RESUMO
Clinical manifestations of biological aging can be remarkably similar to the side effects of frequently used medications. Fatigue, muscle pain, and confusion are common and often not shared as part of proper geriatric patient history. When patients report them, a root cause is usually confounding. These symptoms not only negatively impact health and wellness outcomes, patient quality of life, and increase costs to the healthcare system, but also may be a limitation on provider best practices. The patient, a 71-year-old female of European descent, enrolled in pharmacogenomics-enriched comprehensive medication management (PGx+CMM) program through her retirement benefit. At the time of testing, she was approximately 18 months post cerebrovascular accident and was being observed by her primary care provider for common chronic conditions. Of interest, she had been manifesting unreported clinical symptoms of fatigue, hypotension, and myalgia. Addressing these patient concerns and specifically focusing on an individual's goals, fears, and basic needs, rather than concentrating merely on the absence of disease, is the crux of personalized medicine and programs that address the notion of healthy aging. The patient's therapeutic regimen was adjusted based on PGx+CMM pharmacist review, use of a clinical decision support system (CDSS), and communication of recommendations to the prescribing physician. The patient saw rapid improvements in symptoms, suggesting they were caused by medication side effects. Her blood pressure and cholesterol levels remained controlled while noticeable side effects were eliminated. This case study demonstrates the positive impacts of personalized medicine and shows how pharmacists can be empowered with a CDSS to positively impact healthcare.
RESUMO
Human immunodeficiency virus (HIV) has now transformed into a manageable chronic condition. Highly active antiretroviral therapy (HAART) has proven efficacious at controlling the disease progression. Based on compelling evidence, the Department of Health and Human Services (DHHS) and the Infectious Disease Society of America (IDSA) developed guidelines for the management of persons infected with HIV. However, there are approximately 50 000 new cases of HIV in the United States each year. In this article, we review proactive methods to reduce the transmission of HIV, which include reinforcing patient education, gel-coated condoms that destroy HIV, HIV vaccinations, and adequately utilizing pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP). Further development and consistent utilization of innovative prevention tools can significantly reduce the incidence of HIV infections regardless of HIV status.