Pressing Update: Aprocitentan for the Treatment of Hypertension.

OBJECTIVE: This article reviews the published data including the pharmacology, efficacy, and safety of aprocitentan, a novel endothelin receptor antagonist developed to treat hypertension in conjunction with additional agents. DATA SOURCES: A literature search was conducted from drug discovery until May 2024 through PubMed, MEDLINE, and National Institutes of Health Clinical Trials Registry utilizing the following search terms: Tryvio, aprocitentan, hypertension, resistant hypertension, endothelin receptor antagonist, and ACT-132577. STUDY SELECTION AND DATA EXTRACTION: All relevant English-language studies, or studies that could be appropriately translated into English, containing the pharmacology, pharmacokinetics, safety, and efficacy of aprocitentan, were selected for review. DATA SYNTHESIS: In the setting of resistant hypertension, aprocitentan has shown significant reductions in blood pressure in both medical office and 24-hour ambulatory settings at 4 weeks with a sustained effect at 40 weeks. Studies evaluating cardiovascular risk reduction have not been conducted at this time. Fluid retention and edema were the most frequent adverse events reported in clinical studies with aprocitentan. As a class, endothelin receptor antagonists may cause fetal harm; aprocitentan should be used with caution to avoid embryo-fetal toxicity. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE IN COMPARISON TO EXISTING DRUGS: Owing to the existent barriers for the treatment of resistant hypertension, aprocitentan presents itself as an effective option when added to traditional antihypertensives. This single-strength, once-daily regimen may serve as an appealing option to both patients and prescribers. CONCLUSION: Aprocitentan is a safe and effective medication for the treatment of hypertension when added to other pharmacological therapies.

Impact of a Hospital-Based Food Pharmacy Program on Health Outcomes of Vulnerable Patients.

Access to healthy foods, especially for those who are living with diabetes and hypertension, is crucial in managing these chronic diseases. This study evaluates the implementation of a food pharmacy and food prescription program at a safety-net hospital that serves vulnerable populations. Patients who screen as food insecure using the USDA adult food security survey receive a referral from the physician to the food pharmacy program where a dietician reviews their dietary requirements based on their chronic disease and develops a diet plan. Patients then receive fresh produce, meats and other products every 2 weeks that meets their nutritional needs from the food pharmacy. Biometric data from the patient's most recent clinic visit at the time of enrollment was collected as the baseline measures including blood pressure, weight, and HbA1c (if diabetic). Additionally, biometric information was collected from the patient's medical records from regularly scheduled clinic visits at 6 month intervals. A total of 266 patients were enrolled in the program during the 13-month period that was studied (121 patients with 6-month data and 68 patients with 12-month data). The statistical analysis showed a significant improvement in diastolic blood pressure at 12 months and in weight at both the 6 months and 12 months timeframes when comparing to baseline biometrics.

Using Community Engagement to Move Upstream to Address Social Determinants of Health.

ABSTRACT: Given its role as a safety net institution, the University of Florida Health (UF Health) Jacksonville has responded to the community's needs through partnerships with the community for decades. Such academic-community partnerships have a broad emphasis on population health and primary care that expands the model of care to include community engagement, which allows such partnerships to promote health and well-being and reduce health inequalities by addressing social determinants of health (SDOH).This report describes the UF Health Jacksonville and University of Florida College of Medicine - Jacksonville's creation of the Urban Health Alliance (UHA) in June 2019 due to continued poor health outcomes and inequities within the community. The mission of the UHA is to improve community health using community-focused, self-sustainable strategies and solutions to impact SDOH (i.e., more upstream interventions). Using the tenets of the collective impact model, the UHA acts as a backbone organization to achieve these objectives by empowering community partners to affect changes in policy, systems, and other structures necessary for the optimal health of the community. The UHA's work is divided across 4 pillars: services, research, education, and policy. These pillars reflect the traditional missions of academic medical centers-clinical care, research, and education-and the need to address structural changes to improve community health-namely, policy. By addressing the issues that most impact the patients and community of UF Health Jacksonville, the UHA can serve as an example of how an academic medical center can use the traditional missions to improve the community's health and move toward health equity.

Community Champions: The Crucial Contribution of an Independent Pharmacy in COVID-19 Vaccination Efforts in an Underserved Community.

Historically, pharmacists in independent community pharmacies have been pivotal in promoting community health. During the COVID-19 pandemic, they demonstrated their commitment by advocating for vaccination and providing accessible care, particularly in underserved communities. By addressing disparities, implementing strategies like mobile clinics and community outreach, and fostering trust and engagement, independent community pharmacists played a crucial role in bridging gaps in healthcare access for vulnerable populations and mitigating the impact of the COVID-19 pandemic.

Implementation of a series of advanced pharmacy practice experience (APPE) preparatory topics into a skills lab curriculum.

BACKGROUND AND PURPOSE: Advanced pharmacy practice experiences (APPEs) play a significant role in readying students for professional practice. Factors beyond traditional knowledge and skills taught in the didactic curriculum may play a role in APPE success. The purpose of this manuscript is to describe an activity implemented within a third-year skills lab focused on APPE preparedness, the methods used, and student feedback related to the series. EDUCATIONAL ACTIVITY AND SETTING: Experiential and skills lab faculty collaborated to generate advice for students regarding common misconceptions or areas of difficulty encountered on APPEs. The advice was developed into short topics that were paired with and presented at the start of most lab sessions with impromptu contributions from faculty and facilitators integrated at the time of delivery. FINDINGS: One hundred twenty-seven third-year pharmacy students (54% of the cohort) consented to complete a follow-up survey and provided feedback on the series. Most students agreed or strongly agreed with the elements evaluated, providing positive feedback for all ranked statements. Feedback from free-text response questions indicated that many students found all topics presented to be beneficial and suggested that topics of interest for the upcoming semester included advice regarding residencies/fellowships/employment, wellness, and communication with preceptors. SUMMARY: Student feedback indicated an overall perception of benefit and value from most respondents. Implementation of a similar series in other courses is a potential area for future study.

Smart Meds: Using Pharmacists to Address Health Literacy Disparities Among Medically- and Socially-Vulnerable Populations.

Patients in historically underserved communities are most vulnerable to uncontrolled chronic conditions and report a lack of health knowledge to manage them. This report aims to describe the development of SMART MEDS, a pharmacy-led program implemented to address health literacy disparities among medically and socially vulnerable patients.

Didactic education for the deaf or hard of hearing learner in a pharmacy curriculum: Commentary.

INTRODUCTION: There is a long-standing commitment in higher education to provide parallel experiences for students with disabilities, including those with hearing disabilities or impairments. The commitment remains the same in professional pharmacy school education, with the objective to train competent clinical pharmacy practitioners. COMMENTARY: Limited literature exists to provide schools and colleges of pharmacy (S/COP) with best practices when accommodating students who are deaf or hard of hearing (DHOH) in the didactic pharmacy curriculum. The authors will examine practices implemented at the COP to accommodate students with either a DHOH disability. IMPLICATIONS: Students who are DHOH in didactic pharmacy education require individualized assistance to help ensure success throughout the program. A collaborative approach between the student, disability resources, student affairs office, faculty, and staff help ensure accommodations are met and fosters a culture of inclusiveness.

Exploring Trends in Social Vulnerability for Pharmacy Students at a Large Public University.

OBJECTIVE: This study aimed to describe trends in social vulnerability (SV) among pharmacy students at a large public college of pharmacy, and to describe differences in SV by race and ethnicity using the Centers for Disease Control and Prevention Social Vulnerability Index (SVI). METHODS: The SVI was determined for each student admitted between Fall 2017 and Fall 2022 using the submitted permanent address for each student in a deidentified fashion. International students and students not from the 50 US states were excluded from the analysis. RESULTS: During the study period, 1427 pharmacy students met the study inclusion criteria and were included in the final analysis. Students from historically minoritized populations accounted for 53.4% (n = 763/1427) of students. The median SVI score for all students was 0.4091 (interquartile range [IQR]: 0.2091-0.6395), which is consistent with low/moderate SV risk. When considering SVI by race, students from historically minoritized populations had a higher median SVI (0.4807 [IQR: 0.2791-0.7071] vs 0.3562 [IQR: 0.1561-0.5523]), and were more likely to come from moderate/high SV regions compared with White students (odds ratio 2.00 [95% confidence interval: 1.609-2.486]). CONCLUSION: Among pharmacy students at a large public university, a substantial proportion of students had moderate/high SV risk, particularly those from historically minoritized backgrounds. Colleges and schools of pharmacy need to consider the unique needs of students from high SV backgrounds and provide intentional equity-based mitigation strategies to maximize the potential for student success for all.