Evaluating the Safety and Tolerability of Sacubitril/Valsartan for HFrEF Managed Within a Pharmacist Clinic

Objective To compare polypharmacy and potentially inappropriate medication use in multiple myeloma patients receiving care under a traditional, physician-managed, or collaborative physician–pharmacist clinic. Design Retrospective chart review. Setting Urban academic cancer center. Data source Computerized electronic record. Patients Forty-four patients in the traditional physician-managed clinic and 57 patients in the collaborative physician-pharmacist clinic. Measurements and main results Patients in the collaborative clinic took fewer medications on average (9 vs. 7, p = 0.045). Although the median number of myeloma-related medications was higher (2 vs. 4, p < 0.0001), the number of non-myeloma-related medications was lower (7 vs. 3, p < 0.0001) in the collaborative clinic. Polypharmacy rates were high in both clinics (93% vs. 84%, p = 0.22). However, the collaborative clinic had a lower rate of polypharmacy of non-myeloma medications (71 vs. 33%, p = 0.0003), including both minor (five to nine medications, 48 vs. 28%, p = 0.06) and major (≥10 medications, 23 vs. 5%, p = 0.02) polypharmacy. Minor polypharmacy of myeloma-related medications was higher in the collaborative clinic (32 vs. 2%; p = 0.0002). Multivariate analysis showed a reduced risk of having a higher number of medications (Relative risk (RR) 0.79, 95% confidence interval 0.67–0.93; p = 0.004), a lower risk of having any polypharmacy of non-myeloma-related medications (RR 0.41, 95% confidence interval 0.25–0.67; p < 0.001) and a lower risk of receiving potentially inappropriate medication (RR 0.62, 95% confidence interval 0.41–0.95; p = 0.029) in the collaborative clinic. Conclusions Multiple myeloma patients have a high rate of polypharmacy but comanagement with a pharmacist reduced the number of all medications, but in particular the number of non-myeloma-related medications.

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PTU-140 Does a dedicated inflammatory bowel disease (IBD) pharmacist clinic improve patient safety ?

10.1136/gutjnl-2018-bsgabstracts.518 ◽

2018 ◽

Author(s):

Alan Steel ◽

Helen Morgan ◽

Wei Tan ◽

Vanessa Marvin ◽

Mahmood Wahed

Keyword(s):

Inflammatory Bowel Disease ◽

Patient Safety ◽

Bowel Disease ◽

Improve Patient Safety ◽

Inflammatory Bowel ◽

Improve Patient ◽

Pharmacist Clinic

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Benefits of pharmacist clinic offset costs by 6-fold

PharmacoEconomics & Outcomes News ◽

10.1007/bf03273452 ◽

1998 ◽

Vol 185 (1) ◽

pp. 6-6

Keyword(s):

Pharmacist Clinic

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Initiatives for immune-related adverse events by the outpatient pharmacist clinic

Trends in Immunotherapy ◽

10.24294/ti.v6.i1.1385 ◽

2022 ◽

Vol 6 (1) ◽

pp. 3

Author(s):

Kiyonori Hamatake ◽

Kazuaki Kojima

Keyword(s):

Early Detection ◽

Adverse Events ◽

Immune Checkpoint Inhibitor ◽

Late Onset ◽

Onset Time ◽

Care Practice ◽

Post Marketing Surveillance ◽

Post Marketing ◽

Detection Ratio ◽

Pharmacist Clinic

Early detection is the key in managing side effects because immune-related adverse events (irAEs) are becoming more serious, and their onset time differs. In our hospital, we conducted an outpatient pharmacist clinic for early detection of irAEs by self-care practice for the cases of immune checkpoint inhibitor administration. As a result of a retrospective survey of 207 cases, the percentage of irAEs found by pharmacist’s suggestion of the outpatient pharmacist clinic increased over time, and a high detection ratio was obtained even for irAEs with a late onset time. The incidence of serious irAEs was higher than that in the immediate post-marketing surveillance, and different factors were considered. Although there were some problems, the outpatient pharmacist clinic had a certain effect.

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Outcome Benefits Seen With 1 Year of Optimized Sacubitril/Valsartan for the Treatment of Systolic Heart Failure Managed by Pharmacists in a Cardiology Practice

Annals of Pharmacotherapy ◽

10.1177/10600280211036149 ◽

2021 ◽

pp. 106002802110361

Author(s):

Lindsay E. Davis ◽

Elizabeth K. Pogge

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Secondary Outcome ◽

First Year ◽

Ventricular Ejection Fraction ◽

Neprilysin Inhibitor ◽

The Impact ◽

Pharmacist Clinic

Background: Pharmacists’ care in heart failure (HF) management has been shown to better clinical outcomes, including use of guideline-directed medical therapy and hospital readmission, although the impact observed has varied among studies. Objective: To investigate the rates of all-cause hospitalization and hospitalization from HF (hHF) and changes in surrogate markers (left-ventricular ejection fraction, New York Heart Association Functional Classification [NYHA FC], diuretic requirements) for patients with HF with reduced ejection fraction (HFrEF) on angiotensin receptor-neprilysin inhibitor (ARNi) therapy optimized within a pharmacist clinic. Methods: Retrospective chart review of patients with HFrEF on sacubitril/valsartan from July 7, 2015, through January 1, 2018. Results: For the primary outcome analysis, 70 patients with pre/post hospitalization data had a reduction in the rate of all-cause hospitalization from 45.7% in the 12 months prior to ARNi therapy initiation to 24.3% during the first year on optimized ARNi therapy ( P = 0.004). The rate of hHF reduced from 24.3% to 8.6% ( P = 0.003). For the secondary outcome analyses at the 6-month assessment point, which included 104 patients, ejection fraction improved from 26% to 34% ( P < 0.001), NYHA FC improved or remained unchanged in 86.6% of patients, and weekly loop diuretic dosing requirements were significantly reduced. Conclusion and Relevance: Real-world use of sacubitril/valsartan optimized within a pharmacist clinic was associated with reduced prevalence of all-cause and hHF during the first year of ARNi therapy. This study corroborates pharmacist involvement in HF management, which could be used to support further research and expanded pharmacist services.

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