Pharmacy and Pharmaceutical Sciences Commons^™

Feasibility And Acceptability Of A Proposed Pharmacy-Based Harm Reduction Intervention To Reduce Opioid Overdose, Hiv And Hepatitis C, Beth E. Meyerson, Jon D. Agley, Wasantha Parakrama Jayawardene, Lori Ann Eldridge, Prachi Arora, Carriann Smith, Nina Vadiei, Amy K. Kennedy, Taylor J. Moehling

Scholarship and Professional Work – COPHS

Background: Evidence-based harm reduction intervention components which might benefit pharmacy patients have not been integrated and studied.

Objective: To investigate the feasibility and acceptability of a proposed pharmacy-based harm reduction intervention to reduce opioid overdose, HIV and hepatitis C called PharmNet.

Methods: Indiana managing pharmacists were surveyed in 2018 to assess the feasibility and acceptability of an intervention for opioid misuse screening, brief intervention, syringe and naloxone dispensing, and referrals provision. The Consolidated Framework for Implementation Research informed the survey development and analysis.

Result: The sample included 303 (30.8%) pharmacists; 215 (70.9%) provided detailed written comments. Intervention Characteristics: 83.3% believed …

“Put Me In Coach!”: How Pharmacists Can Contribute To Elite Sports, Mel Sturgill

BU Well

Professional and amateur athletes alike often have teams of healthcare professionals that oversee the care of injuries. Among these healthcare professionals, pharmacists have not been included as a member of the care team. Pharmacists are medication experts that can help mitigate medication mistakes and adverse reactions. Additionally, the pharmacist can provide medication information and doping awareness to help athletes reach and maintain their top performance levels in a healthy and safe manner.

Stress: The Silent Sickness, Neethu George

BU Well

From cramming for a test to arguing with a friend, individuals experience stress every day. While stress can be beneficial in certain situations, letting stress get out of control can lead to a variety of mental and physical health issues. This article examines the different types of stress, ways to cope with stress, and the overall effect of stress on human health.

Transcriptomic Analysis Implicates Necroptosis In Disease Progression And Prognosis In Myelodysplastic Syndromes, Guillermo Montalban-Bravo, Caleb Class, Irene Ganan-Gomez, Rashmi Kanagal-Shamanna, Koji Sasaki, Guillaume Richard-Carpentier, Kiran Naqvi, Yue Wei, Hui Yang, Kelly A. Soltysiak, Kelly Chien, Carlos Bueso-Ramos, Kim-Anh Do, Hagop Kantarjian, Guillermo Garcia-Manero

Scholarship and Professional Work – COPHS

Myelodysplastic syndromes (MDS) are characterized by ineffective hematopoiesis and cytopenias due to uncontrolled programmed cell death. The presence of pro-inflammatory cytokines and constitutive activation of innate immunity signals in MDS cells suggest inflammatory cell death, such as necroptosis, may be responsible for disease phenotype. We evaluated 64 bone marrow samples from 55 patients with MDS or chronic myelomonocytic leukemia (CMML) obtained prior to (n=46) or after (n=18) therapy with hypomethylating agents (HMAs). RNA from sorted bone marrow CD34+ cells was isolated and subject to amplification and RNA-Seq. Compared to healthy controls, expression levels of MLKL (CMML: 2.09 log2FC, p=0.0013; MDS: …

Genomic Context And Tp53 Allele Frequency Define Clinical Outcomes In Tp53-Mutated Myelodysplastic Syndromes, Guillermo Montalban-Bravo, Rashmi Kanagal-Shamanna, Christopher B. Benton, Caleb A. Class, Kelly S. Chien, Koji Sasaki ,, Kiran Naqvi, Yesid Alvarado, Tapan M. Kadia, Farhad Ravandi, Naval Daver, Koichi Takahashi, Elias Jabbour, Gautham Borthakur, Naveen Pemmaraju, Marina Konopleva, Kelly A. Soltysiak, Sherry R. Pierce, Carlos E. Bueso-Ramos, Keyur P. Patel, Hagop Kantarjian, Guillermo Garcia-Manero

Scholarship and Professional Work – COPHS

TP53 mutations are associated with adverse outcomes and shorter response to hypomethylating agents (HMAs) in myelodysplastic syndrome (MDS). Limited data have evaluated the impact of the type, number, and patterns of TP53 mutations in response outcomes and prognosis of MDS. We evaluated the clinicopathologic characteristics, outcomes, and response to therapy of 261 patients with MDS and TP53 mutations. Median age was 68 years (range, 18-80 years). A total of 217 patients (83%) had a complex karyotype. TP53 mutations were detected at a median variant allele frequency (VAF) of 0.39 (range, 0.01-0.94). TP53 deletion was associated with lower overall response rate …

The Value Driven Pharmacist: Basics Of Access, Cost, And Quality 2nd Edition, Carriann Smith, Annette Mcfarland, Chad Knoderer, Joseph Jordan, Trish Devine, Jessica Wilhoite

Butler University Books

No abstract provided.

Understanding The Healthcare Experiences And Needs Of African Immigrants In The United States: A Scoping Review, Ogbonnaya I. Omenk, Dennis P. Watson, Hugh C. Hendrie

Scholarship and Professional Work – COPHS

Background: Africans immigrants in the United States are the least-studied immigrant group, despite the research and policy efforts to address health disparities within immigrant communities. Although their healthcare experiences and needs are unique, they are often included in the “black” category, along with other phenotypically-similar groups. This process makes utilizing research data to make critical healthcare decisions specifically targeting African immigrants, difficult. The purpose of this Scoping Review was to examine extant information about African immigrant health in the U.S., in order to develop lines of inquiry using the identified knowledge-gaps.

Methods: Literature published in the English language between 1980 …

The Effects Of A Glp-1 Receptor Agonist On Hba1c And Weight In Comparison To Standard Therapy In A Veteran Population, Isaac Warshawsky

Undergraduate Honors Thesis Collection

Glucagon-Like Peptide 1 Receptor Agonists (GLP-1 RAs) present a novel therapy for use in Type 2 Diabetes Mellitus (T2DM) patients to reduce Hemoglobin A1c (HbA1c) and weight. GLP-1 RAs are costly medications and are not currently on the national formulary for Veterans Affairs medical centers. This study looks to explore the efficacy data in a veteran population.

Evaluation Of Attendance, Patient Satisfaction, Knowledge, And Clinical Outcomes Following Participation In A Group Diabetes Self-Management Education And Support Program In A Primary Care Clinic Setting, Jordan Rauh

Undergraduate Honors Thesis Collection

Introduction: Although group Diabetes Self-Management Education and Support (DSMES) programs have been attempted throughout Community Health Network, no evaluation of the programs had been conducted.

Objectives: The primary objectives of this study were to evaluate attendance, patient satisfaction and change in disease state knowledge following participation in six sessions of a group DSMES program led by a multidisciplinary team. The secondary objective was to evaluate clinical outcomes.

Methods: This retrospective, observational study focused on process improvement evaluating a standardized approach to a group DSMES program beginning in August 2017 within Community Health Network. Eleven courses ran six sessions lasting approximately …

Counseling On Exercise: The Pharmacist's Role, Katelyn Hettinger

Undergraduate Honors Thesis Collection

Only one in three adults in the United States meets the weekly physical activity recommendations, and only 5% of adults are active for at least 30 minutes a day.¹ Exercise is a key component of health and wellness, especially for patients already experiencing comorbid conditions. Exercise has been proven to help alleviate pain in patients experiencing anything from low back pain to fibromyalgia and has been a helpful adjunct in diabetes management.² Pharmacists are in an exciting position to advocate for changes in patients’ lifestyles daily and are in an incredibly accessible position to do so. However, exercise …

The Impact Of Nurse Stress, Job Distress, Job Satisfaction And Mood On Patient Outcomes, Madelynne Wright

Undergraduate Honors Thesis Collection

This study examined the intercorrelations among nursing home healthcare providers’ stress, job distress, job satisfaction, and mood, as well as the relationships between these factors and patient outcomes. Additionally, this study investigated the impact Butler University’s Music First! program had on nurse job perceptions. A total of 63 nurses from 9 long-term care facilities completed questionnaires asking about stress, job distress, and global job satisfaction. Nurses’ depression, anxiety and hostility were also assessed with a 15-item Profile of Mood States questionnaire. Of these 63 nurses, 20 completed the questionnaires at three different time points during the implementation of the Music …

Evaluating The Impact Of Verigene® Organism Identification On Antimicrobial Stewardship Recommendations, Rebecca Gerske

Undergraduate Honors Thesis Collection

Verigene® is one of many commercially available rapid diagnostic tests (RDT) for organism identification in blood culture. Community Health Network (CHNw) utilizes this system to identify blood cultures and guide antimicrobial therapy. As antibiotic resistance becomes more and more prevalent, limiting exposure to broad-spectrum antibiotic therapy is of paramount importance. RDT provides more timely information to providers, which if utilized appropriately, can result in the patient receiving appropriate antibiotic therapy in a shorter time and further limits unnecessary antibiotic exposure. This study was a three-part, retrospective chart review to determine the microbiological accuracy of Verigene® within CHNw and evaluate the …

Novel Targeting Approaches Of Nanoparticles For Anticancers Drug Delivery: A Focused Review, Yatri S. Patel, Nandita Das, Sudip Das

Scholarship and Professional Work – COPHS

Nanoparticles have presented a new paradigm in anticancer drug delivery to reduce adverse effects and improve therapeutic outcomes. Nanoparticle surface properties and morphology significantly affect the drug delivery to tumors while passive targeting. Conjugations with hyaluronic acid, transferrin and aptamers have shown to be effective in active targeting of anticancer drugs to tumor tissues. This review presents an overview of some credible techniques of passive and active drug delivery to tumors.

Resident Physicians’ Perceptions Of Ambulatory Care Pharmacy, Ashley Meredith, Darin Ramsey, Andrew Schmelz, Rachel Berglund

Scholarship and Professional Work – COPHS

Background: Physicians' acceptance of clinical pharmacy services is dependent on exposure to those services, with use increasing as resident physicians progress through their training. Resident physicians train within environments that have a multidisciplinary teaching and clinical care approach, working closely with other healthcare professionals. Ambulatory care pharmacists are increasingly working with resident physicians in clinic settings as part of the multidisciplinary team, and identification of resident physicians’ perceptions may influence future collaboration.

Objective: The objective of this research is to evaluate the perception of ambulatory care clinical pharmacy services from the perspective of resident physicians.

Methods: A statewide network of …

Extended Infusions Of Meropenem For Febrile Neutropenia, Daniel J. Przybylski, Pharmd, David J. Reeves, Pharmd, Bcop

BU Well

Background: Neutropenic fever is an oncologic emergency that requires quick intervention with anti-pseudomonal beta-lactam antibiotics, such as meropenem. Previous literature suggests that extended infusions of beta-lactam antibiotics may improve clinical outcomes. To date, there are 3 prior studies utilizing an extended infusion beta-lactam in this population; however, there is only one previous study investigating the use of extended infusion meropenem in patients with febrile neutropenia.

Objective: To describe the outcomes of eight patients receiving extended infusions of meropenem for the treatment of febrile neutropenia.

Methods: A retrospective chart review was completed including adult patients admitted to a community teaching hospital …

Characteristics Of Patients Experiencing Extrapyramidal Symptoms Or Other Movement Disorders Related To Dopamine Receptor Blocking Agent Therapy, Shaina Musco, Laura Ruekert, Jaclyn Myers, Dennis Anderson, Michael Welling, Elizabeth Ann Cunningham

Scholarship and Professional Work – COPHS

Purpose/background: Dopamine receptor blocking agents (DRBAs), also known as antipsychotics, are medications widely used to treat a growing number of mental health diagnoses. However, their utility is limited by the potential to cause serious adverse movement reactions. Akathisia, dystonia, parkinsonism, and tardive dyskinesia (collectively known as extrapyramidal symptoms or EPSs) are associated with reduced social and occupational functioning, negative patient attitudes toward treatment, and nonadherence to pharmacotherapy. Neuroleptic malignant syndrome is a life-threatening reaction that can result from DRBA use and cause musculoskeletal dysfunction. The aim of this study is to profile patients who have developed DRBA-related movement adverse effects …

Addressing Drug Misuse On A College Campus: An Academic And Resource Driven Approach, Deborah Ebbinghaus

Undergraduate Honors Thesis Collection

In recent years, the United States has experienced an epidemic of drug misuse. Many studies have indicated those in the typical college age demographic of eighteen to twenty-five years of age are particularly at risk. This research examines prescription drug misuse on college campuses, with the aim of proposing additional resources for the University. It has three components: a literature analysis, a policy, procedure, and resource review, and new resource development. The literature review will examine journal articles published after January 1, 2010 related to prescription misuse in collegians. It also examines state and university specific data. The policy, procedure, …

Assessment And Analysis Of H.Pylori Infection Treatment Strategies Of St. Vincent Hospital's Family And Internal Medicine Clinics, Rebecca Orr

Undergraduate Honors Thesis Collection

Helicobacter pylori is a gram-negative bacteria that is responsible for causing chronic gastritis, ulcers in the stomach and intestine, and eventually even gastric lymphoma or cancer. Multiple treatment options have been recommended for treating an H. pylori infection based on kidney function, previous antibiotic exposure, and whether or not the infection is recurrent. The most common regimens used at St. Vincent's primary care centers closely mimic the American College of Gastroenterology's clinical guidelines. However, these medications (clarithromycin and levofloxacin) have been associated with high rates of resistance in other countries. The United States has very limited data on H. pylori's …

Effect Of Rurality On Diabetes-Related Hospitalizations In A Small Acute Care Hospital In Jackson County, Indiana, Lindsey Ridlen

Undergraduate Honors Thesis Collection

Patient access to healthcare can be a potentially significant barrier to overall health outcomes, especially when paired with a costly and complex disease state such as diabetes. The purpose of this study was to determine if patients with Type 2 diabetes mellitus living in rural areas of Jackson County experience greater health disparity and more diabetes-related hospitalizations than those living in non-rural areas. The study was conducted at Schneck Medical Center in Seymour, Indiana. A total of 164 patients were included in the final analysis based on the presence of a diabetes-related diagnosis code in the patient’s chart; of these, …

Comparison Of Patient Outcomes In A Pharmacist-Led Outpatient Parenteral Antimicrobial Therapy Program, Zachary Howe

Undergraduate Honors Thesis Collection

Purpose: Outpatient parenteral antimicrobial therapy (OPAT) is a therapeutic option meant to conserve healthcare resources when treating infections requiring the administration of IV antibiotics over a prolonged treatment course. In November 2016 at Franciscan Alliance Indianapolis, a dedicated pharmacist was hired to build a formal OPAT program for all patients discharged on IV antimicrobials under the care of the infectious disease physician group. The number of “good catch” events observed since the program’s formal inception has encouraged the creation of this study designed to examine the impact of this program on patient outcomes and antimicrobial stewardship.

Methods: This was a …

Evaluation Of An Outpatient Parenteral Antimicrobial Therapy Program In A Specialty Clinic Setting, Elizabeth Hauk

Undergraduate Honors Thesis Collection

Introduction: Outpatient parenteral antimicrobial therapy (OPAT) has gained popularity since its first description in 1974. At Community Health Network (CHN), the OPAT clinic was developed three years ago by an ambulatory care clinical pharmacist and includes pharmacist driven monitoring for all patients receiving OPAT. The pharmacist ensures labs are drawn weekly to assess for renal or hepatic function changes, medication levels are drawn and adjusted as needed, and repeat labs and levels are ordered to continue assessing therapy. There have not been any studies to date to investigate CHN’s OPAT program both demographically and clinically.

Objectives: The primary objective of …

The Motivations And Perceived Benefits Of Student Participation In Dance Marathon, Emily Nettesheim

Undergraduate Honors Thesis Collection

The Children’s Miracle Network Dance Marathon movement has attracted over one million college students nationwide and fundraised over $38 million in 2017. The objective of this study was to determine student motivations and perceptions of the benefits of participation in Dance Marathon. This was a quantitative and qualitative cross-sectional study administered using an online survey software. Undergraduate students from three different Indiana programs were invited to participate. The survey consisted of 20 questions divided into four categories: demographics, what is Dance Marathon participation, motivations, and perceived benefits from DM involvement. There were 161 respondents out of 1492 recipients for an …

Impact Of Rapid Meca Polymerase Chain Reaction Rapid Diagnostic Testing For Staphylococcus Aureus In A Pediatric Setting, Emily Drwiega

Undergraduate Honors Thesis Collection

Rapid molecular technology can detect the mecA resistance gene in Staphylococcus aureus (SA), predicting methicillin susceptibility in under one hour. In combination with antimicrobial stewardship program interventions in adults with SA bacteremia, rapid mecA testing decreases time to targeted therapy. This intervention has not yet been shown effective in pediatric patients or in the absence of real-time stewardship interventions. The objective of this study was to determine if time to optimal therapy decreased following implementation of GeneXpert rapid diagnostic testing (RDT) in a pediatric institution without a formal antimicrobial stewardship protocol for response. The primary outcome was time to optimal …

Implications Of Student Debt On Financial Wellness: Can Universities Help?, Anne Leighty

Undergraduate Honors Thesis Collection

Introduction. Exploring whether or not students feel prepared financially for graduation is a useful exercise for universities as the results can provide ways to better support their students as they move into life after graduation. Financial wellness plays a role in a person’s overall wellness and happiness. This could be of particular concern for pharmacy students due to increasing cost of education and typically, a minimum of six years of education is required. If universities implemented better ways to educate their students on student loans and financial well-being, new graduates could have decreased financial anxiety, as well as improved overall …

Are We Making Smart Pumps Smarter?, Brittany Schaefer

Undergraduate Honors Thesis Collection

Background: Medication errors comprise a significant proportion of medical errors, and are abundant, costly, and associated with causing harm to patients via adverse drug events. The most serious medication errors often involve IV medications. Smart pumps were developed to improve patient safety by reducing medication errors. While some studies have found that smart pumps do not decrease medication errors, most have found they are effective to some degree. It is believed that routinely analyzing data on smart pump alerts, making corresponding adjustments in the drug libraries, and analyzing those adjustments can reduce alarm fatigue, which may then decrease medication errors …

Evaluation Of Medication Risks For Falls On An Inpatient Medical/Surgical Unit, Joseph Zegar

Undergraduate Honors Thesis Collection

Purpose: Patient falls during hospitalization can delay discharge and decrease quality of life. Medications are one factor that can impact fall risk. This study examines patients who fell while admitted to a cardiac surgery unit to identify which high-risk medications are most prevalent to promote patient safety.

Methods: This was a retrospective case control study. Adult patients over the age of 18 were included. Exclusion criteria included pediatric patients and those with an intentional fall event. A total of 39 falls and 78 controls were analyzed in the study. The primary outcome was a fall event during hospitalization. Other variables …

Evaluation Of An Unfractioned Heparin Pharmacy Dosing Protocol For The Treatment Of Venous Thromboembolism In Nonobese, Obese, And Severely Obese Patients, Chad A. Knoderer, Lindsey M. Hosch, Emily Y. Breedlove, Lauren E. Scono

Scholarship and Professional Work – COPHS

Background: Despite large interpatient variability in dose response, heparin is utilized for treatment of venous thromboembolism (VTE). Current data on the optimal heparin dosing in obese patients are conflicting. Objective: The objective was to evaluate the time and dose required to achieve a therapeutic activated partial thromboplastin time (aPTT) in nonobese, obese, and severely obese patients using a pharmacist-directed heparin dosing protocol. Methods: This was a retrospective cohort study in a single-center community hospital inpatient setting. Adult patients receiving heparin for VTE treatment from July 1, 2013, to July 31, 2015, were evaluated. Patients were categorized into 3 groups: nonobese …

A1c Reduction And Weight Loss In A Veteran Population Using Glp-1-Ras, Shelby L. Beutel Darrow

Undergraduate Honors Thesis Collection

Background: Diabetes mellitus is a metabolic disorder defined by high blood glucose. Glucagon-like peptide-1 receptor agonists (GLP-1-RAs) are a newer class of medications that offer potential 2 to 3 kg weight loss and a 1% to 1.5% decrease in A1c. At the Indianapolis Veterans Affairs Medical Center (VAMC), GLP-1-RAs are non-formulary.

Objectives: Primary outcomes included mean change in weight, body mass index (BMI) and A1c in VAMC patients. Secondary outcomes included the comparison to published values, analysis of insulin needs, and analysis of GLP-1-RA discontinuation reasons.

Methods: Indianapolis VAMC patients ages 18-80 with type 2 diabetes who started a GLP-1-RA …

Do You Have Any Questions For The Pharmacist?, Rachel Mays

BU Well

As perhaps the single-most common inquiry in modern healthcare, the question, “Do you have any questions for the pharmacist?” represents not only an integral step in pharmacy workflow, but also an excellent opportunity for healthcare consumer education. Pharmacy counseling serves as arguably the most convenient, accessible avenue for the public to gain medication-related information in an ever-busying and demanding American healthcare culture. Unfortunately, no “one size fits all” approach to pharmacy counseling exists, and delivering meaningful, effective education requires acknowledgement of a variety of patient-specific factors. This article ex­plores the utilization of Myers-Briggs Type Indicator test results to determine impactful …

Crispr: The Last Piece Of The Genetic Puzzle, Brad Broyles

BU Well

CRISPR/Cas9 is an emerging gene editing tool. This technology, which evolved naturally as a defense mechanism for bacteria and other prokaryotes, has been repurposed to edit genes in a wide array of cells, including human cells. This paper outlines the discovery, mechanism, and potential applications of CRISPR/Cas9.