A Pharmacist-Led Program to Taper Opioid Use at Kaiser Permanente Northwest: Rationale, Design, and Evaluation.

Introduction: Primary care practitioners (PCPs) are concerned about adverse effects and poor outcomes of opioid use but may find opioid tapering difficult because of a lack of pain management training or time constraints limiting patient counseling. In 2010, Kaiser Permanente Northwest implemented a pharmacist-led opioid tapering program-Support Team Onsite Resource for Management of Pain (STORM)-to address high rates of opioid use, alleviate PCPs' workload demands, and improve patient outcomes.

Objective: To describe the rationale, structure, and delivery of this unique pharmacist-led program, which partners with PCPs and provides individualized care to help patients reduce opioid use, and the Facilitating Lower Opioid Amounts through Tapering study, which examines the program's effectiveness, cost-effectiveness, and implementation.

Response of gonococcal clinical isolates to acidic conditions.

This study examined the response to acidic conditions of four gonococcal isolates -NRL38874 (Proto/IB-2), NRL38884 (Pro/IA-2), NRL38953 (Proto/IB-3) and NRL39029 (Pro/IA-3) - obtained from various sites in patients in whom a diagnosis of pelvic inflammatory disease had been made by laparoscopic examination. Acid tolerance of the clinical isolates was strain and growth phase dependent. Growth of the four strains on solid media was undetectable below pH 5.