Medicine and Health Sciences Commons^™

Tertiary Drug Information Sources For Treatment And Prevention Of Covid-19., Robert D. Beckett, Yashawna Brattain, Judy Truong, Genevieve Engle

Parkview Pharmacy Department

OBJECTIVE: To evaluate tertiary drug information databases in terms of scope, consistency of content, and completeness of COVID-19 drug information.

METHODS: Five electronic drug information databases: Clinical Pharmacology, Lexi-Drugs, AHFS DI (American Hospital Formulary Service Drug Information), eFacts and Comparisons, and Micromedex In-Depth Answers, were evaluated in this cross-sectional evaluation study, with data gathered from October 2021 through February 2022. Two study investigators independently extracted data (parallel extraction) from each resource. Descriptive statistics were primarily used to evaluate scope (i.e., whether the resource addresses use of the medication for treatment or prevention of COVID-19) and completeness of content (i.e., whether …

Evaluation Of Piperacillin/Tazobactam Utilization In Suspected Urinary Tract Infections At A Community Hospital, Adam P. Yagodinski, Jamie Gaul Pharmd, Bcps, Dana Lorber Pharmd, Bcps, Alissa Keillor Pharmd

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: Evaluate and characterize the utilization of piperacillin/tazobactam in patients with a suspected urinary tract infection (UTI) at a community hospital in Fort Wayne, Indiana.

Medication Use Evaluation Of Angiotensin Ii, Kevin Baumgartner Pharmd, Dustin D Linn Pharmd, Bcccp, Michael Todt Pharmd

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition

Background: Angiotensin II is a vasopressor agent used for septic shock and has been found to effectively raise the blood pressure in patients who did not respond to other conventional high dose vasopressors. Angiotensin II’s wholesale acquisition cost (WAC) of $1800 per vial creates a significant financial burden for health care institutions. A limited warranty manufacturer program replaces angiotensin II vials in patients not achieving an increase in mean arterial pressure (MAP) of at least 10 mmHg or to >65mmHg within the first 3 hours of initiation.

Objective: Evaluate compliance …

Impact Of Pharmacist-Led Direct Oral Anticoagulant Monitoring On Appropriate Medication Use, Bhavika Patel Pharmd, Kenneth Wiley Pharmd, Bcacp, Alicia Sawmiller Pharmd, Bcacp

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Background: Direct oral anticoagulants (DOACs) are the preferred treatment for patients with venous thromboembolism and atrial fibrillation and are an attractive alternative to vitamin K antagonists in multiple indications for long-term anticoagulation. Although DOACs require less frequent clinical monitoring than vitamin K antagonists and their standardized dosing is often more convenient for patients, these medications still require monitoring. Medication adherence, monitoring renal function, hepatic function and drug interactions are important safety concerns for managing patients on DOAC therapy. Previous studies have shown pharmacist can impact monitoring, dosing and adherence to …

Evaluation Of Therapies For Treatment Of Hyponatremia, Laura Fischer Pharmd Candidate, Jennifer Sposito Pharmd, Blake Burton Pharmd, Bcps, Jamie Gaul Pharmd, Bcps

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: Characterize the use and assess the efficacy of tolvaptan and urea in the treatment of patients who were admitted to the hospital with chronic hyponatremia.

Safety Of 10,000 Unit Unfractionated Heparin Boluses For Acute Myocardial Infarction In The Emergency Department, Emma Pastula Pharmd, Sarah Meeks Pharmd, Amber Ooley Pharmd, Bcps, Bcccp, Sarah Ferrell Pharmd

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

The purpose of this retrospective chart-review study is to evaluate the safety and efficacy of a 10,000 unit unfractionated heparin bolus in the emergency department prior to PCI. • The primary objective was percentage of ACT values within goal range of 250-300 seconds. • Secondary objectives included major bleeding rate, weight-based UFH bolus dose in comparison to guideline recommended bolus dose, percentage of initial ACT values within goal range, protamine use, and need for additional UFH boluses.

Comparison Of Clinical Pharmacist Versus Nurse Led Medicare Annual Wellness Visits In The Primary Care Clinic Setting, Payton Waltz Pharmd, Erin Copi Pharmd, Bcacp, Rachel Steele Pharmd, Bcacp

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: To characterize the impact of a primary care pharmacist completing Medicare Annual Wellness Visits by determining:

• Primary: The rate of overall care gap closure by pharmacist-led versus nurse-led visits.

• Secondary: The percentage of recommended care gap opportunities during pharmacist-led versus nurse-led visits and the number of pharmacist made medication interventions during AWVs.

Impact Of Specialty Pharmacy Services On Pneumococcal Vaccination Rates In A Large Inflammatory Bowel Disease Population, Jessica Offerle Pharmd, Tara Jellison Pharmd, Mba,Fashp, Michele Walters Pharmd, Bcps, Bcidp, Toni Zahorian Pharmd, Bcacp

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: The purpose of this study is to assess the impact of clinical specialty pharmacy services and education on compliance with vaccine recommendations in subjects with IBD.

Continued Use Of Proton Pump Inhibitors And Risk For Recurrence Of Clostridium Difficile Infection-A Retrospective Study, Cecilia Schowe Pharmd Candidate, Breia Leavell Pharmd Candidate, Cole Luty Pharmd

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: To determine if the continued use of proton pump inhibitors leads to an increased risk of recurrent Clostridium difficile infections.

Evaluation Of Rituximab Use At Parkview Health, Sarah Stopczynski Pharmd Candidate, Jesse Christman Pharmd, Bcop, Kristen Christman Pharmd, Bcps, Jamie Gaul Pharmd, Bcps

Parkview Pharmacy Department

Poster Presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: Characterize the use of rituximab at Parkview Health by differentiating between inpatient and outpatient use as well as evaluate indications for use, incidence of documented infusion reactions, and biosimilar use.

Characterizing Appropriate Use Of Octreotide Continuous Infusions For Gastroesophageal Bleeding, Austin Harris Pharmd, Curtis Stump Pharmd, Luke Keller Pharmd, Bcps, Bcccp

Parkview Pharmacy Department

Poster Presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: To characterize the appropriate use of octreotide infusions for gastroesophageal bleeding at a community hospital system to pursue guideline-driven standardization of care.

Evaluation Of Intravenous Loop Diuretic Use In Acute Decompensated Heart Failure In A Community Hospital, Catherine Eichler Pharmd, Cole Luty Pharmd, Kris Howard Pharmd, Aacc

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition

Objective: To characterize the use of intravenous loop diuretics in patients hospitalized with fluid overload secondary to acute decompensated heart failure (ADHF) within the heart failure service of a community hospital

Characterization Of Vancomycin Use At A Community Hospital, Caleb Hoppe Pharmd Candidate, Jamie Gaul Pharmd, Bcps, Christina Ford Pharm, Bcpsd

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: To characterize the use of vancomycin medication therapy at a non-profit community hospital (Parkview Regional Medical Center) in preparation for a potential change to AUC:MIC dosing and monitoring.

Systematic Review And Meta-Analysis Of The Correlation Between Bispectral Index (Bis) And Clinical Sedation Scales: Toward Defining The Role Of Bis In Critically Ill Patients., Mojdeh S Heavner, Emily F Gorman, Dustin D Linn Pharm D, Siu Yan Amy Yeung, Todd A Miano

Parkview Pharmacy Department

INTRODUCTION: The bispectral index (BIS) is an attractive approach for monitoring level of consciousness in critically ill patients, particularly during paralysis, when commonly used sedation scales cannot be used.

OBJECTIVES: As a first step toward establishing the utility of BIS during paralysis, this review examines the strength of correlation between BIS and clinical sedation scales in a broad population of non-paralyzed, critically ill adults.

METHODS: We included studies evaluating the strength of correlation between concurrent assessments of BIS and Richmond Agitation Sedation Scale (RASS), Ramsay Sedation Scale (RSS), or Sedation Agitation Scale (SAS) in critically ill adult patients. Studies involving …

Integrating Pharmacists In Hfref Outpatient Care To Improve Use Of Guideline-Directed Medical Therapy, Roy Robertson Md, Mindy Flanagan Phd, Kris Howard Pharmd, Elizabeth Meisberger Pharmd, Emily Keltner Bs, Ma, Lovekirat Singh Ms, Carly Daley Phd, Shauna Wagner Bsn, Rn, Tammy Toscos Phd, Michael Mirro Md, Facc, Fhrs, Faha

Health Services and Informatics Research

Background: Guideline directed medical therapy (GDMT) is the cornerstone of reducing mortality and morbidity in patients with heart failure with reduced ejection fraction (HFrEF); however, uniform prescribing remains low. There is potential for multidisciplinary care teams, including pharmacists, to improve GDMT use in outpatient care for patients with HFrEF. Investigation is needed to understand the impact of pharmacists in outpatient HFrEF care on GDMT prescribing.

Objectives: To examine the impact of integrating a pharmacist into an outpatient cardiology setting on GDMT prescription rates during HFrEF-related clinic visits.

Methods: This retrospective chart review study examined cardiology clinic visits (HF clinic, “general …

Implementing Services For Pediatric Cystic Fibrosis Treatment In A Community Hospital, Paige M. Grube Pharmd

Parkview Pharmacy Department

Presented at the 36th Great Lakes Pharmacy Residency Conference.

Evaluation Of A Pharmacy-Led Statin Medication Use Review And Outreach Initiative, Megan Wagner Pharmd

Parkview Pharmacy Department

Presented at the 36th Great Lakes Pharmacy Residency Conference.

Ketorolac Ceiling Dose Implementation In The Emergency Department, Abigail Geyer Pharmd

Parkview Pharmacy Department

Presented at the 36th Great Lakes Pharmacy Residency Conference

Osteoporosis: Closing Gaps In Care To Improve Value-Based Contract Measure Outcomes, Zachary Brown Pharmd

Parkview Pharmacy Department

Presented at the 36th Great Lakes Pharmacy Residency Conference.

Development Of A Tool To Assess Hypoglycemia Risk In Patients With Type 2 Diabetes, Katherine Brown Pharmd

Parkview Pharmacy Department

Presented at the 36th Great Lakes Pharmacy Residency Conference.

Evaluation Of A Pharmacist-Led Health Literacy Workflow In The Ambulatory Clinic, Alexis Mann Pharmd, Mba

Parkview Pharmacy Department

Presented at the 36th Great Lakes Pharmacy Residency Conference.

Multicenter Retrospective Review Of Ketamine Use In The Icu., Christine M Groth, Christopher A Droege, Kathryn A Connor, Kimberly Kaukeinen, Nicole M Acquisto, Sai Ho J Chui, Michaelia D Cucci, Deepali Dixit, Alexander H Flannery, Kyle A Gustafson, Nina E Glass, Helen Horng, Mojdeh S Heavner, Justin Kinney, Rachel M Kruer, William J Peppard, Preeyaporn Sarangarm, Andrea Sikora, Velliyur Viswesh, Brian L Erstad, Parkview Health

Parkview Pharmacy Department

This publication is included in our collection because several Parkview pharmacists were involved in the data collection part and acknowledged for the assistance they provided to the overall article. See Comment.

The response of ICU patients to continuously infused ketamine when it is used for analgesia and/or sedation remains poorly established.

OBJECTIVES: To describe continuous infusion (CI) ketamine use in critically ill patients, including indications, dose and duration, adverse effects, patient outcomes, time in goal pain/sedation score range, exposure to analgesics/sedatives, and delirium.

DESIGN SETTING AND PARTICIPANTS: Multicenter, retrospective, observational study from twenty-five diverse institutions in the United States. Patients …

Fanconi Syndrome Leading To Hypophosphatemic Osteomalacia Related To Tenofovir Use., Mana Rao, Liam Dadey, Thomas Glowa, Peter Veldkamp

Parkview Pharmacy Department

Tenofovir disoproxil fumarate (TDF) is used worldwide to treat and prevent Human Immunodeficiency Virus (HIV) infection. Fanconi syndrome is a complication of TDF use and is characterized by inadequate reabsorption of glucose, phosphate and protein in the proximal tubule of the kidney which may eventually lead to osteomalacia manifested by symptoms of pain, muscular weakness and difficulty ambulating. We present a patient with severe osteomalacia due to progressive and unrecognized Fanconi's syndrome, who responded rapidly to TDF withdrawal, oral phosphate repletion and calcitriol. With the widespread use of TDF-containing antiviral regimens, it is critically important that physicians adhere to screening …

Intravenous Smart Pumps During Actual Clinical Use: A Descriptive Comparison Of Primary And Secondary Infusion Practices., Karen K Giuliano, Daleen Penoyer, Rebecca S. Mahuren, Melody Bennett

Parkview Pharmacy Department

This descriptive observational study was conducted to increase understanding of medication administration practices during actual clinical use between 2 commonly used, different types of intravenous (IV) smart pumps. Compliance with manufacturer-recommended setup requirements for both primary and secondary infusions and secondary medication administration delay was compared between a head-height differential system and a cassette system. A total of 301 medication administration observations were included in this study: 102 (34%) for the linear peristaltic IV smart pump (medical-surgical: N = 51; critical care: N = 51) and 199 (66%) for the cassette pump (medical-surgical: N = 88; critical care: N = …

Rasburicase Utilization After Protocol Implementation Focused On Fixed Dosing By Limiting Use Of Weight-Based Dosing To Oncology Providers, Dakota Smith Bs, Jamie Gaul Pharmd, Bcps, Liam Dadey Pharmd, Bcps

Parkview Pharmacy Department

Dec 2021 ASHP Midyear Clinical Meeting / Poster

Objective: Evaluate the change in rasburicase use pre- and post-implementation of dosing restriction protocol.

Evaluation Of Benefits Associated With Chemotherapy Dose-Banding Practices, Alexis Mann Pharmd, Mba, Kyle Becker Pharmd, Mba, Bcop, Jesse Christman Pharmd, Bcop

Parkview Pharmacy Department

2021 ASHP Midyear Clinical Meeting / Virtual Meeting / Poster # 1130014

The objective of this study was to evaluate the benefit of applying a 10% rounding strategy with predetermined dose-bands to the current chemotherapy dosing policy at Parkview Health.

Implementation And Outcomes Assessment Of A 4-Factor Prothrombin Complex Concentrate (4f-Pcc) Tiered Fixed Dosing Protocol In A Health System., Mark Botros Bs, Jamie Gaul Pharmd, Bcps, Dana Lorber Pharmd, Bcps, Sarah Koontz Pharmd, Bcps

Parkview Pharmacy Department

2021 ASHP Midyear Clinical Meeting / Poster

The aim of this study was to evaluate compliance to the newly implemented fixed dosing protocol while assessing for the need for repeat doses of 4F-PCC and the need for further invasive intervention to reverse the bleeding.

Evaluation Of Intravenous Immunoglobulin (Ivig) Utilization After The Implementation Of Indication And Dosing Protocol At A Community Health System., Nicholas Buttermore, Jamie Gaul Pharmd, Bcps, Kate Oetting

Parkview Pharmacy Department

2021 ASHP Midyear Clinical Meeting / Poster

Objective: This study was conducted to evaluate the patient landscape of IVIG use within our community health system, both before and after protocol implementation. Our goals were to identify potential changes with the indication for use along with any prescribed dosing decreases while under protocol.

Evaluation Of Calcitonin Use For Hypercalcemia At Parkview Health, Alison Rydell, Jesse Christman Pharmd, Bcop, Jamie Gaul Pharmd, Bcps

Parkview Pharmacy Department

2021 ASHP Midyear Clinical Meeting / Poster

Objective: Evaluate the appropriateness of calcitonin use for hypercalcemia at Parkview Health, a not-for-profit community hospital health system.

Comparison Of Standard Dose Vs Higher Dose Low Molecular Weight Heparin And Unfractionated Heparin For Dvt Prophylaxis In Covid-19 Patients, Zachary Brown Pharmd, Munyaradzi Chakabva Md, Tabinda Akhtar Md, Sarah Polina Pharmd, Bcps, Michael Todt Pharmd, Bcccp, Mckenna Brauner Np, Meghan Mcguire Np, Aws Polina Md

Parkview Pharmacy Department

2021 ASHP Midyear Clinical Meeting / Virtual / Poster # 1121810

Objective: To evaluate whether higher dose VTE prophylaxis results in a significant reduction in VTE events without significant increase in bleeding risk when compared to standard dose VTE prophylaxis in patients with COVID-19 infection