Pharmacy and Pharmaceutical Sciences Commons^™

Comparing Cardiometabolic Monitoring And Side Effect Management In A Pharmacist-Led Ambulatory Clozapine Clinic Versus Standard Care., Nicholas Buttermore Pharmd, Jenna Gilbert Pharmd, Bcpp, Naana Boachie Pharmd, Bcacp, Kenneth Wiley Pharmd, Bcacp, Sarah Ferrell Pharmd, Bcpps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This study found that cardiometabolic monitoring rates were significantly higher in the pharmacist group compared to standard care, and that clozapine-related side effects were screened more frequently.

Evaluation Of Cardiometabolic Monitoring In Patients Taking Antipsychotic Agents Within A Community Health System., Kendra Yarian Pharmd, Jenna Gilbert Pharmd, Bcpp, Libby Stabler Pharmd, Bcacp, Quyen Nguyen Pharmd, Bcacp, Leia Gaddis Pharmd, Bcps, Dpla

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This evaluation found that the majority of patients on antipsychotic agents do not have all baseline monitoring completed, and that there are significant gaps especially in lipid panel and hemoglobin A1c. Other parameters (e.g., blood pressure, weight) were more likely to be gathered, likely as part of routine visit procedure.

Medication Use Evaluation Of Fecal Microbiota Spores (Live-Brpk) For The Prevention Of Recurrent Clostridioides Difficile Infection., Haley Michaud Pharmd, Trent Towne Pharmd, Bcps, Sarah Ferrell Pharmd, Bcpps, Bhavika Patel Pharmd, Noah Budi Pharmd

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This medication use evaluation found that infectious diseases providers were more likely to prescribe advanced treatments such as fidaxomicin or fecal microbiota compared to other specialties. Of the 93.1% of patients seen by Infectious Disease, 62.9% (n=17) of those patients were prescribed fecal microbiota spores (live-brpk) (VOWST). Of the 29 eligible patients, 41.4% (n=12) were identified as missed opportunities.

Optimization Of Beta-Lactam Dosing In Critically Ill Patients With Continuous Veno-Venous Hemofiltration Or Augmented Renal Clearance., Kristin Lytal Pharmd, Mspgx, Robert D. Beckett Pharmd, Bcps, Luke Keller Pharmd, Bcps, Bcccp, Michael Todt Pharmd, Bcccp

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This evaluation found that traditional dosing of beta-lactams found in practice is often (20 to 90%) suboptimal when compared to ideal evidence-based dosing, that optimizes efficacy while limiting adverse effects from drug toxicity.

Dofetilide Initiation In A Tertiary Medical Center: A Medication Use Evaluation., Zhixi Lui Pharmd, Kris Howard Pharm, Aacc, Megan Straub Pharmd, Bcps, Elizabeth Meisberger Pharmd, Bcps, Bccp, Sarah Ferrell Pharmd, Bcpps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This evaluation found that adherence to a pharmacist-managed protocol significantly increased dofetilide continuation rates at discharge and six months. Future implementation includes refining the current dofetilide order set, expanding the pharmacist’s role in dose selection, and standardizing documentation and intervention notes to improve protocol adherence.

Drop-It Like It’S Hot: A Droperidol Medication Use And Efficacy Evaluation In A Community Health System., Caleb Hoppe Pharmd, Sarah Meeks Pharmd, Allison Clemens Pharmd, Robert D. Beckett Pharm D

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This study found that higher doses of droperidol for abdominal pain could provide more analgesic benefit without compromising patient safety. While droperidol appears effective at relieving nausea, other more cost-effective anti-emetics may be trialed first (without diphenhydramine). Droperidol appeared to provide light sedation, although most doses were low and used on patients without severe agitation (e.g. RASS ≥ 3).

Optimizing Serum Magnesium Monitoring And Replacement In A Community Hospital., Gabrielle O. Carreon Pharmd, Ms, Jesse Christman Pharmd, Bcop, Joshua Winebaugh Pharmd, Bcps, Robert D. Beckett Pharmd, Bcps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

Findings highlight the need to revise our healthcare system’s standard hematology/oncology treatment plans to better align with appropriate magnesium monitoring, with up to 93% of magnesium lab draws potentially being unnecessary, and replacement, including better utilization of oral magnesium formulations instead of IV which can lower costs.

Discharge Antibiotic Use In Patients Hospitalized With Chronic Obstructive Pulmonary Disease (Copd) Exacerbations., Jennifer Mccarthy Pharmd, Ms, Sarah Pfaehler Pharmd, Mba, Bcps, Pacs, Ross Witte Pharmd, Bcps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This medication use evaluation identified opportunities for improved prescribing in this population. The majority of patients receiving antibiotics had increased dyspnea only. Because of this, 90% of patients did not receive antibiotics appropriately; 94% received an excessive duration. The majority of patients had no prior to admission COPD maintenance therapy, potentially related to lack of baseline FEV1 data required for initiating therapy classification.

Using A Modified Delphi Panel To Develop Best Practices In Course Evaluations Of Teaching., Ma. Emmanuelle (Ella) Domingo Vogt Pharmd, Robert D. Beckett Pharmd, Monica Miller Pharmd, Ms, Alex N. Issacs Pharmd, Ms

Parkview Pharmacy Department

Presented at AACP Annual Meeting. Boston, MA: July 2024.

This study generated best practices colleges of pharmacy should employ when conducting student evaluations of teaching and courses.

Best Practices For Pgy1 Letters Of Intent: Recommendations From A Modified Delphi Process., Robert A. Bechtol, Aleda M.H. Chen, Diana M. Sobieraj, Bupendra Shah, Robert D. Beckett Pharmd, Jill Augustine

Parkview Pharmacy Department

Presented at ACCP Virtual Poster Symposium. Lenexa, KS: May 2024.

This study generated best practices student pharmacists pursuing residency training should employ when preparing a letter of intent.

Adherence To The Prisma 2020 Guideline: An Evaluation Of Meta-Analyses And Systematic Reviews Published In Pharmacy Journals., Kendall Littlefield, Samantha Alspaugh, Andrew Forte Pharmd, Robert D. Beckett Pharmd, Bcps

Parkview Pharmacy Department

Presented at ACCP Virtual Poster Sessions. Lenexa, KS: May 2024

This cross-sectional evaluation study found that, on average, published meta-analyses in pharmacy journals are adherent to PRISMA best practices, though several areas, related to background and rationale of the study, discussion items, and search strategy, were identified for improvement.

Penicillin Allergy De-Labeling: Evaluating A Health System’S Implementation Of The Pen-Fast Tool Within An Infectious Disease Clinic., Jennifer Mccarthy Pharmd, Ms

Pharmacy Residency

Presented at the Great Lakes Pharmacy Residents Conference. West Lafayette, IN: April 2024.

This retrospective, post-implementation study found that 81% of patients with a documented penicillin allergy could be de-labeled, and that the majority could theoretically tolerate a penicillin challenge.

Identifying Improvement Opportunities For The Utilization Of Carbapenems At A Community Health System., Kendra Yarian Pharmd

Pharmacy Residency

Presented at the Great Lakes Pharmacy Resident Conference. West Lafayette, IN: April 2024.

This study found opportunities to improve utilization of carbapenems, such as by delabeling inappropriate penicillin and cephalosporin allergies, modifying order sets, providing education, and initiating alerts to prompt de-escalation.

Shock And Awe: An Angiotensin Ii Clinical Outcomes Assessment., Caleb Hoppe Pharmd

Pharmacy Residency

Presented at the Great Lakes Pharmacy Residents Conference. West Lafayette, IN: April 2024.

In this retrospective cohort study, angiotensin II was not found to have a benefit on morbidity and mortality compared to placebo. However, further prospective, randomized controlled trials are needed to identify patient subgroups who might benefit.

Evaluation Of Triple Therapy Use For Copd, Jessica Offerle Pharmd

Pharmacy Residency

Presented at the Great Lakes Pharmacy Residents Conference. West Lafayette, IN: April 2024.

This retrospective, cross-sectional study found that nearly all patients were not administered pulmonary function testing prior to treatment with COPD triple therapy (inhaled corticosteroid plus long-acting muscarinic-antagonist plus long-acting beta-2-agonist). Additionally, the vast majority did not have a documented elevated eosinophil count. These represent good opportunities to optimize population-based care for COPD patients.

Implementing Services For Pediatric Cystic Fibrosis Treatment In A Community Hospital., Paige Grube, Heather Nichols, Sarah Ferrell Pharmd, Denise Gilham Pnp, Allyson Gaylor Pharmd, Bcpps, Karen Dunkelberger Bs Pharm, Mshi, Cpps

Pharmacy Residency

This project aimed to describe how the pharmacy department prepared to care for pediatric patients with cystic fibrosis, a new population being cared for at the institution.

PURPOSE: Our community hospital was recently charged with providing care for pediatric people with cystic fibrosis (PwCF). Pediatric PwCF generally need a higher level of care than is required by other pediatric patients cared for at our institution. This project aimed to prepare the pharmacy department to care for this specialized population safely and efficiently.

SUMMARY: The implementation process was divided into 3 phases to accomplish the larger purpose. These phases were as …

Evaluation Of Intravenous Immunoglobulin Utilization In Pediatric And Neonate Population Within A Community Health System., Hannah Davis Pharm D Candidate, Robert D. Beckett Pharmd, Bcps, Heather Nichols Pharm D, Bcpps, Norm Fenn Bcps, Bcpps

Parkview Pharmacy Department

This project evaluated appropriateness of intravenous immunoglobulin (IVIG) use in pediatric and neonatal patients within a community health system based on current evidence. Presented at 2023 ASHP Midyear Clinical Meeting

Evaluation Of Ambulatory Care Proton Pump Inhibitor Use, Jessica Offerle Pharmd, Shivani Bhakta Pharmd, Bcacp, Noah Budi Pharmd, Ashley Parrott Pharmd, Mba, Bcps, Bcacp, Sarah Pfaehler Pharmd, Mba, Bcps, Pacs

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. December 2023.

The objectives of this project were to assess appropriateness of PPI utilization and identify possible opportunities for alternative PPI or step-down therapy.

Evaluation Of Diabetic Ketoacidosis Management: Comparing The Effectiveness Of Computer Program-Directed Vs Physician-Directed Intravenous To Subcutaneous Insulin, Kendra Yarian Pharmd, Jennifer Sposito Pharmd, Bcps, Bcccp, Christina Ford Pharmd, Bcps, Zachary Crabill Pharmd, Bcps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. December 2023.

This project compared effectiveness of computer-directed versus physician-directed intravenous (IV) to subcutaneous (SC) insulin transition in patients with diabetic ketoacidosis (DKA) by retrospectively reviewing blood glucose values and DKA recurrence.

Heading Towards Relief: An Evaluation Of Headache Management In A Community Hospital., Caleb Hoppe Pharmd, Sarah Meeks Pharmd, Bcccp, Heather Nichols Pharmd, Bcpps, Sarah Ferrell Pharmd, Bcpps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. December 2023.

This study sought to examine the treatment of acute headache at a community hospital including prescribing habits, dosing practices, use of consultants, and analgesic effect of each medication.

A Review Of Guideline Directed Medication Therapy Adherence For Patients With Asthma., Jennifer Mccarthy Pharmd, Ms, Elizabeth Meisberger Pharmd, Bcps, Bccp, Sarah Pfaehler Pharmd, Mba, Bcps, Pacs, Bhavika Patel Pharmd

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. December 2023.

This project evaluated a health system’s prescribing adherence to the 2022 GINA guideline update for inhaled corticosteroid (ICS) in combination with a long-acting beta agonist (LABA) as preferred reliever/rescue therapy for asthma within the ambulatory setting.

Community Acquired Pneumonia Order Set Utilization Evaluation: A Retrospective Chart Review, Kristin Lytal Pharmd, Mspgx, Luke Keller Pharmd, Bcps, Bcccp, Blake Burton Pharmd, Bcps, Sarah Ferrell Pharmd, Bcpps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. December 2023.

This poster evaluated adherence of antimicrobial regimen selection using a community acquired pneumonia (CAP) order set updated to Infectious Disease Society of America/American Thoracic Society guidelines.

Evaluation Of Intravenous Iron In The Inpatient Setting At A Large Health System., Abby Miller Pharmd Candidate, Robert D. Beckett Pharmd, Bcps, Cole Luty Pharmd, Jamie Gaul Pharmd, Bcps

Parkview Pharmacy Department

Presented at the ASHP Midyear Clinical Meeting. December 2023.

This project evaluated the appropriateness of interleukin (IL)-17 and IL-23 inhibitor usage within Parkview Health, in both inpatient and outpatient settings. This project set out to determine whether the inpatient use of intravenous (IV) iron replacement was justified and followed evidence-based guidelines.

Medication Use Evaluation Of Il-17 And Il-23 Inhibitors At A Large Health System., Corey Uetrecht Pharmd Candidate, Robert D. Beckett , Pharmd, Bcps, Kevin Baumgartner Pharmd, Jennifer Sposito Pharmd

Parkview Pharmacy Department

Presented at the ASHP Midyear Clinical Meeting. December 2023.

This project evaluated the appropriateness of interleukin (IL)-17 and IL-23 inhibitor usage within Parkview Health, in both inpatient and outpatient settings.

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 …

The Incidence Of Hematological Toxicities In Colorectal Cancer Patients Treated With Fluoropyrimidine-Based Regimens At Princess Noorah Oncology Center., Mansoor Khan, Sara Alharbi, Shahad Aljuhani, Mariam Tunkar, Amjaad Morya, Abdelmajid Alnatsheh Pharmd, Majed Alshamrani, Razaz Felemban

PCI Publications and Projects

Background Fluoropyrimidine-based regimens are used for the management of colorectal cancer, which is the second most common cancer in Saudi Arabia. We aimed to study the incidence of hematological toxicities in colorectal cancer patients treated with fluoropyrimidine and fluoropyrimidine-based regimens at Princess Noorah Oncology Center, King Abdulaziz Medical City- Jeddah, Saudi Arabia.  Methods A retrospective cohort study that included adult colorectal cancer patients who were treated with fluoropyrimidine-based regimens from January 1, 2018 to December 31, 2018 at Princess Noorah Oncology Center, Jeddah, Saudi Arabia was performed. Our primary objective was to determine the incidence of anemia, neutropenia, and thrombocytopenia …

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.

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.

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.

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.