Ranibizumab: A Review of Its Use in the Treatment of Diabetic Retinopathy in Patients With Diabetic Macular Edema.

Objective: To evaluate the pharmacotherapy role of ranibizumab, a vascular endothelial growth factor (VEGF) inhibitor, for the treatment of diabetic retinopathy (DR) in patients with diabetic macular edema (DME). Data Sources: PubMed, Science Direct, Google Scholar, and ClinicalTrials.gov searches (January 2000-May 2015) were conducted for articles published in English, and limited to clinical trials using the key words ranibizumab, DR, DME, anti-VEGF, and DR treatment. Study Selection and Data Extraction: Following PubMed, Science Direct, Google Scholar, and ClinicalTrials.gov searches, 4 clinical trials were identified and included in this review. Phase III/IV studies evaluating the clinical efficacy of ranibizumab versus placebo, ranibizumab versus laser, and ranibizumab versus other anti-VEGF agents were selected and evaluated. Data Synthesis: Ranibizumab administered to patients with DME for 12 to 36 months improved and prevented worsening of visual acuity. At month 36 the ranibizumab-treated eyes had a >2 or >3 step DR improvement compared with the sham crossover eyes. Ranibizumab was also found to be superior to laser treatment. Patients receiving ranibizumab gained 6.0 letters, improved tritan and protan color contrast thresholds, and demonstrated improved retinal sensitivity versus the subjects receiving laser treatment who lost 0.9 letters. When ranibizumab was compared with other anti-VEGF agents (aflibercept, pegaptanib, and bevacizumab), it was not always demonstrated to be significantly superior. Conclusion: Ranibizumab has been shown to be safe and efficacious for use in the treatment of DR in patients with DME. Thus, it is an alternative treatment approach to laser photocoagulation therapy.

Review of Best Practices for Diversity, Equity, and Inclusion Committees Within Colleges of Pharmacy.

Objective. To provide a review of best practices for diversity, equity, and inclusion (DEI) committees at United States colleges of pharmacy.Findings. In colleges of pharmacy, DEI committees can play a crucial role in promoting a culture change to ensure pharmacy graduates are equipped to provide equitable and representative care for the patients they serve. There is limited literature available on DEI committee composition, roles, and responsibilities, and their place within a college of pharmacy's organizational structure. A commitment to DEI should be part of the college's strategic plan and embedded and supported at all levels of the college and university to ensure success of DEI-related strategic initiatives. For a DEI committee to be effective, its composition should be intentional to include change agents, campus leaders, and members who are passionate and knowledgeable to execute the DEI goals. For sustainable change, involvement of the entire learning community and an organizational culture change is also important. Thus, DEI committees need to establish active bidirectional collaborations and communication with all key committees, offices, community leaders, and alumni to implement diversity goals.Summary. The DEI committee's established place in the organizational structure of the college is essential to ensure fair and appropriate representation of the community it serves. A clearly defined DEI committee with committee composition, roles, responsibilities, and its association with all constituents of the college and community can help achieve its intended strategic goals.

Lessons from a cross-institutional online professional development pilot.

PURPOSE: To reflect on a collaborative approach used by a group of faculty and administrators from historically Black colleges and universities (HBCU) and predominantly Black institution (PBI) pharmacy programs to provide high quality, multiple institution, faculty development programming in online environments. DESCRIPTION: A pilot for a shared online professional development initiative between pharmacy programs at five HBCUs and one PBI was implemented as a two-hour combined video conference and webinar, with structured networking, instructional programming, and breakout group sessions. Learning outcomes focused on increasing knowledge and awareness of mindsets in faculty and students with additional project goals of beta-testing interactive web conference formats, developing cross-institutional networking, and identifying avenues for sharing resources and expertise. ANALYSIS/INTERPRETATION: Kolb's Cycle of Experiential Learning (Concrete Experience, Reflective Observation, Abstract Conceptualization, and Active Experimentation) was used to guide reflection on the joint workshop. The instructional design, delivery, and learning experiences of the program itself were analyzed using Garrison's Community of Inquiry Framework. CONCLUSIONS: Action research approaches can be applied to facilitate the continuous quality improvement cycle in multi-institution initiatives, such as joint faculty development programming. IMPLICATIONS: Lessons related to cross-institutional collaboration, communities of practice development, networking, and communication can be used for future joint faculty development sessions and other shared initiatives for institutions serving minoritized students as well as other multiple institution consortiums.

Envisioning the Future of Student Success: Report of the 2022-2023 AACP Student Affairs Standing Committee.

Over the past several years, traditional metrics have indicated declining student success within colleges and schools of pharmacy. Though students may be less well-prepared for professional school than in years past, once candidates are admitted to our institutions, we have a responsibility to effectively support their progression through the program. The 2022-2023 Student Affairs Committee was convened to evaluate and advance the construct of student success within Doctor of Pharmacy programs. The Student Affairs Committee was charged with identifying environmental factors affecting the ability of pharmacy students to be successful; determining how colleges and schools of pharmacy are currently meeting needs related to student progress; conducting a literature review to determine what academic support measures minimize attrition; and developing innovative suggestions and recommendations that better support student success. To accomplish this work, we conducted an extensive literature review and synthesis of evidence, engaged in professional networking across the Academy, and administered a wide-ranging student success survey to all colleges and schools of pharmacy. In this report, we explore the complex and interacting systems that affect learning behavior and academic success and offer a novel, comprehensive description of how the Academy is currently responding to challenges of academic and student success. Additionally, we envision the future of student success, offering 7 recommendations to the American Association of Colleges of Pharmacy and 5 suggestions to members of the Academy to advance this vision.

Campus-community pharmacy partnership to foster awareness and use of MedlinePlus.

OBJECTIVE: To determine the impact of a campus-community pharmacy partnership to foster awareness and use of National Library of Medicine (NLM) databases, including MedlinePlus, among minority populations. DESIGN: Uncontrolled study with pretest and posttest. SETTING: Two community pharmacies and Bethel World Ministry in the Washington, D.C., metropolitan area. PARTICIPANTS: 8 student pharmacists and pharmacy residents and 92 patients. INTERVENTION: Training of patients by student pharmacists and pharmacy residents in the use of NLM databases during prescription-fill wait time. MAIN OUTCOME MEASURES: Pre- and post-survey responses and telephone followup designed to assess familiarity with NLM databases, including MedlinePlus. RESULTS: Overall, the familiarity of the participants with MedlinePlus and NLM databases increased fivefold before versus after training. The 1-week follow-up confirmed this trend. However, no statistically significant differences in responses (pre-and posttest/follow-up) to the surveys were observed in regard to specific questions on daily and future use of the NLM databases available on the Internet. CONCLUSION: Awareness and use of MedlinePlus by study participants increased.

Adverse Effects Associated With Newer Diabetes Therapies.

The increasing number of newer type 2 diabetes therapies has allowed providers an increased armamentarium for the optimal management of patients with diabetes. In fact, these newer agents have unique benefits in the management of type 2 diabetes. However, they are also associated with certain adverse effects. This review article aims to describe the notable adverse effects of these newer antidiabetic therapies including the glucagon-like peptide 1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and the sodium-glucose cotransporter 2 inhibitors. The adverse effects reviewed herein include pancreatitis, medullary thyroid carcinoma, heart failure, gastrointestinal disturbances, renal impairment, and genitourinary infections. More clinical data are necessary to solidify the association of some of these adverse effects with the newer diabetes agents. However, it is important for health care practitioners to be well informed and prepared to properly monitor patients for these adverse effects.

Aflibercept: A Review of Its Use in the Management of Diabetic Eye Complications.

Aflibercept is the most recently approved vascular endothelial growth factor (anti-VEGF) inhibitor for the management of diabetic macular edema and diabetic retinopathy. The purpose of this article is to review the efficacy and safety of aflibercept in the management of diabetic eye complications and to describe its place in therapy. Anti-VEGF agents have been noted in clinical trials to be superior to laser photocoagulation, the standard therapy ( P < .0001, P ≤ .0085, respectively). Aflibercept has been comparatively studied with other anti-VEGF agents, namely, bevacizumab and ranibizumab, and noted to be equally efficacious and safe in patients with mild visual acuity loss ( P > .50). However, in the treatment of patients with diabetic macular edema having moderate to severe visual acuity loss, aflibercept outperformed the other 2 anti-VEGF agents (aflibercept vs bevacizumab, P < .001; aflibercept vs ranibizumab, P = .003). However, additional studies are needed to fully appreciate the long-term safety and efficacy of aflibercept and the anti-VEGF therapy class.

Complementary and alternative medicine instruction in nursing curricula.

With an ever-increasing number of consumers reportedly using non-conventional methods of disease management, nurses have now been recognized as key providers in education on complimentary and alternative medicine (CAM). The risk of herb-drug interactions secondary to consumer use of alternative medicines further increases the need for nurses to assume the role of patient educators in the area of CAM. Many nurses, however, feel rather ill-prepared to properly care for patients using CAM due to inadequate instruction on the subject matter during their training. Many nursing educators have now moved to address such concerns by considering including education on CAM therapies in the nursing school curriculum. This study evaluated CAM education in US nursing schools to gain a perspective on how nursing students are currently being trained. A survey questioning CAM education was administered to 148 nursing schools and collected over a 3-month period. The results indicate that nearly half of the responding schools offered some form of education on CAM in their curriculum with electives being the primary form of instruction. Teaching methodologies on CAM instruction in the curriculum included group discussion on CAM topics, lectures, and review of case studies. The majority of faculty respondents in this study held Ph.D. degrees followed by instructors holding a MS, DNS, and/or MSN degree.

Novel and emerging diabetes mellitus drug therapies for the type 2 diabetes patient.

Type 2 diabetes mellitus is a metabolic disorder of deranged fat, protein and carbohydrate metabolism resulting in hyperglycemia as a result of insulin resistance and inadequate insulin secretion. Although a wide variety of diabetes therapies is available, yet limited efficacy, adverse effects, cost, contraindications, renal dosage adjustments, inflexible dosing schedules and weight gain significantly limit their use. In addition, many patients in the United States fail to meet the therapeutic HbA1c goal of < 7% set by the American Diabetes Association. As such new and emerging diabetes therapies with different mechanisms of action hope to address some of these drawbacks to improve the patient with type 2 diabetes. This article reviews new and emerging classes, including the sodium-glucose cotransporter-2 inhibitors, 11ß-Hydroxysteroid dehydrogenase type 1 inhibitors, glycogen phosphorylase inhibitors; protein tyrosine phosphatase 1B inhibitors, G Protein-Coupled receptor agonists and glucokinase activators. These emerging diabetes agents hold the promise of providing benefit of glucose lowering, weight reduction, low hypoglycemia risk, improve insulin sensitivity, pancreatic ß cell preservation, and oral formulation availability. However, further studies are needed to evaluate their safety profile, cardiovascular effects, and efficacy durability in order to determine their role in type 2 diabetes management.

Injectable administration privileges among pharmacists in the United States.

PURPOSE: Privileges for administering nonvaccine injectable medications among pharmacists in the United States were assessed. METHODS: An e-mail inquiry on specific protocols for the administration of injectables was sent to the state boards of pharmacy (BOPs) for all 50 states and the District of Columbia that had a valid e-mail address listed on the National Association of Boards of Pharmacy website. Respondents were encouraged to include in their response a link to state regulations so that information from the BOP laws on privileges for administering injectables could be closely reviewed. State guidelines were reviewed online for all BOPs that did not respond to the first e-mail in order to complete the study. A follow-up e-mail was sent only to those respondents whose states granted pharmacists privileges for administering nonvaccine injectables in order to clarify the specific drugs allowed to be injected by pharmacists. RESULTS: Responses received included either links to state regulations or explicit statements of the rules regarding pharmacists' injectable privileges. A total of 21 states currently grant pharmacists articulate written information or rules pertaining to the privilege of administering nonvaccine injectable products. Authority is provided through collaborative practice agreements for most states. Products administered by pharmacists vary by state. CONCLUSION: Pharmacists in 21 states were found to have privileges for administering injectable medications other than vaccines. Pharmacists were authorized to administer these drugs through completion of training approved by the Accreditation Council for Pharmacy Education, collaborative practice agreements, valid prescription orders, board certification, or other broad privileges as specified in state regulations.