Niraparib for the Treatment of Recurrent Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer.

OBJECTIVE: To review the efficacy and safety of niraparib for the treatment of recurrent epithelial ovarian, fallopian tube, and primary peritoneal cancer (OC, FTC, and PPC). DATA SOURCES: A literature search via MEDLINE through PubMed from August 2013 to January 2020 was performed using the key terms niraparib, PARP inhibitors, ovarian cancer, fallopian tube cancer, and primary peritoneal cancer. STUDY SELECTION AND DATA EXTRACTION: Completed and ongoing trials were identified through a review of the website trial registry https://www.clinicaltrials.gov. DATA SYNTHESIS: In a phase III, double-blind clinical trial, progression-free survival improved in patients treated with niraparib compared with placebo as maintenance treatment for patients with platinum-sensitive, recurrent OC: 21 versus 5.5 months in the germline breast cancer susceptibility gene (gBRCA) cohort (hazard ratio [HR] = 0.27; 95% CI = 0.17 to 0.41; P < 0.001) and 9.3 versus 3.9 months in the overall nongermline breast cancer susceptibility gene (non-gBRCA) cohort (HR = 0.45; 95% CI = 0.34 to 0.61; P < 0.001). Adverse events included thrombocytopenia and anemia. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE: Poly (ADP-ribose) polymerase (PARP) inhibitors have gained a place in the therapeutic management of OC, FTC, and PPC because of their ability to suppress growth of homologous recombination deficiency-positive tumors, including those with BRCA1/2 mutations. Niraparib inhibits the DNA repair mechanism vital to the survival of cancer cells, poly-ADP ribose polymerase. CONCLUSIONS: PARP inhibitors can be used as a single agent for maintenance therapy for platinum-sensitive recurrent disease in patients with partial or complete response following 2 or more rounds of platinum-based therapy.

Evaluation of Medication Errors in Community Pharmacy Settings: A Retrospective Report.

Background. Drug-related errors can compromise patient care, increase health care costs, and, in worst case scenarios, result in patient deaths. Objective. To evaluate the incidence and contributing factors of medication dispensing errors in community pharmacy settings reported to the New Hampshire Board of Pharmacy (NHBOP). Methods. Medication errors reported to the NHBOP from February 1, 2007, to July 31, 2012, in a community pharmacy setting were reviewed. Quality Related Event Report (QRER), a standardized form developed by the NHBOP, was used to record the errors. The QRER allows collection of information related to the error, including time, date, type of error, and contributing environmental factors. Results. There were a total of 68 reported errors. The majority of errors (40%) involved dispensing an incorrect medication; 31% involved incorrect doses, and 12% involved incorrect directions. A majority of the errors involved new prescriptions (78%); 51% occurred during the pharmacist final check stage and 26% occurred during the data entry phase of the initial processing of the prescription. A greater percentage of errors (68%) occurred when only 1 pharmacist was on duty versus 29% with 2 pharmacists on duty. Conclusions. Contributing factors for errors included high prescription volumes and lack of adequate pharmacist coverage. Increasing pharmacist overlap hours in stores with high prescription volumes and implementing a formal technician certification program to ensure the consistency in training quality could assist in decreasing medication errors and improving patient safety.

Assessment of Screening, Brief Intervention, and Referral to Treatment Training to Interprofessional Health-Care Students.

Substance abuse and addiction are responsible for an assortment of health and financial concerns in the United States. Tools to identify and assist at-risk persons before they develop a substance use disorder are necessary. Screening, brief intervention, and referral to treatment (SBIRT) can be utilized by health-care professionals to identify those at risk to minimize health-related complications and the potential of developing a substance use disorder. The primary objective of this study was to provide educational training sessions on SBIRT to health-care students utilizing interprofessional education activities and assess perceptions of the training sessions and activities with regard to confidence to utilize SBIRT in at-risk patients and overall student satisfaction with SBIRT instruction. The research protocol enrolled students of pharmacy, nursing, medicine, behavioral health, and physician assistant studies who received interprofessional SBIRT training. Students completed an anonymous posttraining online survey, measuring student perceptions of knowledge gained and confidence to utilize training. A total of 303 students completed the SBIRT training. Approximately 70% of students were satisfied with the training materials, instruction, quality, and experience. After training, 78% were confident that they could perform screening for substance abuse, conduct a brief intervention (80%), and when to refer to treatment (71%). A total 73% of students reported that the asynchronous online-based activity was extremely effective in increasing knowledge of the roles and responsibilities of other disciplines and providing opportunities to interact with students from other health professions. Interprofessional education-trained students from multiple health-care disciplines feel comfortable performing SBIRT to identify persons at risk for substance misuse in practice.

A Novel Structured Format for Engaging Pharmacy Students in Bioethics Discussions.

OBJECTIVE: To describe an active, structured ethics/professionalism discussion format developed for an elective course titled Ethics and Professionalism in Pharmacy. DESIGN: The format uses the acronym ETHICS (Evaluate, Teach, Hear, Interview, Concede, Self-reflect). Before class, students evaluated (Evaluate) literature pertaining to ethics/professionalism topics. Class consisted of faculty-led ethics/professionalism lecture (Teach), student-driven, case discussion, and online self-reflection. Guided by Hear, Interview, and Concede, groups addressed cases from stakeholder perspectives (patient, pharmacist, etc.) considering ethical rules and principles. At the end of class, students answered self-reflection questions. Precourse and postcourse surveys evaluated the impact on students' perceptions of ethical and professional tenets. ASSESSMENT: The format allowed students to actively engage in ethics/professionalism discussions, transforming class into an interactive, structured, student-centered session with self-reflection. CONCLUSION: The format allowed application of concepts to controversial situations. Although the format was created for a pharmacy elective, it is adaptable to any teaching situation.