Determining the association between grocery nutrition scores and number of medications taken for metabolic syndrome: A pilot study.

BACKGROUND: Metabolic syndrome is a cluster of disease states that increases an individual's risk of developing diabetes or cardiovascular disease. When treating metabolic syndrome, lifestyle and diet are primary areas for interventions. A dietician-led grocery nutrition system scoring patients' purchases may correlate to better control of metabolic health. OBJECTIVE: To compare the number of medications taken for metabolic syndrome for patients with grocery nutrition scores at goal versus those below goal as pre-defined by the dietician team. PRACTICE DESCRIPTION: This exploratory, retrospective cohort pilot study took place in a single pharmacy within a large community pharmacy chain in Northwest Ohio. PRACTICE INNOVATION: This retrospective cohort study compared the number of medications taken for metabolic syndrome between two groups: patients with a grocery nutrition score at a dietician-set goal and patients not at goal. EVALUATION METHODS: Data were collected from May 2022 to March 2023, with patients completing a questionnaire collecting information on demographics. In addition, the questionnaire, grocery nutrition scores, and patient medication records were collected. Descriptive statistics were calculated for demographic items. A number of medications taken for metabolic syndrome by patients at dietician-set grocery nutrition score goal and not at goal were compared using a Mann-Whitney U test. RESULTS: A total of 40 patients were enrolled in this study. There was not a significant difference in a number of medications taken for metabolic syndrome between groups, with patients who had a grocery nutrition score at goal taking an average of 1.20 medications compared to 1.96 for those with grocery nutrition scores below goal. CONCLUSIONS: While no statistical difference in mean medication use was identified, grocery nutrition scores may help understand patients' dietary habits. Larger studies are required to test the relationship between grocery nutrition scores, patient-specific factors, and medications taken for metabolic syndrome.

Exploring the medication-related needs of sports medicine organizations.

BACKGROUND: Medication-related services are provided by sports medicine organizations at all levels of competition; however, no studies have been conducted to date that have been aimed at evaluating the medication-related needs among members of each organization, the challenges associated with meeting these needs, and the potential utilization of pharmacists to facilitate these services for athletes. OBJECTIVES: To explore the medication-related needs within sports medicine organizations and identify where services provided by a pharmacist may assist in reaching organizational goals. METHODS: Qualitative semistructured group interviews were utilized to identify the medication-related needs of sports medicine organizations in the U.S. Organizations, including orthopedic centers, sports medicine clinics, training centers, and athletic departments were recruited via email. A survey and a set of sample questions were sent to each participant to gather demographic information and allow time for the participant to reflect on their specific organization's medication-related needs in preparation for the interviews. A discussion guide was created to explore each organization's overarching medication-related functions and the challenges and successes related to their current policies and procedures regarding their medication-related needs. Each interview was conducted virtually, recorded, and transcribed into text. A thematic analysis was conducted by a primary and secondary coder. Themes and subthemes were identified from the codes and defined. RESULTS: Nine organizations were recruited for participation. Of these, individuals from 3 Division 1 university-based athletic programs were interviewed. Twenty-one individuals participated across all 3 organizations including 16 athletic trainers, 4 physicians, and 1 dietitian. The thematic analysis revealed the following themes: Medication-Related Responsibilities, Barriers to Optimizing Medication Use, Contributions to Successful Implementation of the Medication-Related Services, and Opportunities to Improve Medication-Related Needs. Themes were reduced to subthemes to further describe the medication-related needs within each organization. CONCLUSION: Division 1 university-based athletic programs have medication-related needs and challenges that have the potential to be enhanced by services provided by pharmacists.

Technology targeting immunocompromised patients for COVID-19 vaccine in community pharmacies.

BACKGROUND: Medication targeting by community pharmacists may assess medical history of patients for recommendation of clinical services through review of their prescription history. Previous studies have implemented medication targeting to identify patients eligible for vaccine recommendations. Targeting of immunosuppressing medications may impact the rate of third primary doses of COVID-19 vaccine administered to immunocompromised patients. OBJECTIVES: The primary objective was to determine the impact of medication targeting on the rate of third primary doses of COVID-19 vaccine given to immunocompromised patients. METHODS: This observational, retrospective cohort study occurred within one division of a large community pharmacy chain. Included patients were greater than 18 years of age with record of at least one immunosuppressing medication dispensed one year prior to study enrollment and 2 primary COVID-19 vaccine doses in the pharmacy dispensing software. An intervention for pharmacist recommendation of a third primary dose of COVID-19 vaccine was automatically loaded into their prescription profiles. The proportion of patients with completed interventions and confirmation of third dose administration was collected with demographic characteristics. RESULTS: The pharmacy dispensing software identified 1670 interventions through medication targeting, though 69 interventions met criteria for study inclusion. Baseline characteristics of the included population were a mean age of 51.8 years of primarily female sex (69.6%) and Caucasian race (78.3%). Third primary COVID-19 vaccine dose administration and completed pharmacist recommendation was recorded for 2 (2.9%) patients. CONCLUSION: Medication targeting identified immunocompromised patients for the recommendation of a third primary dose of COVID-19 vaccine. Improved specification for targeting of dosing regimen and route of administration may result in greater accuracy of appropriate recommendations identified.

Intravenous Physical Compatibility of Heparin Sodium and Furosemide.

Continuous infusions of heparin and furosemide are often required for hospitalized patients to treat cardiac-related disease states. Concomitant infusion of heparin and furosemide through the same intravenous line minimizes the need for multiple intravenous sites. For concomitant infusions to be administered, knowledge of the physical compatibility for intravenous medications is imperative for patient safety and administering medications to maximize their effectiveness. Currently, heparin and furosemide are listed as Y-site compatible, but precipitation was reported at a large academic medical center, which questions this compatibility. This study investigated the in vitro physical compatibility of heparin sodium premix 25,000 units/250 mL in dextrose 5% water from two different manufacturers with furosemide 40 mg/4 mL at concentrations of 4:1 for heparin sodium and furosemide. The admixtures were prepared in triplicate using aseptic technique, stored at 19°C to 24°C and examined for visual precipitation, turbidity, and pH change at baseline, 1, 5, 8, 24, and 48 hours. Heparin sodium, B. Braun Medical Inc. or Hospira, Inc. solutions, and furosemide admixtures revealed changes over 48 hours. Changes in visual appearance, absorbance, and pH were observed at hour 5 compared to baseline for the B. Braun Medical Inc. admixture. The Hospira, Inc. admixture revealed visual changes by hour 48, but demonstrative changes in absorbance and pH did not occur. Our observations found demonstrative changes in physical compatibility in the admixtures of heparin sodium and furosemide at a ratio of 4:1. The findings suggest that a combination of the solutions in this study be avoided until further research is completed.

Perspectives of athletes and pharmacists on pharmacist-provided sports supplement counseling: An exploratory study.

OBJECTIVES: To identify athletes' interests in receiving advice about sports supplements from a pharmacist in a supermarket setting and to identify pharmacists' knowledge, confidence, and enthusiasm for providing counseling on various sports supplements. METHODS: Two cross-sectional surveys were developed and administered. One survey was administered to athletes at local northwestern Ohio fitness facilities, and 1 survey was administered to pharmacists in chain pharmacies during mid-February to mid-March 2017. The athlete survey gathered demographic information, information sources, products purchased, including their location and selection factors, and perceptions of pharmacists providing sports supplement counseling. The pharmacist survey gathered demographic information; knowledge, confidence, and enthusiasm for providing sports supplement counseling; perceptions of counseling benefit; and barriers to implementation of providing a sports supplement counseling service. RESULTS: The athlete survey had 129 participants. Athletes primarily reported obtaining sports supplement information from supplement stores, and only 2% indicated using a pharmacist. Although 52% said they would talk to a pharmacist about sports supplements, 66% said their perception of a pharmacist's fitness level would influence whether or not they would approach him or her. The pharmacist survey had 143 participants. On a 5-point Likert-type scale (1 = strongly disagree and 5 = strongly agree), the mean (SD) of their knowledge, confidence, and enthusiasm statements were 2.49 (0.89); 2.61 (0.94); and 3.54 (0.87), respectively. Ninety-two percent (n = 130) of pharmacists thought it would be beneficial to provide counseling on sports supplements. Perceived barriers included lack of knowledge, evidence, and time. CONCLUSION: Pharmacists were not identified as a primary resource for sports supplements, but athletes would be willing to discuss this topic with knowledgeable and physically fit pharmacists. Pharmacists felt that they lacked knowledge and confidence regarding sports supplement products but noted enthusiasm to provide counseling. Sports pharmacy counseling could be a viable expansion of pharmacy services in community pharmacies with proper education and tools.