Promoting Pharmacy-Based Referrals to the Tobacco Quitline

Objective: To conduct a pilot study of a student-delivered academic detailing initiative to promote brief, pharmacy-based tobacco cessation interventions, and referrals to the tobacco quitline. Methods: Pharmacy students (n = 11) received training and delivered academic detailing sessions for promoting brief tobacco cessation interventions at community pharmacies (n = 37). Six months after the session, a survey was faxed to each pharmacy to assess (1) the quality and acceptance of the academic detailing session and the materials provided during the session and (2) tobacco cessation counseling perceptions and practices. Results: Pharmacists from 30 (81%) sites responded to the survey; of these, 37% reported that they increased the number of patients asked about smoking since the academic detailing session, 70% reported an increase in the number of participants advised to quit smoking, 57% reported an increase in the number of patients counseled, and 50% reported routinely providing referrals to the tobacco quitline. Conclusion: pharmacy students are capable of providing academic detailing for brief tobacco cessation interventions in community pharmacies. Results of this pilot study suggest a positive impact of this service on pharmacists’ counseling behavior for tobacco cessation.

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Implementing a Referral to Telephone Tobacco Cessation Services in Louisiana Community Pharmacies: A Pilot Study

Annals of Pharmacotherapy ◽

10.1345/aph.1p226 ◽

2010 ◽

Vol 44 (9) ◽

pp. 1395-1402 ◽

Cited By ~ 9

Author(s):

Scott A Baggarly ◽

Tara L Jenkins ◽

Gina C Biglane ◽

Gregory W Smith ◽

Connie M Smith ◽

...

Keyword(s):

Pilot Study ◽

Tobacco Cessation ◽

Community Pharmacies

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Safety of Vinflunine in Patients with Advanced Urothelial Carcinoma Refractory to Platinum-based Chemotherapy: A Prospective Pilot Study

Current Drug Safety ◽

10.2174/1574886313666181001120752 ◽

2019 ◽

Vol 14 (1) ◽

pp. 31-36

Author(s):

Raafat Abdel-Malek ◽

Kyrillus S. Shohdy ◽

Noha Abbas ◽

Mohamed Ismail ◽

Emad Hamada ◽

...

Keyword(s):

Pilot Study ◽

Adverse Events ◽

Urothelial Carcinoma ◽

Transitional Cell ◽

Chemotherapeutic Agents ◽

Serious Adverse Events ◽

Platinum Based Chemotherapy ◽

Number Of Patients ◽

Advanced Urothelial Carcinoma ◽

Grade 3

Background: Several single chemotherapeutic agents have been evaluated as the second-line treatment of advanced urothelial carcinoma. Despite encouraging efficacy outcomes, toxicity has often led to dose modifications or discontinuation. We aimed to assess the safety of vinflunine in a particular population of advanced transitional cell carcinoma of urothelium (TCCU), that were exposed to the previous toxicity of chemotherapy. Methods: This is an open-label, prospective, single-center pilot study to evaluate the response rate and safety profile of vinflunine in patients with advanced TCCU. It was planned to enroll 25 evaluable patients. Eligible patients are those with progressive disease after first-line platinum-based regimen for advanced or metastatic disease. Results: The study was prematurely closed due to two sudden deaths that were judged by the review board as treatment-related. Only ten patients were evaluated and received at least one cycle of vinflunine. All but one were male and seven underwent radical surgery. Eight had a distant metastasis (mainly lung and/or liver). Disease control rate was 40%, four patients had a partial response with median duration of response of 3.5 months. The median overall survival was 3.2 months (95% CI:1.67- 4.73). There were three serious adverse events namely two sudden deaths and one grade 4 thrombocytopenia. Nine grade 3/4 adverse events occurred. The most common all-grade adverse events were fatigue (50%), constipation (40%) and vomiting (40%). Moreover, grade 3 fatigue occurred in 30% of patients. Only one patient, who achieved PR for 5 months, was fit to receive further cytotoxic chemotherapy. Conclusion: The activity of vinflunine in advanced urothelial carcinoma came at the expense of its safety. The use of vinflunine has to be limited to the selected group of patients. However, this is a single institute experience in a limited number of patients.

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"Taming the Monster aka Uncontrolled Diabetes: A Viewpoint" (Preprint)

10.2196/preprints.25150 ◽

2020 ◽

Author(s):

Swati Anand ◽

Amardeep Kalsi ◽

Jonathan Figueroa ◽

Parag Mehta

Keyword(s):

Blood Glucose ◽

Diabetes Management ◽

Positive Impact ◽

The United States ◽

Phone Call ◽

Diabetic Patients ◽

Dietary Compliance ◽

Glucose Levels ◽

Uncontrolled Diabetes ◽

Number Of Patients

BACKGROUND HbA1c between 6% and 6.9% is associated with the lowest incidence of all‐cause and CVD mortality, with a stepwise increase in all‐cause and cardiovascular mortality in those with an HbA1c >7%. • There are 30 million individuals in the United States (9.4% of the population) currently living with Diabetes Mellitus. OBJECTIVE Improving HbA1C levels in patients with uncontrolled Diabetes with a focused and collaborative effort. METHODS Our baseline data for Diabetic patients attending the outpatient department from July 2018 to July 2019 in a University-affiliated hospital showed a total of 217 patients for one physician. • Of 217 patients, 17 had HbA1C 9 and above. We contacted these patients and discussed the need for tight control of their blood glucose levels. We intended to ensure them that we care and encourage them to participate in our efforts to improve their outcome. • We referred 13 patients that agreed to participate to the Diabetic educator who would schedule an appointment with the patients, discuss their diet, exercise, how to take medications, self-monitoring, and psychosocial factors. • If needed, she would refer them to the Nutritionist based on patients’ dietary compliance. • The patients were followed up in the next two weeks via telemedicine or a phone call by the PCP to confirm and reinforce the education provided by the diabetes educator. RESULTS Number of patients that showed an improvement in HbA1C values: 11 Cumulative decrease in HbA1C values for 13 patients: 25.3 The average reduction in HbA1C: 1.94 CONCLUSIONS Our initiative to exclusively target the blood glucose level with our multidisciplinary approach has made a positive impact, which is reflected in the outcome. • It leads to an improvement in patient compliance and facilitates diabetes management to reduce the risk for complications CLINICALTRIAL NA

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Is Biofeedback through an Intra-Aural Device an Effective Method to Treat Bruxism? Case Series and Initial Experience

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010051 ◽

2020 ◽

Vol 18 (1) ◽

pp. 51

Author(s):

Kira Pfeiffer ◽

Thaqif El Khassawna ◽

Deeksha Malhan ◽

Christine Langer ◽

Barbara Sommer ◽

...

Keyword(s):

Clinical Evidence ◽

Positive Impact ◽

Case Series ◽

Physiological Status ◽

Initial Experience ◽

Ear Canal ◽

Number Of Patients ◽

Patient Reported ◽

Unpleasant Feeling ◽

Ear Canals

Biofeedback was reported as an effective concept for bruxism treatment, through increasing patient’s awareness of the habit. During bruxing both ear canals become tighter, therefore, an in-ear device can provide biofeedback. The in-ear device is fitted to the ear canal in physiological status, during bruxing the ear-canal tightens resulting in stress on the canal walls and unpleasant feeling. Subsequently, patients stop their bruxing habit. The aim of this study is to provide first clinical evidence that in-ear devices have a positive impact on relieving bruxism in patients. Despite the low number of patients, this early study was designed as a controlled prospective study. The trial included seven female patients with a median age of 47.3 years (23–64 years). Only two patients implemented their devices for eight and seven months, respectively. One patient reported a relief in her symptoms, like headaches and pain intensity during the night, by 50% after three month and 80% after six months. Despite the limited number of participants, the study reflects a potential of Intra-aural devices as effective biofeedback devices in treating bruxism.

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Patients’ expectations on medicines information

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1194 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Sevikyan ◽

I Kazaryan

Keyword(s):

Storage Conditions ◽

Community Pharmacies ◽

Duration Of Treatment ◽

Pharmacy Staff ◽

Medicine Price ◽

Expiry Date ◽

Face To Face ◽

Medicines Information ◽

Number Of Patients ◽

Effective Use

Abstract Background Medicines information is important for patients as it assists them in achieving more safe and effective use of pharmaceuticals. Many patients seek information from community pharmacies' staff. The objectives of this study were to identify specific topics of medicines information which patients expect to receive at community pharmacies. Methods Face-to-face interviews were conducted with 1059 visitors of community pharmacies in Armenia. Previously developed questionnaire was used for interviewing patients. Data were analysed with the SPSS statistical software. Results Most of participants acknowledged importance of receiving from community pharmacies' staff information on therapeutic indications of medicines (91.1%), dosage and method of administration (90.8%), the duration of treatment (86.3%), expiry date (85.7%), adverse reactions (85.0%), contraindications (84.6%), storage conditions (77.5%) and type of activity (76.0%). Importance of receiving information on some specific topics depends on patients' age. Participants' acknowledgement of information on interaction with other medicines, certain categories of users, and potential effects on the ability to drive is decreasing with patients' age increasing (p < 0.001). The opposite trend was observed with attitude to receiving information on medicine price that was mostly valued by elderly patients (p = 0.046). The number of patients who trust the information provided was higher among those who more often received comprehensive responses from pharmacists and pharmacy assistants (p < 0.001). Conclusions Receiving medicines information from the staff of community pharmacies is important for patients, and the majority of them trust to information received. Patients are mainly provided with comprehensive responses to their questions about medicines, and there was dependence between a frequency of receiving comprehensive responses and a level of patients' trust the information provided by pharmacy staff. Key messages Increasing patients’ awareness on their right to get medicines information can be beneficial. Comprehensive responses increase patients trust medicines information provided by pharmacists.

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A Collaborative Deprescribing Intervention in a Subacute Medical Outpatient Clinic: A Pilot Randomized Controlled Trial

Metabolites ◽

10.3390/metabo11040204 ◽

2021 ◽

Vol 11 (4) ◽

pp. 204

Author(s):

Anissa Aharaz ◽

Jens Henning Rasmussen ◽

Helle Bach Ølgaard McNulty ◽

Arne Cyron ◽

Pia Keinicke Fabricius ◽

...

Keyword(s):

Pilot Study ◽

Controlled Trial ◽

Inappropriate Medication ◽

Intervention Group ◽

Control Group ◽

Randomized Controlled ◽

Patient Interviews ◽

Number Of Patients ◽

Multimorbid Patients ◽

And Control

Medication deprescribing is essential to prevent inappropriate medication use in multimorbid patients. However, experience of deprescribing in Danish Subacute Medical Outpatient Clinics (SMOCs) is limited. The objective of our pilot study was to evaluate the feasibility and sustainability of a collaborative deprescribing intervention by a pharmacist and a physician to multimorbid patients in a SMOC. A randomized controlled pilot study was conducted, with phone follow-up at 30 and 365+ days. A senior pharmacist performed a systematic deprescribing intervention using the Screening Tool of Older Persons’ potentially inappropriate Prescriptions (STOPP) criteria, the Danish deprescribing list, and patient interviews. A senior physician received the proposed recommendations and decided which should be implemented. The main outcome was the number of patients having ≥1 medication where deprescribing status was sustained 30 days after inclusion. Out of 76 eligible patients, 72 (95%) were included and 67 (93%) completed the study (57% male; mean age 73 years; mean number of 10 prescribed medications). Nineteen patients (56%) in the intervention group and four (12%) in the control group had ≥1 medication where deprescribing status was sustained 30 days after inclusion (p = 0.015). In total, 37 medications were deprescribed in the intervention group and five in the control group. At 365+ days after inclusion, 97% and 100% of the deprescribed medications were sustained in the intervention and control groups, respectively. The three most frequently deprescribed medication groups were analgesics, cardiovascular, and gastrointestinal medications. In conclusion, a collaborative deprescribing intervention for multimorbid patients was feasible and resulted in sustainable deprescribing of medication in a SMOC.

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Provider Education About Pneumococcal Vaccination Practices for Older Adults

The Senior Care Pharmacist ◽

10.4140/tcp.n.2019.432 ◽

2019 ◽

Vol 34 (7) ◽

pp. 432-438

Author(s):

Kimberly C. McKeirnan ◽

Karen Colorafi ◽

Shannon G. Panther ◽

Darryl Potyk ◽

John McCarthy

Keyword(s):

Project Team ◽

Lessons Learned ◽

Community Pharmacies ◽

Academic Detailing ◽

Care Providers ◽

Interprofessional Practice ◽

Team Members ◽

Interprofessional Team ◽

Medical Clinics ◽

Field Notes

OBJECTIVE: To describe an interdisciplinary academic detailing project implemented to address low pneumococcal immunization rates. SETTING: Two medical clinics and four community pharmacies in rural Washington state. PRACTICE DESCRIPTION: The two medical clinics and four community pharmacies were all located in two rural counties and serve geographically large rural areas. PRACTICE INNOVATION: Academic detailing is an evidence-based approach designed to change clinical practice and improve decision-making. Our team utilized the academic detailing model to provide educational outreach to local rural health care providers. The detailing team visited each clinic and pharmacy on a defined schedule and provided information to physicians, clinic administrators, nurses, pharmacists, pharmacy technicians, medical assistants, and clinic front-end staff. MAIN OUTCOME MEASUREMENTS: The project team maintained detailed field notes from each academic detailing the visit and met to debrief about each encounter. From the field notes, through the process of thematic analysis and analytic memoing, the project team produced a list of "lessons learned" that could be used to guide other interprofessional teams wishing to embark on an academic detailing project. RESULTS: We have identified four key "lessons learned": Interprofessional team members bring different strengths to the project; using same-discipline team members paved the way for success; involving students aids in educating future practitioners in interprofessional practice; and scheduling meetings in advance is important. CONCLUSION: We described an approach to enhanced academic detailing using interprofessional team delivery, bringing interprofessional practice into the real-world practice setting.

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Using Interactive Technology to Aid Smokeless Tobacco Cessation: A Pilot Study

American Journal of Health Education ◽

10.1080/19325037.2001.10603495 ◽

2001 ◽

Vol 32 (6) ◽

pp. 332-342 ◽

Cited By ~ 5

Author(s):

K. John Fisher ◽

Herbert H. Severson ◽

Steven Christiansen ◽

Chris Williams

Keyword(s):

Pilot Study ◽

Smokeless Tobacco ◽

Tobacco Cessation ◽

Interactive Technology

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Perceived Impact of a Longitudinal Leadership Program for All Pharmacy Students

INNOVATIONS in pharmacy ◽

10.24926/iip.v5i3.349 ◽

2014 ◽

Vol 5 (3) ◽

Cited By ~ 2

Author(s):

Jane R. Mort ◽

Joe D. Strain ◽

David L. Helgeland ◽

Teresa M. Seefeldt

Keyword(s):

Positive Impact ◽

Leadership Skills ◽

Pharmacy Students ◽

First Year ◽

Leadership Perceptions ◽

Leadership Program ◽

Leadership Potential ◽

Professional Business ◽

Perceived Impact

Objective: To describe a longitudinal leadership program involving all students and report the perceived impact. Design: The program included a first year Leadership Interview, a third year Report of Leadership, and a fourth year Professional Business Meeting Attendance. Activities involved guided reflection. Assessment: Students (n=138) indicated the activities helped them recognize the importance of leadership and their leadership potential (e.g., 72.5% and 62.3% of students due to meeting attendance, respectively). Students participated in leadership activities that they would not have pursued otherwise, either in response to the activity (27.7% due to interview) or as a requirement of the activity (51.1% for leadership report). Students reported developing specific leadership skills through the activities. Most students planned to be involved in a district/regional (72.5%), state (84.1%), and national (51.4%) meeting in the five years following graduation. Conclusion: Students reported a positive impact on leadership perceptions and participation. The report is a preliminary step in the development and assessment of a longitudinal curricular initiative involving all pharmacy students. Type: Case Study

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Pilot Study on Frailty and Functionality on Routine Clinical Assessment in Allogeneichematopoietic Cell Transplantation to Predict Outcomes

Blood ◽

10.1182/blood-2019-126071 ◽

2019 ◽

Vol 134 (Supplement_1) ◽

pp. 380-380 ◽

Cited By ~ 1

Author(s):

Maria Queralt Salas ◽

Eshetu G Atenafu ◽

Ora Bascom ◽

Leeann Wilson ◽

Arjun Law ◽

...

Keyword(s):

Stem Cell ◽

Pilot Study ◽

Stem Cell Transplantation ◽

Grip Strength ◽

Cell Transplantation ◽

Waiting Time ◽

Acute Gvhd ◽

Number Of Patients ◽

And Function

Introduction: Frailty can adversely affect the outcomes of allogeneic hematopoietic stem cell transplantation (alloHSCT) but is difficult to measure in busy transplant clinics. The limited published studies have used dedicated trained persons and comprehensive geriatric assessment (GA) tools, which are time consuming (Muffly LS, Haematologica 2014; Holmes HM, J Geriatr Oncol 2014; Rodrigues M, J Geriatr Oncol 2019). The difficulty in application of GA tools by transplant clinicians, residents and nurses in their clinics has resulted in low adoption rates in routine practice. At our center we adopted selected tests for frailty and function which could be conducted during pre-transplant consultation in a busy clinic, without extra waiting time for patients, and using existing staff. The Timed up and Go test (TUGT) was adopted as it could be done in any closed clinic room, without need for a corridor. Thus it was considered safer than a gait speed test and was even applicable to patients in "isolation". We aim to share a preliminary analysis of the applicability and correlation between our selected frailty assessment with transplant outcomes and complications. Methods: Patients referred for transplant underwent the following assessments conducted by different providers. All ages were included. Relevant tests and source of data are as follows: Frailty and function by clinician evaluating (a) Clinical Frailty scale (CFS) with 9 points based on clinical judgement (Rockwood 2005) (b) Lawton's Instrumental activities of daily living (IADL). Objective physical performance by nursing BMT coordinator using (a) TUGT and (b) Grip strength using hydraulic "Jamar" hand dynamometer conducted in clinic room at time of documentation. Self assessment by patient completing (a) Self-rated health (SRH) question and (b) a question on falls. Blood tests (a) CRP (b) Albumin. The present study is a single center prospective observational study. Patients who did not proceed to transplant were excluded. Ninety-six consecutive adult allo-HSCT patients were eligible for the present analysis, updated on July 2019. The parameters were individually correlated with overall survival (OS), non-relapse mortality (NRM), cumulative incidence (cum.Inc) of acute GVHD, median time of transplant hospitalization and readmissions. Multivariate analysis was not performed in this pilot study due to limited number of patients and low frequency of adverse events. Results: Baseline characteristics and main post-transplant information are noted in Table 1. Median follow up of cohort was 5 months. Table 2 shows the main outcomes (with normal values). For the entire cohort the median OS at 6 months was 73.9% (range 61.7-82.8), NRM at day+100 was 8.7% (range 2.6-14.7), Cum.Inc of Acute GVHD 41.1% (range 30.1-52.1), Cum.Inc gr II-IV acute GVHD was 25.7% (range 15.6-35.9). Relapse occurred in 8 cases (8.3%) and deaths in 23 (23.9%). A TUGT of more than 10 seconds and raised CRP predicted poor OS (p<0.05). Abnormal TUGT, SRH question score of <A (excellent), lower albumin levels and raised CRP levels correlated with high NRM (p<0.05). A Clinical Frailty Score of more than 2, limitations of 1 or more IADLs, Grip strength below normal for age and sex, TUGT >10 seconds, SRH question <A, and lower albumin level were significant predictors for a longer median duration of transplant hospitalization. No frailty or functionality parameter correlated significantly with the Cum.Inc of any grade of acute GVHD, grade II-IV acute GVHD or the risk of rehospitalization after alloHSCT. Conclusions: Our pilot study shows that with selected brief tools, frailty and functionality can be assessed as part of routine clinical practice in allogeneic-stem cell transplantation in all age groups without extra waiting time for patients or additional human resources. TUGT is a useful prognostic tool which can be conducted in a clinic room and correlates with OS, NRM, and duration of hospitalization. Larger number of patients and longer follow-up will help to evaluate the different assessment modalities as prognostic tools in allo-HSCT and their wider applicability. Disclosures Michelis: CSL Behring: Other: Financial Support. Mattsson:Gilead: Honoraria; Celgene: Honoraria; Therakos: Honoraria.

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