Evaluation of an inpatient automatic dose reduction protocol for concentrated insulin glargine upon therapeutic interchange to insulin detemir on hypoglycemia rates.

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Rate of Inpatient Hypoglycemia Following a 1:1 Dose Interchange Between Concentrated Insulin Glargine to Insulin Detemir.

Background: Insulin remains a mainstay of treating hyperglycemia in an acute setting. Insulin glargine 300 units/mL (Toujeo, iGlar300) has a different pharmacokinetic profile than 100 units/mL basal insulins, such as insulin detemir (iDet100) and iGlar100. While conversion from iGlar300 to iGlar100 requires a 20% dose decrease, there is currently no recommended interchange from iGlar300 to iDet100.

Assessing the impact of virtual medication history technicians on medication reconciliation discrepancies.

Background To overcome resource limitations, Ascension hospitals have implemented a virtual pharmacy technician program to facilitate the completion of medication histories in select emergency departments. Objective This multicenter retrospective study aimed to assess the impact of taking a medication history virtually by pharmacy technicians on medication reconciliation accuracy in comparison to other clinicians. Setting Ascension Seton hospitals in Austin, Texas, United States.

Validation of Available Extended-Spectrum-Beta-Lactamase Clinical Scoring Models in Predicting Drug Resistance in Patients with Enteric Gram-Negative Bacteremia Treated at South Texas Veterans Health Care System.

Extended-spectrum-beta-lactamase (ESBL)-producing are increasingly common; however, predicting which patients are likely to be infected with an ESBL pathogen is challenging, leading to increased use of carbapenems. To date, five prediction models have been developed to distinguish between patients infected with ESBL pathogens. The aim of this study was to validate and compare each of these models to better inform antimicrobial stewardship.

Determining Indicators of High-Quality Application Activities for Team-Based Learning.

To determine the indicators of quality for application activities in pharmacy team-based learning (TBL). A modified Delphi process was conducted with pharmacy TBL experts. Twenty-three experts met the inclusion criteria, including having at least four years of TBL experience, designing at least eight TBL sessions, training others to use TBL, and authoring a peer-reviewed TBL pharmacy paper.

Educational Outcomes Resulting From Restructuring a Scholarship Course for Doctor of Pharmacy Students.

To compare educational outcomes between two iterations of a scholarship and research course for Doctor of Pharmacy (PharmD) students at Virginia Commonwealth University's School of Pharmacy. The first iteration of a course intended to teach pharmacy students the knowledge and skills necessary to design and conduct research involved lectures and application exercises, including limited guided questions about different aspects of the research process. In the fall of 2015, multiple structured activities and accompanying grading rubrics, each designed around the structure and content of a section of a research proposal, were introduced to the course to supplement lectures.

Comprehensive health management pharmacist-delivered model: impact on healthcare utilization and costs.

Objectives: To (1) examine the impact of the Comprehensive Health Management Patient Service (CHaMPS) on unplanned hospital admissions and emergency department (ED) visits in patients with chronic conditions, (2) describe the number and type of pharmacist interventions, and (3) determine the cost savings of CHaMPS.

Study Design: Retrospective, cross-sectional design with a matched comparator group.

Methods: CHaMPS integrated pharmacists within family medicine clinics to optimize medication use among patients with chronic conditions.

Effects of the synthetic psychedelic 2,5-dimethoxy-4-iodoamphetamine (DOI) on ethanol consumption and place conditioning in male mice.

Rationale: Approximately 20 million adults in the USA have an alcohol use disorder (AUD). There are clinical and preclinical data suggesting that psychedelics may have benefits for AUD.

Objective: To investigate the effects of the synthetic psychedelic 2,5-dimethoxy-4-iodoamphetamine (DOI) on the behavioral effects of ethanol.

A qualitative study to understand over-the-counter medication use and decision-making among residents of senior-living communities.

Introduction: OTC medications are generally considered safe and convenient to use without requiring a prescription. However, the safety of an OTC medication and the final health outcome depends in part upon consumers' perceptions, beliefs, and their decision-making about OTC medication use. This study uses a qualitative approach to explore the knowledge, beliefs, and practices associated with OTC medication use and decision-making in adults aged 65 years and older.

Patterns of antiepileptic drug use in patients with potential refractory epilepsy in Texas Medicaid.

Objectives: Antiepileptic drug (AED) monotherapy is usually effective in 60% of the patients with epilepsy while the remaining patients have refractory epilepsy. This study compared treatment patterns (adherence, persistence, addition, and switching) associated with refractory and nonrefractory epilepsy.

Methods: Texas Medicaid claims from 09/01/07-12/31/13 were analyzed, and patients eligible for the study 1) were between 18 and 62 years of age, 2) had a prescription claim for an AED during the identification period (03/01/08-12/31/11) with no prior baseline AED use (6-month), and 3) had evidence of epilepsy diagnosis within 6 months of AED use.

Sorafenib improves alkylating therapy by blocking induced inflammation, invasion and angiogenesis in breast cancer cells.

Molecular targeted compounds are emerging as a strategy to improve classical chemotherapy. Herein, we describe that using low dose of the multikinase inhibitor sorafenib improves cyclophosphamide antitumor activity by inhibiting angiogenesis, metastasis and promoting tumor healing in MDA-MB231 xenografts and the 4T1-12B syngeneic breast cancer metastasis model. Mechanistic studies in MDA-MB231 cells revealed that alkylation upregulates inflammatory genes/proteins such as COX-2, IL8, CXCL2 and MMP1 in a MEK1/2-ERK1/2-dependent manner.

Refining a Claims-based Algorithm to Estimate Biologic Medication Effectiveness and Cost per Effectively Treated Patient with Rheumatoid Arthritis.

Background: Claims data generally lack information on clinical outcomes. However, a validated claims-based algorithm for estimating the effectiveness of biologic agents in treating rheumatoid arthritis (RA) was recently developed and applied to various databases.

Objectives: The objectives of the study were to implement a claims-based algorithm in a large nationwide database to estimate medication effectiveness and cost for patients with RA using biologic disease-modifying antirheumatic drugs (DMARDs) and to assess the effect of eliminating one criterion from the algorithm on results.

Phase I study of sorafenib and tipifarnib for recurrent glioblastoma: NABTC 05-02.

Recurrent glioblastoma (GBM) has a very low 6-month progression free survival (PFS) with currently available treatments. Combination chemotherapy to target multiple cell signaling pathways is currently being investigated in order to improve prognosis for recurrent disease. The purpose of this phase I study was to determine the maximum tolerated dose (MTD) for the combination of tipifarnib and sorafenib for the treatment of recurrent GBM.

Retrospective comparison of low molecular weight heparin vs. warfarin vs. oral Xa inhibitors for the prevention of recurrent venous thromboembolism in oncology patients: The Re-CLOT study.

Background There is increasing evidence indicating oral factor Xa inhibitors can be used for secondary prevention of venous thromboembolism. Studies are needed to compare oral factor Xa inhibitors, low molecular weight heparins, and warfarin in the oncology population. The purpose of this study is to evaluate the recurrent venous thromboembolism incidence in oncology patients utilizing oral Xa inhibitors, low molecular weight heparins, or warfarin.

Adherence, Persistence, and Health Care Costs for Patients Receiving Dipeptidyl Peptidase-4 Inhibitors.

Background: The dipeptidyl peptidase-4 (DPP-4) inhibitors are among the newer, yet more established, classes of diabetes medications.

Objective: To compare adherence, persistence, and health care costs among patients taking DPP-4 inhibitors.

Methods: Claims were extracted from Humana Medicare Advantage Prescription Drug (MAPD) or commercial plans for patients aged > 18 years with ≥ 1 prescription filled for a DPP-4 inhibitor between July 1, 2011, and March 31, 2013.

Homeless patients' perceptions about using cell phones to manage medications and attend appointments.

Objectives: The objectives of this study were to (1) describe homeless persons' access and use of cell phones and their perceptions about using cell phone alerts to help manage medications and attend health care appointments and (2) identify demographic characteristics, medication use and appointment history and perceptions associated with interest in receiving cell phone alerts to manage medications and appointments.

Methods: A cross-sectional survey was conducted in 2013 at a homeless clinic in Virginia. The questionnaire comprised items about cell phone usage, ownership and functions such as text messaging.

Clostridium difficile infection health disparities by race among hospitalized adults in the United States, 2001 to 2010.

Background: Recognition of health disparities in Clostridium difficile infection (CDI) is an initial step toward improved resource utilization and patient health. The purpose of this study was to identify health disparities by black vs. white race among hospitalized adults with CDI in the United States (U.

Drug Class Combination-Associated Acute Kidney Injury.

Objective: To evaluate the quality of available evidence of drug class combinations and their association with the development of acute kidney injury (AKI).

Data Sources: A search of MEDLINE and Embase databases was completed using the following terms: "risk factor AND (acute kidney injury or acute kidney failure) AND (drug or medication)."

Study Selection And Data Extraction: Inclusion criteria were the following: English language, full-text availability, and at least 1 drug-combination.

Adherence to the 2013 Blood Cholesterol Guidelines in Patients With Diabetes at a PCMH: Comparison of Physician Only and Combination Physician/Pharmacist Visits.

Purpose: The purpose of this study is to assess adherence to the 2013 blood cholesterol guideline in a population with diabetes based on the atherosclerotic cardiovascular (ASCVD) risk.

Methods: Patients with diabetes were assessed to see whether they received the appropriate intensity statin therapy via chart review. Patients seen by a physician or pharmacist at CommUnityCare, a PCMH, from December 2013 to October 2014 were included in this retrospective study.

Patients' Experiences Using a Brief Screening Tool for Medication-Related Problems in a Community Pharmacy Setting.

Objectives: The objective of this study was to explore patient perceptions and the practical implication of using a brief 9-item scale to screen for medication-related problems in community pharmacies.

Methods: Semistructured, audio-recorded, telephonic interviews were conducted with 40 patients who completed the scale and reviewed its results with their pharmacist. Audio recordings were transcribed verbatim and analyzed using qualitative methods to identify themes.

Patterns of treatment and correction of hyponatremia in intensive care unit patients.

Purpose: The goal of this study was to examine the real-world patterns of care and interventions among intensive care unit (ICU) patients with hypervolemic and euvolemic hyponatremia using a large clinical database.

Materials And Methods: The Phillips eICU Research Institute database was used to investigate hyponatremia treatment patterns and trends, mortality, and ICU and hospital length of stay. Demographics, clinical characteristics, and outcome variables were compared in patients corrected for hyponatremia using both a more strict and a less strict definition.

Daily costs of hospitalization in non-valvular atrial fibrillation patients treated with anticoagulant therapy.

Background: Atrial fibrillation (AF) is the most common cardiac rhythm disturbance in the US, with an estimated prevalence of 2.7-6.1 million persons in 2010.

Tbo-Filgrastim versus Filgrastim during Mobilization and Neutrophil Engraftment for Autologous Stem Cell Transplantation.

There are limited data available supporting the use of the recombinant granulocyte colony-stimulating factor (G-CSF), tbo-filgrastim, rather than traditionally used filgrastim to mobilize peripheral blood stem cells (PBSC) or to accelerate engraftment after autologous stem cell transplantation (ASCT). We sought to compare the efficacy and cost of tbo-filgrastim to filgrastim in these settings. Patients diagnosed with lymphoma or plasma cell disorders undergoing G-CSF mobilization, with or without plerixafor, were included in this retrospective analysis.

Current treatment practice and outcomes. Report of the hyponatremia registry.

Current management practices for hyponatremia (HN) are incompletely understood. The HN Registry has recorded diagnostic measures, utilization, efficacy, and outcomes of therapy for eu- or hypervolemic HN. To better understand current practices, we analyzed data from 3087 adjudicated adult patients in the registry with serum sodium concentration of 130 mEq/l or less from 225 sites in the United States and European Union.

Daily hospitalization costs in patients with deep vein thrombosis or pulmonary embolism treated with anticoagulant therapy.

Background: Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), affects about 900,000 persons in the United States each year.

Objectives: To quantify the progression of daily hospitalization costs among DVT and PE patients.

Patients/methods: A retrospective claims analysis was conducted from 01/01/2009 to 03/01/2013 using the Premier Perspective Comparative Hospital Database.