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DiPiro JT, Hoffman JM, Schweitzer P, Chisholm-Burns MA, Nesbit TW, Fabian TJ, Cunningham FE, Barrett A, Fine MJ, Tichy E, Hernandez I, Scott CM, Norman C, Nelson SD, Kumah-Crystal Y. ASHP and ASHP Foundation Pharmacy Forecast 2024: Strategic Planning Guidance for Pharmacy Departments in Hospitals and Health Systems. Am J Health Syst Pharm 2024; 81:5-36. [PMID: 38048298 DOI: 10.1093/ajhp/zxad231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023] Open
Abstract
Purpose: The 2024 ASHP Pharmacy Forecast identifies and contextualizes emerging issues and trends that will influence healthcare, health systems, and the pharmacy profession and provides recommendations to inform long-term strategic planning that should prompt action by pharmacists and health-system leaders. Methods: Drawing on the “wisdom of crowds” concept, a survey was constructed with 6 general themes, each with 6 to 9 focused statements and a seventh theme on preparedness (58 survey items in total). The size of and representation within the survey panel were intended to capture opinions from a wide range of pharmacy leaders. The survey instructed panelists to consider the likelihood of the events/scenarios described in the statements occurring in the next 5 years as being likely, somewhat likely, somewhat unlikely, or very unlikely. Then, survey panelists assessed the preparedness (from very unprepared to very prepared) for 12 of the statements. Results: The 6 survey themes identified were Urgent Public Health Priorities, Responding to the Mental Health Crisis, Achieving Care Equity, New Disease Paradigms and Treatment Innovations, Workforce: Focus on Culture for the Future, and Artificial Intelligence: Can Ethics and Regulators Catch Up? The survey was completed by 250 respondents, yielding an 88% response rate. Analysis of survey results was provided by chapter authors along with strategic recommendations to guide actions for each theme. Conclusion: The focus of the Pharmacy Forecast is on large-scale, long-term trends that will influence healthcare and the pharmacy profession over months and years and not on day-to-day situational dynamics. The report provides insight to stimulate thinking and discussion and provides a starting point to proactively position leaders, their teams, and departments for potential future events and trends.
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Affiliation(s)
- Joseph T DiPiro
- Professor of Pharmacy, Associate Vice President for Health Sciences - Faculty Affairs, Virginia Commonwealth University, Richmond, VA, USA
| | - James M Hoffman
- Senior Vice President - Quality and Safety, and Member, Pharmacy and Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Pamela Schweitzer
- former Assistant Surgeon General, Chief Pharmacist Officer, US Public Health Service Commissioned Corps, Windsor Mill, MD, USA
| | - Marie A Chisholm-Burns
- Executive Vice President and Provost, Oregon Health & Science University, Portland, OR, USA
| | - Todd W Nesbit
- Vice President for Pharmacy Services, Johns Hopkins Health System, Baltimore, MD
- Chief Pharmacy Officer, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Tanya J Fabian
- Director, Pharmacy Research and Pharmacy Services, UPMC Western Psychiatric Hospital, Pittsburgh, PA
- Associate Professor of Pharmacy & Therapeutics and Psychiatry, University of Pittsburgh Schools of Pharmacy and Medicine, Pittsburgh, PA, USA
| | - Francesca E Cunningham
- Director, VA Center for Medication Safety, Hines, IL
- Associate Chief Consultant, PBM, Department of Veterans Affairs, Hines, IL, USA
| | - Alexis Barrett
- Research Health Science Specialist, VA Center for Health Equity, Research and Promotion, VA Center for Medication Safety/Pharmacy Benefits Management, Services, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Michael J Fine
- Director, VA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, and Distinguished Professor of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Eric Tichy
- Division Chair, Mayo Clinic, Rochester, MN, and Associate Professor, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Inmaculada Hernandez
- Professor, Division of Clinical Pharmacy, University of California, San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA
| | | | - Christy Norman
- Vice President, Pharmacy Services, Emory Healthcare, Atlanta, GA, USA
| | - Scott D Nelson
- Associate Professor, Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yaa Kumah-Crystal
- Associate Professor, Biomedical Informatics and Pediatric Endocrinology, Vanderbilt University Medical Center, Nashville, TN, USA
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2
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Dell KA, Frankart LM, Ogbonna KC, DiPiro JT. Falling NAPLEX pass rates are cause for concern. Curr Pharm Teach Learn 2024; 16:1-4. [PMID: 38129217 DOI: 10.1016/j.cptl.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/04/2023] [Accepted: 11/26/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION First-time pass rates of the North American Pharmacist Licensure Examination (NAPLEX) have declined 7% from 2019 to 2022 with more than a third of schools experiencing a decline of ≥10%. COMMENTARY The cause of the decline is likely multifactorial and extends beyond the impact of the COVID-19 pandemic. Changes to the NAPLEX blueprint in 2021, curricular revisions in response to the implementation of Accreditation Council for Pharmacy Education Standards 2016, and changes to prerequisite course requirements in response to declining enrollment must also be evaluated as potential causes. IMPLICATIONS The academy must respond to this decline by scrutinizing admissions, curriculum, and assessment processes. We urge the National Association of Boards of Pharmacy to provide access to student-level data on NAPLEX performance and increase transparency in passing standard practices to inform this process.
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Affiliation(s)
- Kamila A Dell
- Pharmacotherapeutics and Clinical Research, University of South Florida Taneja College of Pharmacy, 12901 Bruce B. Downs Blvd, MDC 30, Tampa, FL 33612, United States of America.
| | - Laura M Frankart
- Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, 410 N. 12th St., P.O. Box 980581, Richmond, VA 23298, United States of America.
| | - Kelechi C Ogbonna
- Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, 410 N. 12th St., P.O. Box 980581, Richmond, VA 23298, United States of America.
| | - Joseph T DiPiro
- Pharmacotherapy and Outcomes Science, Associate Vice President for Health Sciences, Faculty Affairs, Virginia Commonwealth University, 1012 E. Marshall St., P.O. Box 980549, Richmond, VA 23298, United States of America.
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DiPiro JT, Nesbit TW, Reuland C, Cunningham FE, Schweitzer P, Chisholm-Burns MA, Martinez L, Shane R, Scott CM, Nelson SD, Mize DLE, Van Devender EA, Oyen L. ASHP Foundation Pharmacy Forecast 2023: Strategic Planning Guidance for Pharmacy Departments in Hospitals and Health Systems. Am J Health Syst Pharm 2023; 80:10-35. [PMID: 36450306 DOI: 10.1093/ajhp/zxac274] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Joseph T DiPiro
- Professor of Pharmacy, Associate Vice President for Health Sciences - Faculty Affairs, Virginia Commonwealth University, Richmond, VA, USA
| | - Todd W Nesbit
- Vice President for Pharmacy Services, Johns Hopkins Health System and Chief Pharmacy Officer, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Charles Reuland
- Executive Vice President and Chief Operating Officer, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Francesca E Cunningham
- Director, VA Center for Medication Safety, Hines, IL, and Associate Chief Consultant, PBM, Department of Veterans Affairs, Hines, IL, USA
| | - Pamela Schweitzer
- Assistant Surgeon General and Chief Pharmacist Officer (Ret), US Public Health Service Commissioned Corps, Windsor Mill, MD, USA
| | - Marie A Chisholm-Burns
- Executive Vice, President and Provost, Oregon Health & Science University, Portland, OR, USA
| | - Leyner Martinez
- Director of Pharmacy Services, Baptist Hospital of Miami | Baptist Health South Florida, Miami, FL, USA
| | - Rita Shane
- Vice President and Chief Pharmacy Officer and Professor of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA
| | | | - Scott D Nelson
- Program Director, MS Applied Clinical Informatics (MS-ACI)
- Assistant Professor, Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dara L E Mize
- Assistant Professor, Department of Biomedical Vanderbilt University Medical Center, Nashville, TN
- Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Elva Angelique Van Devender
- Regional Program Manager, Clinical Pharmacy Education, Providence Health & Services, Oregon Region, Portland, OR, USA
| | - Lance Oyen
- Chief Pharmacy Officer, Mayo Clinic, Rochester, MN, USA
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4
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DiPiro JT, Allen DD, Lin A, Scott SA, Sorensen TD, Maine LL. Impact of Social Forces and Environmental Factors on Healthcare and Pharmacy Education: The Report of the 2021-2022 AACP Argus Commission. Am J Pharm Educ 2023; 87:ajpe9452. [PMID: 36781186 PMCID: PMC10159613 DOI: 10.5688/ajpe9452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
| | - David D Allen
- University of Health Sciences and Pharmacy, St. Louis, Missouri
| | - Anne Lin
- Notre Dame of Maryland University, Baltimore, Maryland
| | - Steven A Scott
- Purdue University, College of Pharmacy, West Lafayette, Indiana
| | - Todd D Sorensen
- University of Minnesota, College of Pharmacy, Minneapolis, Minnesota
| | - Lucinda L Maine
- American Association of Colleges of Pharmacy, Arlington, Virginia
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Brazeau GA, Romanelli F, DiPiro JT. Dr. Lucinda Maine: Twenty Years of Supporting Scholarship and the Advancement of the American Journal of Pharmaceutical Education. Am J Pharm Educ 2022; 86:9158. [PMID: 35764414 PMCID: PMC10159492 DOI: 10.5688/ajpe9158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 05/06/2023]
Affiliation(s)
- Gayle A Brazeau
- Marshall University, School of Pharmacy, Huntington, West Virginia
- Editor, American Journal of Pharmaceutical Education
| | - Frank Romanelli
- University of Kentucky, College of Pharmacy, Lexington, Kentucky
- Executive Associate Editor, American Journal of Pharmaceutical Education
| | - Joseph T DiPiro
- Virginia Commonwealth University, Richmond, Virginia
- Editor Emeritus, American Journal of Pharmaceutical Education
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DiPiro JT, Carmichael JM, Johnson VB, Daftary MN, Martinez L, Wiest MD, Patel B, Woller T, Van Devender EA, Shane R, Cunningham F. ASHP Foundation Pharmacy Forecast 2022: Strategic Planning Guidance for Pharmacy Departments in Hospitals and Health Systems. Am J Health Syst Pharm 2021; 79:23-51. [PMID: 34864861 DOI: 10.1093/ajhp/zxab355] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Joseph T DiPiro
- School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia, USA
| | | | | | - Monika N Daftary
- Department of Clinical & Administrative Pharmacy Sciences, Howard University, College of Pharmacy, Washington, DC, USA
| | - Leyner Martinez
- Baptist Hospital of Miami
- Baptist Health South Florida, Miami, FL, USA
| | | | - Binita Patel
- Pharmacy Services, Memorial Hermann Health System, Houston, TX, USA
| | | | | | - Rita Shane
- Department of Pharmacy Services, Professor of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, and Professor of Medicine and Associate Dean, Clinical Pharmacy, UCSF School of Pharmacy, Los Angeles, CA, USA
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7
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Boyle CJ, Allen DD, DiPiro JT, Scott SA, Sorensen TD, Maine LL. Adaptability, Agency, and Association to Influence Change: The Report of the 2020-21 AACP Argus Commission. Am J Pharm Educ 2021; 85:8722. [PMID: 34301583 PMCID: PMC8715969 DOI: 10.5688/ajpe8722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
EXECUTIVE SUMMARY The 2020-21 AACP Argus Commission was charged to 1) review the 2019-2020 standing committee reports; 2) describe the impact of COVID-19 on healthcare delivery with an emphasis on health equity and social justice, 3) identify strategies to work with other health professions associations to advance interprofessional education and practice, and 4) offer recommendations for activities for the Center to Accelerate Pharmacy Practice Transformation and Academic Innovation (CAPT). Two work groups divided charges 2 and 3 and provided assessments of how health care and education might change due to all we have experienced over the 12-plus months of the pandemic. A review of plans for the first year of the CAPT activities and recommendations for additional activities are included in report. The Commission has proposed two new policy statements on digital health, five recommendations for AACP and five suggestions for colleges and schools of pharmacy. The Argus Commission affirms academic pharmacy's adaptability, agency, and association to influence changes in healthcare delivery and interprofessional education and practice.
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Affiliation(s)
- Cynthia J Boyle
- University of Maryland, School of Pharmacy, Baltimore, Maryland
| | - David D Allen
- University of Mississippi, School of Pharmacy, University, Mississippi
| | - Joseph T DiPiro
- Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia
| | - Steven A Scott
- Purdue University, College of Pharmacy, West Lafayette, Indiana
| | - Todd D Sorensen
- University of Minnesota, College of Pharmacy, Minneapolis, Minnesota
| | - Lucinda L Maine
- American Association of Colleges of Pharmacy, Arlington, Virginia
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DiPiro JT, Fox ER, Kesselheim AS, Chisholm-Burns M, Finch CK, Spivey C, Carmichael JM, Meier J, Woller T, Pinto B, Bates DW, Hoffman JM, Armitstead JA, Segovia D, Dodd MA, Scott MA. ASHP Foundation Pharmacy Forecast 2021: Strategic Planning Advice for Pharmacy Departments in Hospitals and Health Systems. Am J Health Syst Pharm 2021; 78:472-497. [PMID: 33539516 PMCID: PMC7944506 DOI: 10.1093/ajhp/zxaa429] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Joseph T DiPiro
- School of Pharmacy, Virginia Commonwealth University, Richmond, VA
| | - Erin R Fox
- Drug Information and Support Services, University of Utah Health, and Adjunct Associate Professor, University of Utah College of Pharmacy, Salt Lake City, UT
| | - Aaron S Kesselheim
- Professor of Medicine, Harvard Medical School, Director, Program on Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Boston, MA
| | - Marie Chisholm-Burns
- University of Tennessee Health Science Center College of Pharmacy, and Professor of Surgery, University of Tennessee Health Science Center College of Medicine, Memphis, TN
| | - Christopher K Finch
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy, Memphis, TN
| | - Christina Spivey
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy, Memphis, TN
| | | | - Joy Meier
- VA Sierra Pacific Network, Pleasant Hill, CA
| | - Thomas Woller
- Pharmacy Services, Advocate Aurora Health, Waukesha, WI
| | | | - David W Bates
- Professor of Medicine, Harvard Medical School, and Chief of General Internal Medicine, Brigham and Women’s Hospital, Boston, MA
| | - James M Hoffman
- Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis TN
| | | | - Dorinda Segovia
- Vice President Pharmacy Services, Memorial Healthcare System, Hollywood, FL
| | - Melanie A Dodd
- The University of New Mexico College of Pharmacy, Albuquerque, NM
| | - Mollie Ashe Scott
- UNC Eshelman School of Pharmacy, Asheville Campus, and Clinical Associate Professor, UNC School of Medicine Division of Family Medicine, Asheville, NC
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Abstract
The COVID-19 pandemic has highlighted the limitations of the current health care workforce. As health care workers across the globe have been overwhelmed by the crisis, oversight entities and training programs have sought to loosen regulations to support ongoing care. Notably, however, workforce challenges preceded the current crisis. Now may be the time to address these underlying workforce challenges and emerge from the COVID-19 pandemic with a stronger health care workforce.Building upon historical exemplars in the context of the current crisis, the authors of this Perspective provide a roadmap to rapidly and safely increase the workforce for COVID-19 and beyond. The authors recommend the following: (1) a comprehensive approach to guide health care workforce development, (2) streamlining transitions to the next level of practice, (3) reciprocity among state licensing boards or national licensure, (4) payment reform to support a strengthened health care workforce, and (5) efforts by employers to ensure the ongoing safety and competence of the bolstered workforce. These steps require urgent collaboration among stakeholders commensurate with the acuity of the pandemic. Implemented together, these actions could address not only the novel challenges presented by COVID-19 but also the underlying inadequacies of the health care workforce that must be remedied to create a healthier society.
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Affiliation(s)
- Alan W. Dow
- A.W. Dow is assistant vice president, Interprofessional Education and Collaborative Care, and professor, internal medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia; ORCID: http://orcid.org/0000-0002-9004-7528
| | - Joseph T. DiPiro
- J.T. DiPiro is dean, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia; ORCID: http://orcid.org/0000-0002-5442-0129
| | - Jean Giddens
- J. Giddens is dean, Virginia Commonwealth University School of Nursing, Richmond, Virginia
| | - Peter Buckley
- P. Buckley is dean, Virginia Commonwealth University School of Medicine, and interim vice president and chief executive officer, Virginia Commonwealth University Health Sciences, Richmond, Virginia
| | - Sally A. Santen
- S.A. Santen is senior associate dean, Evaluation, Assessment and Scholarship, and professor of emergency medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia; ORCID: http://orcid.org/0000-0002-8327-8002
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Chair PAC, Allen DD, Boyle CJ, DiPiro JT, Scott SA, Maine LL. Advancing Our Pharmacy Reformation - Accelerating Education and Practice Transformation: Report of the 2019-2020 Argus Commission. Am J Pharm Educ 2020; 84:ajpe8205. [PMID: 33149341 PMCID: PMC7596599 DOI: 10.5688/ajpe8205] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
The Argus Commission examined changes that should be considered by colleges and schools of pharmacy to meet the bold aim of better integrating pharmacists' and physicians' practices articulated by President Sorensen. The Commission assessed the readiness of pharmacy educators to contribute to the acceleration of practice transformation. The primary focus of the report is on how the doctor of pharmacy curriculum and post-graduate training might be modified and better aligned to ensure that graduates complete their education ready to engage in roles partnered with primary care clinicians. The aim is to achieve comprehensive medication management and other pharmacist patient care services as standards of care. The Argus Commission provides preliminary recommendations for new or more intensified priorities by the 2020-21 AACP Strategic Planning Committee as they update the AACP plan. This includes the recommendation that AACP should create the Center for Academic Innovation and Practice Transformation, a hub to coordinate many current and emerging activities relevant to accelerating change in pharmacy education and practice.
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Affiliation(s)
- Patricia A Chase Chair
- Oregon State University/Oregon Health Sciences University College of Pharmacy, Portland, Oregon
| | - David D Allen
- University of Mississippi, School of Pharmacy, University, Mississippi
| | - Cynthia J Boyle
- University of Maryland, School of Pharmacy, Baltimore, Maryland
| | - Joseph T DiPiro
- Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia
| | - Steven A Scott
- Purdue University, College of Pharmacy, West Lafayette, Indiana
| | - Lucinda L Maine
- American Association of Colleges of Pharmacy, Arlington, Virginia
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Abstract
To address the changes in health care and the needs of society related to medicines, we must redefine the profession of pharmacy. We have defined the next generation pharmacists (NGP) as "a health care provider and change agent on the interprofessional health care team, personalizing medication use, managing safe and effective medication systems, and creating healthier communities." Schools and colleges of pharmacy should thoroughly examine their curriculum to ensure it is preparing pharmacists for this future. By creating a vision for the NGP and implementing the best curriculum, we ensure that pharmacists of the future will be up to the challenge of our society's health care needs..
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Affiliation(s)
- Joseph T DiPiro
- School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
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12
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Piascik P, Boyle CJ, Chase P, DiPiro JT, Scott ST, Maine LL. Reexamining the Academic Partnerships with Federal Pharmacy: 2018-19 Argus Commission Report. Am J Pharm Educ 2019; 83:7655. [PMID: 32001893 PMCID: PMC6983897 DOI: 10.5688/ajpe7655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The Argus Commission examined the history and current status of progressive pharmacy patient care services across several federal branches of government, including the Veterans Administration, Department of Defense, and the U.S. Public Health Service where officers and civilian pharmacists practice in the Indian Health Service, Bureau of Prisons, Area Health Education Centers and other locations. The engagement of pharmacy faculty, students and residents in these practices was assessed. Colleges and schools of pharmacy advocate for the expansion of the capacity for placement of learners in these progressive practices. AACP is encouraged to establish on going collaborations with federal pharmacy leaders to create new opportunities for partnerships that advance patient care, especially for special populations served in these federal programs.
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Affiliation(s)
- Peggy Piascik
- University of Kentucky College of Pharmacy, Lexington, Kentucky, Chair
| | - Cynthia J Boyle
- University of Maryland School of Pharmacy, Baltimore, Maryland
| | - Patricia Chase
- Oregon State University/Oregon Health Sciences University College of Pharmacy, Portland, Oregon
| | - Joseph T DiPiro
- Virginia Commonwealth University School of Pharmacy, Richmond, Virginia
| | - Steven T Scott
- Purdue University College of Pharmacy, West Lafayette, Indiana
| | - Lucinda L Maine
- American Association of Colleges of Pharmacy, Arlington, Virginia, Staff Liaison
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Baker B, DiPiro JT. Evaluation of a Structured Onboarding Process and Tool for Faculty Members in a School of Pharmacy. Am J Pharm Educ 2019; 83:7100. [PMID: 31507295 PMCID: PMC6718493 DOI: 10.5688/ajpe7100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 12/03/2018] [Indexed: 05/26/2023]
Abstract
Objective. To develop and assess the usefulness of a structured onboarding process and tool at a school of pharmacy to improve the overall onboarding experience for new faculty members. Methods. An assessment of a previously existing, informal onboarding process was conducted from January 1 to February 28, 2017. A structured onboarding tool was developed based on interviews with nine recently hired faculty members regarding their experiences with this legacy, unstructured onboarding process. Nine faculty members who onboarded while the legacy onboarding process was in place and six faculty members who onboarded after the new, onboarding tool was in place were included in the study. The experience of the pre-tool cohort was compared to that of the post-tool cohort. Results. More positive responses in the post-tool cohort were obtained compared to the pre-tool cohort in regard to timeline, expectations, and mentorship. More negative responses for the post-tool group were observed for communication. Overall utility of the onboarding tool changed from 56% (pre-tool group) to 80% (post-tool group). Free text feedback included recommendations to rearrange tasks throughout the onboarding process; clarifying mentor responsibilities and expectations; and providing an overview of the checklist to new faculty members on day 1. Conclusion. Overall, a structured onboarding process tool improved the onboarding experience for new faculty members. Given the lack of literature regarding a structured onboarding process in the academic setting, further refinement and analysis of the onboarding tool is needed.
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Affiliation(s)
| | - Joseph T. DiPiro
- School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia
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14
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Bootman JL, Boyle CJ, Chase P, DiPiro JT, Piascik P, Maine LL. Vital Directions for Pharmacy Education and Practice: Report of the 2017-18 Argus Commission. Am J Pharm Educ 2018; 82:7161. [PMID: 30323402 PMCID: PMC6181168 DOI: 10.5688/ajpe7161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The Argus Commission examined the National Academy of Medicine's publication "Vital Directions for Health and Health Care" and engaged with six guests from outside academic pharmacy to identify the salience of the key issues and recommendations for pharmacy education and practice. To be part of the changing health care system we must prepare graduates and faculty to be patient- and community-centered, to command electronic systems of communication with members of interprofessional teams and to create and apply real-world evidence. Sustainable practice models will depend upon the measurement of performance and the assessment of the value produced by clinicians. To that end, the Commission advances a proposed policy related to the knowledge graduates must possess in key areas, including informatics, data analytics, genomics and value-based payment schemes. This will require new forms of faculty development and engagement between AACP members and their communities.
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Affiliation(s)
| | | | - Patricia Chase
- Oregon State University/Oregon Health Sciences University College of Pharmacy
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15
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DiPiro JT. Marking our Milestones: Address of the 2016-2017 President to the Opening General Session at the 2017 Annual Meeting. Am J Pharm Educ 2017; 81:6719. [PMID: 29367780 PMCID: PMC5774200 DOI: 10.5688/ajpe6719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Joseph T DiPiro
- Past President, American Association of Colleges of Pharmacy, Alexandria, Virginia
- Virginia Commonwealth University School of Pharmacy, Richmond, Virginia
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16
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Affiliation(s)
| | | | | | | | | | - Murray P Ducharme
- PK/PD MDS Pharma Services, and Professeur Associe, Faculte de Pharmacie, University of Montreal, Montreal, Canada
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17
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DiPiro JT. Strategic Priorities for AACP: Address of the 2015-2016 President-elect to the AACP House of Delegates. Am J Pharm Educ 2016; 80:S5. [PMID: 27756937 PMCID: PMC5066932 DOI: 10.5688/ajpe807s5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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18
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DiPiro JT. MEET THE PRESIDENT. Am J Pharm Educ 2016; 80:91. [PMID: 27667828 PMCID: PMC5023983 DOI: 10.5688/ajpe80691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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DiPiro JT, Maine LL, Brazeau GA. Enhancing AJPE and pharmacy education--thank you Dr. Jack Fincham. Am J Pharm Educ 2014; 78:174. [PMID: 25657361 PMCID: PMC4315196 DOI: 10.5688/ajpe7810174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Joseph T DiPiro
- American Journal of Pharmaceutical Education Editor Emeritus
| | - Lucinda L Maine
- American Association of Colleges of Pharmacy Executive Vice President and CEO
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DiPiro JT, Crismon ML, Evans RL, Meyer SM, Eddington ND, Lau V. AACP Council of Deans report, July 2013. Am J Pharm Educ 2013; 77:S14. [PMID: 24249870 PMCID: PMC3831420 DOI: 10.5688/ajpe779s14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Parker RB, Ellingrod V, DiPiro JT, Bauman JL, Blouin RA, Welage LS. Preparing clinical pharmacy scientists for careers in clinical/translational research: can we meet the challenge?: ACCP Research Affairs Committee Commentary. Pharmacotherapy 2013; 33:e337-46. [PMID: 24114730 DOI: 10.1002/phar.1348] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Developing clinical pharmacists' research skills and their ability to compete for extramural funding is an important component of the American College of Clinical Pharmacy's (ACCP) vision for pharmacists to play a prominent role in generating the new knowledge used to guide patient pharmacotherapy. Given the recent emphasis on clinical/translational research at the National Institutes of Health (NIH) and the key role of drug therapy in the management of many diseases, there is an unprecedented opportunity for the profession to contribute to this enterprise. A crucial question facing the profession is whether we can generate enough appropriately trained scientists to take advantage of these opportunities to generate the new knowledge to advance drug therapy. Since the 2009 publication of the ACCP Research Affairs Committee editorial recommending the Ph.D. degree (as opposed to fellowship training) as the optimal method for preparing pharmacists as clinical/translational scientists, significant changes have occurred in the economic, professional, political, and research environments. As a result, the 2012 ACCP Research Affairs Committee was charged with reexamining the college's position on training clinical pharmacy scientists in the context of these substantial environmental changes. In this commentary, the potential impact of these changes on opportunities for pharmacists in clinical/translational research are discussed as are strategies for ACCP, colleges of pharmacy, and the profession to increase the number and impact of clinical pharmacy scientists. Failure of our profession to take advantage of these opportunities risks our ability to contribute substantively to the biomedical research enterprise and ultimately improve the pharmacotherapy of our patients.
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DiPiro JT. 2013 Rho Chi Lecture: writing the headlines of tomorrow. Am J Pharm Educ 2013; 77:92. [PMID: 23943931 PMCID: PMC3687125 DOI: 10.5688/ajpe77592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Joseph T DiPiro
- South Carolina College of Pharmacy, Columbia, South Carolina, USA.
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DiPiro JT. Keeping your eyes on the dashboard. Am J Pharm Educ 2012; 76:36. [PMID: 22544953 PMCID: PMC3327234 DOI: 10.5688/ajpe76336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Harrison LC, Congdon HB, DiPiro JT. The status of US multi-campus colleges and schools of pharmacy. Am J Pharm Educ 2010; 74:124. [PMID: 21088729 PMCID: PMC2972518 DOI: 10.5688/aj7407124] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2010] [Accepted: 05/03/2010] [Indexed: 05/22/2023]
Abstract
OBJECTIVE To assess the current status of multi-campus colleges and schools of pharmacy within the United States. METHODS Data on multi-campus programs, technology, communication, and opinions regarding benefits and challenges were collected from Web sites, e-mail, and phone interviews from all colleges and schools of pharmacy with students in class on more than 1 campus. RESULTS Twenty schools and colleges of pharmacy (18 public and 2 private) had multi-campus programs; 16 ran parallel campuses and 4 ran sequential campuses. Most programs used synchronous delivery of classes. The most frequently reported reasons for establishing the multi-campus program were to have access to a hospital and/or medical campus and clinical resources located away from the main campus and to increase class size. Effectiveness of distance education technology was most often sited as a challenge. CONCLUSION About 20% of colleges and schools of pharmacy have multi-campus programs most often to facilitate access to clinical resources and to increase class size. These programs expand learning opportunities and face challenges related to technology, resources, and communication.
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DiPiro JT. New IDEAS to improve the quality of AJPE articles. Am J Pharm Educ 2009; 73:41. [PMID: 19564984 PMCID: PMC2703283 DOI: 10.5688/aj730341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Affiliation(s)
- Joseph T DiPiro
- American Journal of Pharmaceutical Education, South Carolina College of Pharmacy, Columbia, SC 29208, USA.
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DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, Streetman DS, Streetman DAD. Book Review: Pharmacotherapy: A Pathophysiologic Approach, 7th Edition. Ann Pharmacother 2009. [DOI: 10.1345/aph.1l477] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
| | | | - Gary C Yee
- The McGraw-Hill Companies Inc., New York, NY
| | | | | | | | - Daniel S Streetman
- Pharmacotherapy Specialist, Metabolism, Interactions, & Genomics Group, Lexi-Comp, Inc., Hudson, OH
| | - Darcie-Ann D Streetman
- Clinical Pharmacist, Department of Pharmacy Services, University of Michigan Health System, Ann Arbor, MI
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DiPiro JT. American Journal of Pharmaceutical Education. Report of the journal editor. Am J Pharm Educ 2009; 73 Suppl:S1. [PMID: 20344867 PMCID: PMC3058399 DOI: 10.5688/aj7303s01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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DiPiro JT. The best lecture of the year. Am J Pharm Educ 2006; 70:108. [PMID: 17149437 PMCID: PMC1637019 DOI: 10.5688/aj7005108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Mazuski JE, Sawyer RG, Nathens AB, DiPiro JT, Schein M, Kudsk KA, Yowler C. The Surgical Infection Society guidelines on antimicrobial therapy for intra-abdominal infections: an executive summary. Surg Infect (Larchmt) 2006; 3:161-73. [PMID: 12542922 DOI: 10.1089/109629602761624171] [Citation(s) in RCA: 160] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
The Surgical Infection Society last published guidelines on antimicrobial therapy for intra-abdominal infections in 1992 (Bohnen JMA, et al., Arch Surg 1992;127:83-89). Since then, an appreciable body of literature has been published on this subject. Therefore, the Therapeutics Agents Committee of the Society undertook an effort to update the previous guidelines, primarily using data published over the past decade. An additional goal of the Committee was to characterize its recommendations according to contemporary principles of evidence-based medicine. To develop these guidelines, the Committee carried out a systematic search for all English language articles published between 1990 and 2000 related to antimicrobial therapy for intra-abdominal infections. This literature was reviewed individually and collectively by the Committee, and categorized according to the type of study and its quality. Additional articles published prior to 1990 were also utilized when necessary. By a process of iterative consensus, the Committee developed provisional guidelines for antimicrobial therapy for intra-abdominal infections based on this evidence. Following extensive review by members of the Society, these guidelines were approved for publication in final form by the Council of the Surgical Infection Society. This executive summary delineates the Society's current recommendations for antimicrobial therapy of patients with intra-abdominal infections. Topics discussed include the selection of patients needing therapeutic antimicrobials, duration of antimicrobial therapy, acceptable antimicrobial regimens, and identification and treatment of higher-risk patients. Guidelines for patient selection and specific antimicrobial regimens were based on relatively good evidence, but those regarding optimal duration of therapy and treatment of higher-risk patients relied mostly on expert opinion, since there was a paucity of high-quality studies on those issues. Relevant areas for future investigation include the safety, convenience, and cost-effectiveness of available antimicrobial regimens for lower-risk patients, and better means for identifying and treating higher-risk patients with intra-abdominal infections.
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Affiliation(s)
- John E Mazuski
- Department of Surgery, Saint Louis University School of Medicine, St. Louis, MO 63110-1093, and Bronx Lebanon Hospital Center, Bronx, NY, USA.
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Mazuski JE, Sawyer RG, Nathens AB, DiPiro JT, Schein M, Kudsk KA, Yowler C. The Surgical Infection Society guidelines on antimicrobial therapy for intra-abdominal infections: evidence for the recommendations. Surg Infect (Larchmt) 2006; 3:175-233. [PMID: 12542923 DOI: 10.1089/109629602761624180] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Revised guidelines for the use of antimicrobial therapy in patients with intra-abdominal infections were recently developed by the Therapeutic Agents Committee of the Surgical Infection Society (Mazuski et al., Surg Infect 2002;3:161-173). These were based, insofar as possible, on evidence published over the past decade. The objective of this document is to describe the process by which the Committee identified and reviewed the published literature utilized to develop the recommendations and to summarize the results of those reviews. English-language articles published between 1990 and 2000 related to antimicrobial therapy for intra-abdominal infections were identified by a systematic MEDLINE search and an examination of references included in recent review articles. If current literature with regard to a specific issue was lacking, relevant articles published prior to 1990 were identified. All prospective randomized controlled trials, as well as other articles selected by the Committee, were evaluated individually and collectively. Data with regard to patient numbers, types of infections, and results of interventions were abstracted. Studies were categorized according to their design, and all included trials were graded according to quality. On the basis of this evidence, the Committee formulated recommendations for antimicrobial therapy for intra-abdominal infections and graded those recommendations. After receiving comments from invited reviewers and the general membership of the Society, the guidelines were finalized and submitted to the Council of the Surgical Infection Society for approval. The final recommendations related to the selection of patients needing therapeutic antimicrobials, acceptable antimicrobial regimens, duration of antimicrobial use, and the identification and treatment of higher-risk patients. Although numerous publications pertaining to these topics were identified, but nearly all of the prospective randomized controlled trials represented comparisons of different antimicrobial regimens for the treatment of intra-abdominal infections. A few prospective trials evaluated the need for therapeutic antimicrobial therapy in patients with peritoneal contamination following abdominal trauma. The quality of these prospective trials was highly variable. Many did not limit enrollment to patients with complicated intra-abdominal infections, lacked blinding of treatment assignment, did not provide a complete description of the criteria used to determine therapeutic success or failure, failed to identify the reasons why patients were excluded from analysis, or did not include an intention-to-treat analysis. For many issues, no prospective randomized controlled trials were encountered, and guidelines had to be formulated using evidence from studies with historical controls or uncontrolled data, or on the basis of expert opinion
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Affiliation(s)
- John E Mazuski
- Department of Surgery, Saint Louis University School of Medicine, St. Louis, MO 63110-1093, and Bronx Lebanon Hospital Center, Bronx, NY, USA.
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Abstract
Tumor necrosis factor-alpha (TNF-alpha) is a proinflammatory cytokine involved in a wide range of important physiologic processes. This cytokine has a pathologic role in some diseases, and TNF-alpha antagonists are effective in treating inflammatory conditions. Given the putative role of TNF-alpha in host defense against tuberculosis and other infections, the risk of infection with TNF-alpha antagonists is a concern. Therefore, we searched the literature for reports of tuberculosis and other infections associated with TNF-alpha-antagonist therapy. Although tuberculosis was rarely reported in randomized clinical comparisons of these antagonists, case reports and submissions to the MedWatch program of the United States Food and Drug Administration have been numerous. Most instances were associated with infliximab, but etanercept and adalimumab may also be associated with an increased risk of tuberculosis. Histoplasmosis, listeriosis, aspergillosis, coccidioidomycosis, and candidiasis have been associated with TNF-alpha antagonists, but the causative relationship is not clear. Potential recipients of these drugs should be rigorously screened with skin testing, detailed questioning about recent travel and potential tuberculosis exposure, assessment for symptoms such as cough and weight loss, and chest radiography to minimize their risk of acquiring or reactivating tuberculosis. As with other immunosuppressant drugs, TNF-alpha antagonists should not be given to patients with active infection.
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Affiliation(s)
- David J Rychly
- College of Pharmacy, University of Georgia, Athens, Georgia, USA
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Abstract
BACKGROUND The purpose of this study is to determine if there is a difference in renal transplant patients' (RTPs) adherence to cyclosporine compared to tacrolimus when medications are supplied free to the RTPs. METHODS Adult primary RTPs were included in the study if they received a renal transplant at the Medical College of Georgia (MCG) from June 1998 through August 2001 and received their first post-transplant year of follow-up care at MCG and free cyclosporine or free tacrolimus from the MCG outpatient pharmacy. Adherence was estimated by comparing each RTPs' tacrolimus or cyclosporine pharmacy refill records to the prescribed regimen for 12 months after transplant. Patients' cyclosporine and tacrolimus serum concentrations were used to validate adherence. Kaplan-Meier analysis was used to estimate the fraction of RTPs remaining adherent and to compare the mean time RTPs were adherent in each group (cyclosporine vs. tacrolimus). RESULTS Thirty-three RTPs were included in the study, 25 (76%) received cyclosporine and eight received tacrolimus. The mean time to the first non-adherent month was 8 months post-transplant. At 12-months post-transplant, approximately 42% of the patients remained adherent. A greater percentage of the patients who received tacrolimus remained adherent compared with those who were taking cyclosporine (63% vs. 33%, p < 0.05). Approximately 75% of non-adherent patients were found to have subtarget drug concentrations, and only 24% of adherent patients had subtarget levels (p < 0.01). CONCLUSIONS When provided free, patients are more adherent to tacrolimus than cyclosporine. Regardless of treatment, intensive efforts to increase adherence should be implemented.
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Affiliation(s)
- Marie A Chisholm
- University of Georgia College of Pharmacy, Augusta, GA 30912, USA.
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Fisher JF, Woeltje K, Espinel-Ingroff A, Stanfield J, DiPiro JT. Efficacy of a single intravenous dose of amphotericin B for Candida urinary tract infections: further favorable experience. Clin Microbiol Infect 2003; 9:1024-7. [PMID: 14616745 DOI: 10.1046/j.1469-0691.2003.00711.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Studies in experimental animals and humans have shown that Amphotericin B (AmB) persists in urine for days to weeks after a single IV dose in levels that should inhibit candidal organisms and thereby obviate the need for frequent dosing. Including data from four previously described patients, we have now treated a total of 11 patients (12 episodes) with Candida urinary tract infections with single-dose AmB (six, Candida albicans; two, C. tropicalis; four, other nonalbicans Candida). The duration of candiduria prior to entry ranged from 18 to 180 days. Predisposing conditions included renal transplantation (1), diabetes mellitus (8), genitourinary stones (1) or anomalies (4), catheterization (2), and antibacterial therapy (11). A single patient was intolerant of AmB. Out of 11 evaluable candiduric episodes, eight resolved. Failure occurred in one patient with a chronic indwelling bladder catheter and in the allograft recipient. The data suggest that the sustained urinary excretion of AmB may permit successful single- or paucidose therapy of Candida urinary tract infections in some patients with a minimum of toxicity.
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Affiliation(s)
- J F Fisher
- Medical College of Georgia, Augusta, Georgia 30912-4765, USA.
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Solomkin JS, Mazuski JE, Baron EJ, Sawyer RG, Nathens AB, DiPiro JT, Buchman T, Dellinger EP, Jernigan J, Gorbach S, Chow AW, Bartlett J. Guidelines for the Selection of Anti-infective Agents for Complicated Intra-abdominal Infections. Clin Infect Dis 2003; 37:997-1005. [PMID: 14523762 DOI: 10.1086/378702] [Citation(s) in RCA: 379] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2003] [Accepted: 06/30/2003] [Indexed: 02/02/2023] Open
Affiliation(s)
- Joseph S Solomkin
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0558, USA.
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Affiliation(s)
- Marie A Chisholm
- Department of Clinical and Administrative Pharmacy, The University of Georgia College of Pharmacy, Augusta, GA, USA.
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Bailey JA, Virgo KS, DiPiro JT, Nathens AB, Sawyer RG, Mazuski JE. Aminoglycosides for intra-abdominal infection: equal to the challenge? Surg Infect (Larchmt) 2003; 3:315-35. [PMID: 12697079 DOI: 10.1089/109629602762539544] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Aminoglycosides, combined with antianaerobic agents, have been used widely for the treatment of intra-abdominal infection. However, some prospective randomized controlled trials and other data suggested that aminoglycosides were less efficacious than newer comparators for the treatment of these infections. We therefore performed a meta-analysis of all prospective randomized controlled trials utilizing aminoglycosides to reevaluate the efficacy of these agents for the treatment of intra-abdominal infection. METHODS Published English-language prospective randomized controlled trials comparing aminoglycosides with other agents for treatment of intra-abdominal infection were identified by MEDLINE search. For each study, data were collected regarding the number of patients enrolled and evaluated, their basic demographic characteristics, the sources of the intra-abdominal infections, the number of failures as determined by the study investigators, quality score, and the use of serum drug concentrations to monitor aminoglycoside therapy. These data were combined to calculate odds ratios for risk of therapeutic failure, which were assessed for significance using Chi-square analysis. RESULTS Forty-seven prospective randomized controlled trials comparing aminoglycosides to other agents were identified. These were published between 1981 and 2000, and included a total of 5,182 evaluable patients. Analysis of all studies combined revealed an odds ratio that slightly, but significantly, favored the comparators. After excluding six trials using comparators that lacked accepted antianaerobic efficacy, the odds ratio more strongly favored comparators. Trials published since 1990 also notably favored comparators. Analyzing results by quality score or the use of aminoglycoside monitoring did not alter these findings. CONCLUSIONS In this meta-analysis, aminoglycosides were less efficacious than newer comparators for the treatment of intra-abdominal infection. Given the well-known toxicities of these agents, we conclude that they should not be used as first-line therapy for these infections.
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Affiliation(s)
- Jeffrey A Bailey
- Department of Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri 63110, USA.
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Chisholm MA, Mulloy LL, Jagadeesan M, Martin BC, DiPiro JT. Effect of clinical pharmacy services on the blood pressure of African-American renal transplant patients. Ethn Dis 2003; 12:392-7. [PMID: 12148711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
OBJECTIVE The objective of this study was to determine if African-American renal transplant patients who received direct patient care from a clinical pharmacist had better blood pressure control compared to African-American renal transplant patients who did not have clinical pharmacy services. METHODS Renal transplant patients were prospectively randomized into an intervention group or a control group. Patients in the intervention group received clinical pharmacy services that included a clinical pharmacist performing patient medication reviews, with emphasis on preventing or resolving medication-related problems and providing medication recommendations. Patients in the control group received routine clinic services, but had no clinical pharmacist interaction. Analysis was performed to detect differences between the intervention and control groups in baseline and quarterly systolic blood pressure (SBP) and diastolic blood pressure (DBP) for one year post-study enrollment. RESULTS There were no differences between the intervention (N = 13) and control (N = 10) groups in baseline blood pressures or in the percentage of hypertensive patients. Significant differences in the change in SBP and DBP from baseline between the intervention and control groups were observed at the second, third, and fourth quarters of the study, favoring the intervention group (P < .01). Mean SBP was significantly lower in the intervention group at the second (137.8 +/- 15.0 vs 168.9 +/- 15.3), third (135.9 +/- 11.7 vs 164.6 +/- 20.1), and fourth (145.3 +/- 16.8 vs 175.8 +/- 33.9) quarters of the study (P < .05). Mean DBP was significantly lower in the intervention group at the second (76.0 +/- 11.8 vs 84.9 +/- 6.1) and fourth (77.0 +/- 10.2 vs 91.8 +/- 12.0) quarters (P < .05). CONCLUSION Direct patient care services provided by a clinical pharmacist, in addition to routine clinical services, have a positive effect on the blood pressure of African-American renal transplant patients. A multidisciplinary team that includes a clinical pharmacist is beneficial to patient care.
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Abstract
A literature search was conducted to examine the safety and effectiveness of low-dosage methotrexate for treatment and maintenance of remission in patients with inflammatory bowel disease. Nine published articles indicated that for patients with Crohn's disease, oral or intramuscular methotrexate 20-25 mg/week is safe and effective to induce remission, followed by a lower dosage to maintain remission. In addition, methotrexate allows for corticosteroid dosage reduction. Therapy may be continued until the disease flares or adverse events occur. Evidence is insufficient to support methotrexate as treatment for ulcerative colitis.
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