Implementation of Pharmacist Driven Gabapentinoid Titration for Diabetic Peripheral Neuropathy in a Primary Care Setting.

Previous studies suggest that patients with diabetic peripheral neuropathy (DPN) frequently do not receive the minimum effective doses of a gabapentinoid according to guidance from national organizations. There is opportunity to assess the implementation of pharmacist intervention for patients not meeting minimum effective gabapentinoid dosing for DPN. This prospective, single site quality improvement project was conducted at a primary care clinic and included patients with DPN prescribed a gabapentinoid by their primary care provider (PCP) at a dose lower than minimum effective dosing.

Framework for exploring the sensory repertoire of the human gut microbiota.

Bacteria sense changes in their environment and transduce signals to adjust their cellular functions accordingly. For this purpose, bacteria employ various sensors feeding into multiple signal transduction pathways. Signal recognition by bacterial sensors is studied mainly in a few model organisms, but advances in genome sequencing and analysis offer new ways of exploring the sensory repertoire of many understudied organisms.

Provider Responsiveness to Pharmacist Recommendations in a Population Health Setting.

Geriatric patients are more sensitive to medications and are at risk for polypharmacy, requiring a medication review. It is hypothesized that a justin-time message to the primary care provider (PCP) recommending a change to potentially inappropriate medications may increase the rate of acceptance of pharmacist recommendations.
Prospective, quality improvement study.

Clinical Track Program Expansion Increases Rotation Capacity for Experiential Program.

To evaluate the rotation capacity at the University of Maryland School of Pharmacy and see if the implementation of clinical track programs across the state correlates to an increase in rotation capacity for the school. The following information was collected: number of preceptors over the years in the school's experiential learning program, number of clinical track programs from 2012 to 2015, rotation type, availability submissions per rotation type per year, and availability submissions per hospital participant in the clinical track program per year. The rotation capacity and rotation types from 2012 to 2015 academic years were assessed and compared to see if there was any impact on the clinical track programs implemented.

Evaluation of a Standardized Perioperative Management Protocol in the Adult Hematology Anticoagulation Management Service.

Background: In North America, 250,000 patients on vitamin K antagonists require surgical procedures each year. Temporary interruption of oral anticoagulation and perioperative bridging therapy with unfractionated heparin or low-molecular-weight heparin are recommended by the American College of Chest Physicians 2012 for select patients.

Objectives: The study objectives are to evaluate adherence and nonadherence to the Johns Hopkins clinic guidelines for perioperative management of anticoagulation and identify bleeding or thromboembolic events during perioperative management of anticoagulation.

Implementation of an emergency department-based clinical pharmacist transitions-of-care program.

Purpose: The implementation of an emergency department (ED)-based clinical pharmacist transitions-of-care (TOC) program is described.

Summary: The intervention program consisted of collaboration between ED and ambulatory care pharmacists to provide patient-specific comprehensive medication review and education in the ED setting and to help ensure a coordinated transition to the ambulatory care setting by scheduling an ambulatory pharmacy clinic or home-based visit. Patients who sought care at an adult ED for an exacerbation of asthma, chronic obstructive pulmonary disease (COPD), or congestive heart failure (CHF) were assessed for issues with medication adherence or administration technique, patient-specific concerns regarding medication use, access to medications at discharge, the need for modification of chronic therapy, contraindicated medications, and vaccination status, if applicable.

Pharmacist-managed international normalized ratio patient self-testing is associated with increased time in therapeutic range in patients with left ventricular assist devices at an academic medical center.

Patients with left ventricular assist devices (LVADs) are at increased risk of bleeding and thrombotic complications making warfarin therapy particularly challenging. Patient self-testing (PST) using point-of-care international normalized ratio (INR) devices has shown favorable outcomes in other populations, but the use of PST in LVAD patients has not been well described. The purpose of this study was to evaluate the effectiveness of pharmacist-managed INR PST versus usual care (UC) in patients with LVADs at a single center.

Patterns of non-administration of ordered doses of venous thromboembolism prophylaxis: implications for novel intervention strategies.

Background: Recent studies have documented high rates of non-administration of ordered venous thromboembolism (VTE) prophylaxis doses. Intervention strategies that target all patients have been effective, but prohibitively resource-intensive. We aimed to identify efficient intervention strategies based on patterns of non-administration of ordered VTE prophylaxis.

Analysis of the projected utility of dabigatran, rivaroxaban, and apixaban and their future impact on existing Hematology and Cardiology Anticoagulation Clinics at The Johns Hopkins Hospital.

The purpose of this study is to determine the percentage of patients in the Johns Hopkins Anticoagulation Clinics that are potential candidates for the new oral anticoagulants, dabigatran, rivaroxaban, and apixaban. A retrospective chart review was conducted of patients managed in the Johns Hopkins Cardiology and Hematology Anticoagulation Clinics between November 1, 2009 and October 31, 2010. Data elements collected include demographics, primary indication for anticoagulation, renal function, hepatic function, and concomitant medications.

Development and implementation of a pharmacist-managed inpatient anticoagulation monitoring program.

PURPOSE. A stepwise approach to development and implementation of a program to standardize and increase pharmacists' involvement in anticoagulation therapy at a large academic medical center is described. SUMMARY.

Sorting out the concept 'disorder'.

Current debates concerning the concept of mental disorder involve many different philosophical issues. However, it is not always clear from these discussions how, or whether, these issues relate to one another, or in exactly what way they are important for the definition of disorder. This article aims to sort through some of the philosophical issues that arise in the current literature and provide a clarification of how these issues are related to one another and whether they are necessary for defining disorder.