Direct-acting oral anticoagulants in patients with atrial fibrillation and valvular heart disease.

ABSTRACT: Direct-acting oral anticoagulants (DOACs) are an effective alternative to warfarin for patients with atrial fibrillation (AF) who require thromboembolic risk reduction. This article discusses the newly acceptable use of DOACs in patients with valvular AF, including native valvular heart disease and patients with bioprosthetic valves.

Comparison of Virtual Simulations with Peers versus Actors as Standardized Patients on Virtual OSCE Scores.

OBJECTIVE: This study's primary aim is to assess the use of different types of standardized patients (SPs) during formative simulation activities on summative objective structured clinical exams (OSCE) in a PharmD curriculum. METHODS: Randomized-controlled study with first-year pharmacy students in a Pharmacist Patient Care Lab (PCL) course. Students were randomized into groups with either hired actors or their peers as SPs for virtual simulation activities. All students then completed a virtual teaching OSCE (TOSCE) and virtual OSCE. A mixed effects analysis was done to compare TOSCE and OSCE scores between the two groups. RESULTS: There were no significant differences between the two groups in their TOSCE or OSCE scores for the analytical and global rubrics. CONCLUSION: This study demonstrates that peers may be as effective as having hired actors as SPs in preparing students for virtual skills exams.

The Use of Continuous Glucose Monitoring in Older People With Type 2 Diabetes.

Objective To review current guidelines and literature regarding continuous glucose monitoring (CGM) use in the management of type 2 diabetes mellitus (T2DM) in older people. Data Sources A PubMed search of articles published through August 2020 using a combination of the following: older people, T2DM, continuous glucose monitoring, hypoglycemia, and hyperglycemia. Study Selection/Data Extraction Relevant randomized control trials, meta-analyses, and guidelines were assessed for the use of CGM in older patients with T2DM. Articles were included based on relevance to the topic, detailed methods, and complete results. Data Synthesis CGM use in T2DM management in older people is not well defined. CGM may be a valuable technology in older people who face unique challenges, such as hypoglycemia, decline in cognitive function, and variable glucose levels. This article provides a review of recommendations for glucose monitoring in T2DM and discusses the role of specific CGM products. Conclusion CGM is a viable option for older people with T2DM to help improve overall diabetes control. Pharmacists can play an important role in educating patients about this technology.