Direct Oral Anticoagulants: Probability of Recurrent Venous Thromboembolism and Bleeding Risk in an Obese Population.

Background: Direct-acting oral anticoagulants (DOACs) have become the preferred drugs for managing venous thromboembolism (VTE). Despite their advantages over vitamin K antagonists such as warfarin, their use in obese patients remains controversial with many providers reluctant to switch patients managed on warfarin. Outcome research that opts to increase provider confidence when prescribing DOACs for patients with obesity will be invaluable.

A Novel Formulation: Donepezil Patch.

Prevalence of dementia continues to increase with limited pharmacotherapy options available. Acetylcholinesterase inhibitors remain a mainstay of treatment. The US FDA has approved three oral medications within this class- donepezil, galantamine, and rivastigmine.

Relationship Among Diabetes Distress, Health Literacy, Diabetes Education, Patient-Provider Communication and Diabetes Self-Care.

Objectives: Mechanisms underlying relationships among patients' health literacy, diabetes distress, diabetes education, and provider counseling for self-care of chronic conditions are unclear. This study tested these relationships using SEM with adult patients with comorbid diabetes and hypertension in rural WV.

Methods: Ninety-one participants of a 12-week self-management program reported on diabetes self-care (diet, exercise, blood glucose (BG) monitoring) and related provider counseling.

Initial maintenance therapy adherence among older adults with asthma-COPD overlap.

Objectives: To examine the impact of initial maintenance therapy (IMT) type (inhaled corticosteroid [ICS] vs fixed-dose combination of ICS and long-acting β agonist [ICS/LABA]) on trajectories of adherence among older adults (≥ 65 years) with coexisting asthma and chronic obstructive pulmonary disease (COPD), known as asthma-COPD overlap (ACO).

Study Design: We used a longitudinal, retrospective cohort design.

Methods: This study used a cohort of older adults with ACO using longitudinal data from a 10% sample of Optum's Deidentified Clinformatics Data Mart.

Economic Burden of Asthma-Chronic Obstructive Pulmonary Disease Overlap among Older Adults in the United States.

The objective of this study is to estimate the excess economic burden of Asthma-COPD Overlap (ACO) among older adults in the United States. We used a cross-sectional study design with data from a nationally representative survey of Medicare beneficiaries (Medicare Current Beneficiary Survey) linked to Medicare fee-for-service claims. Older adults with ACO had higher average total healthcare expenditures ($45,532 vs.

Patient-Directed Home Drain Removal in Head and Neck Surgery.

Objectives/hypothesis: The purpose of this study was to evaluate the efficacy and safety of at home drain removal in head and neck surgery patients.

Methods: The study population included patients who underwent head and neck surgery at an academic tertiary care center between February 2020 and November 2020 and were discharged with one to four drains with instructions for home removal. Prior to discharge, patients received thorough drain removal education.

Improving Bisphosphonate Use and Evaluation in a Rural Family Medicine Practice.

Objective: To evaluate the prevalence of bisphosphonate use without a drug holiday and to assess the success of an interdisciplinary approach to manage and discontinue bisphosphonate therapy.

Setting: The study was completed at one rural family medicine center.

Practice Description: The practice employs two fulltime pharmacists.

Frailty: Evaluation and Management.

Frailty, which is a geriatric syndrome that affects 5% to 17% of older adults, is a state of increased vulnerability across multiple health domains that leads to adverse health outcomes. Frail older adults are at increased risk of falls, disability, hospitalizations, and death. Frailty may initially be overlooked or incorrectly identified as part of the normal aging process because of the variable nature of the presentation and diagnosis.

Improving Chronic Obstructive Pulmonary Disease (COPD) Symptoms Using a Team-Based Approach.

Background: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States (US), with West Virginia bearing a disproportionate disease burden. Complex COPD cases can be difficult to manage during a standard primary care provider (PCP) visit, and pharmacological treatment regimens should be individually tailored to each patient.

Methods: To address these needs, the West Virginia University Department of Family Medicine created an interdisciplinary COPD specialty clinic that uses a team-based approach to treat patients with COPD.

Development of coupled patient care experience courses to enhance patient care skills in the ambulatory and acute care settings.

Background And Purpose: Providing opportunities to allow pharmacy students to apply clinical skills is essential to ensure that they are comfortable and competent to perform these skills during advanced pharmacy practice experiences (APPEs) and in practice. We describe unique coupled courses that require students to apply clinical skills during real patient encounters and simulation activities in the ambulatory and acute care setting to ensure that they are ready for APPEs.

Educational Activity And Setting: New required courses were developed at West Virginia University School of Pharmacy that focused on teaching and reinforcing patient care skills in the ambulatory and acute care settings.

Adolescent Vaccines: Current Recommendations and Techniques to Improve Vaccination Rates.

With multiple vaccines for adolescents recommended, it is imperative providers remain up to date with the current recommendations. With misinformation of vaccine safety and effectiveness in the mainstream media and social media, adolescents are a vulnerable population that needs to be reviewed and educated. Adolescents are typically only just starting to take ownership of their health care.

Bazex syndrome in a patient with head and neck malignancy.

Bazex syndrome (acrokeratosis paraneoplastica) is an uncommon dermatologic condition associated with an underlying malignancy, most commonly squamous cell carcinomas of the head and neck. This article describes Bazex syndrome in a 56-year-old woman who presented with bilateral cervical lymphadenopathy and a mass at the base of her tongue.