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Educating Patients and Prescribers About Deprescribing to Reduce Medication Burden May Not Be Enough

Unsurprisingly, medication burden increases as we age. At each clinic visit, we consider starting new medications, but it’s still relatively uncommon to critically evaluate medications that could be deprescribed. How can we change the culture to embrace deprescribing as an integral part of patient care?  The OPTIMIZE study was a provider- and patient-level educational intervention that attempted to increase deprescribing.

Guest Authors:  Kashelle Lockman, PharmD, MA and Sarah Greiner, PharmD

Music by Good Talk

Finally! Something FDA-Approvable for Non-alcoholic Steatohepatitis (NASH)?

Nonalcoholic steatohepatitis (NASH) is quickly emerging as one of the most common reasons for both liver cirrhosis and liver transplant in the United States – soon predicted to overtake hepatitis C virus as the predominant etiology.  Currently, there are no FDA-approved medications to treat these disorders.  Hopefully, that will soon change.

Guest Author: Scott Malinowski, PharmD

Music by Good Talk

Continuous Glucose Monitors (CGMs) - Patient Management Strategies and Getting Paid!

This episode is a collaboration between the ACCP Ambulatory Care Practice and Research Network (PRN) ... and iForumRx.org.

Wondering if a continuous glucose monitor (CGM) is right for your patient?  Worried about workflow, prior authorization, billing, and payment?  Our expert panelists explain how they manage patients in their practices and how they bill for their services.

Guests:  Jennifer Trujillo, PharmD, BCPS, CDCES, BC-ADM; Edward Saito, PharmD, BCACP; and Christina Sherrill, PharmD, BCACP, CPP

Produced by Jonathan Hughes, PharmD, BCPS, BCACP and Anna Love, PharmD, BCACP

Music by lemonmusicstudio from Pixabay

On the Look Out for Prescribing Cascades

Is my patient’s forgetfulness due to dementia or diphenhydramine? In older adults, adverse drug events (ADEs) can often be misinterpreted and lead to the initiation of new medications, which carry their own risks of ADEs … that can be misinterpreted as a new problem … leading to even more medications being prescribed.  In this episode, our guests critically examine a study that identified a new prescribing cascade:  gabapentinoid -> diuretics.

Guest Authors: Veronica Arceri, PharmD and Mallory Telese, BA, PharmD, BCACP 

Music by Good Talk

Top Ten Things Every Clinician Should Know about Continuous Glucose Monitors (CGM)

Continuous glucose monitors (CGMs) are now commonplace, and every clinician should know the basics about who can benefit from CGM use and how to address common questions and problems. 

Authors:  Brianna Patacini, PharmD, BCACP, CDCES and Dawn Fuke, PharmD, BCPS

Special Guest: Jennifer Trujillo, PharmD, BCPS, CDCES, BC-ADM

Music by Good Talk

Guiding Antiplatelet Therapy: Is a Personalized Approach Worth It?

Variability in clopidogrel pharmacokinetics among patients has been appreciated for years and this results in inconsistent effects on platelet inhibition and poor outcomes. Multiple strategies to personalize antiplatelet therapy intended to balance the risks and benefits of therapy have been tested. A recent systematic review and meta-analysis attempts to answer the question: Is a personalized approach worth it?

Guest Authors:  Kiana R. Green, PharmD and Augustus (Rob) Hough, PharmD, BCPS, BCCP

Music by Good Talk

Up the Creek Without a Paddle? Look to Your Pharmacist to Bridge-It

Nearly half of all pregnancies are unintended and a high percentage of unwanted pregnancies lead to an abortion. Reducing the number of unintended pregnancies and increasing the use of effective birth control are two public health priorities. Could the implementation of pharmacist contraception prescribing combined with EC on the same day help “bridge the gap?”

Guest Authors:  Ashley H. Meredith, PharmD, MPH, BCACP, BCPS, CDCES and Veronica P. Vernon, PharmD, BCPS, BCACP, NCMP

Music by Good Talk

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

Music by Good Talk

STEP-ping Up the Game for Weight Management

More than two-thirds of adults in the United States are overweight or obese — thus, obesity is, by far, the most common preventable health-related problem seen in practice today. Obesity is associated with several comorbidities, and weight reduction leads to positive outcomes in many diseases. Studies have shown that a weight loss of 10% improves cardiovascular risk and outcomes. Unfortunately, current pharmacological options for weight loss do not consistently achieve a 10% weight loss.  Can semaglutide deliver?

Guest Panelists: Teney Mathew, PharmD, Jason Zupec, PharmD, BCACP, and Amy Heck Sheehan, PharmD, BCPS

Music by Good Talk

Tiny (n-of-1) Trials to Overcome Statin-Associated Muscle Pain

In blinded clinical trials the percentage of patients who experience muscle symptoms while taking a statin is typically in the 3-5% range.  In practice, the percentage of patients who report muscle symptoms is 10-25%.  This disparity between what has been observed in blinded trials and what patients experience when treated with a statin is due, in part, to the nocebo effect — a belief that a medication may cause harm.  How many lives could be saved if we routinely used tiny randomized, controlled, blinded trials to determine when statin therapy can be safely continued?

Guest Panelists: Elizabeth Hearn, PharmD; Stuart T Haines PharmD, BCPS, BCACP; and Kathryn (Katie) Kiser, PharmD, BCACP

Music by Good Talk

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