Antibiotic Stewardship Improvement Initiative at a Veterans Health Administration Ambulatory Care Center.

Background: The negative impact of unnecessary antibiotic prescribing is well known and includes risks of antibiotic adverse effects, overgrowth of pathogenic organisms, unnecessary costs, and selection of antibiotic-resistant organisms in the populace at large. Acute viral respiratory infections are among the leading causes of inappropriate antibiotic usage.

Methods: This study examined the effect on inappropriate antibiotic prescribing rates of educating clinicians regarding antibiotic stewardship and making a prepackaged kit (containing symptom relief and patient education) for clinicians to distribute to patients with viral upper respiratory tract infections vs writing a prescription for antibiotics.

Prospective Study of a Novel Risk Stratification Process for Opioid-Related Harm Reduction in Cancer Patients Seen in an Outpatient Palliative Care Clinic.

Oncologists and palliative specialists prescribe opioids for millions of cancer patients despite limited research on effective screening and mitigation strategies to reduce risk of opioid-related harm in that population. To evaluate the efficacy of a novel opioid risk stratification process for predicting significant aberrant behaviors (SABs) related to prescribed opioid medications. This is a prospective, longitudinal study of 319 consecutive patients referred to an outpatient palliative care clinic between 2010 and 2012, a period during which prescription opioid-related deaths began to increase in the United States.

Something to talk about: Topics of conversation between romantic partners during military deployments.

Long-distance communication has been frequently identified as essential to military couples trying to maintain their relationship during a deployment. Little quantitative research, however, has assessed the types of topics discussed during such communication and how those topics relate to overall relationship satisfaction. The current study draws on a sample of 56 Army couples who provided data through online surveys while the service member was actively deployed.

The impact of extended release exenatide as adjuvant therapy on hemoglobin A1C, weight, and total daily dose of insulin in patients with type 2 diabetes mellitus using U-500 insulin.

Aims: To evaluate the efficacy and safety of adjuvant exenatide extended release (ER) therapy in patients treated with regular U-500 insulin.

Methods: In this retrospective chart review at an ambulatory care center in the Midwest, 18 patients with type 2 diabetes being treated with regular U-500 insulin and adjuvant exenatide ER were identified. These patients were evaluated for outcomes following the addition of exenatide ER.

Pharmacologic treatment of type 2 diabetes: injectable medications.

Objective: To review the oral and injectable pharmacologic treatment options for type 2 diabetes.

Data Sources: A literature search was conducted using PubMed electronic database for studies published in English between 1993 and September 2014. Search terms included diabetes mellitus, type 2 diabetes, and the individual name for each antidiabetic medication reviewed.

Pharmacologic treatment of type 2 diabetes: oral medications.

Objective: To review the oral and injectable pharmacologic treatment options for type 2 diabetes.

Data Sources: A literature search was conducted using PubMed electronic database for studies published in English between 1993 and September 2014. Search terms included diabetes mellitus, type 2 diabetes, and the individual name for each antidiabetic medication reviewed.

Implementation and outcomes of a pharmacist-managed clinical video telehealth anticoagulation clinic.

Purpose: The use of clinical video telehealth (CVT) technology to optimize the deployment of clinical pharmacy specialist resources in a community-based outpatient clinic (CBOC) is described.

Summary: In 2012, clinical pharmacy specialists at a Veterans Affairs (VA) medical center began using CVT technology to provide anticoagulation therapy management services to patients at a CBOC about 12 miles away. Using videoconferencing technology (video cameras and high-definition widescreen monitors), the remotely located pharmacists conduct patient interviews, evaluate International Normalized Ratio (INR) values, and gather other clinical data for use in therapeutic planning.