Finding our Voice: Evaluation of Goal Setting Using the Habits of Preceptors Rubric in Terms of Focus, "SMARTness," and Impact.

Introduction: Effective leadership propels teams from effectiveness to greatness and is accomplished when everyone achieves and contributes their full potential, or "voice." The Clinician Educators Program Teaching and Learning Curriculum fosters preceptor development using the Habits of Preceptors Rubric (HOP-R) to guide participants in finding their precepting "voice." After the HOP-R self-assessment, participants select a habit of focus (HOF) and craft a SMART (specific/measurable/achievable/relevant/time-bound) goal.

Are beta-blockers safe and effective after myocardial infarction in patients with COPD?

Clinicians may be hesitant to prescribe beta-blockers in patients with chronic obstructive pulmonary disease (COPD) who have a comorbid compelling cardiovascular indication for beta-blocker therapy. This article summarizes the available data on the safety and efficacy of beta-blockers in patients with COPD and recent myocardial infarction.

Geriatric Pharmacotherapy Case Series: Neurogenic Orthostatic Hypotension.

This case illustrates the pharmacist's role in the outpatient management of neurogenic orthostatic hypotension (nOH) in a community-dwelling older person. In this case, the patient has a long-standing history of asymptomatic hypotension with recent onset of falls with temporary loss of consciousness prompting initiation of pharmacologic therapy. This case reviews nonpharmacological and pharmacological treatment options for older people with symptomatic nOH.

Evaluating the impact of integrating SMART goal setting in preceptor development using the Habits of Preceptors Rubric.

Purpose: The impact of goal setting in pharmacy preceptor development was evaluated using the Habits of Preceptors Rubric (HOP-R), a criterion-referenced assessment developed to assess, quantify, and demonstrate growth across 11 preceptor habits.

Methods: This study retrospectively evaluated initial and follow-up survey responses from the 2019-2020 Clinician Educators Program cohort at Midwestern University College of Pharmacy, Glendale Campus. Enrollees in this teaching and learning curriculum (TLC) were invited to assess their precepting habits using the HOP-R after attending the first seminar and again toward the end of the longitudinal program.

Evaluating the impact of a "grand rounds" elective course on students' perceived motivations, comfort, and confidence in providing constructive and reinforcing feedback to guest lecturers.

Background And Purpose: Providing feedback is an important skill for all healthcare professionals both within and outside of their discipline. Although student pharmacists frequently receive feedback during both didactic and experiential education, training on how to provide feedback to others is less common.

Educational Activity And Setting: An elective was designed to expose second-year pharmacy students to "grand rounds" with practicing pharmacists as the presenters.

Outcome Benefits Seen With 1 Year of Optimized Sacubitril/Valsartan for the Treatment of Systolic Heart Failure Managed by Pharmacists in a Cardiology Practice.

Background: Pharmacists' care in heart failure (HF) management has been shown to better clinical outcomes, including use of guideline-directed medical therapy and hospital readmission, although the impact observed has varied among studies.

Objective: To investigate the rates of all-cause hospitalization and hospitalization from HF (hHF) and changes in surrogate markers (left-ventricular ejection fraction, New York Heart Association Functional Classification [NYHA FC], diuretic requirements) for patients with HF with reduced ejection fraction (HFrEF) on angiotensin receptor-neprilysin inhibitor (ARNi) therapy optimized within a pharmacist clinic.

Methods: Retrospective chart review of patients with HFrEF on sacubitril/valsartan from July 7, 2015, through January 1, 2018.

Estimating the Lactate Threshold Using Wireless Near-Infrared Spectroscopy and Threshold Detection Analyses.

The present investigation examined the ability of two threshold detection analyses (maximum distance, Dmax; modified maximum distance, mDmax) in identifying the near-infrared spectroscopy (NIRS) threshold, a lactate threshold (LT) estimate, from exercising tissue oxygen saturation (StO) responses. Additionally, the test-retest reliability of exercising StO and total hemoglobin concentration (THC) responses were examined at moderate and peak cycling intensities. Fourteen healthy, recreationally active participants performed maximal incremental step cycling tests (+25 W / 3 minutes) to volitional fatigue on two separate occasions while StO and THC of the vastus lateralis were monitored.

Fostering Mindfulness in Continuing Pharmacy Education Using a Board Game: Initial Experiences and Perceptions.

Introduction: Expansion of pharmacists' scope of practice creates a need to optimize learning within continuing professional development (CPD) that can simultaneously promote mindfulness and enhance clinical decision-making. An educational board game embracing the principles of situated learning was developed with the purpose of promoting clinical reasoning skills and mindfulness.

Methods: Iter Vitae was used in a national pharmacy meeting CPD session.

A Retrospective Chart Review Evaluating Efficacy, Tolerability, and Cost of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors (PCSK9i) in Older Adults.

Introduction: Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) are proven to have profound lowering of low-density lipoprotein cholesterol (LDL-C) in patients with clinical atherosclerotic cardiovascular disease or familial hypercholesterolemia.

Aim: The primary purpose of this study was to evaluate PCSK9i utilization in older adults, with a focus on efficacy outcomes within 6 months of initiation. Secondary outcomes included tolerability, out-of-pocket expenses (OPE), and barriers to initiation of therapy.

Development of a tool to assess and advance the effectiveness of preceptors: The Habits of Preceptors Rubric.

Purpose: Present the research performed to identify and describe habits of effective pharmacy preceptors and provide a framework for targeted preceptor assessment and development.

Methods: A 5-round Delphi consensus-building process was used to refine the initial Habits of Preceptors Rubric (HOP-R) developed by the research team. Twenty experts in pharmacy experiential education participated.

Combined angiotensin receptor and neprilysin inhibition therapy for heart failure.

The FDA has approved sacubitril/valsartan, an angiotensin-receptor-neprilysin inhibitor, for the treatment of chronic symptomatic heart failure (stage C) in patients with a left ventricular ejection fraction of 35% or less. This article discusses results from a major clinical trial, PARADIGM-HF, and the role of this new drug in heart failure treatment.

A Pilot Study on an Interprofessional Course Involving Pharmacy and Dental Students in a Dental Clinic.

To assess the effect of a dental clinical rotation program involving pharmacy students and dental students. An interprofessional education (IPE) course was offered as an elective to second-year pharmacy students and required for third-year dental students. The course included two in-class sessions, one online lecture, and five clinic sessions.

Evaluating the Safety and Tolerability of Sacubitril/Valsartan for HFrEF Managed Within a Pharmacist Clinic.

Objective: The objective of this research was to describe the use of pharmacist-managed sacubitril/valsartan therapy in a multi-center, outpatient cardiac group.

Background: Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor (ARNi), is a novel agent for the treatment of heart failure. An ARNi is recommended by national guidelines to be used in place of angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) therapy for patients who remain symptomatic.

Diagnoses of Cardiovascular Disease or Substance Addiction/Abuse in US Adults Treated for ADHD with Stimulants or Atomoxetine: Is Use Consistent with Product Labeling?

Background: Among US adults, utilization of pharmacotherapy for attention-deficit hyperactivity disorder (ADHD) has increased more than ninefold since 1995-1996. Potential contraindications to ADHD pharmacotherapy include serious cardiovascular disease (CVD) and, for stimulants, addictions and bipolar disorder (BPD).

Objective: To assess the prevalence of potential contraindications among adults treated with ADHD pharmacotherapy.

The Diuretic Potential of Sacubitril/Valsartan: A Tale of 2 Patients.

Background: Heart failure prevalence continues to rise in the United States causing significant morbidity and mortality and costing billions in healthcare expenditures. Consensus guidelines updated in 2016 recommend an angiotensin receptor-neprilysin inhibitor (ARNi) as a therapeutic option in lieu of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker for the management of stage C heart failure with reduced ejection fraction (HFrEF). For chronic HFrEF patients with New York Heart Association class II or III symptoms tolerating an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, a change in therapy to an ARNi is recommended to further reduce morbidity and mortality.

Real-world use of PCSK-9 inhibitors by early adopters: cardiovascular risk factors, statin co-treatment, and short-term adherence in routine clinical practice.

Background: Inconsistency of real-world medication use with labeled indications may affect cost and clinical value of pharmacotherapy. PCSK-9 inhibitors are labeled in the US for use with statins to reduce low-density lipoprotein cholesterol in patients with atherosclerotic cardiovascular disease (ASCVD) or familial hypercholesterolemia (FH).

Objective: To assess consistency with labeled indications and treatment persistency for early (first 5 post-launch months) adopters of PCSK-9 inhibitor pharmacotherapy.

Financial Impact of Direct-Acting Oral Anticoagulants in Medicaid: Budgetary Assessment Based on Number Needed to Treat.

Background: Faced with rising healthcare costs, state Medicaid programs need short-term, easily calculated budgetary estimates for new drugs, accounting for medical cost offsets due to clinical advantages.

Objective: To estimate the budgetary impact of direct-acting oral anticoagulants (DOACs) compared with warfarin, an older, lower-cost vitamin K antagonist, on 12-month Medicaid expenditures for nonvalvular atrial fibrillation (NVAF) using number needed to treat (NNT).

Method: Medicaid utilization files, 2009 through second quarter 2015, were used to estimate OAC cost accounting for generic/brand statutory minimum (13/23%) and assumed maximum (13/50%) manufacturer rebates.

Should patients with chronic liver disease receive venous thromboembolism prophylaxis?

Chronic liver disease has long been considered the prime example of acquired bleeding disorders due to its associated coagulopathies, namely elevated international normalized ratio (INR) and thrombocytopenia. Recent evidence has shown that patients with chronic liver disease also are at risk for hospital-acquired venous thromboembolism (VTE). The safety and efficacy of low-dose anticoagulants for VTE prophylaxis have not been firmly established in this patient population.

A workshop series using peer-grading to build drug information, writing, critical-thinking, and constructive feedback skills.

Objective: To utilize a skills-based workshop series to develop pharmacy students' drug information, writing, critical-thinking, and evaluation skills during the final didactic year of training.

Design: A workshop series was implemented to focus on written (researched) responses to drug information questions. These workshops used blinded peer-grading to facilitate timely feedback and strengthen assessment skills.

Proton Pump Inhibitors and the Risk for Hospital-Acquired Clostridium difficile Infection.

Objective: To examine the relationship between proton pump inhibitor (PPI) usage and nosocomial Clostridium difficile infection (CDI) and determine the duration of therapy at which CDI risk increases.

Patients And Methods: This retrospective case-control study included consecutive adult patients in whom nosocomial CDI developed after hospitalization for 3 or more days at one of 2 affiliated hospitals between June 1, 2010, and October 31, 2011. These patients were matched to patients hospitalized within 6 months who did not have CDI development in a 1:2 ratio using age, sex, and antibiotic usage.

High-fidelity simulation for advanced cardiac life support training.

OBJECTIVE. To determine whether a high-fidelity simulation technique compared with lecture would produce greater improvement in advanced cardiac life support (ACLS) knowledge, confidence, and overall satisfaction with the training method. DESIGN.

Key articles and guidelines in the primary prevention of ischemic stroke.

Ischemic stroke is a prevalent disease with a large burden on the health system. Preventive strategies, therefore, are paramount. Primary prevention is aimed at reducing the risk of stroke in asymptomatic people.