Costs associated with unplanned readmissions among patients with heart failure with and without hyponatremia.

Purpose: Costs associated with unplanned readmissions among patients with heart failure with and without hyponatremia were studied.

Methods: This study estimated the costs of patients hospitalized for heart failure (HF) discharged with or without corrected sodium. A model was developed to monetize the 30-day readmission risk based on hyponatremia correction.

Utilization and budget impact of tolvaptan in the inpatient setting among patients with heart failure and hyponatremia.

Objective: Assess characteristics of patients with heart failure (HF) and hyponatremia (HN) using tolvaptan, a selective vasopressin V2-receptor antagonist, for sodium correction, and estimate the budget impact of tolvaptan use in a hospital.

Methods: The Premier hospital database was analyzed to assess the utilization of tolvaptan, characteristics of users and non-users, and hospitalization costs among patients with HF and HN. Using these findings, a model was developed to estimate tolvaptan costs in proportion to total medical costs of managing patients with HF and HN, and the budget impact of tolvaptan use.

Current Management of Hyponatremia in Acute Heart Failure: A Report From the Hyponatremia Registry for Patients With Euvolemic and Hypervolemic Hyponatremia (HN Registry).

Background: Hyponatremia (HN) occurs commonly in patients with acute heart failure and confers a worse prognosis. Current HN treatment varies widely, with no consensus. This study recorded treatment practices currently used for patients hospitalized with acute heart failure and HN.

Anticholinergic medications for managing noisy respirations in adult hospice patients.

Purpose: Anticholinergic medications for reducing noisy respirations in adult hospice patients are evaluated.

Summary: Anticholinergic medications used to reduce noisy respirations from retained secretions in terminal patients include atropine, glycopyrrolate, scopolamine, and scopolamine derivatives. Pharmaceutical anticholinergic treatment of retained secretions in hospice patients was evaluated in six studies, three of which compared the efficacy of glycopyrrolate to scopolamine in actively dying patients.

Increased risk of metabolic syndrome, diabetes mellitus, and cardiovascular disease in men receiving androgen deprivation therapy for prostate cancer.

Prostate cancer is the leading cancer diagnosis and second leading cause of cancer-related mortality for men in the United States. Due to the increased prevalence of prostate cancer in men older than 50 years, men at risk for prostate cancer represent the same population of men who are at greatest risk for metabolic syndrome, diabetes mellitus, and coronary artery disease (CAD). In addition to risk factors for CAD that are applicable to the general population, men with prostate cancer can be at increased risk for CAD due to long-term androgen deprivation therapy (ADT) administered as treatment for prostate cancer.

Clinical and economic implications of new strategies for heart failure management in the managed care setting.

Clinical pharmacists in all settings see a large number of patients with heart failure, many of whom are Medicare recipients. Clinical studies have identified appropriate drug therapy for patients with heart failure, and several professional organizations have compiled excellent guidelines. Regardless, many patients are not benefiting from treatment with drugs proven to help reduce morbidity and mortality.