Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists

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OBJECTIVE : To assess whether a letter explaining the risks of alprazolam can engage older adults to call a clinical pharmacist (CP) to initiate reduction in alprazolam use. DESIGN : Randomized, controlled study. SETTING : Integrated health care delivery system. PATIENTS : Patients 65 years of age and older who resided at home, had a current supply of alprazolam as of December 15, 2016, and had four outpatient dispensings of alprazolam during the previous 12 months. INTERVENTION : Patients were randomized to receive an educational outreach regarding alprazolam use reduction via a mailed letter (intervention group) or receive usual care (control group)...

Alzheimer's disease is becoming more predominant in our aging population. Statin medications have been reported to contribute to cognitive impairment. Updated cholesterol treatment guidelines significantly increase the proportion of people eligible for treatment with statins. Therefore, uncommon adverse effects related to this medication class have the potential to impact health care by increasing cognitive impairment and/or contributing to statin treatment avoidance. CASE : An 83-year-old Caucasian male was seen in a cognitive evaluation clinic for noticeable memory decline...

A 78-year-old Hispanic woman presented to an ambulatory care clinic for older adults describing memory impairment and requesting an assessment of her cognitive status. A Mini-Mental State Examination (MMSE) was performed and found to be 29/30 (normal). One year later, the same situation occurred and her MMSE was again found to be 29/30 (normal). However, a Saint Louis University Mental Status (SLUMS) examination administered that same day demonstrated a different result: a score of 19/30 (dementia). Fourteen months later, the patient returned again and scored 26/30 (normal) on the MMSE and 22/30 (mild neurocognitive disorder) on the SLUMS...

OBJECTIVE : Review the clinical manifestations and treatment of primary Sjögren's syndrome. DATA SOURCES : Articles indexed in PubMed, Scopus, and the Cochrane Library in the past 10 years using the key words "Sjögren," "Sjögren's syndrome," "Sjögren's disease," and "Sjögren's syndrome AND treatment." Primary sources were used to locate additional resources. STUDY SELECTION AND DATA EXTRACTION : Forty-six publications were reviewed and criteria supporting the primary objective were used to identify useful resources...

The use of medical marijuana-both the psychoactive tetrahydrocannabinol and its nonpsychoactive relative cannabidiol-is a growing practice in facilities served by senior care pharmacists. Currently, 30 states have approved its use under a variety of different regulations and for a number of conditions. Its use is bolstered by a growing number of Americans who support legalization of cannabis. Though oral synthetic cannabinoid compounds are approved by the Food and Drug Administration for chemotherapy-induced nausea and vomiting and appetite stimulation associated with AIDS, synthetic products differ from plant-derived products in several ways...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

OBJECTIVE: The purpose of this report is to describe the case of a 43-year-old male with asthma who was hospitalized for an exacerbation of non-cystic fibrosis bronchiectasis (NCFB), a chronic lung disease that is characterized by dilation of the airways, persistent cough, chronic sputum production, and recurrent respiratory infections. He was treated with oral and inhaled antibiotics, inhaled bronchodilators, and aggressive airway-clearance techniques including nebulized 7% sodium chloride, flutter valve, and high-frequency chest wall oscillation...

OBJECTIVE: Provide an up-to-date review for health care providers regarding clinically significant food-drug interactions and summarize recommendations for optimal medication administration in older adults and long-term care patients. DATA SOURCES: A literature search was performed using MEDLINE, PUBMED, and IPA abstracts to locate relevant articles published between January 1982 and July 2017. DAILYMED was used to identify manufacturer-specific medication administration recommendations. STUDY SELECTION AND DATA EXTRACTION: Articles were reviewed for inclusion based on their relevance to this subject matter and the integrity of the information provided...

OBJECTIVES: To describe the prevalence of potentially inappropriate medications (PIMs) in older patients (65 years of age and older) in three selected polyclinics (PCs) and gather the perceptions of the health care providers in these PCs on the barriers and facilitators of deprescribing in their practice. To analyze the patients' age, number of active chronic diseases, and number of medicines, and investigate if they could influence the presence of PIMs. DESIGN: The study has two separate parts: The first part is a retrospective cross-sectional data collection of prescriptions; the second part is a prospective cross-sectional analysis of questionnaires by health care providers...

OBJECTIVES: Prevalence of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs). DESIGN: Cross-sectional study through review of residents' records. SETTING: Three nursing homes of Puerto Rico's metropolitan area. PARTICIPANTS: Nursing home residents. INTERVENTION: Records of residents 65 years of age and older with documented medications and chronic diseases were reviewed. Hospitalized and hospice/palliative care residents were excluded. Beers criteria-2015 and START-STOPP criteria-2014 were applied to identify PIMs and PPOs...

Chronic care management (CCM) aims to improve health outcomes by enhancing care coordination for patients with multiple chronic conditions. However, few incentives have been provided in recent years for health care professionals to engage in models that improve care coordination. These potential models could help avoid poor health outcomes that lead to hospitalizations and rehospitalizations. Fortunately, in January 2015, under Medicare's physician fee schedule, Medicare began paying separately for CCM services...

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No abstract text is available yet for this article.

Introduction Elderly patients are particularly susceptible to polypharmacy issues because of age-related changes in pharmacokinetics and pharmacodynamics as well as to chronic diseases resulting in a continuous increasing demand for drugs. Objective This study captures the prevalence of polypharmacy and adherence in Greece and identifies related risk factors in adult patients with diabetes. Design A cross-sectional study was conducted among patients diagnosed with diabetes mellitus attending public and private outpatients' clinics in the regions of Attica and Western Greece...

Objective The resident-directed medication administration program (RDMA) is a personalized medication approach designed to improve the medication administration process in long-term care facilities (LTCFs). This evaluation aimed to document staff experience with the RDMA program compared with staff working in facilities using a facility-directed medication administration program (FDMA). Design This descriptive program evaluation invited staff members to share their experiences with the medication administration process through an anonymous survey...

The Chesapeake Regional Information System for our Patients (CRISP) is a health information exchange in Maryland that is designed to improve communication among members of the health care team including physicians, nurses, and other health professionals. Senior care pharmacists gained access to CRISP through successful collaborative efforts at both the state and national levels. This involved efforts to address medication-related problems that continue to be a concern during transitions of care, especially for older, vulnerable adults...

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