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Is As-Needed Nasal Corticosteroid Use Needed for Allergic Rhinitis Management?

Allergic rhinitis affects millions of children and adults. Indeed, it is the fifth most common chronic disease in the United States.  Although people do not die from allergic rhinitis, it sure can make you feel miserable, disturb sleep, and impair daily activities. Guidelines recommend the use of intranasal corticosteroids on a daily basis since the onset of action takes a few days. In reality, however, patients adjust their treatment according to the severity of their symptoms. As-needed corticosteroid use is effective for the treatment and prevention of asthma symptoms. Can we apply this same concept to allergic rhinitis? Could the as-needed use of intranasal corticosteroids achieve the same outcomes as daily use?

Guest Authors: Lalitha Sukumar, PharmD; Alyssa Gallipani, PharmD, BCACP; and Rahul Jacob, PharmD

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Can a Polypill ‘TIP’ the Scale to a One-Size-Fits All Approach?

Creating an ideal therapeutic regimen is often like putting a puzzle together, with adherence being a critical piece of that puzzle. Studies, and clinical experience, show that patients are more likely to adhere to once-daily medication administration when compared to regimens that require more frequent dosing.  Given that pill burden and medication cost are an increasing problem, would our patients benefit from a simple, low-cost, one-size-fits-all approach to addressing cardiovascular risk?

Guests:  Ebony Isis Evans, PharmD, Katy Pincus, PharmD, BCPS, BCACP, and Sara Wettergreen, PharmD, BCACP

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A CLEAN Sweep: Getting Rid of the Medication Cost Barrier

Medication adherence plays a very significant role in achieving positive patient health outcomes and when medication regimens are not followed, patients often fail to reach optimal disease control. This is especially concerning in ambulatory care settings where chronic disease states are most often treated. One of the potential barriers to optimal medication use is cost.

Guest Authors:  Emily Eddy, PharmD, BCACP, BC-ADM; Brittany Long, PharmD, BCACP; and Lindsey Petters, PharmD, BCPS

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Should Bedtime be Med-Time for Hypertension?

Few medications are specifically dosed at night to optimize outcomes. However, antihypertensive medications may soon belong on our patients’ nightstands. It is common practice for patients to take all antihypertensive medications in the morning, but perhaps daytime dosing doesn’t maximize cardiovascular risk reduction? The potential benefits of chronotherapy and its impact on BP and CV outcomes have been investigated since the 1980s. However, current practice guidelines do not explicitly recommend dosing antihypertensive medications at bedtime.

Guest Authors:  Vivian Cheng, PharmD, BCPS and Joseph Saseen, PharmD, BCPS, BCACP

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

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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Cutting Down HIV Treatment to a 2-Drug Regimen

While multi-drug combination therapies for HIV has resulted in longer lifespans, simplified medication regimens are needed to reduce pill-burden in an aging population with HIV. Two-drug regimens are potentially attractive because they may minimize drug exposure; reduce risks for adverse effects, drug-drug interactions, and long-term toxicities; and potentially increase patient adherence.  The SWORD-1 and SWORD-2 trials evaluated the efficacy and safety of a two-drug regimen to maintain viral suppression in HIV infected patients.

Guest Authors Tinh An (April) Nguyen, PharmD and Jihae Lim, PharmD

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