Correlation between medication adherence using proportion of days covered and achieving viral suppression in patients living with HIV.

Medication adherence plays an important role for patients living with HIV and achieving the treatment goal of viral suppression. A goal adherence rate of at least 90% has been previously cited and endorsed; however, studies have demonstrated that lower rates of adherence may still lead to high rates of viral suppression. Adherence rates are increasingly being used by payers to assess pharmacy performance.

Anti-Xa activity by weight in critically ill patients receiving unfractionated heparin for venous thromboembolism prophylaxis.

Purpose: This study compared anti-Xa activity in critically ill patients receiving UFH for VTE prophylaxis between two weight groups (<100 kg vs ≥100 kg).

Methods: This prospective, observational study included critically ill patients on UFH 5000 or 7500 units every 8 h. A peak and trough anti-Xa activity assay was ordered for each patient at steady state.

Evaluation of the Brief Alcohol Withdrawal Scale Protocol at an Academic Medical Center.

Objectives: The standard of care for treatment of alcohol withdrawal is symptom-triggered dosing of benzodiazepines using a withdrawal scale. Abbreviated scales are desired for clinician efficiency. The objective of this study was to evaluate the use of the 5-item Brief Alcohol Withdrawal Scale (BAWS) protocol.

Expansion of inpatient clinical pharmacy services through reallocation of pharmacists.

Purpose: The redesign of an inpatient pharmacy practice model through reallocation of pharmacy resources in order to expand clinical services is described.

Methods: A pharmacy practice model change was implemented at a nonprofit academic medical center to meet the increasing demand for direct patient care services. In order to accomplish this change, the following steps were completed: reevaluation of daily tasks and responsibilities, reallocation of remaining tasks to the most appropriate pharmacy staff member, determination of the ideal number of positions needed to complete each task, and reorganization of the model into a collection of teams.

Implementation of transitions-of-care services through acute care and outpatient pharmacy collaboration.

Purpose: The implementation of a practice model designed to reduce hospital readmissions through optimal deployment of pharmacy staff on multidisciplinary care collaboration teams is described.

Summary: In response to Affordable Care Act provisions aimed at reducing preventable hospital readmissions, the pharmacy department at The Johns Hopkins Hospital (JHH) led the implementation of a new pharmacy services model spanning both inpatient and outpatient settings. Key components of the model include (1) increased pharmacist participation in multidisciplinary rounds, (2) targeted medication reconciliation and patient education, (3) postdischarge phone monitoring of selected patients, and (4) bedside discharge medication delivery performed by a "transitions pharmacist extender.

Development and implementation of a postdischarge home-based medication management service.

Purpose: The development and implementation of a postdischarge home-based, pharmacist-provided medication management service are described.

Summary: A work group composed of pharmacy administrators, clinical specialists, physicians, and nursing leadership developed the structure and training requirements to implement the service. Eligible patients were identified during their hospital admission by acute care pharmacists and consented for study participation.