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Top Ten Things Every Clinician Should Know About the KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease

The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines were recently updated with a focus on kidney health in patients with diabetes.  The updated guidelines include recommendations on screening, prevention, and treatment of chronic kidney disease (CKD), including the use of SGLT2 inhibitors, finerenone, and ACE inhibitors or ARBs.  The written commentary posted on the iForumRx website provides a succinct summary of the Top Ten Things Every Clinician Should Know.

Guest Authors:  Kara Olstad, PharmD; Gurminder Sanghera, BSc, PharmD; and Darren Grabe, PharmD

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Is In-Personal Care Better than Care Delivered at a Distance?

If we’ve learned anything from the COVID-19 pandemic, it’s that delivering healthcare to patients at a distance is possible. Telehealth can help increase access to care for patients in medically underserved communities and for those who have transportation, cost, and time barriers.  But one question has not been adequately answered—is telehealth an effective method to deliver primary care?   

Guest Authors:  Keaton Thomas, PharmD and Haley M. Klassing, PharmD, 

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How Many Patients Can a Pharmacist Reasonably Manage? Estimating An Appropriate Panel Size

Several studies have shown the benefits of involving pharmacists in the primary care setting.  And there are some recommendations regarding an appropriate physician-patient panel size per pharmacist.  But what's the ideal ambulatory care pharmacist-patient panel size?

Guest Authors: Benjamin King, PharmD, BCACP, Jubilee Winar, PharmD, and Jasmin Ortiz, PharmD

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Is There a CLEAR Role for Bempedoic Acid in Cardiovascular Risk Reduction?

There are a variety of non-statin lipid-lowering medications with proven cardiovascular benefits; however, most of the evidence supporting their use has been as an adjunct with a statin. Bempedoic acid offers a novel mechanism of action to treat hypercholesterolemia. But is there a CLEAR role for bempedoic acid in the treatment and prevention of ASCVD in statin-intolerant patients?

Guest Authors: Sarah B. Edwards, PharmD and Briana Williams, PharmD, BCPS, BCACP

Special Guest: Joseph Saseen, PharmD, BCPS, BCACP

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Is MBSR* as Good as Meds for Anxiety Disorders?

One in five people in the U.S. report suffering from anxiety in the past year, and one in three will experience an anxiety disorder in their lifetime, but 40% of patients go untreated. Perhaps patients are disinterested (or distrust) in traditional pharmacotherapy ... or perhaps it is due to a lack of availability of services (like cognitive behavioral therapy – CBT). Many patients (and clinicians) are interested in exploring and using alternative treatment approaches, but are they effective?

Guest Authors:  Cindy King, PharmD, BCACP and Chris Paxos, PharmD, BCPP, BCPS, BCGP

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*MBSR = Mindfulness-base Stress Reduction

GLP-1 Receptor Agonists and SGLT2 Inhibitors: Don’t Sugarcoat the Costs!

The cost of diabetes in the United States has nearly doubled over the past decade in part due to rising prices and the cost of newer medications used to manage the disease.  With new, improved, but costly alternatives available, it’s going to be challenging for ambulatory care practitioners to evaluate if the potential benefits of using these newer medication classes as first-line therapy (instead of metformin) outweigh their big price tag.

Guest Authors:  Amanda Smith, PharmD and Nicole Slater, PharmD, BCACP

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Is Combination Therapy Superior to Monotherapy for Painful Diabetic Peripheral Neuropathy?

Several medication classes can be used to treat diabetic peripheral neuropathic pain (DPNP); however, many patients have a suboptimal response or experience dose-limiting side effects. Treatment guidelines suggest several first-line options but, in the absence of compelling evidence, offer no direction as to which agent to try first or if we should consider combination therapy.

Guest Authors: Shilpa Klocke, PharmD, BCPS and Nicole Hahn, PharmD, BCACP

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How VITAL is Vitamin D in Preventing Statin Associated Muscle Symptoms (SAMS)?

You’ve probably encountered many patients who have experienced muscle symptoms after starting a statin.  Statin-associated muscle symptoms (SAMS) contribute to treatment discontinuation and significantly increase cardiovascular (CV) adverse events and mortality. What strategies do you recommend to increase statin tolerance? 

Guest Author:  Rick Hess, PharmD, CDCES, BCACP

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Under Pressure: Measuring and Managing Hypertension

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

Measuring blood pressure (BP) and managing hypertension are among the essential roles that pharmacists play in ambulatory care and community-based practice environments.  This program is a question-and-answer session as a follow-up to the Ambulatory Care PRN program at the 2022 ACCP Global Conference on Clinical Pharmacy.  The panelists answer YOUR questions about the role of manual vs. automated BP readings, using self-monitored BP readings to make clinical decisions, 24-hour ambulatory care BP monitoring, and bedtime administration of antihypertensive agents.

Guests:  Andrew Hwang, PharmD, BCPS; Dr. Anthony Ishak, PharmD, BCPS, and Dr. Lalita Prasad-Reddy, PharmD, BCPS, BCACP

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

Music by lemonmusicstudio from Pixabay

Top Ten Things Every Clinician Should Know About Payment for Pharmacists’ Patient Care Services

Patient for pharmacists' patient care services remains a challenge.  While provider status at the federal level has not yet been realized, there has been a steady growth of payers and programs covering services provided by pharmacists in recent years.

Guest Author: E. Michael Murphy, PharmD, MBA

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