Defining the role of pharmacists in medication-related genetic counseling

2021 ◽  
Author(s):  
Nova A Chart ◽  
David F Kisor ◽  
Christopher L Farrell
Keyword(s):  
Genetic Risk ◽  
Pharmacy Practice ◽  
Interdisciplinary Team ◽  
Standard Of Care ◽  
Treatment Team ◽  
Multiple Cancer ◽  
Cancer Treatments ◽  
Disease States ◽  
Practice Approach

There is little question that precision medicine will eventually be the standard of care in treatment with algorithms designed for therapy selection and is already being used in some specialties such as cystic fibrosis and multiple cancer treatments. Genetic counselors are the heart of the treatment team in relation to counseling regarding genetic risk factors and disease states. A framework for treatment within the interdisciplinary team with more defined roles and areas of specialty will need to be in place as this practice approach expands with new data and treatments. Pharmacists are poised to be of great assistance in this matrix as many of these roles are merely an extension of current tasks and responsibilities of pharmacy practice.

scholarly journals Update on the role of pembrolizumab in patients with unresectable or metastatic colorectal cancer

2021 ◽  
Vol 14 ◽  
pp. 175628482110244
Author(s):  
Vanessa Wookey ◽  
Axel Grothey
Keyword(s):  
Colorectal Cancer ◽  
Immune Checkpoint ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Standard Of Care ◽  
Cancer Type ◽  
Cancer Therapies ◽  
Multiple Cancer ◽  
Multiple Treatment

Colorectal cancer (CRC) is the third most common cancer type in both men and women in the USA. Most patients with CRC are diagnosed as local or regional disease. However, the survival rate for those diagnosed with metastatic disease remains disappointing, despite multiple treatment options. Cancer therapies for patients with unresectable or metastatic CRC are increasingly being driven by particular biomarkers. The development of various immune checkpoint inhibitors has revolutionized cancer therapy over the last decade by harnessing the immune system in the treatment of cancer, and the role of immunotherapy continues to expand and evolve. Pembrolizumab is an anti-programmed cell death protein 1 immune checkpoint inhibitor and has become an essential part of the standard of care in the treatment regimens for multiple cancer types. This paper reviews the increasing evidence supporting and defining the role of pembrolizumab in the treatment of patients with unresectable or metastatic CRC.

Introduction to Public Health in Pharmacy

2018 ◽  
Keyword(s):  
Public Health ◽  
Population Health ◽  
Pharmacy Practice ◽  
The United States ◽  
Pharmacy Education ◽  
Health Care Outcomes ◽  
Disease States ◽  
Care Outcomes ◽  
The Impact

The need for texts that blend the areas of pharmacy and public health has continued to expand. Introduction to Public Health in Pharmacy (second edition), builds upon the Center for the Advancement of Pharmacy Education (CAPE) Educational Outcomes report, which emphasizes public health in the domains of Foundational Knowledge and Essentials of Pharmacy Practice and Care, focusing on both patient and population health care outcomes. This second edition has (a) a strong pharmacy-relevant emphasis on the foundations of public health in pharmacy and (b) an increased emphasis on the impact of pharmacy on disease states important in public health and pharmacy in the United States and internationally. This text can be adopted for pharmacy and public health courses but would also be a valuable resource to those teaching therapeutics, patient care, disease prevention, and community engagement. In addition, it is an invaluable resource and handbook for practitioners. The focus is on the role of pharmacy in population health.

Some Legal Issues Presented in Clinical Pharmacy Practice

1976 ◽  
Vol 10 (8) ◽  
pp. 444-447 ◽  
Author(s):  
Joseph L. Fink
Keyword(s):  
Pharmacy Practice ◽  
Standard Of Care ◽  
Legal Issues ◽  
Clinical Activity ◽  
Clinical Role ◽  
Everyday Practices ◽  
Legal Questions ◽  
Federal Food ◽  
General Principles Of Law

As the pharmacist's clinical role expands he is confronted with legal questions concerning actual or proposed activities. A number of papers have appeared in the literature of pharmacy which address the potential legal liability of the pharmacist who engages in clinical activity but most are written in terms of general principles of law with few specific circumstances addressed. In this article, legal questions raised by clinical pharmacists in the course of their everyday practices are evaluated and discussed. Among the issues presented are use of an FDA-approved drug for an unapproved use, informed consent in administration of unapproved drugs, the role of the pharmacist in managing hypertensive patients visiting a hospital-based clinic, the legality of a pharmacist administering injectible drugs, the legality of permitting Pharm.D. students to draw blood, and the application of the Federal Food, Drug and Cosmetic Act to the preparation of aluminum hydroxide cookies for dialysis patients. The specific questions are answered and the legal standard of care expected of pharmacists performing clinical functions is discussed. While no cases have been decided yet concerning newer clinical activities, some precedent can be found in past cases. Approaches to handling these questions should be of value in addressing future legal issues presented as pharmacists further seek to better utilize their knowledge.

Professional Liability for Pharmacists: A Focus on Pharmacy Practice Acts

1988 ◽  
Vol 22 (11) ◽  
pp. 886-888 ◽  
Author(s):  
Mark A. Munger ◽  
Jeffrey A. Green ◽  
Paul A. Greve ◽  
Lynn S. Lovejoy
Keyword(s):  
Drug Use ◽  
Drug Administration ◽  
Pharmaceutical Research ◽  
Pharmacy Practice ◽  
Standard Of Care ◽  
Administrative Law ◽  
Professional Standard ◽  
State Statutes ◽  
Definition Of

The increased complexity of pharmacotherapeutics and the expanded role of pharmacists in the drug-use process may bring about an increased liability exposure for failure to conform to a professional standard of care. Therefore, a survey of 51 state pharmacy practice acts was conducted: (1) to establish a nationwide statutory definition of pharmacy practice, and (2) to outline possible use of the statutes in civil and administrative law. Twenty percent of state statutes contain no definition of pharmacy practice. Of the remaining 41 states, dispensing (97.5 percent), compounding (92.5 percent), interpretation and evaluation of prescriptions (68.2 percent), and consultation (73 percent) are legally defined. Pharmacokinetic consultation, drug administration, pharmacist prescribing, and pharmaceutical research are defined in one, seven, four, and one state(s), respectively. Pharmacists may face legal responsibilities from both the courts and state boards of medical and pharmacy practice. Aggressively updating the statutes and regulations to reflect contemporary pharmacy practice may provide a mechanism for a defense in court litigation and regulatory action.

ROLE OF INDOCYANINE GREEN (ICG) IN SENTINEL NODE MAPPING IN GYNECOLOGIC CANCER: A TIME FOR A NEW STANDARD OF CARE?: IGCS-0083 Imaging / Staging

2015 ◽  
Vol 25 (Supp 1) ◽  
pp. 44-45
Author(s):  
M. C. Darin ◽  
Rodriguez N. Gómez-Hidalgo ◽  
P. Escobar ◽  
M. Frumovitz ◽  
P. T. Ramirez
Keyword(s):  
Indocyanine Green ◽  
Sentinel Node ◽  
Gynecologic Cancer ◽  
Standard Of Care ◽  
Sentinel Node Mapping

scholarly journals Assessing social preferences in reimbursement negotiations for new Pharmaceuticals in Oncology: an experimental design to analyse willingness to pay and willingness to accept

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dominik J. Wettstein ◽  
Stefan Boes
Keyword(s):  
Willingness To Pay ◽  
Real World ◽  
Cognitive Biases ◽  
Social Preferences ◽  
Standard Of Care ◽  
Added Value ◽  
Amazon Mechanical Turk ◽  
Patient Organisation ◽  
Patient Benefit

Abstract Background Price negotiations for specialty pharmaceuticals take place in a complex market setting. The determination of the added value of new treatments and the related societal willingness to pay are of increasing importance in policy reform debates. From a behavioural economics perspective, potential cognitive biases and other-regarding concerns affecting outcomes of reimbursement negotiations are of interest. An experimental setting to investigate social preferences in reimbursement negotiations for novel, oncology pharmaceuticals was used. Of interest were differences in social preferences caused by incremental changes of the patient outcome. Methods An online experiment was conducted in two separate runs (n = 202, n = 404) on the Amazon Mechanical Turk (MTurk) platform. Populations were split into two (run one) and four (run two) equally sized treatment groups for hypothetical reimbursement decisions. Participants were randomly assigned to the role of a public price regulator for pharmaceuticals (buyer) or a representative of a pharmaceutical company (seller). In run two, role groups were further split into two different price magnitude framings (“real world” vs unconverted “real payoff” prices). Decisions had real monetary effects on other participants (in the role of premium payers or investors) and via charitable donations to a patient organisation (patient benefit). Results 56 (run one) and 59 (run two) percent of participants stated strictly monotone preferences for incremental patient benefit. The mean incremental cost-effectiveness ratio (ICER) against standard of care (SoC) was higher than the initial ICER of the SoC against no care. Regulators stated lower reservation prices in the “real world” prices group compared to their colleagues in the unconverted payoff group. No price group showed any reluctance to trade. Overall, regulators rated the relevance of the patient for their decision higher and the relevance of their own role lower compared to sellers. Conclusions The price magnitude of current oncology treatments affects stated preferences for incremental survival, and assigned responsibilities lead to different opinions on the relevance of affected stakeholders. The design is useful to further assess effects of reimbursement negotiations on societal outcomes like affordability (cost) or availability (access) of new pharmaceuticals and test behavioural policy interventions.

scholarly journals The Role of Extracellular Vesicles in the Development of a Cancer Stem Cell Microenvironment Niche and Potential Therapeutic Targets

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2435
Author(s):  
Thomas J. Brown ◽  
Victoria James
Keyword(s):  
Systematic Review ◽  
Tumor Microenvironment ◽  
Extracellular Vesicles ◽  
Multiple Cancer ◽  
Therapeutic Targeting ◽  
Small Component ◽  
Facilitated Communication ◽  
Cell Microenvironment ◽  
Cancer Types

Cancer stem cells (CSCs) have increasingly been shown to be a crucial element of heterogenous tumors. Although a relatively small component of the population, they increase the resistance to treatment and the likelihood of recurrence. In recent years, it has been shown, across multiple cancer types (e.g., colorectal, breast and prostate), that reciprocal communication between cancer and the microenvironment exists, which is, in part, facilitated by extracellular vesicles (EVs). However, the mechanisms of this method of communication and its influence on CSC populations is less well-understood. Therefore, the aim of this systematic review is to determine the evidence that supports the role of EVs in the manipulation of the tumor microenvironment to promote the survival of CSCs. Embase and PubMed were used to identify all studies on the topic, which were screened using PRISMA guidelines, resulting in the inclusion of 16 studies. These 16 studies reported on the EV content, pathways altered by EVs and therapeutic targeting of CSC through EV-mediated changes to the microenvironment. In conclusion, these studies demonstrated the role of EV-facilitated communication in maintaining CSCs via manipulation of the tumor microenvironment, demonstrating the potential of creating therapeutics to target CSCs. However, further works are needed to fully understand the targetable mechanisms upon which future therapeutics can be based.

scholarly journals Macrocyclic Peptides as Allosteric Inhibitors of Nicotinamide N-Methyltransferase (NNMT)

2021 ◽  
Author(s):  
Matthijs van Haren ◽  
Yurui Zhang ◽  
Vito Thijssen ◽  
Ned Buijs ◽  
Yongzhi Gao ◽  
...  
Keyword(s):  
Allosteric Inhibitors ◽  
Methyl Donor ◽  
Disease States ◽  
Macrocyclic Peptides

Nicotinamide N-methyltransferase (NNMT) methylates nicotinamide to form 1-methylnicotinamide (MNA) using S-adenosyl-L-methionine (SAM) as the methyl donor. The complexity of the role of NNMT in healthy and disease states is slowly...

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