Effects of a community pharmacy cardiovascular practice transformation (CPT) program on blood pressure.

Objectives: To implement the Cardiovascular Practice Transformation (CPT) program and evaluate its impact on blood pressure, and to assess the feasibility of implementing the CPT program by identifying obstacles and facilitators.

Methods: Twenty-three Iowa pharmacies participated in the program, each monitoring approximately 10 hypertensive patients for 6 months. Pharmacists assessed blood pressure, medication adherence and addressed medication-related problems during patient visits.

Reprint of: Impact of outpatient pharmacist dispensing in an opioid use disorder clinic.

Background: Medications for opioid use disorder are effective in reducing opioid deaths, but access can be an issue. Relocating an outpatient pharmacist for weekly buprenorphine dispensing in an outpatient clinic may facilitate coverage for buprenorphine and mitigate access and counseling barriers.

Objectives: This study aimed to evaluate whether staffing an outpatient resident pharmacist to dispense in the buprenorphine clinic had a positive impact on (1) mean cost per prescription charged to charity care and (2) basic elements of patient satisfaction with the on-site pharmacist.

Evaluation of an enhanced depression and anxiety screening with targeted pharmacist intervention.

Background: Depression is a major source of morbidity but often goes undiagnosed. Broader screening is recommended, and pharmacists could contribute.

Objectives: This study aimed to assess the feasibility of community pharmacy depression and anxiety screening and describe the medication-related problems (MRPs) identified, pharmacist interventions, and provider responses for high-risk patients.

Impact of outpatient pharmacist dispensing in an opioid use disorder clinic.

Background: Medications for opioid use disorder are effective in reducing opioid deaths, but access can be an issue. Relocating an outpatient pharmacist for weekly buprenorphine dispensing in an outpatient clinic may facilitate coverage for buprenorphine and mitigate access and counseling barriers.

Objectives: This study aimed to evaluate whether staffing an outpatient resident pharmacist to dispense in the buprenorphine clinic had a positive impact on (1) mean cost per prescription charged to charity care and (2) basic elements of patient satisfaction with the on-site pharmacist.

Evaluation of an enhanced depression and anxiety screening with targeted pharmacist intervention.

Background: Depression is a major source of morbidity but often goes undiagnosed. Broader screening is recommended, and pharmacists could contribute.

Objectives: This study aimed to assess the feasibility of community pharmacy depression and anxiety screening and describe the medication-related problems (MRPs) identified, pharmacist interventions, and provider responses for high-risk patients.

Hepatitis C screening in a community pharmacy setting: Patient perspective.

Background: Hepatitis C virus (HCV) is an infection of the liver, which contributes to over 15,000 deaths in the United States annually. When treated, HCV has a 90% or greater cure rate, however testing for HCV remains low.

Objectives: To assess patient perspectives on HCV screenings in the community pharmacy setting including awareness of screening, willingness to be screened, barriers to screening, and willingness to pay for HCV screening.

Evaluation of medication disposal behaviors after counseling by a community pharmacist and provision of a home medication disposal kit.

Objectives: To evaluate providing an at-home medication disposal kit on opioid disposal behaviors. Self-report of prior disposal behaviors also was assessed to describe the sample.

Design: Pilot study with randomization.

Making Use of Your Assets: Clinical Use of EOD Radiography in the Forward-Deployed Setting.

Ultrasonography is currently the primary means of imaging for forward surgical teams/forward resuscitative surgical teams (FSTs/FRSTs). As FSTs/FRSTs are pushed farther forward into more austere environments, access to other imaging modalities may be limited, potentially affecting resources. On a recent deployment, the 126th FRST was able to use radiography equipment from a co-located explosive ordnance disposal (EOD) team to assist in the diagnosis and treatment of medical and surgical patients, thereby saving time and resources.

InSight Care Pilot Program: Redefining Seeing a Patient.

Purpose: Early detection and management of symptoms in patients with cancer improves outcomes. However, the optimal approach to symptom monitoring and management is unknown. InSight Care is a mobile health intervention that captures symptom data and facilitates patient-provider communication to mitigate symptom escalation.

Use of a fall risk evaluation in a community-based pharmacy.

Background: Falls in older adults are a serious public health concern. They increase health care expenditure and account for more than $30 billion in direct medical costs. Medication-related problems can contribute to fall risk, and community-based pharmacists are well positioned to intervene, given their role in monitoring ongoing medications.

Retrospective analysis of drug therapy problems identified with a telephonic appointment-based model of medication synchronization.

Objectives: To describe the drug therapy problems (DTPs) identified for patients enrolled in an Appointment Based Model (ABM) for medication synchronization, describe the pharmacist-delivered clinical interventions, and assess what patient characteristics are associated with the number of DTPs identified.

Methods: A cross-sectional chart review of 1 month of pharmacist notes for telephone ABM encounters at one independent community pharmacy in the Midwest U.S.

Development of Community Pharmacy Characteristics Questionnaire: Application of Cognitive Interviewing.

Background: A questionnaire specific to community pharmacy characteristics, such as staffing models for clinical activities and business operations, does not exist. As community pharmacy practice expands, it is important to characterize how pharmacies are changing for outcomes research. The aim of this study was to conduct cognitive interviewing with community pharmacists to gain feedback on the formatting, readability, and content of items measuring community pharmacy characteristics to develop such a questionnaire.

Evaluation of community pharmacist-provided telephone interventions to improve adherence to hypertension and diabetes medications.

Objectives: To 1) identify specific patient barriers and pharmacist interventions to medication adherence by means of the Drug Adherence Work-Up (DRAW) tool; and 2) measure patient adherence to antihypertensive and antidiabetic medications by calculating proportion of days covered (PDC) before and after pharmacist telephone adherence interview.

Design: This prospective quality-improvement study consisted of telephonic interviews and targeted interventions to increase medication adherence based on patient-specific barriers. The baseline PDC was electronically calculated for each patient, and postintervention PDCs were manually calculated at 90 days and 180 days after baseline.

Analysis of a Community Pharmacy Intervention to Improve Low Adherence Rates to Oral Diabetes Medications.

For patients with diabetes, suboptimal medication adherence contributes to disease progression, complications, and increased healthcare costs. Identification of, and intervention for patient-identified reasons for nonadherence are essential to improving medication adherence. This prospective, quality improvement study was conducted at an independent community pharmacy in the Mid-West United States.

A survey of pharmacists' preparedness for provider status implementation.

Objectives: 1) To measure pharmacists' preparedness for the implementation of provider status; and 2) to measure pharmacists' perceived stakeholder readiness for provider status implementation.

Methods: An anonymous 24-item electronic survey was sent to a convenience sample of approximately 1500 licensed Iowa pharmacists. They were contacted by means of their membership in the Iowa Pharmacists Association, 1 of 6 regional associations; Drake University and University of Iowa faculty listservs; and the University of Iowa alumni office.

Large Cell Neuroendocrine Carcinoma of the Lung: Clinico-Pathologic Features, Treatment, and Outcomes.

Background: Large cell neuroendocrine carcinoma (LCNEC) accounts for approximately 3% of lung cancers. Pathologic classification and optimal therapies are debated. We report the clinicopathologic features, treatment and survival of a series of patients with stage IV LCNEC.

Severe anaphylactic reaction after repeated intermittent exposure to lepirudin.

Lepirudin, a recombinant DNA derivative of hirudin, is used to prevent thromboembolic complications caused by heparin-induced thrombocytopenia type II. Anaphylactic and anaphylactoid reactions have been reported with its use in patients both with and without known previous exposure to lepirudin. We describe the case of a 57-year-old woman who received five uneventful courses of lepirudin therapy before having a severe anaphylactic reaction during administration of the intravenous bolus dose that began her sixth course.

Randomized clinical trial of mitomycin-C with or without pretreatment with WR-2721 in patients with advanced colorectal cancer.

The use of mitomycin for metastatic colorectal cancer has been limited by mitomycin's myelosuppressive potential. The objective of this randomized study was to determine whether WR-2721 would decrease the hematologic toxicity of mitomycin in patients with colorectal cancer resistant to fluorouracil-based therapy. Ninety-seven patients with refractory colorectal cancer were randomized to receive either mitomycin 20 mg/m2 only or the same dose of mitomycin after pretreatment with WR-2721, 910 mg/m2.

A phase II trial of carboplatin (CBDCA) in small-cell and non-small-cell lung cancer with correlation to in vitro analysis of cytotoxicity.

A Phase II trial of carboplatin (CBDCA) was performed in 33 patients with advanced lung cancer, including 15 patients with inoperable Stage III non-small-cell (NSCLC) and 18 patients with relapsed small-cell (SCLC) lung cancer. Initial dosage was 320 mg/m2 infused over 24 h; in the absence of hematologic toxicity, subsequent doses were escalated to 400 mg/m2. Patients received a median of two cycles (range 1-13 for NSCLC and 1-5 for SCLC) of therapy.

Phase II trial of intermittent high-dose recombinant interferon alfa-2a in mycosis fungoides and the Sézary syndrome.

We previously demonstrated that recombinant interferon alfa-2a (IFN-alfa) in a dose of 50 X 10(6) U million units (MU)/m2 intramuscularly (IM) three times per week has efficacy against mycosis fungoides (MF) and the Sézary syndrome (SS). However, this regimen given to patients with refractory disease was uniformly complicated by toxicities requiring major dose reductions. The present study was designed to determine if intermittent high-dose IFN-alfa would preserve efficacy and decrease toxicity in a similar patient population.

Histopathologic staging at initial diagnosis of mycosis fungoides and the Sézary syndrome. Definition of three distinctive prognostic groups.

Study Objective: To determine the optimal staging evaluation at the time of initial diagnosis of mycosis fungoides or the Sézary syndrome.

Design: Retrospective review of a uniformly staged inception cohort.

Setting: Single-institution tertiary care center.

Female patients with small cell lung cancer live longer than male patients.

Purpose: The incidence of lung cancer is rising in women in the United States, and recent reports have suggested that female patients treated for small cell lung cancer have an improved survival compared with their male counterparts. In view of these findings, we decided to determine if, in our patient population, women live longer than men and if a higher proportion of female patients are entering our trials.

Patients And Methods: The survival of women entering therapeutic clinical trials for small cell lung cancer from 1973 through 1986 at the National Cancer Institute-Navy Medical Oncology Branch was evaluated and compared with the survival of similarly treated men during the same time period.

The development of small cell lung cancer in the contralateral lung of a patient surviving 8 years after the original diagnosis of small cell lung cancer.

The development of non-small cell lung cancer in patients successfully treated for small cell lung cancer has been previously described. Many of these non-small cell tumors appear to be second primary lung tumors. However, the development of second primary small cell lung cancers has not been clearly delineated.