Novel T Cell reactivities to Hybrid Insulin Peptides in Islet Autoantibody-Positive At-Risk Subjects.

Type 1 Diabetes (T1D) is an autoimmune disease mediated by autoreactive T cells. Our studies indicate that CD4 T cells reactive to Hybrid Insulin Peptides (HIPs) play a critical role in T cell-mediated beta-cell destruction. We have shown that HIPs form in human islets between fragments of the C-peptide and cleavage products of secretory granule proteins.

Contributors and Solutions to High Out-of-Pocket Costs for Heart Failure Medications.

As expensive therapeutics rise to the fore of heart failure management, out-of-pocket (OOP) medication costs have become increasingly relevant to patient care. Prescription medication costs influence medical decision-making and affect adherence. Yet, individualized cost estimates are seldom available during clinical encounters when prescription decisions are made.

Unsupervised machine learning analysis to identify patterns of ICU medication use for fluid overload prediction.

Background: Fluid overload (FO) in the intensive care unit (ICU) is common, serious, and may be preventable. Intravenous medications (including administered volume) are a primary cause for FO but are challenging to evaluate as a FO predictor given the high frequency and time-dependency of their use and other factors affecting FO. We sought to employ unsupervised machine learning methods to uncover medication administration patterns correlating with FO.

UPJE: Most pharmacy law educators have heard of it, but support remains divided.

Background: Most states require pharmacists to successfully pass the Multistate Pharmacy Jurisprudence Examination (MPJE) required by the National Association of Boards of Pharmacy (NABP) to obtain licensure as a pharmacist, though pass rates for the MPJE have declined in recent years. Meanwhile, NABP is pursing efforts to standardize the exam with the emergent Uniform Pharmacy Jurisprudence Examination (UPJE).

Objective: This study aimed to describe the current thinking of pharmacy law educators across the US on the UPJE.

The Pharmacogenomics Global Research Network Implementation Working Group: global collaboration to advance pharmacogenetic implementation.

Pharmacogenetics promises to optimize treatment-related outcomes by informing optimal drug selection and dosing based on an individual's genotype in conjunction with other important clinical factors. Despite significant evidence of genetic associations with drug response, pharmacogenetic testing has not been widely implemented into clinical practice. Among the barriers to broad implementation are limited guidance for how to successfully integrate testing into clinical workflows and limited data on outcomes with pharmacogenetic implementation in clinical practice.

A Survey Analysis of Motivations and Perceived Consequences of Work Hours Among Pharmacy Students.

Objective: To determine pharmacy students' weekly work hours during Doctor of Pharmacy (PharmD) semesters, the primary reasons for working or not working, and how work hours impact their pharmacy education experience.

Methods: A multicenter cross-sectional survey was conducted among first-year (P1) to fourth-year (P4) pharmacy students enrolled in PharmD programs at 3 colleges of pharmacy between January and February 2024. The 22-item anonymous survey queried student characteristics, current and ideal paid work hours, primary reasons for working, and perceived consequences of work hours on pharmacy education.

Effectiveness of direct patient outreach with a narrative naloxone and overdose prevention video to patients prescribed long-term opioid therapy in the USA: the Naloxone Navigator randomised clinical trial.

Introduction: Public health efforts to reduce opioid overdose fatalities include educating people at risk and expanding access to naloxone, a medication that reverses opioid-induced respiratory depression. People receiving long-term opioid therapy (LTOT) are at increased risk for overdose, yet naloxone uptake in this population remains low. The objective of this study was to determine if a targeted, digital health intervention changed patient risk behavior, increased naloxone uptake, and increased knowledge about opioid overdose prevention and naloxone.

Barriers and facilitators of the use of clinical informatics resources to facilitate pharmacogenomic implementation in resource-limited settings.

Objective: Understand perceived barriers to and facilitators of using clinical informatics applications for pharmacogenomic (PGx) implementation in resource-limited settings.

Materials And Methods: We conducted a qualitative research study using a semi-structured interview guide informed by the Consolidated Framework for Implementation Research (CFIR). Interview questions assessed CFIR contextual determinants related to: electronic health record (EHR) infrastructure; clinical informatics personnel and resources; EHR integration of PGx test results; PGx clinical decision support (CDS) tools; institutional resources; and partner receptivity.

Major Publications in the Critical Care Pharmacotherapy Literature: 2023.

Objectives: We aimed to summarize the most significant and impactful publications describing the pharmacotherapeutic care of critically ill patients in 2023.

Data Sources: PubMed/MEDLINE and the Clinical Pharmacy and Pharmacology Pharmacotherapy Literature Update.

Study Selection: Randomized controlled trials and prospective studies of adult critically ill patients assessing a pharmacotherapeutic intervention and reporting clinical endpoints published between January 1, 2023, and December 31, 2023, were eligible for inclusion in this article.

A doctor of pharmacy curriculum revision process focused on curricular overload.

Objective: The objective is to describe the impact of a curricular revision process using the 8-step Kotter change model to decrease curricular overload in a Doctor of Pharmacy program at a public, research-intensive school of pharmacy.

Methods: In alignment with the 8-step Kotter change model, the first step was to create urgency for change, which was supported by calls to action to address curricular overload. Next, a coalition of change leaders was formed, who developed 7 curriculum renewal targets to collectively address curricular overload.

Strategies for DPYD testing prior to fluoropyrimidine chemotherapy in the US.

Purpose: Patients with dihydropyrimidine dehydrogenase (DPD) deficiency are at high risk for severe and fatal toxicity from fluoropyrimidine (FP) chemotherapy. Pre-treatment DPYD testing is standard of care in many countries, but not the United States (US). This survey assessed pre-treatment DPYD testing approaches in the US to identify best practices for broader adoption.

Practice Pearls for Stimulant Treatment of Attention-Deficit/Hyperactivity Disorder in Youth.

Over half of youth with attention-deficit/hyperactivity disorder (ADHD) have co-occurring psychiatric or medical conditions that present treatment challenges. Stimulants are the most effective pharmacologic treatment of ADHD for preschoolers to adults but questions about safety with co-occurring conditions frequently arise. In addition, stigma surrounding diagnosis and treatment can negatively impact care.

Evaluation of Aspirin Prescribing and Gastrointestinal Bleeding in Adults 60 Years of Age and Older in a Large, Academic Health System.

National guidelines no longer recommend adults 60 years of age and older to begin treatment with low-dose daily aspirin for primary prevention of atherosclerotic cardiovascular disease (CVD) due to a lack of proven net benefit and a higher risk of bleeding. The objective of this cross-sectional retrospective analysis was to evaluate the appropriateness of low-dose aspirin prescribing and subsequent gastrointestinal bleeding in older persons receiving primary care in a large academic health system. Large, academic health system within Colorado.