Medicine and Health Sciences Commons^™

Bridging The Gap: Characterization Of A Dual Pharmacist Role In Drug Information And Investigational Drug Services, Lauren Karel, Pharmd, Bcps, Rania Sadaka, Pharmd, Cindy Wordell, Pharmd, Bcps, Fashp

Pharmacy Presentations, Posters, and Grand Rounds

Background

• Thomas Jefferson University Hospital (TJUH) is a tertiary academic medical center with 951 licensed beds

• TJUH offers a wide variety of clinical services, as well as multiple residency programs including a PGY2 specialty residency in Drug Information

• The Investigational Drug Service (IDS) at TJUH is responsible for the procurement, storage, dispensing and maintenance of records for inpatient and outpatient clinical trials

o IDS pharmacy staff ensure study drug medication safety, patient safety, and local, state, national, and federal regulatory compliance for all investigational drug research

A Randomized Placebo-Controlled Pilot Study Of The Efficacy And Safety Of D-Cycloserine In People With Chronic Back Pain., Thomas J. Schnitzer, Souraya Torbey, Kristi Herrmann, Gagan Kaushal, Renita Yeasted, A. Vania Apkarian

College of Pharmacy Faculty Papers

BACKGROUND: Few effective pharmacological treatment options exist for chronic back pain, the leading cause of disability in the US, and all are associated with significant adverse effects.

OBJECTIVE: To determine the efficacy and safety of D-cycloserine, a partial agonist to the N-methyl-D-aspartate receptor, in the treatment of chronic low back pain.

METHODS: A total of 41 participants with chronic back pain who met all inclusion and exclusion criteria were enrolled in a double-blind, placebo-controlled randomized pilot trial of D-cycloserine. Treatment was administered orally for six weeks at escalating daily doses of 100 mg, 200 mg, and 400 mg, each for …

An Interprofessional Clinical Integrations Pilot Program: Integrating Third-Year Pharmd Students Into Family Medicine Clinics, Eric Gilliam, Pharmd, Arian Hilsendager, Fnp, Erin Hagerman, Pa, Benjamin Kirkley, Md, Benjamin Chavez, Pharmd, Kari Franson, Pharmd

JCIPE Conference

Purpose: Pilot an interprofessional student placement model by entrusting Doctor of Pharmacy students to deliver value-added patient engagement within interprofessional clinical environments.

Background: Beginning in January 2016, pharmacy education standards mandate students actively engage in early patient care experiences with interprofessional teams, thus necessitating new models by which students collaborate with providers in the provision of patient care.

Intervention: Between May and August 2016, two family medicine clinics are incorporating 65 third-year pharmacy students into shared medical patient care visits during an interprofessional-provider introductory pharmacy practice experience (IP Provider IPPE) pilot program. Students engage with patients and …

Clinical Impact Of A Novel Interprofessional Dental And Pharmacy Student Tobacco Cessation Education Program On Dental Patients, Matthew Boyd, Pharmd Candidate, Jillian Lykon, Pharmd Candidate, Jacqueline M. Theodorou, Pharmd, Bcps, Melissa E. Rotz, Pharmd, Bcps, Shannon Myers Virtue, Psyd, Elizabeth Waldron, Ba

JCIPE Conference

Objectives:

• To compare the difference between IPE care and standard care (SC) groups regarding dental patients' perceptions of knowledge gained about tobacco cessation, intentions to quit tobacco use, and quit attempts at follow-up.

• To evaluate perceptions of IPE care.

Background:

Based on the link between tobacco use and oral health and the frequent contact between dental providers and patients, the dental clinic is an ideal setting to address tobacco use.1

• Many dentists feel unprepared providing tobacco cessation education, particularly pharmacologic treatment options.1-3

• Pharmacists promote safe and effective pharmacologic treatment options for tobacco dependence and patients’ perceptions …

National Interprofessional Education Initiatives, Abby A. Kahaleh, Phd, Ms, Mph, Bpharm, Kari L. Franson, Phd, Pharmd

JCIPE Conference

Purpose: The goal of this presentation is to define the IPE activities that meet the national competencies and share strategies for designing, implementing, and assessing IPE programs.

Background: According to the World Health Organization (WHO), interprofessional education is defined as students from 2 or more professions learning about, from, and with each other to enable effective collaborations and improve health outcomes. The institute of Medicine (IOM) reports that IPE must be included in the education and training of health care professionals to enhance the delivery of health care services. Most recently, many accrediting agencies have refined IPE to …

Development, Assessment, And Evolution Of An Interprofessional Activity With Senior Nursing And Pharmacy Students: Application Of Quality Improvement In Interprofessional Education (Ipe), Michelle R. Musser, Pharmd, Bcps, Robin White, Phd, Msn, Rn, Lisa Walden, Med, Mls(Ascp)Cm, Erin Petersen, Pharmd, Bcps, Megan Lieb, Msn, Rn

JCIPE Conference

Purpose: Concurrent development IPE activities and an assessment strategy is essential for informed evolution of such initiatives. This study provides an active example of the progression of IPE at an institution utilizing an active assessment plan.

Background: IPE is advocated as a method to develop students who are prepared for interprofessional practice, which is essential for optimal patient outcomes. While IPE has been integrated in many health professional curricula, focus on assessment is needed to ensure obtainment of educational outcomes and truly prepare students for interprofessional collaboration in the work place.

Description of Intervention/Program: IPE activities were …

Pharmacy Strategic Approaches For Ipe Assessment, Abby A. Kahaleh, Phd, Ms, Mph, Bpharm, Sarah Shrader, Pharmd, Michelle Z. Farland, Pharmd, Jennifer Danielson, Pharmd, Elena Umland, Pharmd

JCIPE Conference

Purpose: The main goal of this presentation is to share pharmacy-specific strategies for assessing the structure, process, and outcomes of IPE programs.

Background: An effective assessment plan includes evaluating each component of the IPE model: Structure, Process, and Outcomes. The structure of IPE contains curriculum, facilities, capacity, and technology. The process encompasses development of faculty/preceptors, in addition to engaging students, patients, and collaborative practices. And the outcomes comprise achieving the educational and clinical goals of an IPE program and meeting its vision and mission. There is a need to provide this critical information in a succinct format as …

Designing And Evaluating An Interprofessional Practice Experience Involving Dental And Pharmacy Students, Melissa Rotz, Pharmd, Bcps, Jacqueline Theodorou, Pharmd, Bcps, Maria Fornatora, Dmd, Chizobam Idahosa, Bds, Dds, Ms, Laurie Macphail, Dmd, Phd, Elizabeth Tweddale, Dmd, Shannon Myers Virtue, Psyd

JCIPE Conference

Purpose: To describe the design and evaluation of an innovative interprofessional practice experience involving pharmacy and dental students.

Background: Accreditation standards for pharmacy and dentistry schools mandate that interprofessional education (IPE) is introduced and practiced throughout the curriculum. There is a paucity of data involving interprofessional practice experiences with dental and pharmacy students.

Description of Program: Pharmacy and dental student-teams conduct health and medication histories for patients seen at Temple University’s dental admissions clinic. Additionally, these teams collaborate to conduct tobacco cessation counseling for current tobacco users. This interprofessional practice experience was designed to prepare students to build more effective …

Assessment Of Ipe Core Competencies During Advanced Pharmacy Practice Clinical Experiences, Elena M. Umland, Pharmd., Gerald Meyer, Pharmd, Mba, Andrea Joseph, Ms, Rph

JCIPE Conference

Purpose: To illustrate incorporation of select interprofessional education collaborative (IPEC) competencies into preceptor evaluations of students for advanced pharmacy practice experiences (APPEs). To describe the tool and evaluate the results obtained.

Background: Interprofessional education (IPE) is a necessary component of pharmacy curricula. Pharmacy students at this health sciences university participate in a required two-year, longitudinal IPE program during their first two program years; some students participate in additional IPE programming throughout the final two program years. To evaluate the success of these experiences, student achievement of IPEC competencies during their APPEs in the curriculum’s final year was measured.

Description of …

Development Of An Inter-Professional Root Cause Analysis Workshop Within A Required Medication Safety Course, Ginah Nightingale, Pharmd, Bcop, Marybeth Pavlik, Rn, Msn, Jason J. Schafer, Pharmd, Mph, Bcps, Aahivp, Elena M. Umland, Pharmd

JCIPE Conference

Purpose: To present the development/delivery of an Interprofessional Root Cause Analysis (RCA) Workshop by colleges of pharmacy and nursing at a health sciences university.

Background: Hospitals and regulatory agencies emphasize the significance of patient safety and recommend that medication/patient safety principles be introduced in health care professions’ education. A college of pharmacy’s required Medication Safety course introduces essential content on principles including culture of medication safety, error reporting systems, medication error causes and technology’s influence on errors. One key course element is completing a team-based RCA. This assignment was completed solely by Pharm.D. students (fall 2009-2014). Given increased …

Polypharmacy And Potentially Inappropriate Medication Use In Geriatric Oncology., Manvi Sharma, Kah Poh Loh, Ginah Nightingale Pharmd, Bcop, Supriya G. Mohile, Holly M. Holmes

College of Pharmacy Faculty Papers

Polypharmacy is a highly prevalent problem in older persons, and is challenging to assess and improve due to variations in definitions of the problem and the heterogeneous methods of medication review and reduction. The purpose of this review is to summarize evidence regarding the prevalence and impact of polypharmacy in geriatric oncology patients and to provide recommendations for assessment and management. Polypharmacy has somewhat variably been incorporated into geriatric assessment studies in geriatric oncology, and polypharmacy has not been consistently evaluated as a predictor of negative outcomes in patients with cancer. Once screened, interventions for polypharmacy are even more uncertain. …

Effect Of Vorapaxar Alone And In Combination With Aspirin On Bleeding Time And Platelet Aggregation In Healthy Adult Subjects., Walter K. Kraft, J H Gilmartin, D L Chappell, F Gheyas, B M Walker, S Nagalla, U P Naik, J C Horrow, R E Wrishko, S Zhang, M S Anderson

Department of Pharmacology and Experimental Therapeutics Faculty Papers

The effect of the protease-activated receptor-1 (PAR-1) antagonist vorapaxar on human bleeding time is not known. This was a randomized, two-period, open-label trial in healthy men (n = 31) and women (n = 5). In period 1, subjects received 81 mg aspirin q.d. or a vorapaxar regimen achieving steady-state plasma concentrations equivalent to chronic 2.5 mg q.d. doses, for 7 days. In period 2, each group added 7 days of the therapy alternate to that of period 1 without washout. Bleeding time and platelet aggregation using arachidonic acid, ADP, and TRAP agonists were assessed. Bleeding time geometric mean ratio (90% …

Aptamer-Hybrid Nanoparticle Bioconjugate Efficiently Delivers Mirna-29b To Non-Small-Cell Lung Cancer Cells And Inhibits Growth By Downregulating Essential Oncoproteins., Maryna Perepelyuk, Christina Maher, Ashakumary Lakshmikuttyamma, Sunday A. Shoyele

College of Pharmacy Faculty Papers

MicroRNAs (miRNAs) are potentially attractive candidates for cancer therapy. However, their therapeutic application is limited by lack of availability of an efficient delivery system to stably deliver these potent molecules intracellularly to cancer cells while avoiding healthy cells. We developed a novel aptamer-hybrid nanoparticle bioconjugate delivery system to selectively deliver miRNA-29b to MUC1-expressing cancer cells. Significant downregulation of oncoproteins DNMT3b and MCL1 was demonstrated by these MUC1 aptamer-functionalized hybrid nanoparticles in A549 cells. Furthermore, downregulation of these oncoproteins led to antiproliferative effect and induction of apoptosis in a superior version when compared with Lipofectamine 2000. This novel aptamer-hybrid nanoparticle bioconjugate …

Did A Physician-Targeted Intervention That Reduced Potentially Inappropriate Prescribing To Elderly Patients Also Reduce Related Hospitalizations?, Jacquelyn Mcrae, Pharmd, Sarah E. Hegarty, Pharmd, M. Alcusky, A. Vegesna, S. Varga, S. W. Keith, S. Del Canale, M. Lombardi, Vittorio Maio, Pharmd, Msph

College of Population Health Posters

Objectives:

To determine whether a general practitioner focused intervention aimed at decreasing PIM prescribing in the elderly can decrease the risk of PIM-related hospitalizations.

Poster presented at 2016 ISPOR conference in Washington DC.

Pharmacologic And Clinical Evaluation Of Posaconazole., Jason N. Moore, Jason R. Healy, Walter K. Kraft

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Posaconazole, a broad-spectrum triazole antifungal agent, is approved for the prevention of invasive aspergillosis and candidiasis in addition to the treatment of oropharyngeal candidiasis. There is evidence of efficacy in the treatment and prevention of rarer, more difficult-to-treat fungal infections. Posaconazole oral suspension solution has shown limitations with respect to fasting state absorption, elevated gastrointestinal pH and increased motility. The newly approved delayed-release oral tablet and intravenous solution formulations provide an attractive treatment option by reducing interpatient variability and providing flexibility in critically ill patients. On the basis of clinical experience and further clinical studies, posaconazole was found to be …

Methemoglobinemia In Acetaminophen Overdose And Glucose-6-Phosphate Dehydrogenase Deficiency, Maelen Ignacio, Pharmd, Colin Craft, Md, Fern M. Martin, Md, Cara Mcdaniel, Pharmd, Bcps

College of Pharmacy Posters

Background:

• Methemoglobin (MetHb) is formed when the iron moiety of hemoglobin (Hgb) is oxidized from ferrous (Fe²⁺) to ferric (Fe³⁺) state à impaired O₂ delivery to tissues
• Acetaminophen Metabolism:

~90% is metabolized in liver via sulfation and glucuronidation

remainder is metabolized via CYP450 to a toxic oxidizing agent, N-acetyl-p-benzoquinone imine (NAPQI), which is detoxified via glutathione¹

• Acute Acetaminophen Overdose:

saturates sulfation and glucuronidation pathways

depletes glutathione stores

leads to excess NAPQI à oxidative stress à methemoglobinemia¹

• MetHb Reduction Pathway:

cytochrome b5 reductase removes 95% to 99% of endogenous MetHb

nicotinamide adenine dinucleotide phosphate …