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.

Effects of GLP-1 receptor agonists on cardiovascular outcomes in patients with type 2 diabetes and chronic kidney disease: A systematic review and meta-analysis.

AIM: To evaluate the cardiovascular outcomes of glucagon-like peptide-1 receptor agonists (GLP1-RA) in patients with type 2 diabetes (T2DM) and chronic kidney disease (CKD). MATERIALS AND METHODS: We searched PubMed, Ovid MEDLINE, CINAHL, and Web of Science databases for randomized controlled trials reporting event rates for a composite cardiovascular outcome of cardiovascular death, myocardial infarction, and stroke in patients with T2DM and CKD receiving GLP1-RA or placebo. Studies were restricted to those reporting specific event rates for patients with CKD separately from the overall population. We conducted a meta-analysis using a random-effects model. This meta-analysis was registered on PROSPERO (CRD42022320157). RESULTS: A total of four studies comprising 7130 patients was included in our analysis. Four different GLP1-RA were assessed in a population with CKD defined as estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 . Treatment with GLP1-RA was not associated with a significant reduction in the composite cardiovascular end point of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke (odds ratio (OR) 0.80; 95% confidence interval (CI), 0.59-1.07; p = 0.13) among patients with T2DM and CKD. Individual components of the composite cardiovascular end point were assessed in two trials and did not show evidence of an effect of GLP1-RA in reducing cardiovascular end points. CONCLUSIONS: Pooled analysis of clinical trials reporting separate cardiovascular events rates in patients with T2DM and CKD did not find GLP1-RA to be associated with a reduction in composite cardiovascular event rates. Select GLP1-RA may offer cardiovascular event reduction in patients with T2DM and CKD, but this does not appear to be a class effect. Use of GLP1-RA with demonstrated cardiovascular benefits should be preferred in patients with CKD and T2DM to further reduce cardiovascular risk.

Antiplatelet Therapy in Older Patients Post-Myocardial Infarction.

This case study reviews appropriate antiplatelet treatment options for an older patient post-myocardial infarction and stent placement. This case investigates the benefits and risks associated with antiplatelet agents in older people and what patient- and drug-specific factors, such as adverse effects and drug interactions, to consider when choosing treatment.

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.