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OBJECTIVE: To describe the validation and reliability assessment of a rubric designed to assess the participants' teaching portfolios and identify teaching excellence among teaching and learning curriculum (TLC) program participants. METHODS: Following focus groups with program leadership at a single TLC program, an initial rubric was developed, consisting of criteria mapped to 5 domains, to be rated on a 4-point scale. The rubric was then redistributed to the TLC program leadership and external stakeholders for evaluation of face and content validity. The rubric was piloted using teaching portfolios from 3 cycles of the program. Cronbach αwas used to measure internal consistency and a 2-way random-effects model was used to assess the inter-rater reliability. RESULTS: A total of 18 portfolios were independently evaluated by 4 raters. The overall mean Cronbach α for internal consistency was 0.90 and ranged from 0.65 to 0.84 by domain. The overall mean intraclass correlation coefficient for inter-rater reliability was 0.95 and ranged from 0.57 to 0.91 by domain. CONCLUSION: The rubric evaluates characteristics of teaching portfolios important to internal and external stakeholders and had good to excellent internal consistency and inter-rater reliability. It can be adapted and applied by TLC programs to identify teaching excellence.
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Currículo , Educação em Farmácia , Ensino , Currículo/normas , Humanos , Reprodutibilidade dos Testes , Ensino/normas , Educação em Farmácia/métodos , Avaliação Educacional/métodos , Aprendizagem , Grupos Focais , Avaliação de Programas e Projetos de SaúdeRESUMO
PURPOSE: The aim of this study was to provide consensus recommendations from residency program leaders on letters of intent (LOIs) written by postgraduate year 1 (PGY1) pharmacy residency candidates. METHODS: A 3-round modified Delphi process was used to determine consensus among PGY1 residency program leaders across the country. A screening and demographic survey was utilized to ensure representation of panelists. The initial items for round 1 of the study were developed using existing published literature, with pilot testing by 2 residency program directors. For each round, respondents rated items on a 7-point Likert scale, with opportunities to provide qualitative feedback and modifications for lower-rated items. For future rounds, items were adjusted based on respondent feedback. Only items meeting predefined consensus were included in the final recommendations. RESULTS: A total of 254 pharmacists were invited to participate in the panel, with 41 completing the demographic and study consent survey. There were 35 participants in round 1, 34 of whom remained for rounds 2 and 3. The panel created 18 LOI recommendations for PGY1 residency candidates. Most recommendations were focused on the content of the LOI, while others were related to formatting. CONCLUSION: The recommendations from this study can be employed by PGY1 pharmacy residency candidates to enhance their likelihood of success in the residency application process.
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Técnica Delphi , Residências em Farmácia , Humanos , Residências em Farmácia/organização & administração , Correspondência como Assunto , Feminino , Estudantes de Farmácia , Masculino , Farmacêuticos/organização & administração , Consenso , Adulto , Inquéritos e Questionários , IntençãoRESUMO
Objective: To evaluate tertiary drug information databases in terms of scope, consistency of content, and completeness of COVID-19 drug information. Methods: Five electronic drug information databases: Clinical Pharmacology, Lexi-Drugs, AHFS DI (American Hospital Formulary Service Drug Information), eFacts and Comparisons, and Micromedex In-Depth Answers, were evaluated in this cross-sectional evaluation study, with data gathered from October 2021 through February 2022. Two study investigators independently extracted data (parallel extraction) from each resource. Descriptive statistics were primarily used to evaluate scope (i.e., whether the resource addresses use of the medication for treatment or prevention of COVID-19) and completeness of content (i.e., whether full information is provided related to the use of the medication for treatment or prevention of COVID-19) based on a 10-point scale. To analyze consistency among resources for scope, the Fleiss multi-rater kappa was used. To analyze consistency among resources for type of recommendation (i.e., in favor, insufficient evidence, against), a two-way mixed effects intraclass coefficient was calculated. Results: A total of 46 drug monographs, including 3 vaccination monographs, were evaluated. Use of the agents for treatment of COVID-19 was most frequently addressed in Lexi-Drugs (73.9%), followed by eFacts and Comparisons (71.7%), and Micromedex (54.3%). The highest overall median completeness score was held by AHFS DI followed by Micromedex, and Clinical Pharmacology. There was moderate consistency in terms of scope (kappa 0.490, 95% CI 0.399-0.581, p<0.001) and recommendations (intraclass correlation coefficient 0.518, 95% CI 0.385-0.651, p<0.001). Conclusion: Scope and completeness results varied by resource, with moderate consistency of content among resources.
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COVID-19 , Fonte de Informação , Estados Unidos , Humanos , Estudos Transversais , Serviços de Informação sobre Medicamentos , Bases de Dados FactuaisRESUMO
OBJECTIVE: To document the performance of first-year pharmacy students on a revised objective structured clinical examination (OSCE) based on national entrustable professional activities, identify risk factors for poor performance, and assess its validity and reliability. METHODS: A working group developed the OSCE to verify students' progress toward readiness for advanced pharmacy practice experiences at the L1 level of entrustment (ready for thoughtful observation) on the national entrustable professional activities, with stations cross-mapped to the Accreditation Council for Pharmacy Education educational outcomes. Baseline characteristics and academic performance were used to investigate risk factors for poor performance and validity, respectively, by comparing students who were successful on the first attempt with those who were not. Reliability was evaluated using re-grading by a blinded, independent grader, and analyzed using Cohen's kappa. RESULTS: A total of 65 students completed the OSCE. Of these, 33 (50.8%) successfully completed all stations on first attempt, and 32 (49.2%) had to re-attempt at least 1 station. Successful students had higher Health Sciences Reasoning Test scores (mean difference 5, 95% CI 2-9). First professional year grade point average was higher for students who passed all stations on first attempt (mean difference 0.4 on a 4-point scale, 95% CI 0.1-0.7). When evaluated in a multiple logistic regression, no differences were statistically significant between groups. Most kappa values were above 0.4 (range 0.404-0.708), suggesting moderate to substantial reliability. CONCLUSION: Though predictors of poor performance were not identified when accounting for covariates, the OSCE was found to have good validity and reliability.
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Desempenho Acadêmico , Educação em Farmácia , Humanos , Reprodutibilidade dos Testes , Exame Físico , AcreditaçãoRESUMO
The oral sodium-glucose cotransporter 2 inhibitor, dapagliflozin, is used to treat kidney disease, heart failure, and diabetes in adults, but has not been well studied in pediatrics, and does not have a recognized place in therapy in current practice guidelines. The purpose of this review is to summarize studies that have investigated the efficacy of dapagliflozin in pediatric patients. A systematic review was performed to identify clinical studies of oral dapagliflozin in children 0 to 17 years. Studies were identified through searches of Scopus, Web of Science, PubMed, Google Scholar, Embase, clinical trial registries, research registries, and key journals through August 2022. The Cochrane scoring system was used to assess the methodological quality of the included randomized trials. Five studies were reviewed and included in this analysis. Dapagliflozin at a dose of 5 to 10 mg was utilized in adolescents and young adults with heart failure, chronic kidney disease with proteinuria, type 1 diabetes, or type 2 diabetes. Studies evaluating dapagliflozin in type 1 diabetes evaluated single doses while the other studies monitored long-term use. Dapagliflozin was overall considered to be safe and effective in the studies included in this review, but further studies in larger populations and over extended periods of time are necessary.
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RATIONALE, AIMS AND OBJECTIVES: Clinical practice guidelines (CPGs) have been evaluated for reporting transparency and methodological quality in a number of studies in various disciplines, but few studies have focused on critical care and none on pharmacotherapy-related guidelines specifically. The objective of this study was to evaluate the quality of critical care CPGs with a focus on pharmacotherapy using the Appraisal of Guidelines, Research and Evaluation (AGREE) II instrument. METHOD: A cross-sectional study of CPGs published from 2013 through August 2021 was conducted. Following establishment of interrater reliability, guidelines were independently evaluated by three reviewers to rate guidelines on criteria set forth by the AGREE II instrument. Domain scores and item scores were calculated using the AGREE II user manual, and results described with descriptive statistics. RESULTS: Out of 192 guidelines identified, 73 met inclusion criteria and were screened using the AGREE II instrument. Most guidelines were authored by a professional organization or government agency. Domain quality scores were calculated for each domain as recommended by the AGREE II instrument. Domain 4 (clarity of presentation) had the highest AGREE II domain score with a median score of 87.0% (interquartile range: 79.6%-92.6%). Domain 5 (applicability) received the lowest domain score with a mean score of 41.8 ± 21.1%. The majority of guidelines were recommended for use as published or with modifications, while only six guidelines (8.2%) were not recommended for use. CONCLUSIONS: The majority of critical care guidelines that include pharmacotherapy recommendations were recommended for use by study authors when the AGREE II instrument was applied. While guidelines generally scored highly in clarity of presentation, additional time and effort should focus on providing solutions to guideline implementation and inclusion of patient preferences.
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Cuidados Críticos , Humanos , Estudos Transversais , Reprodutibilidade dos TestesRESUMO
Objective: To compare electronic drug information resources for scope, completeness, and consistency of off-label uses information, and to group resources into tiers based on these endpoints. Methods: An evaluation study of six electronic drug information resources (Clinical Pharmacology, Lexi-Drugs, American Hospital Formulary Service Drug Information, Facts and Comparisons Off-Label, Micromedex Quick Answers, and Micromedex In-Depth Answers) was conducted. All off-label uses for the top 50 prescribed medications, by volume, were extracted from all resources and used to determine scope (i.e., whether the resource listed the use). Fifty randomly selected uses were then evaluated for completeness (i.e., whether the entry cited clinical practice guidelines, cited clinical studies, provided a dose, described statistical significance, and described clinical significance) and consistency (i.e., whether the resource provided the same dose as the majority). Results: A sample of 584 uses was generated. The largest number of listed uses was in Micromedex In-Depth Answers (67%), followed by Micromedex Quick Answers (43%), Clinical Pharmacology (34%), and Lexi-Drugs (32%). The highest scoring resources for completeness were Facts and Comparisons Off-Label (median score 4/5), Micromedex In-Depth Answers (median score 3.5/5), and Lexi-Drugs (median score 3/5). Consistency with the majority in terms of dosing was highest for Lexi-Drugs (82%), Clinical Pharmacology (62%), Micromedex In-Depth Answers (58%), and Facts and Comparisons Off-Label (50%). Conclusion: The top-tiered resources for scope were Micromedex In-Depth and Quick Answers. For completeness, the top-tiered resources were Facts and Comparisons Off-Label and Micromedex In-Depth Answers. Lexi-Drugs and Clinical Pharmacology were the most consistent in dosing.
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Serviços de Informação sobre Medicamentos , Uso Off-Label , Estados Unidos , Bases de Dados FactuaisRESUMO
Objective. The objectives of this study were to (1) describe characteristics of preparation programs for the North American Pharmacist Licensure Examination (NAPLEX) that are currently used by colleges and schools of pharmacy and (2) evaluate these program characteristics in relation to first-attempt NAPLEX pass rates.Methods. This cross-sectional study was based on an online survey administered between February and March 2020. Assessment leads from 143 PharmD programs were invited to answer questions on their schools' PharmD program characteristics and various aspects of NAPLEX preparation programs. The study included regression analyses to investigate associations between the NAPLEX first-attempt pass rates and PharmD demographic characteristics as well as between first-attempt pass rates and various aspects of the NAPLEX preparation programs. Finally, common themes from open-ended questions were identified.Results. Fifty-eight participants completed the survey out of 132 successfully delivered email invitations (response rate = 44%). Fifty participants (86%) indicated that their PharmD program offers a NAPLEX preparation program. Our data indicate that offering a NAPLEX preparation program was not significantly associated with higher NAPLEX first-attempt pass rates. The analysis identified possible explanations for this lack of association, including student concerns with balancing a preparation program with advanced pharmacy practice experiences (APPEs) and the faculty workload associated with delivering such programs.Conclusion. The current findings show no association between offering a NAPLEX preparation program and NAPLEX first-attempt pass rates. Future research should continue to examine the impact of these programs on individual school pass rates and factors that may enhance student motivation to engage in these programs.
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Educação em Farmácia , Estudantes de Farmácia , Estudos Transversais , Educação em Farmácia/métodos , Avaliação Educacional/métodos , Humanos , Licenciamento em Farmácia , Farmacêuticos , Faculdades de FarmáciaRESUMO
OBJECTIVE: The study evaluated point-of-care resources for scope, completeness, and consistency of information describing interactions between therapeutic drugs and drugs of abuse (DoA). METHODS: A cross-sectional evaluation study was conducted focusing on seven resources: Clinical Pharmacology, Facts & Comparisons eAnswers, Lexicomp Online, Micromedex, Drug Interactions Analysis and Management, Drug Interaction Facts, and Stockley's Drug Interactions. A sample of clinically relevant interactions was developed through review of tertiary literature and resources, and input was solicited from subject matter experts. Entries from each resource for each interaction were evaluated for scope (i.e., whether there was an entry for the interaction); completeness (i.e., whether there was information addressing mechanism; clinical effects, severity, course of action, and level of certainty, described as a median rating on a 5-point scale); and consistency (i.e., whether the information in the resource was similar to the majority) among resources with an entry. RESULTS: Following review by subject matter experts, the final sample contained 159 interactions. Scope scores ranged from 0.6% (Drug Interactions Analysis and Management) to 43.4% (Lexicomp Online). Completeness scores ranged from 2 (interquartile range [IQR] 0 to 3, Stockley's Drug Interactions) to 5 (IQR 5 to 5, Drug Interaction Facts, Micromedex, Facts & Comparisons eAnswers). Consistency scores ranged from 30.8% (Stockley's Drug Interactions) to 87.1% (Clinical Pharmacology) for severity and from 15.4% (Facts & Comparisons eAnswers) to 71.4% (Drug Interaction Facts) for course of action. CONCLUSIONS: Although coverage of drug-DoA interactions was low and content was often inconsistent among resources, the provided information was generally complete.
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Bases de Dados Factuais/normas , Serviços de Informação sobre Medicamentos , Interações Medicamentosas , Estudos Transversais , Humanos , Sistemas Automatizados de Assistência Junto ao LeitoRESUMO
OBJECTIVES: Intranasal ketamine has not been well studied in acute pain treatment and does not have a recognized place in therapy in current practice guidelines for pediatric patients. Ketamine has a unique mechanism of action with a favorable side effect profile that may provide benefit to the pediatric population for acute pain. The purpose of this review is to summarize the evidence evaluating intranasal ketamine versus any other comparator for children who require acute pain treatment. METHODS: A systematic review was performed to include clinical studies of intranasal ketamine for acute pain that reported any pain-related outcome and adverse events in children 0 to 17 years old. Trials were identified through PubMed, Google Scholar, clinical trial registries, research registries, and key journals through April 2018. The Jadad scoring system was used to assess the methodological quality of the included randomized controlled trials. RESULTS: Six studies consisting of 261 patients were reviewed. Intranasal ketamine demonstrated pain relief in all included clinical studies; however, there was inconsistency in dosing, comparators, scales, and indications. Two of the randomized controlled trials were rated as high quality, and 1 randomized controlled trial was rated as poor quality on the Jadad scale. CONCLUSIONS: Intranasal ketamine was safe and effective in the 6 clinical studies included in this systematic review.
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Dor Aguda/tratamento farmacológico , Analgésicos/administração & dosagem , Ketamina/administração & dosagem , Administração Intranasal , Criança , HumanosRESUMO
Most pharmacy faculty members are more confident in their foundation as research scientists or clinical pharmacists than with the scholarship of teaching and learning (SoTL). However, many wish to enter this rewarding field of scholarship in order to test pedagogical innovations, measure teaching effectiveness, and share success with the Academy. This commentary provides general advice for those who wish to explore SoTL but lack formal education and training in this area. Four opportunities are highlighted: educational research, small activities and projects, course redesign, and longitudinal assessment and evaluation.
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Educação em Farmácia/métodos , Docentes , Bolsas de Estudo/métodos , Humanos , Aprendizagem , Estudos Longitudinais , Farmacêuticos , Desenvolvimento de Pessoal/métodos , EnsinoRESUMO
BACKGROUND AND PURPOSE: The Indiana Pharmacy Teaching Certificate Program (IPTeC) offered a live, two-day conference to pharmacy residents, fellows, and preceptors in Indiana, while simultaneously live-streaming to participants in Doha, Qatar. Participants engaged in longitudinal activities for a one-year period. The purpose is to evaluate this pilot extension of a teaching and learning curriculum (TLC) to experienced preceptors in a global partnership and determine whether global and local participants perceive similar quality of programming. EDUCATIONAL ACTIVITY AND SETTING: Upon completion of the two-day conference, all pharmacists from two years of the program were encouraged to complete the standard course evaluations, consisting of nine items, in order to obtain continuing education (CE) credit. Evaluations of the program were analyzed by location cohort. FINDINGS: A total of 206 eligible pharmacists attended the program, with 154 completing the course evaluations (response rate 75%). "Good" or "outstanding" median ratings were given to each learning objective by both location cohorts, with domestic participants more likely to give "outstanding" ratings (6/9 items versus 0/9 items). SUMMARY: This pilot extension was successful in providing educational content satisfying learning objectives from the perspective of domestic participants and remote participants in Qatar. This type of global collaboration can meet the needs of trainees and experienced preceptors to advance pharmacy education and training.
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Currículo/tendências , Educação em Farmácia/métodos , Currículo/normas , Educação em Farmácia/tendências , Educação de Pós-Graduação em Farmácia/métodos , Humanos , Indiana , Internacionalidade , CatarRESUMO
BACKGROUND: Survey research methodology is commonly used in the pharmacy literature and standards have been set forth for quality reporting. A systematic review to assess the reporting quality of survey research has only been completed for general medical literature. OBJECTIVES: The objective of this study is to examine the quality of survey research reporting published in the pharmacy literature and identify reporting areas researchers can focus on for increased transparency in survey research methodology. METHODS: A cross-sectional study of survey research articles published in seven key pharmacy journals in 2016 was conducted using a published 30-item checklist instrument designed for the reporting quality surveys. Each article was evaluated by two independent study investigators and assigned a final score out of 30. RESULTS: Out of 197 articles assessed for eligibility, 105 (53%) used survey research as the primary methodology and were included in the study. The average reporting score was 18.2±3.0 (range 10-25) out of 30, with the highest average scores reported for PharmacoEconomics (22.5), JMCP (20.4) and RSAP (19.8). Checklist items related to the quality of reporting survey research methodology with the highest compliance included: original reference cited for use of existing tools (100%), description of survey population and sample frame (90%); and reporting response rate (90%). Checklist items with low reporting included: psychometric properties for existing tools (14%); reliability and validity for new instruments (11%); analysis of nonresponse bias (8%); definition of complete versus partial responses (8%); methods of handling missing data (19%); and information about how non-respondents differ from respondents (14%). CONCLUSIONS: Survey research published in the pharmacy literature scored moderately on a published instrument designed for systematic appraisal of survey research reporting quality. Several areas for continued improvement exist for survey research reporting quality in the pharmacy literature.
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Lista de Checagem , Farmácia , Estudos Transversais , Humanos , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
PURPOSE: To develop an evidence-based tool that will provide concise guidance to pharmacy students who want to become competitive postgraduate year 1 (PGY1) residency applicants. METHODS: A systematic literature search was conducted to identify articles describing student or school factors and specific interventions or activities associated with improved or decreased residency match rates, as well as studies describing residency program directors' (RPDs') or preceptors' perceptions of qualified applicants. An initial checklist was developed, with an item for each relevant factor. A consensus on checklist items was built through a 2-round Delphi process with a panel of RPDs. Ultimately, items that received a median score of at least 5 on a 7-point scale with less than one-third of the ratings being a 1, 2, or 3 were included. RESULTS: The initial checklist of 34 items, primarily related to grade point average, professional involvement, work experience, or professional development, was evaluated by a panel of 25 RPD participants. Six of 34 items (18%) were reevaluated in round 2, along with 1 added item and 4 items substantively modified based on comments; 2 items were merged. Ultimately, 33 items met the criteria for consensus and were included in the final checklist. CONCLUSION: A checklist of items to guide prospective pharmacy residency applicants was developed through a systematic literature search and verified by program directors using a Delphi process.
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Lista de Checagem , Residências em Farmácia/organização & administração , Estudantes de Farmácia , Técnica Delphi , Humanos , Critérios de Admissão EscolarRESUMO
OBJECTIVES: Propofol has not been extensively studied as an acute migraine therapy; however, based on the limited evidence from outpatient and inpatient settings, propofol has been proposed as an option for patients who present to the emergency department (ED). The purpose of this review was to evaluate the existing literature regarding the safety and efficacy of propofol for acute migraine treatment in the ED. METHODS: A systematic review of clinical studies of propofol treatment for acute migraine in the ED was performed using Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Trials were identified through PubMed, Google Scholar, clinical trial registries, research registries, and key journals through May 2019. A modified Jadad scoring system was used to assess the methodologic quality of the included randomized controlled trials, and the Newcastle-Ottawa Scale was used for the retrospective cohort study. RESULTS: Nine studies, including five case reports or series, one retrospective cohort study, and three randomized controlled trials, consisting of 290 patients, were reviewed. All studies in adults reported propofol to be an effective therapy for migraine, but the strength of these results was limited by dosing variations, small sample sizes, and limited generalizability. Pediatric studies produced mixed results. CONCLUSIONS: Propofol may be an effective rescue therapy for patients presenting to the ED for acute migraine, but its place in therapy based on the limited available evidence is unknown. The safety of propofol for migraine management in the ED has not been adequately examined.
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Transtornos de Enxaqueca/tratamento farmacológico , Propofol/administração & dosagem , Doença Aguda , Adolescente , Adulto , Criança , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Adulto JovemRESUMO
Objective. To determine the perceived value that pharmacy practice department chairs ascribe to pharmacy faculty candidates having completed a teaching and learning curriculum (TLC) program and related activities.Methods. An 18-item survey instrument was created that was intended to capture the overall impressions of pharmacy practice chairs regarding the value of TLC programs, relative importance compared to other accomplishments (eg, residency completion, board certification), and importance of specific activities. Following pilot testing and establishment of intra-rater reliability, invitations to complete the electronic survey instrument were sent to pharmacy practice chairs (or their equivalent) at accredited Doctor of Pharmacy (PharmD) programs in the United States.Results. Of the 127 pharmacy practice chairs invited, 53 completed the survey (response rate of 41.7%). The majority of respondents held a PharmD degree (90.6%), had been in their role of chair for zero to five years (60.4%), and represented a private institution (54.7%). The majority of respondents who answered the question (32 of 49) felt it was very important or important (16.3% and 49.0%, respectively) that teaching experiences be completed within a formal teaching and learning curriculum program. These programs were believed to be most important for candidates with less than five years of professional experience. Teaching and learning curriculum programs were not deemed to be more important than other accomplishments by most responders. The perceived most important TLC program activities were instruction on didactic and experiential teaching strategies, and experience developing learning objectives, developing examination items, evaluating examination results, and facilitating case conferences or practice laboratory activities.Conclusion. Teaching and learning curriculum programs may provide the foundational experiences needed for pharmacy graduates to stand out among other candidates, although department chairs' perceptions of the value of teaching and learning curriculum experiences varied.
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Educação em Farmácia , Farmácia , Currículo , Humanos , Reprodutibilidade dos Testes , Faculdades de Farmácia , Inquéritos e Questionários , Ensino , Estados UnidosRESUMO
OBJECTIVE: The research evaluated point-of-care drug interaction resources for scope, completeness, and consistency in drug-ethanol and drug-tobacco content. METHODS: In a cross-sectional analysis, 2 independent reviewers extracted data for 108 clinically relevant interactions using 7 drug information resources (Clinical Pharmacology Drug Interaction Report, Facts & Comparisons eAnswers, Lexicomp Interactions, Micromedex Drug Interactions, Drug Interactions Analysis and Management, Drug Interaction Facts, and Stockley's Drug Interactions). Scope (presence of an entry), completeness (content describing mechanism, clinical effects, severity, level of certainty, and course of action for each present interaction; up to 1 point per assessed item for a total possible score of 5 points), and consistency (similarity among resources) were evaluated. RESULTS: Fifty-three drug-ethanol and 55 drug-tobacco interactions were analyzed. Drug-ethanol interaction entries were most commonly present in Lexicomp (84.9%), Clinical Pharmacology (83.0%), and Stockley's Drug Interactions (73.6%), compared to other resources (p<0.05). Drug-tobacco interactions were more often covered in Micromedex (56.4%), Stockley's Drug Interactions (56.4%), Drug Interaction Facts (43.6%), and Clinical Pharmacology (41.8%) (p<0.001). Overall completeness scores were higher for Lexicomp, Micromedex, Drug Interaction Facts, and Facts & Comparisons (median 5/5 points, interquartile range [IQR] 5 to 5, p<0.001) for drug-ethanol and for Micromedex (median 5/5 points, IQR 5 to 5, p<0.05) for drug-tobacco, compared to other resources. Drug Interaction Facts and Micromedex were among the highest scoring resources for both drug-ethanol (73.7%, 68.6%) and drug-tobacco (75.0%, 32.3%) consistency. CONCLUSIONS: Scope and completeness were high for drug-ethanol interactions, but low for drug-tobacco interactions. Consistency was highly variable across both interaction types.
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Bases de Dados Factuais/normas , Serviços de Informação sobre Medicamentos/normas , Interações Medicamentosas , Etanol/efeitos adversos , Nicotiana/efeitos adversos , Estudos Transversais , HumanosRESUMO
OBJECTIVE: The purpose of this study is to compare the incidence of venous thromboembolism between obese and non-obese hospitalized patients who received United States Food and Drug Administration-approved prophylactic enoxaparin doses and to describe enoxaparin dosing strategies used in obese patients. METHODS: This was a retrospective cohort study including patients who were admitted to Parkview Regional Medical Center, Parkview Hospital, or Parkview Orthopedic Hospital between September 2011 and August 2012 and received at least one dose of enoxaparin 30 mg twice daily or enoxaparin 40 mg once daily for venous thromboembolism prophylaxis. Patients classified based on their body mass index into three groups, Group 1 (non-obese: body mass index < 25 kg/m2), Group 2 (overweight: body mass index ≥ 25 kg/m2 but < 30 kg/m2), and Group 3 (obese: body mass index ≥ 30 kg/m2). The primary endpoint was venous thromboembolism occurrence within 90 days, considering day 1 of hospitalization as day 1. RESULTS: Of the 428 patients included, 8 cases of venous thromboembolism (1.9%) were identified; 3 in the non-obese group, 2 in the overweight group, and 3 in the obese group, no statistically significant differences were found between the three groups, p = 0.81. When venous thromboembolism incidence was adjusted for age and sex, no statistically significant differences were found between overweight (OR = 0.685; 95% CI 0.115-4.095), obese (OR = 0.797; 95% CI 0.353-1.796), and combined overweight and obese (OR = 0.656; 95% CI 0.154-2.799) groups compared to patients with normal body weight. CONCLUSION: This study did not find a statistically significant difference in venous thromboembolism incidence between obese, overweight, and non-obese hospitalized patients receiving approved enoxaparin prophylaxis doses.