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Youn J, Seguchi O, Cole R, Geft D, Nishihara K, Shen A, Sharoff R, Ramzy D, Kobashigawa J, Moriguchi J. Desensitization in Mechanical Circulatory Support Patients Awaiting Heart Transplantation: What is the Post-Transplant Outcome? J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ramzy D, Esmailian F, Emerson D, Megna D, Levine R, Cole R, Passano E, Runyan C, Velleca A, Kobashigawa J, Moriguchi J. The New UNOS Heart Allocation Changes Significantly Changed the Landscape of Heart Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Gerhard E, Singh R, Psotka M, Cavallo K, Genovese L, Cooper L, Edwards L, May C, Cole R, Sinha S, Desai S, Shah P. Long-Term Cardiac Remodeling after LVAD Deactivation for Myocardial Recovery. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Runyan C, Zabner R, Ramzy D, Esmailian F, Emerson D, Megna D, Passano E, Hajj J, Huie N, Lindsay M, Aguillon M, Lam L, Chang D, Kobashigawa J, Moriguchi J, Cole R. Increased Incidence of Cholecystitis with Total Artificial Heart versus Left Ventricular Assist Device. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Emerson D, Megna D, Cole R, Levine R, Esmailian F, Chikwe J, Trento A, Ramzy D, Kransdorf E, Kobashigawa J. Does Brain Death Related to Underlying Donor Disease Correlate with Adverse Outcomes after Heart Transplant? J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Seguchi O, Youn J, Geft D, Cole R, Shen A, Nishihara K, Mersola S, Runyan C, Hajj J, Ramzy D, Kobashigawa J, Moriguchi J. The Burden of Total Artificial Heart Patients and Complications after Heart Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Sandau K, Williams M, Canakes K, Martinez B, Barone H, Aronow H, Hajj J, Huie N, Lindsay M, Aguillon M, Runyan C, Cole R, Coleman B. Patient Perspectives of Managing Life with a Left Ventricular Assist Device: “I Could Connect How I Felt with What Was Going on.” A Qualitative Analysis. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Megna D, Emerson D, Cole R, Levine R, Chikwe J, Esmailian F, Trento A, Ramzy D, Kobashigawa J. Orthotopic Heart Transplantation in the Diabetic Patient, are We Still Worried? A Review of 952 Consecutive Patients. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Lane D, Alghamdi R, Muscat M, Kaur MS, Davis T, Cole R, Patel P, Tomaszewski M, Gupta P. 1424The diagnosis of non-adherence in hypertension using a urine biochemical screen is unaffected by drug pharmacokinetics. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Suboptimal drug adherence in hypertension is pandemic and traditional diagnostic tools to detect non-adherence have lacked accuracy and robustness. The inability to identify non-adherence has therefore driven the development of biochemical drug screening by liquid chromatography tandem mass spectrometry (LC- MS/MS) in urine and blood, which are the most accurate metrics presently available. Urinary antihypertensive testing is evidenced to improve non-adherence rates, significantly decrease blood pressure after physician intervention, and be cost effective. The European Society of Cardiology (ESC) and European Society of Hypertension (ESH) 2018 guidelines have recommended the use of biochemical testing for non-adherence diagnosis. However, it has been argued that the variable pharmacokinetic parameters of the medication (such as their half-lives and clearance rates) may affect the detection of medications in urine and hence the determination of adherence. We hypothesized that pharmacokinetic parameters do not affect the detection of antihypertensive medications in urine.
Aim
This study compared the pharmacokinetic parameters of the most commonly prescribed antihypertensive medications against their detection in urine by LC-MS/MS.
Methods
Results of urinary drug screens from 463 hypertensive patients (total prescribed medications N=1709) were collated. An adherence score termed as the C score (number of detected vs. prescribed medication) was generated for each of the 27 common antihypertensive medications. Pharmacokinetic parameters such as bioavailability, plasma concentration, volume of distribution, half-life, plasma clearance and urinary excretion values for each drug were obtained from published literature. Partial linear correlation was conducted between the C score of all the medications and each pharmacokinetic parameter studied.
Results
40% of patients were non-adherent. The average number of prescribed medications was high (N=3.7, SD: 1.5), and the average number of drugs detected was lower (N=2.5, SD: 1.6). Amlodipine was the most prescribed (N=224), and clonidine was the least (N=10). The half-lives ranged from 0.87 to 39 hours for bumetanide and amlodipine respectively. The urinary excretion percentage varied from <1% for nifedipine, and 94% for benfroflumethiazide. No significant correlation was found between any drug C score and their respective pharmacokinetic variables such as the medication half-lives (figure1).
Half-life versus adherence score
Conclusion
This study reports no significant correlation between drug pharmacokinetics and adherence. To the best of our knowledge this is the first study of its kind. Urinary biochemical testing by LC-MS/MS for non-adherence remains a valid tool for diagnosis although further detailed pharmacokinetic studies are needed to confirm this finding.
Acknowledgement/Funding
None
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Fischer JH, Taylor GA, Cole R, Debski I, Armstrong DP, Wittmer HU. Population growth estimates of a threatened seabird indicate necessity for additional management following invasive predator eradications. Anim Conserv 2019. [DOI: 10.1111/acv.12516] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kittleson M, Patel J, Cole R, Geft D, Dimbil S, Levine R, Mersola S, Czer L, Azarbal B, Zabner R, Zakowski P, Kobashigawa J. Does Thymoglobulin Induction Lead to Increased CMV Infection after Heart Transplantation in the Current Tacrolimus Era. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Barone H, Olman M, Fishman A, Olanisa L, Runyan C, Hajj J, Huie N, Lindsay M, Passano E, Kobashigawa J, Moriguchi J, Cole R, Esmailian F, Chung J, Ramzy D. The Value of Licensed Clinical Social Worker Pre-Implant Assessment in Predicting Non-Compliance in Durable Mechanical Circulatory Support Device Patients. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Patel J, Kittleson M, Chang D, Kransdorf E, Levine R, Dimbil S, Kao T, Czer L, Cole R, Esmailian F, Kobashigawa J. 5-Year Outcome of Photopheresis in Heart-Transplantation with Refractory/Persistent Rejection. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Patel J, Kittleson M, Chang D, Cole R, Levine R, Dimbil S, Jain A, Kearney B, Czer L, Hage A, Esmailian F, Kobashigawa J. The Evolving Long-Term Outcome of Heart Transplantation in Amyloid Patients. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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McGlinchey L, Cole R, Caldwell FJ. Reoccurrence of a paranasal osteoma following surgical removal in a 6‐month‐old Warmblood filly. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Burns AD, Lane D, Cole R, Patel P, Gupta P. Cardiovascular Medication Stability in Urine for Non-Adherence Screening by LC–MS-MS. J Anal Toxicol 2018; 43:325-329. [DOI: 10.1093/jat/bky090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 09/21/2018] [Indexed: 12/20/2022] Open
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Colnel J, Ravenel N, Nouailletas R, Caulier G, Moreau P, Treutterer W, Lueddecke K, Cole R. Adapting DCS real time framework for WEST plasma control. FUSION ENGINEERING AND DESIGN 2018. [DOI: 10.1016/j.fusengdes.2018.02.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Esmailian F, Arabia F, Czer L, Kittleson M, Geft D, Cole R, Esmailian G, Rafiei M, Passano E, Barone H, Moriguchi J. Does the Type of Mechanical Circulatory Support as a Bridge to Heart Transplant Affect Outcome after Transplant? J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Stains M, Harshman J, Barker MK, Chasteen SV, Cole R, DeChenne-Peters SE, Eagan MK, Esson JM, Knight JK, Laski FA, Levis-Fitzgerald M, Lee CJ, Lo SM, McDonnell LM, McKay TA, Michelotti N, Musgrove A, Palmer MS, Plank KM, Rodela TM, Sanders ER, Schimpf NG, Schulte PM, Smith MK, Stetzer M, Van Valkenburgh B, Vinson E, Weir LK, Wendel PJ, Wheeler LB, Young AM. Anatomy of STEM teaching in North American universities. Science 2018; 359:1468-1470. [PMID: 29599232 PMCID: PMC6310123 DOI: 10.1126/science.aap8892] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
National and local initiatives focused on the transformation of STEM teaching in higher education have multiplied over the last decade. These initiatives often focus on measuring change in instructional practices, but it is difficult to monitor such change without a national picture of STEM educational practices, especially as characterized by common observational instruments. We characterized a snapshot of this landscape by conducting the first large scale observation-based study. We found that lecturing was prominent throughout the undergraduate STEM curriculum, even in classrooms with infrastructure designed to support active learning, indicating that further work is required to reform STEM education. Additionally, we established that STEM faculty’s instructional practices can vary substantially within a course, invalidating the commonly-used teaching evaluations based on a one-time observation. Although lecture is prominent throughout the undergraduate STEM curriculum, STEM faculty employ varied teaching practices within the same course.
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Hatch A, Cole R, McGraw S, DiChiara A, Merrill E, Wright A, Lieberman H, Bukhari A. Increased Dietary Supplement Use by Soldiers Suggests a Need to Promote Food-Based Strategies for Optimal Nutrition. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gupta P, Patel P, Strauch B, Lai F, Akbarov A, Gulsin G, Maresova V, Rosa J, Cole R, Smith P, Widimsky J, Samani N, Williams B, Tomaszewski M. 3894Predictors of non-adherence to antihypertensive treatment: insights from liquid chromatography tandem mass spectrometry based analysis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.3894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kim J, Pekarek A, Nguyen D, Vega J, Cole R, Morris A, Smith A, Laskar S, Gupta D. (1297) Elevated Pre-Operative Creatinine Is a Risk Factor for Late-Onset Right Heart Failure After Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Yin M, Esmaeeli A, Morris A, Gupta D, Vega D, Laskar R, Smith A, Cole R. Early Exposure to ISHLT Grade 1R Rejection Reduces Long-Term Mortality in Heart Transplant Recipients Surviving the First Year. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Kim J, Pekarek A, Nguyen D, Vega J, Cole R, Morris A, Smith A, Laskar S, Gupta D. Late-Onset Right Heart Failure After Left Ventricular Assist Device Implantation Is Associated with Poor Prognosis. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Jolley CJ, Healey A, Cole R, Baker-Wilding R, Tas B, Moxham J, Strang J, Kelleher M. P214 The prevalence of respiratory symptoms and lung disease in a south london “lung health in addictions” service. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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