Association of blood pressure with sodium-related knowledge and behaviors in adults with hypertension.

 

Increased sodium consumption can increase ones chances of developing hypertension. The purpose of this study was to evaluate a test group of 664 patients with hypertension to see if they were aware of this fact, and if they regularly checked the amount of sodium that was in their food. The vast majority of the patients (91.1%) reported that they were aware of the correlation between sodium and hypertension, but only 15% reported that they regularly check the sodium content of the food that they buy.

It is an interesting problem that so many patients are aware of the effects of excessive sodium intake, but so few actually do anything to regulate their sodium intake. It is possible that people just don’t realize they can keep track of the amount of sodium that is in their foods so easily. If that is the case, doctors and pharmacists should make sure that they are not only telling hypertensive patients about the effects of sodium, but also reminding them that they can easily keep track of how much sodium they are getting by looking at the nutrition facts labels of the food they buy.

Westrick SC, Garza KB, Stevenson TL, Oliver WD. Association of blood pressure with sodium-related knowledge and behaviors in adults with hypertension. Journal of American Pharmacists Association. 2014;54;154-158.

Variability in compounding of oral liquids for pediatric patients: A patient safety concern

There are many medications that are compounded into a liquid so that children can take them more easily. This study used a survey to ask pharmacists about their compounding technique and the different concentrations of the medications that they compound. The results was that there are many different ways that pharmacists will compound drugs, and that the end liquid can be many different concentrations. This could be because children of different sizes need different doses, but it also because there is not a set standard for what the concentrations of compounded drugs should be.

This can be a concern in transition of care settings, where a patient may be receiving a certain concentration of their medication, but then get it from a different place than before and receive a different concentration. This could potentially lead to the patient taking too much of the medication if they are not paying close attention. This study only looked at the variation in compound concentrations, and did not look at how often variations in concentrations actually lead to an adverse event, so it is not clear if this is actually a serious problem.

 

Rood JM, Engels JM, Ciarkowski SL, et al. Variability in compounding of oral liquids for pediatric patients: A patient safety concern. Journal of American Pharmacists Association. 2014;54; 383-389

http://www.japha.org/article/S1544-3191(15)30212-0/abstract

Anticholinergic drugs and health-related quality of life in older adults with dementia

This study was done to see if anticholinergic drugs could be leading to a decreased quality of life among older adults with dementia. There were 112 people involved in the study, most of whom were between the ages of 65 and 79 years old. The results were measured using two separate scores. There was a Physical Component score and a Mental Component score. The results showed a significant decrease in the physical component score, equating to a decreased quality of life. There was no association found between anticholinergic drug use and the mental component score.

Anticholinergic drugs are used to treat a wide variety of medical conditions, many of which are common in older adults, but there are adverse effects with these drugs that could potentially be very dangerous. Anticholinergic drugs can effect mental concentration and increase the risk of falls in older adults. They also cause other adverse effects, such as constipation, urinary retention, and xerostomia, which can lead to a decrease in the patient’s quality of life. Since the drugs were only shown to decrease patient’s physical quality of life and did not improve their mental component score, anticholinergic drugs may not be the best way to treat older patients with dementia.

 

Sneha D. Sura, Ryan M. Carnahan, Hua Chen, Rajender R. Aparasu. Anticholinergic drugs and health-related quality of life in older adults with dementia. Journal of American Pharmacists Association.  2015;55;282-287

http://www.japha.org/article/S1544-3191(15)30061-3/fulltext

Ceftolozane–tazobactam: A new-generation cephalosporin

Bacterial resistance to current antibiotics is a major concern today. Some people do not take their medications properly, leading to the development of antibiotic resistant bacteria. In response to this, scientists are trying to develop new antibiotics that can kill these resistant bacteria. One new antibiotic is ceftolozane-tazobactam. Ceftolozane-tazobactam, a cephalosporin, is a beta-lactam and beta-lactamase inhibitor that can be used to treat urinary tract and intraabdominal infections. Its suggested use is to treat multi-drug-resistant bacterial infections.

This medication could be very beneficial to people who have an infection that can not be treated by other antibiotics, but the cost is very expensive. The wholesale acquisition cost for seven days of treatment with ceftolozane-tazobactam is $1700, and the article states that there are alternative antibiotics that are have a similar efficacy and are much less expensive. Due to this, I’m not sure how much this new antibiotic will actually be used in practice, but I think it is good that there are people still working to find better antibiotics.

David Cluck, Paul Lewis, Brooke Stayer, Justin Spivey, and Jonathan Moorman. “Ceftolozane–tazobactam: A new-generation cephalosporin” American Journal of Health-System Pharmacy. 72.24 (2015): 2135-2146

<http://www.ajhp.org.pitt.idm.oclc.org/content/72/24/2135.full>

Impact of a transition-of-care pharmacist during hospital discharge

Around 60% of all medication errors happen during transitions between health care settings. These errors can lead to adverse effects and readmission into hospitals. Having a pharmacist present during these transitions to educate patients on their medications and to talk to the patient to make sure that they can afford all of their medications can decrease the rate of readmissions to hospitals and improve adherence. This study was done at a hospital in Arizona that had previously only had physicians or nurses talking to patients during the transition-of-care period. The pharmacist not only educated patients, but also fixed medication errors such as duplications in therapy, incorrect doses, and inappropriate prescriptions, which were found with nearly half of the patients leaving the hospital.

The addition of a pharmacist in this setting improved the hospitals’ readmission rate by a statistically significant amount.  This shows the importance of pharmacists in a hospital setting, and also shows that pharmacists are currently being underused. Pharmacists are the health care professionals that know the most about medications, so it makes sense that they should be involved when patients are leaving hospitals with new medications. This study has shown the benefits of having a pharmacist playing a more active role in health care, specifically in transitions of care. Hopefully this will lead to a greater recognition of this facts and we will see more pharmacists in the transition of care setting.

Balling, Lauren, Erstad, Brian L., and Weibel, Kurt. “Impact of a transition-of-care pharmacist during hospital discharge.” Journal of the American Pharmacists Association 55.4 (2015): 443-448. Sciencedirect. Web. < http://www.sciencedirect.com.pitt.idm.oclc.org/science/journal/15443191/55/4>

Physician–pharmacist collaborative care model for buprenorphine-maintained opioid-dependent patients

Opioid abuse is a growing problem in the United States. Many people who have been prescribed opioids have developed a dependence to them, and it can be difficult for these people to find help due to stigmas against addicts. A new way to help these people become independent from opioids is to treat them with buprenorphine/naloxone. Buprenorphine, a partial opioid agonist, has been shown to be effective in treating opioid use disorder.

This study involved collaboration between the physicians and pharmacists so that they could work together to help the patients manage their opioid dependence.  The study showed that this treatment, along with weekly to monthly follow up visits with the physician and pharmacist, and the collaboration between the physician and pharmacist, increased patient outcomes significantly. This study not only shows the benefits of buprenorphine treatment, but also shows how important interprofessional communication can be, and how effective it is at improving patient outcomes.

 

DiPaula, Bethany A., and Elizabeth Menachery. “Physician–pharmacist Collaborative Care Model for Buprenorphine-maintained Opioid-dependent Patients.” Journal of the American Pharmacists Association 55.22 (2015): 187-92. Sciencedirect. Web. <http://www.sciencedirect.com.pitt.idm.oclc.org/science/journal/15443191/55/2>.