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|The Consultant Pharmacist|
IN THIS ISSUE
August 2017 | Volume 32 | Number 8
Exercising with Veterans: How Social Interaction with a Pharmacy Student Improves Patient Care
A Pharmacist-Driven Deprescribing Initiative in a Nursing Facility: Lessons Learned
Editor-in-Chief, H. Edward Davidson, PharmD, MPH, gives a brief commentary on this issue of the journal and current new items of interest to consultant pharmacists.
Pharmacists and other health care professionals can be perplexed by the growing body of literature regarding the use of probiotics—a microorganism introduced into the body for its beneficial qualities—for a variety of symptoms and diseases and by an increasing number of probiotic products available. Pharmacists are faced with trying to translate the science and the research into usable, patient-specific recommendations and help patients—including elderly patients—understand the risks and benefits of probiotics.
In an elderly patient with atrial fibrillation, a pharmacist should evaluate bleeding risk if direct oral anticoagulants are continued, risk for stroke if anticoagulants are discontinued, and determine appropriate antibiotic prophylaxis prior to Mohs micrographic surgery.
By participating in the exercise program at a Veterans Affairs facility, a pharmacy student was able to get to know the veterans on a much deeper level than just completing their monthly chart reviews and attending treatment team meetings. By attending these exercise classes, she was able to see the veterans’ physical and cognitive abilities in action, which allowed her to cultivate more appropriate medication recommendations. Because of this, she was able to provide more individualized care for each veteran. New video interview for this article.
Prediction Accuracy of Winter-Tozer Equations to Estimate Free Phenytoin Concentrations in Non-Critically Ill Hospitalized Patients
Use of traditional and revised Winter-Tozer equations in primarily elderly, non-critically ill African-American populations can be considered to accurately predict phenytoin (PHT) levels in populations with altered PHT albumin binding resulting from hypoalbuminemia or end-stage renal disease and settings where free PHT levels are not readily obtainable. Seventy-seven percent of the non-critically ill hospitalized patients were African-Americans and primarily individuals 65 years of age and older.
There is an overall need for deprescribing for nursing facility residents with life-limiting illnesses. One potential implementation model—a pharmacist-driven initiative (DE-PHARM)—has shown promise in reducing potentially inappropriate medication for residents within the nursing facility setting. Because of the complexity of such a process, special attention must be paid to eligible residents and medications, the need for interprofessional collaboration, and the operational process. New video interview for this article.
Robert Warnock DPh, CGP, FASCP, is senior vice president of pharmacy Services, PruittHealth. He calls on pharmacists not to take a diminished role; instead they should make their voices heard because they are the drug experts and the lives of patients depend on them.
More than half of cancer diagnoses are in patients older than 65 years of age. The prevalence of cancer is increasing in geriatric patients as life expectancy increases. Geriatric oncology patients are a challenging population to care for, as they experience important age-related physiologic changes that must be considered when making therapeutic decisions and recommendations.
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The Consultant Pharmacist® is the official monthly peer-reviewed journal of the American Society of Consultant Pharmacists (ASCP). It is the only journal dedicated exclusively to the medication therapy needs of seniors. ASCP members receive The Consultant Pharmacist® as a member benefit. All articles (2004 to present) are free online for members.
2017 ASCP Integrated Media Kit
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