Heart Failure in Older People Part 2: Guideline-Directed Medical Therapy.

Heart failure is a common cardiovascular disease that affects older people and has a high rate of mortality. Treatment for heart failure has evolved in the past 10 years to include novel evidence-based agents as well as changes in how medications are initiated and up-titrated. Despite evidence of the importance of using four guideline-directed medications, older people are often undertreated with these lifesaving therapies.

Pharmacotherapy-Induced Hepatitis B Reactivation Among Patients With Prior Functional Cure: A Systematic Review.

Objective: To describe and quantify the incidence and morbidity of hepatitis B reactivation (HBVr) secondary to pharmaceutical agents (eg, rituximab, tumor necrosis factor inhibitors, direct-acting antivirals [DAAs] for hepatitis C) among patients with previously resolved hepatitis B infection.

Data Sources: The MEDLINE database was searched from inception through July 2018 using the terms hepatitis B + ( reactivation OR [drug or drug class linked to HBVr]).

Study Selection And Data Extraction: Relevant English-language cohort studies or randomized trials quantifying the incidence of HBVr secondary to pharmacotherapy among patients negative for hepatitis B surface antigen and DNA and positive for hepatitis B core antibody were included.

The Effect of Clinical Pharmacists on Readmission Rates of Heart Failure Patients in the Accountable Care Environment.

Background: Recent changes in the health care delivery landscape have expanded opportunities for clinical pharmacists in the ambulatory care setting. This article describes the successful integration of a clinical pharmacist-led chronic disease management service in a patient-centered medical home (PCMH) and accountable care organization (ACO) environment.

Program Description: In 2008, the year before PCMH implementation, 36% of patients who were hospitalized at Advocate Trinity Hospital for a heart failure exacerbation were readmitted within 30 days of their hospital stay for heart failure exacerbation.

Assessing Quality of Care in Pharmacy: Remembering Donabedian.

Unlabelled: While some incremental and fragmented progress has been made in recent years, assessing the quality of care provided by pharmacists and pharmacy organizations remains an elusive goal. Revisiting the simple, elegant model of quality assessment originally proposed by physician and scholar Avedis Donabedian can assist pharmacy quality managers to develop a more comprehensive approach to measuring, monitoring, and managing the quality of care.

Disclosures: No funding supported the writing of this article.

Guide for Drug Selection During Pregnancy and Lactation: What Pharmacists Need to Know for Current Practice.

Objective: To provide guidance for clinicians on risk assessment of medication use during pregnancy and lactation.

Data Sources: Authors completed PubMed searches to identify articles focused on the use of medications in pregnancy, including fetal development, drug transfer across the placenta, trimester exposure, chronic conditions in pregnancy, medications in lactation, and lactation and chronic disease.

Study Selection And Data Extraction: Articles were reviewed to provide overall guidance to medication selection during pregnancy.

Occupational Therapy Practitioners' Perspectives of Mental Health Practices With Clients in Stroke Rehabilitation.

Following a stroke, depression and anxiety may negatively affect recovery and decrease quality of life. Occupational therapy (OT) practitioners are distinctly qualified to address both the physical and psychosocial sequelae of a stroke, including clients' mental and emotional health. This study explored the ways in which OT practitioners address the mental health needs of clients post stroke.

Lesinurad: A Novel Agent for Management of Chronic Gout.

Objective: To review the pharmacology, efficacy, and safety of lesinurad and determine its role relative to other agents in the management of chronic gout.

Data Sources: A PubMed search (1946 to February 2018) using the terms lesinurad and RDEA594 was conducted to identify relevant articles.

Study Selection And Data Extraction: In vitro or in vivo evaluations of lesinurad published in the English language were eligible for inclusion.

Improving Clinical Decision Support in Pharmacy: Toward the Perfect DUR Alert.

Unlabelled: The cornerstone of every health care profession is decision making. Historically, the decisions made by pharmacists have focused on ensuring the accuracy and physical integrity of the pharmaceutical product delivered to the patient in strict compliance with the prescriber's order. As the role of the pharmacist evolved over the past half century, the focus of decision making progressively shifted from a product-centric orientation to optimizing the interaction that occurs between the pharmaceutical product and the patient.

Nanocarrier-based antioxidant therapy: promise or delusion?

Introduction: Oxidative stress has generally been recognized as an important factor in the pathogenesis of human diseases, making antioxidant therapy a plausible strategy to either prevent or treat human disorders. Yet so far, numerous antioxidant-based clinical trials aimed at developing clinically approved protocols have been disappointing and many reasons for their failure are being discussed, including the limited bioavailability of most antioxidants. To overcome the hurdles associated with the direct administration of antioxidant molecules, a variety of nanotechnology-based drug delivery systems are being developed.