e-cigarette use as a potential smoking cessation aid.

Guest Authors: Diane Kim, PharmD and Amanda Schartel, PharmD, BCACP

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