Pharmacy and Pharmaceutical Sciences Commons^™

Case Report: The Complexities Of Managing Medications And The Importance Of Deprescribing Anticholinergics In Older Adults, Taylor Elliott, Lynne Eckmann, Daniela C. Moga

Pharmacy Practice and Science Faculty Publications

Potentially inappropriate anticholinergic medications (including over-the-counter products), polypharmacy, and the existence of communication barriers among members of the interprofessional team frequently contribute to clinical complexity in older adults. We present the case of a frail 86-year old female from the perspective of a community pharmacist managing outpatient medications and transitions of care. CD’s past medical history is significant for dementia, multiple falls, recurrent urinary tract infections, depression, cardiac arrhythmia, macular degeneration, chronic pain, depression, and cerebrovascular disease.

An Experimental Education Project For Consultations Of Older Adults During The Pandemic And Healthcare Lockdown, Agnieszka Neumann-Podczaska, Mikołaj Seostianin, Konrad Madejczyk, Piotr Merks, Urszula Religioni, Zofia Tomczak, Sławomir Tobis, Daniela C. Moga, Melody Ryan, Katarzyna Wieczorowska-Tobis

Pharmacy Practice and Science Faculty Publications

Objective: To develop a mentor-supervised, interprofessional, geriatric telemedicine experiential education project in response to the COVID-19 pandemic. Method: Medical and pharmacy students collaborated via remote consultations to address the coexistence of multimorbidity and polypharmacy in geriatric patients. In-depth interviews of students and patients as well as Likert scale-based telephonic survey were performed for a comprehensive evaluation of the project’s significance. Results: To date, 49 consultations have been conducted. Remote consultations performed by medical and pharmacy students working collaboratively were beneficial for both students, participants. Conclusions and Practice Implications: This experimental education project provided students with authentic challenges while simultaneously delivering …

Efficacy And Safety Of Vancomycin Loading Doses In Critically Ill Patients With Methicillin-Resistant Staphylococcus Aureus Infection, Alexander H. Flannery, Katie L. Wallace, Christian N. Rhudy, Allison S. Olmsted, Rachel C. Minrath, Stuart M. Pope, Aaron M. Cook, David S. Burgess, Peter E. Morris

Pharmacy Practice and Science Faculty Publications

Background: While vancomycin loading doses may facilitate earlier pharmacokinetic–pharmacodynamic target attainment, the impact of loading doses on clinical outcomes remains understudied. Critically ill patients are at highest risk of morbidity and mortality from methicillin resistant Staphylococcus aureus (MRSA) infection and hypothesized to most likely benefit from a loading dose. We sought to determine the association between receipt of a vancomycin loading dose and clinical outcomes in a cohort of critically ill adults.

Methods: Four hundred and forty-nine critically ill patients with MRSA cultures isolated from blood or respiratory specimens were eligible for the study. Cohorts were established by receipt of …

Variations In Schedule Iii Prescription Patterns In A Medicaid Population Pre- And Post-Policy, Radhakrishnan Nagarajan, Jeffery C. Talbert, Craig S. Miller, Jeffrey Ebersole

Pharmacy Practice and Science Faculty Publications

The present study investigated variations in patient movement patterns between prescribers before and after House Bill 1 (HB1) implementation in Kentucky using network abstractions (PPN: prescriber-prescriber networks) from a one-month cross-sectional Schedule III prescription data in a Medicaid population. Network characteristics such as degree centrality distribution of PPN was positively skewed and revealed Dental Practitioners to be the highly connected specialty with opioid analgesic hydrocodone-acetaminophen to be the most commonly prescribed drug. Taxonomy enrichment of the prescriber specialties in PPN using chi-square test revealed a reduction in the enriched taxonomies Post-HB1 compared to Pre-HB1 with Dental practitioners being constitutively enriched …

How Well Can We Assess The Validity Of Non-Randomised Studies Of Medications? A Systematic Review Of Assessment Tools, Elvira D'Andrea, Lydia Vinals, Elisabetta Patorno, Jessica M. Franklin, Dimitri Bennett, Joan A. Largent, Daniela C. Moga, Hongbo Yuan, Xuerong Wen, Andrew R. Zullo, Thomas P. A. Debray, Grammati Sarri

Pharmacy Practice and Science Faculty Publications

OBJECTIVE: To determine whether assessment tools for non-randomised studies (NRS) address critical elements that influence the validity of NRS findings for comparative safety and effectiveness of medications.

DESIGN: Systematic review and Delphi survey.

DATA SOURCES: We searched PubMed, Embase, Google, bibliographies of reviews and websites of influential organisations from inception to November 2019. In parallel, we conducted a Delphi survey among the International Society for Pharmacoepidemiology Comparative Effectiveness Research Special Interest Group to identify key methodological challenges for NRS of medications. We created a framework consisting of the reported methodological challenges to evaluate the selected NRS tools.

STUDY SELECTION: Checklists …

Pace Yourself: Impact Of Covid-19 On Patient-Centered Care Experience, Kristen Wilhite, Mikael D. Jones, Clark D. Kebodeaux

Pharmacy Practice and Science Faculty Publications

(1) Background: The outbreak of the novel coronavirus, COVID-19, forced colleges of pharmacy to implement new online learning methodologies to ensure that students could complete required courses. This transition was especially acute for laboratory simulation courses that require students to practice professional skills. This study aims to compare student assessment performance within a simulation-based laboratory course for students who completed the module prior to and after the online transition. (2) Methods: This study was a retrospective cohort comparison of student outcome performance with two distinct content delivery methods. Students were organized into two tracks at the beginning of the semester …

Obstetrician-Gynecologist Perceptions And Utilization Of Prescription Drug Monitoring Programs: A Survey Study, Amie Goodin, Jungjun Bae, Chris Delcher, Joshua Brown, Dikea Roussos-Ross

Pharmacy Practice and Science Faculty Publications

Query of Prescription Drug Monitoring Programs (PDMPs) is recommended before prescribing opioids by the US Centers for Disease Control and Prevention, to inform clinical practice and aid diversion prevention. Many states mandate prescriber PDMP use; however, little is known about PDMP perception of utility and use among Obstetricians-Gynecologists (OB/GYN), who are the primary provider for most women during pregnancy.

This study examined OB/GYN perceptions and utilization of their state PDMP.

Survey items were developed by expert consensus. A voluntary anonymous survey was emailed to a random sample of 5000 OB/GYNs (adjusted participants n = 1470, minus unread/refusals). Responses were stratified …

Treatment Of Headache In Aneurysmal Subarachnoid Hemorrhage: Multimodal Approach, Garrett B. Hile, Aaron M. Cook

Pharmacy Practice and Science Faculty Publications

Sudden severe headache is a cardinal symptom and the most common complaint amongst patients presenting with aneurysmal subarachnoid hemorrhage. The multifactorial etiology of these headaches makes pharmacotherapy problematic. Current aneurysmal subarachnoid hemorrhage guidelines have limited or no recommendations for headache treatment. Our institution utilizes a multimodal pharmacotherapy protocol in the management of aneurysmal subarachnoid hemorrhage headache. The purpose of this study was to evaluate the efficacy of the current aneurysmal subarachnoid hemorrhage headache treatment approach at our institution. This was a retrospective cohort study of patients presenting with aneurysmal subarachnoid hemorrhage. A multimodal aneurysmal subarachnoid hemorrhage headache treatment protocol was …

Development And Implementation Of An Influenza Point-Of-Care Testing Service In A Chain Community Pharmacy Setting, Rachel Hardin, Pheli Roberts, Brooke Hudspeth, Angela Tracy, Lauren Baldwin, Michael Raque, Clark D. Kebodeaux

Pharmacy Practice and Science Faculty Publications

Point-of-care testing is becoming increasingly commonplace in community pharmacy settings. These tests are often used in the management of chronic disease, such as blood sugar, hemoglobin A1c and lipid levels, but can also be used for acute conditions such as influenza infection and group A streptococcus pharyngitis. When used for these acute infections, point-of-care tests can allow for pharmacist-initiated treatment. In this study, an influenza point-of-care testing service was developed and implemented in a chain community pharmacy setting and a retrospective review was conducted to assess the service. Of patients tested, 29% tested positive for influenza A and/or B; 92% …

Haiti's Hiv Surveillance System: Past, Present, And Future, Chris Delcher, Ermane G. Robin, Daniella Myriam Pierre

Pharmacy Practice and Science Faculty Publications

No abstract provided.

Suspected Malignant Hyperthermia And The Application Of A Multidisciplinary Response, Laura Ebbitt, Eric Johnson, Brooke Herndon, Kristina Karrick, Aric Johnson

Pharmacy Practice and Science Faculty Publications

Purpose: Malignant hyperthermia (MH) is a critical and potentially life-threatening emergency associated with inhaled anesthetic and depolarizing neuromuscular blocker administration. This is a single center’s response to MH. Summary: When signs of MH are observed, a page for “anesthesia STAT-MH crisis” is called, triggering a multidisciplinary response, including the deployment of a Malignant Hyperthermia Cart. The MH cart and the delegation of duties allows nurses, physicians and pharmacists to quickly understand their role in the stabilization, transition and recovery of a suspected MH patient. Conclusion: This case highlights the importance of multi-disciplinary involvement in these rare, but potentially fatal, cases.

Afatinib For The Treatment Of Egfr Mutation-Positive Nsclc: A Review Of Clinical Findings, R. Donald Harvey, Val R. Adams, Tyler Beardslee, Patrick Medina

Pharmacy Practice and Science Faculty Publications

Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors represent the standard of care in patients with EGFR mutation-positive (EGFRm+) non-small cell lung cancer (NSCLC). The availability of several EGFR tyrosine kinase inhibitors approved for use in the first-line or later settings in NSCLC warrants an in-depth understanding of the pharmacological properties of, and clinical data supporting, these agents. The second-generation, irreversible ErbB-family blocker, afatinib, has been extensively studied in the context of EGFRm+ NSCLC. Results from the LUX-Lung 3 and 6 studies showed that afatinib was more active and better tolerated than chemotherapy in patients with tumors …

Expanding Pharmacotherapy Data Collection, Analysis, And Implementation In Eras® Programs—The Methodology Of An Exploratory Feasibility Study, Eric Johnson, Richard Parrish Ii, Gregg Nelson, Kevin Elias, Brian Kramer, Marian Gaviola

Pharmacy Practice and Science Faculty Publications

Surgical organizations dedicated to the improvement of patient outcomes have led to a worldwide paradigm shift in perioperative patient care. Since 2012, the Enhanced Recovery After Surgery (ERAS^®) Society has published guidelines pertaining to perioperative care in numerous disciplines including elective colorectal and gynecologic/oncology surgery patients. The ERAS^® and ERAS-USA^® Societies use standardized methodology for collecting and assessing various surgical parameters in real-time during the operative process. These multi-disciplinary groups have constructed a bundled framework of perioperative care that entails 22 specific components of clinical interventions, which are logged in a central database, allowing a system …

Using Medical Claims Database To Develop A Population Disease Progression Model For Leuprorelin-Treated Subjects With Hormone-Sensitive Prostate Cancer, Yixuan Zou, Fei Tang, Jeffery C. Talbert, Chee M. Ng

Pharmacy Practice and Science Faculty Publications

Androgen deprivation therapy (ADT) is a widely used treatment for patients with hormone-sensitive prostate cancer (PCa). However, duration of treatment response varies, and most patients eventually experience disease progression despite treatment. Leuprorelin is a luteinizing hormone-releasing hormone (LHRH) agonist, a commonly used form of ADT. Prostate-specific antigen (PSA) is a biomarker for monitoring disease progression and predicting treatment response and survival in PCa. However, time-dependent profile of tumor regression and growth in patients with hormone-sensitive PCa on ADT has never been fully characterized. In this analysis, nationwide medical claims database provided by Humana from 2007 to 2011 was used to …

Vancomycin Dosing Practices Among Critical Care Pharmacists: A Survey Of Society Of Critical Care Medicine Pharmacists, Alexander H. Flannery, Drayton A. Hammond, Douglas R. Oyler, Chenghui Li, Adrian Wong, Andrew P. Smith, Qiu Min Yeo, Whitney Chaney, Caitlin E. Pfaff, Angela M. Plewa-Rusiecki, Paul Juang

Pharmacy Practice and Science Faculty Publications

Introduction: Critically ill patients and their pharmacokinetics present complexities often not considered by consensus guidelines from the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists. Prior surveys have suggested discordance between certain guideline recommendations and reported infectious disease pharmacist practice. Vancomycin dosing practices, including institutional considerations, have not previously been well described in the critically ill patient population.

Objectives: To evaluate critical care pharmacists' self-reported vancomycin practices in comparison to the 2009 guideline recommendations and other best practices identified by the study investigators.

Methods: An online survey developed by the …

Intervention For Cognitive Reserve Enhancement In Delaying The Onset Of Alzheimer's Symptomatic Expression (Increase), A Randomized Controlled Trial: Rationale, Study Design, And Protocol, Daniela C. Moga, Brooke F. Beech, Erin L. Abner, Frederick A. Schmitt, Riham H. El Khouli, Ashley I. Martinez, Lynne Eckmann, Mark Huffmyer, Rosmy George, Gregory A. Jicha

Pharmacy Practice and Science Faculty Publications

BACKGROUND: The course of Alzheimer's disease (AD) includes a 10-20-year preclinical period with progressive accumulation of amyloid β (Aβ) plaques and neurofibrillary tangles in the absence of symptomatic cognitive or functional decline. The duration of this preclinical stage in part depends on the rate of pathologic progression, which is offset by compensatory mechanisms, referred to as cognitive reserve (CR). Comorbid medical conditions, psychosocial stressors, and inappropriate medication use may lower CR, hastening the onset of symptomatic AD. Here, we describe a randomized controlled trial (RCT) designed to test the efficacy of a medication therapy management (MTM) intervention to reduce inappropriate …

Innovative Solutions For State Medicaid Programs To Leverage Their Data, Build Their Analytic Capacity, And Create Evidence-Based Policy, Lauren Adams, Susan Kennedy, Lindsay Allen, Andrew Barnes, Tom Bias, Dushka Crane, Paul Lanier, Rachel Mauk, Shamis Mohamoud, Nathan Pauly, Jeffery C. Talbert, Cynthia Woodcock, Kara Zivin, Julie Donohue

Pharmacy Practice and Science Faculty Publications

As states have embraced additional flexibility to change coverage of and payment for Medicaid services, they have also faced heightened expectations for delivering high-value care. Efforts to meet these new expectations have increased the need for rigorous, evidence-based policy, but states may face challenges finding the resources, capacity, and expertise to meet this need. By describing state-university partnerships in more than 20 states, this commentary describes innovative solutions for states that want to leverage their own data, build their analytic capacity, and create evidence-based policy. From an integrated web-based system to improve long-term care to evaluating the impact of permanent …

Diagnosis, Treatment And Follow Up Of Acute Pulmonary Embolism: Consensus Practice From The Pert Consortium, Belinda Rivera-Lebron, Michael Mcdaniel, Kamran Ahrar, Abdulah Alrifai, David M. Dudzinski, Christina Fanola, Danielle Blais, David Janicke, Roman Melamed, Kerry Mohrien, Elizabeth Rozycki, Charles B. Ross, Andrew J. Klein, Parth Rali, Nicholas R. Teman, Leoara Yarboro, Eugene Ichinose, Aditya M. Sharma, Jason A. Bartos, Mahir Elder, Brent Keeling, Harold Palevsky, Soophia Naydenov, Parijat Sen, Nancy Amoroso, Josanna M. Rodriguez-Lopez, George A. Davis, Rachel Rosovsky, Kenneth Rosenfield, Christopher Kabrhel, James Horowitz, Jay S. Giri, Victor Tapson, Richard Channick, Pert Consortium

Pharmacy Practice and Science Faculty Publications

Pulmonary embolism (PE) is a life-threatening condition and a leading cause of morbidity and mortality. There have been many advances in the field of PE in the last few years, requiring a careful assessment of their impact on patient care. However, variations in recommendations by different clinical guidelines, as well as lack of robust clinical trials, make clinical decisions challenging. The Pulmonary Embolism Response Team Consortium is an international association created to advance the diagnosis, treatment, and outcomes of patients with PE. In this consensus practice document, we provide a comprehensive review of the diagnosis, treatment, and follow-up of acute …

Prescription And Over-The-Counter Medication Record Integration: A Holistic Patient-Centered Approach, Clark D. Kebodeaux

Pharmacy Practice and Science Faculty Publications

Objective: Nonprescription or over-the-counter (OTC) medications play a crucial role in a patient’s ability to make choices to manage his or her own health care. Often these nonprescription choices are unknown to health care practitioners and thus are often not included as part of patients’ health records. The exclusion of these therapies can pose risks to patient safety. There is a significant need to address the capture of OTC medication use in both the physician and pharmacy electronic health records (EHRs) and during the practitionerepatient medication history and reconciliation process.

Data sources: On October 26, 2016, the National Association of …

Incidence Of Acute Kidney Injury Among Patients Treated With Piperacillin-Tazobactam Or Meropenem In Combination With Vancomycin, Wilbur Cliff Rutter, David S. Burgess

Pharmacy Practice and Science Faculty Publications

Acute kidney injury (AKI) increases during empirical antimicrobial therapy with the combination of piperacillin-tazobactam (TZP) and vancomycin (VAN) compared to the number of incidences with monotherapy or the combination of cefepime and VAN. Limited data regarding the impact of meropenem (MEM) combined with VAN exist. This study examined the AKI incidence among patients treated with MEM plus VAN (MEM+VAN) or TZP+VAN. Data were collected from the University of Kentucky Center for Clinical and Translational Science Enterprise Data Trust from September 2007 through October 2015. Adults without previous renal disease who received MEM+VAN or TZP+VAN for at least 2 days were …

Low-Fat Abiraterone Food Effect Is Of Little Consequence, Jill M. Kolesar, Glenn X. Liu

Pharmacy Practice and Science Faculty Publications

No abstract provided.

Risk Stratification For Bleeding Complications In Patients With Venous Thromboembolism: Application Of The Has-Bled Bleeding Score During The First 6 Months Of Anticoagulant Treatment, Joshua D. Brown, Amie J. Goodin, Gregory Y. H. Lip, Val R. Adams

Pharmacy Practice and Science Faculty Publications

Background—The Hypertension, Abnormal renal/liver function, Stroke, Bleeding, Labile International Normalized Ratio (INR), Elderly, Drugs or alcohol use (HAS-BLED) score has strong predictive validity for major bleeding complications, but limited validation has been conducted in venous thromboembolism (VTE). This study evaluates the HAS-BLED score in a large cohort of VTE patients.

Methods and Results—A retrospective cohort of adults ≥ 18 years with primary diagnosis of VTE between January 1, 2010 and November 31, 2013 were identified in an insurance claims database. Patients were tracked until death, any bleed event, or end of study period. HAS-BLED score and components were …

Longitudinal Patterns Of Potentially Inappropriate Medication Use Following Incident Dementia Diagnosis, Christine M. Ramsey, Danijela Gnjidic, George O. Agogo, Heather Allore, Daniela Moga

Pharmacy Practice and Science Faculty Publications

Introduction: Potentially inappropriate medication (PIM) use in older adults with dementia is an understudied area. We assessed longitudinal changes in PIM exposure by dementia type following dementia diagnosis.

Methods: We followed 2448 participants aged ≥ 65 years (52% women, 85.5% Caucasian, mean age 80.9 ± 7.5 years) diagnosed with dementia after enrollment in the National Alzheimer's Coordinating Center (2005-2014). We estimated the association between dementia type and PIM annually for 2 years after diagnosis, using Generalized Estimating Equations.

Results:Participants with Lewy body dementia had more PIM use, and participants with frontotemporal dementia had less PIM use than participants with …

An Investigation Of Factors Predicting The Type Of Bladder Antimuscarinics Initiated In Medicare Nursing Homes Residents, Daniela C. Moga, Qishan Wu, Pratik Doshi, Amie J. Goodin

Pharmacy Practice and Science Faculty Publications

Background: To examine factors predicting type of bladder antimuscarinics (BAM) initiated in nursing home (NH) residents.

Methods: Incident BAM initiators following NH admission were identified by constructing a retrospective cohort from Medicare files and Minimum Data Set (MDS). Participants included all residents 65 years and older admitted in Medicare-certified NH between January 1, 2007 and December 31, 2008 who were prescribed BAM and had continuous Medicare (Part A, B, and D) enrollment. Patient characteristics, medications, and comorbidities were derived from Medicare enrollment and claims. NH characteristics and health status were derived from MDS assessments. The outcome was defined as type …

Design And Validation Of Patient-Centered Communication Tools (Pact) To Measure Students' Communication Skills, Gloria R. Grice, Nicole M. Gattas, Theresa Prosser, Mychal Voorhees, Clark D. Kebodeaux, Amy Tiemeier, Tricia M. Berry, Alexandria Garavaglia Wilson, Janelle Mann, Paul Juang

Pharmacy Practice and Science Faculty Publications

Objective. To develop a comprehensive instrument specific to student pharmacist-patient communication skills, and to determine face, content, construct, concurrent, and predictive validity and reliability of the instrument.

Methods. A multi-step approach was used to create and validate an instrument, including the use of external experts for face and content validity, students for construct validity, comparisons to other rubrics for concurrent validity, comparisons to other coursework for predictive validity, and extensive reliability and inter-rater reliability testing with trained faculty assessors.

Results. Patient-centered Communication Tools (PaCT) achieved face and content validity and performed well with multiple correlation tests with significant findings for …

Influence Of Β-Lactam Infusion Strategy On Acute Kidney Injury, Sarah E. Cotner, Wilbur Cliff Rutter, Donna R. Burgess, Katie L. Wallace, Craig A. Martin, David S. Burgess

Pharmacy Practice and Science Faculty Publications

Limited literature is available assessing nephrotoxicity with prolonged β-lactam infusions. This study compared the incidence of acute kidney injury (AKI) associated with a prolonged β-lactam infusion or an intermittent infusion. This was a retrospective, matched-cohort study at an academic medical center from July 2006 to September 2015. Adult patients who received piperacillin-tazobactam (TZP), cefepime (FEP), or meropenem (MEM) for at least 48 h were evaluated. Patients were excluded for preexisting renal dysfunction or pregnancy. The primary outcome was difference in incidence of AKI evaluated using the RIFLE (risk, injury, failure, loss, and end-stage) criteria. Patients in the intermittent group …

Vena Cava Filter Retrieval Rates And Factors Associated With Retrieval In A Large Us Cohort, Joshua D. Brown, Driss Raissi, Qiong Han, Val R. Adams, Jeffery Talbert

Pharmacy Practice and Science Faculty Publications

Background Retrieval of vena cava filters (VCFs) is important for safety as complications increase with longer dwell times. This study assessed VCF retrieval rates and factors associated with retrieval in a national cohort.

Methods and Results VCFs were identified by procedural codes from an administrative claims database. Patients were identified who had a VCF placement during a hospitalization from a national commercial administrative claims database. Indications for VCF placement were identified as pulmonary embolism with or without deep vein thrombosis, deep vein thrombosis only, or prophylactic. Patient demographic and clinical characteristics were included in proportional hazard regression models to find …

Optimizing Medication Appropriateness In Older Adults: A Randomized Clinical Interventional Trial To Decrease Anticholinergic Burden, Daniela C. Moga, Erin L. Abner, Dorinda N. Rigsby, Lynne Eckmann, Mark Huffmyer, Richard R. Murphy, Beth B. Coy, Gregory A. Jicha

Pharmacy Practice and Science Faculty Publications

Background

The complexity of medication therapy in older adults with multiple comorbidities often leads to inappropriate prescribing. Drugs with anticholinergic properties are of particular interest because many are not recognized for this property; their use may lead to increased anticholinergic burden resulting in significant health risks, as well as negatively impacting cognition. Medication therapy management (MTM) interventions showed promise in addressing inappropriate medication use, but the effectiveness of targeted multidisciplinary team interventions addressing anticholinergic medications in older populations is yet to be determined.

Methods

We conducted an 8-week, parallel-arm, randomized trial to evaluate whether a targeted patient-centered pharmacist–physician team MTM …

Quality Of Life And Medication Adherence Of Independently Living Older Adults Enrolled In A Pharmacist-Based Medication Management Program, Christopher Harlow, Catherine Hanna, Lynne Eckmann, Yevgeniya Gokun, Faika Zanjani, Karen Blumenschein, Holly Divine

Pharmacy Practice and Science Faculty Publications

This study sought to understand the medication adherence and quality of life (QOL) of recipients of a pharmacist-based medication management program among independently living older adults. Using a cross-sectional, quasi-experimental study design, we compared older adults enrolled in the program to older adults not enrolled in the program. Data were collected via face-to-face interviews in independent-living facilities and in participants’ homes. Independently living older adults who were enrolled in the medication management program (n = 38) were compared to older adults not enrolled in the program (control group (n = 41)). All participants were asked to complete questionnaires …

Nephrotoxicity In Patients With Or Without Cystic Fibrosis Treated With Polymyxin B Compared To Colistin, Ryan L. Crass, Wilbur Cliff Rutter, Donna R. Burgess, Craig A. Martin, David S. Burgess

Pharmacy Practice and Science Faculty Publications

Nephrotoxicity is the primary adverse effect of the polymyxins. The relative rates of toxicity of polymyxin B and colistin have not been fully elucidated, especially in patients with cystic fibrosis (CF). A retrospective cohort study of adults treated with polymyxin B or colistin for at least 48 h was conducted. The primary endpoint was the incidence of kidney injury assessed by RIFLE (i.e., risk, injury, failure, loss, end-stage renal disease) criteria. Risk factors for kidney injury were evaluated using multivariate Cox regression. A total of 414 patients were evaluated, 220 of whom had CF. In patients without CF, there was …