Evaluation of Student Academic Performance After Curricular Content Reduction.

OBJECTIVE: To evaluate the effect of curricular content reduction in an integrated course sequence spanning 3 years of a Doctor of Pharmacy curriculum on student examination scores and course grades. METHODS: This 2-year, prepost study compared student overall average and final examination scores and overall course grades after the transition from a 5-day to a 4-day week of an integrated learning experience (ILE) course sequence. In addition, an anonymous, optional 23-item survey was distributed to first to third year pharmacy students asking about the 4-day week change, how they utilized the non-ILE day, and additional demographic and social characteristics to identify factors influencing success on examination and course performance during the 4-day week. RESULTS: There were 533 students included in the overall analysis, with no significant differences in overall course grades in the 5-day vs 4-day week. Examination scores were not significantly different after the transition, except in 2 of 12 courses where scores were higher and final examination scores were not significantly different, except for higher final examination scores in 1 course during the 5-day week. Significant positive influencers of top quartile of examination performance included prepharmacy grade point average ≥ 3.5, age 25 to 29 years, and prepharmacy coursework at the parent institution, whereas using the non-ILE day primarily to sleep negatively influenced outcomes. CONCLUSION: Curricular density is a prevalent problem and addressing it at a program level is essential. Reducing curricular content and hours at our institution did not adversely impact student examination and course performance and slight improvement was noted in some areas.

Evaluation of the creation of podcasts for instructional delivery in a post-graduate training elective course.

OBJECTIVES: To describe the creation of podcasts for instructional delivery and evaluate strengths and areas for improvement in a post-graduate training (PGT) elective course. METHODS: After creating a podcast series, students in the PGT elective from Spring 2021 to Fall 2022 listened to the series then completed a reflection based on five open-ended questions that provoked their thoughts and feelings about use of podcasts as a method of delivering information and teaching. Responses were downloaded and a content analysis was performed. Each investigator analyzed responses from all reflections to identify major themes and subthemes. Letter of intent assignment and overall course grades were compared to assess if podcasts affected student learning. RESULTS: Ninety-one students provided reflections about the use of podcasts in the PGT elective course, which revealed three major themes with 13 subthemes, including perception of guests, learner experience, and show and episode production. Students appreciated the various perspectives, authenticity, relatability, and diversity of the guest speakers; the learning environment was described as flexible, relatable, positive, and a safe space; the podcast design was noted to be informative, organized, and easily accessible. Areas for improvement included more interaction with guests and more visuals. Letter of intent assignment and overall course grades were similar before and after podcast implementation. CONCLUSION: The use of podcasts as an educational tool in a PGT elective course had a variety of characteristics that students preferred to traditional lecture-style classes.

Head-to-head comparison of multi-dose oritavancin and dalbavancin for complicated infections: A propensity score-matched analysis.

BACKGROUND: Oritavancin and dalbavancin are long-acting lipoglycopeptide antibiotics approved for the treatment of skin and skin structure infections. Recently, they have been used for outpatient antimicrobial therapy for complicated infections. No head-to-head studies exist for this purpose. OBJECTIVE: To compare outcomes of patients treated with multiple doses of oritavancin or dalbavancin for complicated infections. PATIENTS AND METHODS: This was a single-centre, retrospective cohort study evaluating adult patients who received two or more doses of lipoglycopeptides for complicated infections from February 2019 through December 2022. Patients receiving oritavancin were compared to dalbavancin after propensity score-matching. The primary endpoint was clinical success at 90 days. Other endpoints included: 30-day re-admission, 30-day mortality, adverse drug reactions (ADRs), and changes in white blood cell count and inflammatory markers after the first dose. RESULTS: After exclusions and propensity score-matching, 131 matched pairs (N = 262) were included in the analysis. Most patients were receiving lipoglycopeptide therapy for osteomyelitis. There was no significant difference in clinical success at 90 days in patients who received oritavancin compared to those who received dalbavancin (99 [76%] vs. 103 [79%], respectively; P = 0.556). There was no significant difference in secondary endpoints, however, there was a trend towards higher incidence of ADRs oritavancin compared to dalbavancin (9 [7%] vs. 2 [2%], respectively; P = 0.060) which led to more treatment discontinuation. CONCLUSION: There was no significant difference in efficacy between multi-dose oritavancin and dalbavancin for the treatment of complicated infections. Both agents were generally well tolerated; however, dalbavancin may be better tolerated when long-term treatment is warranted.

Dosing and Administration Strategies of Tocilizumab in Patients With COVID-19: A Retrospective Cohort Analysis.

BACKGROUND: Tocilizumab may reduce the risk of death, length of stay, and time of mechanical ventilation in patients hospitalized with COVID-19. Limited data are available evaluating low-dose subcutaneous administration of tocilizumab in this setting. OBJECTIVE: To compare outcomes of 2 tocilizumab dosing and administration strategies in patients hospitalized with COVID-19. METHODS: A retrospective, observational cohort study was conducted to compare clinical outcomes in patients hospitalized with COVID-19 receiving tocilizumab 400 mg intravenously (400 mg IV) or 162 mg subcutaneously (162 mg SC). Hospitalized patients receiving a single dose of tocilizumab were eligible for inclusion and grouped by dosing and administration strategy. The primary endpoint was ventilator-free days at day 28. Secondary endpoints included length of stay (LOS), intensive care unit (ICU) LOS, mechanical ventilation required after dose, 28-day readmission, 28-day mortality, and change in inflammatory markers. RESULTS: A total of 303 patients were included, with 147 who received tocilizumab 400 mg IV and 156 who received 162 mg SC. There was no significant difference in average ventilator-free days at day 28 in patients receiving 400 mg IV compared with 162 mg SC (26.4 ± 5.3 vs 25.6 ± 6.8 days, respectively; P = 0.812). There was also no difference in LOS (10.4 ± 12.6 vs 10.5 ± 14.0 days; P = 0.637), ICU LOS (3.9 ± 9.0 vs 3.5 ± 8.3 days; P = 0.679), mechanical ventilation after dose (15.6% vs 19.2%; P = 0.412), 28-day readmission (6.1% vs 9.6%; P = 0.268), or 28-day mortality (23.1% vs 25.6%; P = 0.611). Finally, there was no difference regarding change in inflammatory markers at 48 hours (P > 0.05 for all interactions). CONCLUSION AND RELEVANCE: In this retrospective study involving hospitalized patients with COVID-19, there was no difference between tocilizumab 162 mg SC and 400 mg IV in terms of efficacy. The 162 mg SC dose may be a reasonable alternative to traditional doses.

A few small steps or giant leap? De-densify the curriculum in one move.

INTRODUCTION: We describe a two-year, stepwise curricular change plan with a goal to address student and faculty wellbeing by reducing curricular density and rescheduling courses. METHODS: At year five of a new practice-ready curriculum, we strategically assessed and redesigned our integrated learning experience (ILE) course sequence to minimize curricular density with consideration for student and faculty wellbeing. This stepwise approach to curricular revision involved converting an in-class day (three hours) to asynchronous delivery in 12 core didactic courses (first- through third-professional years) for one year followed by a transition to a four-day vs. five-day course week the following year. Additional scheduling changes were implemented to improve the use of physical classroom space and overlapping student activities. RESULTS: Whereas thinking a gradual transition would be more accepted, moving straight to a four-day ILE week would have been more beneficial for faculty workload and wellbeing and decreased student confusion. However, the rescheduling of courses freed up classroom space allowing all classes to be held in person in a physical classroom and alleviated overlapping curricular activities during the week. CONCLUSIONS: The stepwise change of including an asynchronous day resulted in confusion and stress during the transition to a four-day class week and additional faculty work. However, adjusting the course schedule increased uncommitted student and faculty time, alleviated classroom constraints, and eliminated overlapping curriculum activities. Learning about our process and approach to reduce curricular density, what worked well, and lessons learned may allow other programs to be more efficient when making curricular changes.

Effect of microbiology comment nudging on antibiotic use in asymptomatic bacteriuria: A before-and-after quasi-experimental study.

OBJECTIVE: To describe the effect of a microbiology comment nudge on antibiotic use for asymptomatic bacteriuria (ASB). DESIGN: Single-center, before-and-after, quasi-experimental study. SETTING: Community-based, public, not-for-profit teaching hospital in the southeastern United States. PARTICIPANTS: Adult inpatients with a positive urine culture and the absence of urinary tract infection signs and symptoms. INTERVENTION: Implementation of a microbiology comment nudge on urine cultures. RESULTS: In total, 204 patients were included in the study. Antibiotics were less likely to be continued beyond 72 hours in the postimplementation group: 57 (55%) of 104 versus 38 (38%) of 100 (P = .016). They were less likely to have antibiotics continued beyond 48 hours: 60 (58%) of 104 versus 43 (43%) of 100 (P = .036). They were also less likely to have antibiotics prescribed at discharge 35 (34%) of 104 versus 20 (20%) of 100 (P = .028). In addition, they had fewer total antibiotic days of therapy: 4 (IQR, 1-6) versus 1 (IQR, 0-6) (P = .022). CONCLUSION: Microbiology comment nudging may contribute to less antibiotic utilization in patients with ASB.

Comparison of Inpatient Standard-of-Care to Outpatient Oritavancin Therapy for Patients With Acute Uncomplicated Cellulitis.

BACKGROUND: Shifting inpatient antibiotic treatment to outpatient parenteral antimicrobial therapy may minimize treatment for acute bacterial skin and skin structure infections, including cellulitis. The purpose of this evaluation was to compare 30-day hospital readmission or admission due to cellulitis and economic outcomes of inpatient standard-of-care (SoC) management of acute uncomplicated cellulitis to outpatient oritavancin therapy. METHODS: This retrospective, observational cohort study was conducted at a 941-bed community teaching hospital. Adult patients 18 years and older treated for acute uncomplicated cellulitis between February 2015 to December 2018 were eligible for inclusion. Information was obtained from hospital and billing department records. Patients were assigned to either inpatient SoC or outpatient oritavancin cohorts for comparison. RESULTS: 1,549 patients were included in the study (1,348 in the inpatient SoC cohort and 201 in the outpatient oritavancin cohort). The average length of stay for patients admitted was 3.6 ± 1.5 days. The primary outcome of 30-day hospital readmission or admission due to cellulitis occurred in 49/1348 (3.6%) patients in the inpatient SoC cohort versus 1/201 (0.5%) in the outpatient oritavancin cohort (p = 0.02). The difference between costs and reimbursement was improved in the outpatient oritavancin group (p < 0.001). CONCLUSION: Outpatient oritavancin for acute uncomplicated cellulitis was associated with reduction in 30-day hospital readmissions or admissions compared to inpatient SoC. Beneficial economic outcomes for the outpatient oritavancin cohort were observed. Additional studies are required to confirm these findings.

Exploration of wellbeing in entering first year doctor of pharmacy students.

INTRODUCTION: The purpose of this study was to assess wellbeing in entering first-year student pharmacists beginning their doctor of pharmacy degree program. METHODS: This was a mixed-methods study conducted in entering first-year student pharmacists during their pharmacy school orientation. After their wellbeing orientation session, students were asked to complete a voluntary survey that asked students to rate their current level of wellbeing according to the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). Students also wrote a reflection related to their wellbeing and perceptions. Qualitative analysis was completed for student responses to reflection questions to identify recurring themes. RESULTS: One hundred thirty-one students attended the wellbeing orientation session and completed the reflection assignment. Of those, 87 (66.4%) completed the voluntary quantitative survey. On average, first-year student pharmacists indicated having a moderate level of wellbeing based on WEMWBS scores. Major themes that emerged as most influential on student pharmacist wellbeing included sense of optimism/self-care, social isolation and emotional connectedness, and uncertainty/worry/anxiety. CONCLUSIONS: Entering student pharmacists had slightly lower than average levels of wellbeing based on WEMWBS scores. Pharmacy programs should continue to consider the importance of variables that impact student wellbeing (e.g., promotion of self-care, mental health, social and emotional connectedness).

A 20-year single community-based tertiary care center's experience with cardiac myxomas.

We analyzed 54 cases of cardiac myxoma (n = 40) and non-myxoma (n = 14) diagnosed at a single community-based tertiary care center over 20 years. The data were retrospectively collected for patients between the period January 2000 and September 2020 from the hospital database. We described patient characteristics and clinical features of cardiac myxoma. In patients with diagnosis of cardiac myxoma, the median age was 64 years (range 41-78), with 58% females. Cardiac myxoma patients presented in a variety of ways, as dyspnea (42%), palpitations (20%), and chest pain (15%). Transesophageal echocardiogram was performed in 82.5% of patients. Chest computed tomography (CT) was performed in 32.5%, while cardiac magnetic resonance imaging (CMRI) was performed in 10%. Ischemic evaluation was performed in the majority of patients, primarily having cardiac catheterization. All cardiac myxomas were a single mass and the most common location was the left atrium (n = 34, 85%), followed by the right atrium (n = 6, 15%). 33 (83%) of them were larger than 2 cm. We differentiated cardiac myxoma from non-myxoma mass, which was most commonly a thrombus by histopathology. More patients with cardiac myxoma underwent surgical resection and required hospital and ICU stay than non-myxoma patients. No patients in either group experienced inpatient mortality or a mass recurrence with a median follow-up period of 2 years.

Evaluating the Impact of Advanced Pharmacy Practice Experiences on Student Pharmacist Metacognition.

Objective. To assess factors impacting metacognition during the advanced pharmacy practice experience (APPE) year (final year of the Doctor of Pharmacy program) for student pharmacists at five different institutions.Methods. Student pharmacists completed a pre- and post-APPE year survey that collected data on demographics, curricular and co-curricular experiences, and the 19-item modified metacognition assessment inventory (MAI). Additionally, the post-APPE survey collected data on learning activities completed during the APPE year. Matched survey responses were analyzed to identify associations between change in MAI score and individual experiences.Results. One hundred thirty-nine matched responses were analyzed. A significant improvement in overall student pharmacist metacognition was seen in matched pre- vs post-APPEs surveys. Several significant, moderate to weak correlations were associated with a change in MAI score over the APPE year.Conclusion. The APPE year resulted in a significant change in student pharmacists' metacognition at five institutions. This improvement was multifactorial as individual factors had minimal association with the change in metacognition.

Effectiveness of Journal Club Activities Versus Clinical Debate Activities in Pharmacy Experiential Education.

Objective. Within pharmacy experiential education, practicing literature evaluation skills usually occurs via journal clubs. Clinical debates have gained traction as an engaging alternative to journal club meetings while completing advanced pharmacy practice experiences (APPEs). The purpose of this study was to compare clinical knowledge and literature evaluation application between journal clubs and clinical debates during APPEs.Methods. This mixed-methods prospective study was conducted in fourth year pharmacy students completing inpatient general medicine APPEs at four institutions. Students participated in a journal club and clinical debate during their experience. Students completed a 10-item knowledge assessment after each activity. Differences in journal club and clinical debate assessment scores were analyzed. Following completion of both activities, a perception survey was administered to gauge preferences and opinions. Differences in perception survey scores for journal clubs compared to clinical debates were evaluated quantitatively, and a thematic analysis was completed for qualitative responses.Results. Fifty students participated in both activities. There were no differences between journal club and clinical debate assessment scores (57.4%±21.0% and 62.9%±20.7%, respectively). Forty students completed the post-perceptions survey and globally agreed or strongly agreed that both journal clubs and clinical debates improved confidence in literature evaluation and clinical skills. Common themes identified included applicability to pharmacists' roles and need for clear instructions and examples.Conclusion. There was no significant difference between student performance on knowledge assessments of journal clubs and clinical debates, and students found both activities to be beneficial. Clinical debates are a reasonable alternative to journal clubs to improve pharmacy students' knowledge and literature evaluation skills.

Effect of Interprofessional Clinical Debates on Attitudes of Interprofessional Teams.

INTRODUCTION: Current evidence supports the notion of debates as a pedagogical method to teach literature evaluation skills in health care education; however, there are no reports of this method as an interprofessional approach and its potential benefits. The aim of this study was to assess the impact of interprofessional clinical debates on attitudes toward interprofessional teamwork and perceived literature evaluation skills. METHODS: We invited third-year family medicine residents and fourth-year pharmacy students to complete a survey before and after participating in an interprofessional clinical debate. The anonymous survey was composed of the Students' Perceptions of Interprofessional Clinical Education-Revised (SPICE-R2) instrument to evaluate perceptions of interprofessional teamwork, literature evaluation, and other skills gained through the process. We evaluated matched responses for change in attitudes toward interprofessional teams. RESULTS: We evaluated 41 matched responses, which indicated improvement in attitudes toward interprofessional teams and was statistically significant ( P<.001). This finding held true for subscales of roles/responsibilities for collaborative practice and patient outcomes from collaborative practice (P<.001). Participants also perceived improvements in literature evaluation, problem-solving, critical thinking, teamwork, and communication skills. CONCLUSION: The interprofessional clinical debate activity positively impacted medical residents and pharmacy students, and improved attitudes toward interprofessional teams.

Comparison of blood cultures versus T2 Candida Panel in management of candidemia at a large community hospital.

The T2 Candida Panel (T2CP) has high sensitivity and specificity to detect candidemia. Its role in the diagnosis and management of candidemia compared to blood cultures (BC) remains unclear. The purpose of this study was to evaluate the T2CP versus BC in detecting and treating candidemia. A retrospective, observational cohort study was conducted to compare clinical outcomes in patients with candidemia identified by BC versus T2CP. Patients with a positive BC or T2CP for Candida spp. from January 2012 to August 2020 were grouped by initial method of detection (BC vs T2CP). Co-primary endpoints assessed included time to detection of candidemia and time to antifungal therapy. Key secondary endpoints included length of stay (LOS), ICU LOS, and mortality. One hundred sixty-three patients with a positive BC and 89 patients with a positive T2CP were included in the evaluation. The average time to detection of candidemia was significantly shorter in the T2CP group compared to BC group (9 vs 41 h, p < 0.001). The time to antifungal was also significantly shorter in the T2CP group compared to the BC group (4 vs 37 h, p < 0.001). However, LOS was significantly shorter in the BC positive group than the T2CP group with no difference in ICU LOS. There was no difference in in-hospital or 30-day mortality between the two groups. Of patients diagnosed with candidemia at our large community hospital, identification by T2CP led to faster detection and initiation of antifungal compared to blood cultures without improvement in LOS or mortality.

Evaluation of area under the concentration-time curve-guided vancomycin dosing with or without piperacillin-tazobactam on the incidence of acute kidney injury.

OBJECTIVES: Recent studies suggest that the combination of piperacillin-tazobactam (P-T) and vancomycin increases the risk for acute kidney injury (AKI). The purpose of this study was to determine if area under the concentration-time curve (AUC)-guided vancomycin dosing reduced the incidence of AKI in a sample of patients who also received P-T. METHODS: This single-centre, retrospective, pre-post quasi-experimental study compared the incidence of AKI before and after a health-system-wide change from trough- to AUC-guided vancomycin dosing using two post-distribution levels. The primary outcome was AKI, defined as an increase in serum creatinine ≥0.5 mg/dL or 50% from baseline for two consecutive measurements, in patients who received vancomycin with or without concomitant P-T. RESULTS: In total, 636 patients were included in this study (308 trough-guided, 328 AUC-guided); of these, 118 patients in each group received concomitant P-T. The primary outcome occurred in 35 (11.4%) patients in the trough-guided group and 24 (7.3%) patients in the AUC-guided group (P=0.105). There was no difference in the incidence of AKI in the population receiving concomitant P-T between dosing strategies. The incidence of AKI was significantly higher in patients who received concomitant P-T compared with patients who did not receive concomitant P-T in both the trough-guided group [21/118 (17.8%) versus 14/190 (7.4%), respectively; P=0.003] and the AUC-guided group [16/118 (13.6%) versus 8/210 (3.8%), respectively; P=0.0011]. CONCLUSIONS: The incidence of AKI did not differ significantly between trough- and AUC-guided vancomycin dosing. Caution should be taken when combining vancomycin and P-T regardless of dosing strategy. Larger studies are needed to confirm these findings.

A Systematic Review and Meta-Analysis of Metolazone Compared to Chlorothiazide for Treatment of Acute Decompensated Heart Failure.

Treatment of volume overload in the setting of acute decompensated heart failure (ADHF) is typically achieved through the use of loop diuretics. While they are highly effective, some patients may develop loop diuretic resistance. One strategy to overcome this scenario includes sequential nephron blockade with a thiazide-type diuretic; however, it is unknown which thiazide-type diuretic used in this setting is most effective. A systematic review and meta-analysis were performed to compare the efficacy and safety of chlorothiazide with metolazone as add-on therapy in the setting of loop diuretic resistance for the treatment of ADHF. Literature searches were conducted through PubMed, Google Scholar, and Science Direct from inception through February 2020 using the following search terms alone or in combination: metolazone, chlorothiazide, acute decompensated heart failure, loop diuretic, and urine output. All English-language prospective and retrospective trials and abstracts comparing metolazone to chlorothiazide for the treatment of ADHF were evaluated. Studies were included if they analyzed urine output for at least 24 hours in patients with ADHF. Meta-analysis was conducted to evaluate pooled effect size by using a random-effect model. Primary outcomes included net and total urine output. Secondary outcomes included commonly reported safety outcomes. Four studies comparing the use of metolazone to chlorothiazide as an adjunct to loop diuretics to treat ADHF were included in the evaluation. Metolazone was as effective as chlorothiazide to augment loop diuretic therapy in ADHF in most studies with no pooled difference in net or total urine output. However, there were notable differences in baseline loop diuretic dosing, ejection fraction, renal function, race, and endpoint timing across studies. Adverse effects were commonly observed and included electrolyte abnormalities, change in renal function, and hypotension but were comparable between groups. Metolazone is as effective as chlorothiazide as add-on to loop diuretics in treating ADHF without an increase in safety concerns.

Utilization and impact of a rapid Candida panel on antifungal stewardship program within a large community hospital.

BACKGROUND: The T2 Candida Panel (T2CP) bodes high sensitivity and specificity to detect candidemia, enabling providers to make quick therapy decisions and possibly decrease mortality. However, utilization in practice and clinical application remains to be evaluated. OBJECTIVES: To evaluate the overall provider-utilization of the T2CP at a large community hospital. METHODS: This single center, retrospective, observational study compared antifungal management in all patients with positive or negative T2CP. Additional endpoints included patient-specific variables influencing antifungal management decisions. RESULTS: Six hundred twenty-eight T2CP results were evaluated. Antifungal optimization occurred in 54% of patients who had antifungal orders at the time of T2CP test. Antifungal therapy was avoided in 60.4% of negative cases. Patients with negative T2CP had significantly fewer days of therapy compared to positive tests. CONCLUSIONS: Although the T2CP led to fewer days of antifungal therapy with negative tests, many opportunities for improvement in antifungal stewardship were identified, specifically, with negative tests.

Grit in pharmacy faculty: A pilot analysis focused on productivity measures.

INTRODUCTION: Grit, a "perseverance and passion for long-term goals," is an important characteristic that has been linked to success in academics and career endeavors. In pharmacy education, there have been mixed results on grit as a predictor of academic performance in pharmacy students. Furthermore, there have been no studies on the implications of grit in pharmacy faculty. The purpose of this study was to determine pharmacy faculty Short Grit Scale (Grit-S) scores at two universities and whether those scores correlate with faculty productivity. METHODS: A 36-item electronic survey was administered to pharmacy faculty members at two institutions. Baseline demographics and self-reported Grit-S scores were obtained. Metrics of productivity in the areas of teaching, scholarship, and service were defined using quantitative measures. Non-parametric analyses were conducted to test if higher Grit-S scores correlated with other variables. RESULTS: Faculty reported an average Grit-S score of 3.68. There was no significant correlation between Grit-S scores and components of faculty productivity in teaching and service for the previous academic year or career. Higher Grit-S scores had a moderately positive correlation with the number of peer-reviewed publications in 2017. CONCLUSION: Grit-S scores are high among pharmacy faculty and were not correlated with higher productivity in most components of faculty workload.

Nondihydropyridine Calcium Channel Blockers for the Treatment of Proteinuria: A Review of the Literature.

Objective: To review the use of nondihydropyridine calcium channel blockers (non-DHP CCBs) for the treatment of proteinuria in diabetic and nondiabetic kidney disease. Data Sources: A search using PubMed and MEDLINE, Scopus, and Google Scholar was performed from 1964 through February 2019 using the following search terms alone or in combination: verapamil, diltiazem, non-dihydropyridine calcium channel blocker, proteinuria, albuminuria, microalbuminuria, kidney disease, renal disease. Study Selection and Data Extraction: All prospective English-language trials examining one or more non-DHP CCB for the treatment of proteinuria were evaluated. Data Synthesis: A total of 13 clinical trials examining the use of non-DHP CCBs to treat proteinuria alone or in combination with angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) were included in the evaluation. Most studies evaluated patients with macroalbuminuria secondary to diabetes and hypertension. Verapamil was the most common agent studied. Non-DHP CCBs were effective in reducing proteinuria in diabetic kidney disease but did not reduce renal or cardiovascular outcomes in the one trial that evaluated clinical end points. They were generally well tolerated, with the most common adverse effect reported being constipation. Relevance to Patient Care and Clinical Practice: This review evaluates and summarizes the available evidence on non-DHP CCBs for treatment of proteinuria in patients with existing kidney disease. Conclusion: Non-DHP CCBs may be a reasonable therapeutic option for patients with diabetic kidney disease and persistent proteinuria despite maximum doses of ACE inhibitors or ARBs. Additionally, they may be reasonable alternatives to ACE inhibitors or ARBs if a contraindication or intolerance exists.