Association between potentially inappropriate medications prescription and health-related quality of life among US older adults.

Background: Potentially inappropriate medications (PIMs) are associated with worse health outcomes among older adults. Our objective was to examine the association between PIM prescription and health-related quality of life (HRQoL) among older adults in the United States using nationally representative data.

Methods: This was a retrospective study utilizing 2011-2015 Medical Expenditure Panel Survey (MEPS) data.

Transitions of Care: Strategies for Medication Optimization and Deprescribing in Older Adults.

Older adults have an increased risk of adverse drug events related to polypharmacy and potentially inappropriate medication (PIM) use. These patients are even more vulnerable as they transition through different health care settings. In 2023, the American Geriatrics Society published an updated version of the Beers Criteria, providing updated guidance on identifying and managing PIMs.

Patient and social factors related to nebulizer use in COPD patients at the transition of care: a qualitative study.

Background: Transition from hospital to home is a vulnerable period for patients with COPD exacerbations, with a high risk for readmission and mortality. Twenty percent of patients with an initial hospitalization for a COPD exacerbation are readmitted to a hospital within 30 days, costing the health care system over $15 billion annually. While nebulizer therapy directed at some high-risk COPD patients may improve the transition from hospital to home, patient and social factors are likely to contribute to difficulties with their use.

Impact of a pharmacist collaborative drug therapy management protocol on utilization of a discharge prescription program and hospital readmissions.

Purpose: To evaluate the impact of a collaborative drug therapy management (CDTM) agreement allowing a pharmacist to automatically prescribe refills of discharge medications to patients' preferred outpatient pharmacy on utilization of a hospital discharge prescription program and hospital readmission rates.

Methods: This was a single-center, quasi-experimental pre-post intervention study. Patients aged 18 years or older discharged from the cardiology services to home were eligible for inclusion in the study.

Transitions of care education in US colleges and schools of pharmacy.

Introduction: Pharmacist-led transitions of care (TOC) services have demonstrated a positive impact on patient care and professional pharmacy organizations recommend integration of TOC-related education into doctor of pharmacy (PharmD) curricula. The objective of this study is to determine the extent to which TOC is taught in United States (US) colleges and schools of pharmacy and to characterize the educational content and the instructional methods used.

Methods: An 18-question electronic survey about TOC education was sent to US school of pharmacy faculty.

Comparison of Higher-Than-Standard to D-Dimer Driven Thromboprophylaxis in Hospitalized Patients With COVID-19.

Coronavirus disease 2019 is a global health threat often accompanied with coagulopathy. Despite use of thromboprophylaxis in this population, thrombotic event rates are high. This was a multicenter, retrospective cohort study comparing the safety and effectiveness of thromboprophylaxis strategies at 2 institutions in hospitalized patients with coronavirus disease 2019.

Combination Therapy of Ezetimibe and Rosuvastatin for Dyslipidemia: Current Insights.

Cardiovascular disease is one of the leading causes of death around the world with various efforts being made to reduce risk in patients through preventive measures. One major method for prevention has been managing cholesterol, particularly low-density lipoprotein to decrease atherosclerotic plaque burden, potentially decreasing future cardiac complications. Statins have been the gold standard therapy for hypercholesterolemia treatment due to their ease of dosing, limited drug interactions, and favorable safety profile.

Comparison of Bleeding Rates between Oral Anticoagulants in Combination with Dual Antiplatelet Therapy (Triple Therapy) in a Real-World Cohort.

Triple antithrombotic therapy including an anticoagulant, P2Y12 inhibitor, and aspirin increases bleed risk up to 27%. The components of this regimen can vary, which may impact bleed risk. To compare the safety of various triple antithrombotic regimens.

Early Versus Late Administration of P2Y 12 Inhibitors in Non-ST Segment Elevation Myocardial Infarction and Delayed Cardiac Catheterization.

Regardless of early invasive or ischemia-guided approaches to non-ST segment elevation myocardial infarction (NSTEMI) management, P2Y 12 inhibitors remain the backbone in therapy. The ideal timing of administration remains unclear. The purpose of this study was to determine the safety and effectiveness of early versus late administration of P2Y 12 inhibitors in patients presenting with an NSTEMI who go to the catheterization laboratory beyond 24 hours from presentation.

Targeted Medication Review of Falls-Risk Medications in Older Patients: A Community Pharmacy-Based Approach.

To assess a community pharmacist-provided targeted medication review (TMR) intervention to reduce the number of falls risk-increasing drugs (FRIDs) prescribed to older patients in a community pharmacy setting. A single-site, prospective, interventional pilot study with a historical control group. A single independent community pharmacy in rural Western New York.

Socio-demographic and -economic factors associated with 30-day readmission for conditions targeted by the hospital readmissions reduction program: a population-based study.

Background: Early hospital readmissions remain common in patients with conditions targeted by the CMS Hospital Readmission Reduction Program (HRRP). There is still no consensus on whether readmission measures should be adjusted based on social factors, and there are few population studies within the U.S.

Readmissions and costs among younger and older adults for targeted conditions during the enactment of the hospital readmission reduction program.

Background: The Hospital Readmissions Reduction Program (HRRP) was introduced to reduce readmission rates among Medicare beneficiaries, however little is known about readmissions and costs for HRRP-targeted conditions in younger populations. The primary objective of this study was to examine readmission trends and costs for targeted conditions during policy implementation among younger and older adults in the U.S.

Trends in fall-related mortality and fall risk increasing drugs among older individuals in the United States,1999-2017.

Background: Previous studies have demonstrated increasing mortality due to falls among older adults. The objective of this study was to determine whether there was an increase in fall risk increasing drug prescribing and if this is concurrent with an increase in fall-related mortality in persons 65 years and older in the United States.

Methods: The study is a serial cross-sectional analysis utilizing data from both the National Vital Statistics System (NVSS) and the medical expenditure panel survey (MEPS) for years 1999-2017.

Knowledge and Attitudes of Student Pharmacists Regarding Polypharmacy and Deprescribing: A Cross-Sectional Study.

Pharmacists play a key role in deprescribing medications. Incorporation of this concept into pharmacy school curricula is important in ensuring that graduates can address the complex needs of an aging population. The aims of this study were to assess if and how student pharmacists were exposed to deprescribing within their curriculum, to assess students' perceptions regarding their attitudes, ability and confidence in deprescribing, and to assess if reported curricular exposure to this topic resulted in improved perceptions or objective knowledge assessment scores.

Student Pharmacist Perceptions of the Utility of a Medication Therapy Management-Based, Medication-Related, Falls Risk-Assessment Tool.

To evaluate student pharmacists' perceptions of the Medication Fall Risk-Assessment Tool (MFRAT), a novel medication therapy management (MTM)-based clinical decision support tool.
A cross-sectional study
One school of pharmacy
Participants were eligible if they had used the MFRAT as part of a wellness clinic or as part of required coursework prior to April 2016.
An online, author developed survey was distributed to assess previous MFRAT use, perceptions of the tool on a 5-point Likert-type scale, and qualitative feedback related in the areas of pharmacy workflow, clinical utility, and perceived patient acceptance.

Opportunities and Recommendations for Improving Medication Safety: Understanding the Medication Management System in Primary Care Through an Abstraction Hierarchy.

Background: Despite making great strides in improving the treatment of diseases, the minimization of unintended harm by medication therapy continues to be a major hurdle facing the health care system. Medication error and prescription of potentially inappropriate medications (PIMs) represent a prevalent source of harm to patients and are associated with increased rates of adverse events, hospitalizations, and increased health care costs. Attempts to improve medication management systems in primary care have had mixed results.

Potentially Inappropriate Medications Are Associated with Increased Healthcare Utilization and Costs.

Background/objectives: To examine the prevalence of potentially inappropriate medication (PIM) prescribing and its association with healthcare utilization and related expenditures utilizing nationally representative data from the United States.

Design: Retrospective cohort study.

Setting: The 2011-2015 Medical Expenditure Panel Survey (MEPS).

Antibiotic prescribing in the emergency department versus primary care: Implications for stewardship.

Objective: This study sought to compare the appropriateness of antibiotic prescribing by drug, dose, duration, and indication between the emergency department (ED) and primary care (PC) within the Veterans Affairs Western New York Healthcare System (VAWNYHCS) to aid in focusing antimicrobial stewardship efforts.

Design: In this prospective observational cohort study, patients were identified using electronic alerts at the time of antibiotic prescribing. Prescriptions were retrospectively analyzed for appropriateness of antibiotic indication, drug choice, dose, and duration on the basis of current guideline recommendations.

Implementation of a Pharmacist-Led Transitions of Care Program within a Primary Care Practice: A Two-Phase Pilot Study.

Pharmacists in primary care settings have unique opportunities to address the causes of ineffective care transitions. The objective of this study is to describe the implementation of a multifaceted pharmacist transitions of care (TOC) intervention integrated into a primary care practice and evaluate the effectiveness of the program. This was a two-phase pilot study describing the development, testing, and evaluation of the TOC program.

Interventions to deprescribe potentially inappropriate medications in the elderly: Lost in translation?

What Is Known And Objective: Use of potentially inappropriate medications (PIMs) remains common in older adults, despite the easy availability of screening tools such as the Beers and Screening Tool of Older Person's Prescriptions (STOPP) criteria. Multiple published studies have implemented these screening tools to encourage deprescribing of PIMs, with mixed results. Little is known about the reasons behind the success or failure of these interventions, or what could be done to improve their impact.

Fact versus Fiction: a Review of the Evidence behind Alcohol and Antibiotic Interactions.

Many antibiotics carry caution stickers that warn against alcohol consumption. Data regarding concurrent use are sparse. An awareness of data that address this common clinical scenario is important so health care professionals can make informed clinical decisions and address questions in an evidence-based manner.

Pharmacist-led transitions-of-care services in primary care settings: Opportunities, experiences, and challenges.

Objective: To initiate a call to action for ambulatory care pharmacists to play a more active role in transitional care management within primary care settings by discussing relevant opportunities, experiences, and challenges.

Summary: With the shift to value-based health care, greater emphasis is being placed on improving patient care quality at the lowest cost. This represents an opportunity for pharmacist integration into primary care teams to address medication management challenges in the postdischarge period.

Revefenacin for the treatment of chronic obstructive pulmonary disease.

: Chronic obstructive pulmonary disease (COPD) is a progressive condition characterized by irreversible or incompletely reversible airflow limitation. Long-acting bronchodilators, including β agonists (LABA) and muscarinic antagonists (LAMA), serve as the standard of care for maintenance therapy in COPD. Individualizing therapy to optimize selection of delivery device has the potential to improve medication adherence and clinical outcomes among COPD patients.

A pharmacist-led pilot program to facilitate deprescribing in a primary care clinic.

Objective: To develop and pilot-test a model in which a community-based clinical pharmacist was incorporated as part of a Medicare Annual Wellness Visit (AWV) to make deprescribing recommendations targeted at potentially inappropriate medications (PIMs) in seniors.

Setting: A family medicine patient-centered medical home (PCMH) clinic in Buffalo, NY.

Practice Description: Implementation and evaluation of a pilot program incorporating a pharmacist-provided medication review targeting PIMs in seniors as part of a Medicare AWV.

Impact of Beta-lactam Allergy on Treatment of Outpatient Infections.

Purpose: The most commonly reported medication allergies in the United States involve beta-lactam antibiotics, creating an important consideration for prescribers when choosing optimal treatment of infections. Currently, few data exist on outpatient prescribing patterns in response to patients with a beta-lactam allergy. This study sought to evaluate the appropriateness of outpatient antibiotic therapy in patients with documented beta-lactam allergies within a Veterans Affairs health care system to evaluate areas of improvement in prescribing practices.