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1.
Am J Pharm Educ ; 88(7): 100723, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38821189

RESUMO

From 2021 to 2023, 7978 graduates of pharmacy programs failed the North American Pharmacist Licensure Examination on the first attempt. Presently, the Accreditation Council for Pharmacy Education monitors programs with a passage rate of ≥ 2 SDs below the national mean pass rate. In 2023, this should lead to monitoring 7 programs that produced 140 failures out of the total of 2472 failures (5.7 %). In our view, this is neither equitable nor demonstrative of sufficient accountability. Analysis of failure counts among the 144 programs reported by the National Association of Boards of Pharmacy demonstrates a distribution curve highly skewed to the right. The evaluation of average failure counts across all programs suggests that schools with absolute failures ≥ 2 SDs higher than the average number of failures should be identified for monitoring, in addition to those falling ≥ 2 SDs below the national mean pass rate. Based on the 2023 data, this additional criterion corresponds to ≥ 35 failures/program. This threshold would prompt monitoring of 18 programs and 36.5 % of the total failures. Of the 7 programs that will be monitored based on the current Accreditation Council for Pharmacy Education criteria, only 1 would be captured by the ≥ 35 failure method of selection; the remaining 6 contribute 85 total failures to the pool. Thus, if both criteria were to be applied, ie, ≥ 35 failures and ≥ 2 SDs below the national mean pass rate, a total of 24 programs would be monitored (16.6 % of the 144 programs) that contribute 987 of the total failures (39.9 %).

2.
Res Social Adm Pharm ; 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38565426

RESUMO

BACKGROUND: Research in Social and Administrative Pharmacy has been expanding in the last decade. The recently published Granada Statements offer key recommendations to improve the quality of research in this field. OBJECTIVES: To identify the factors associated with the citations of articles in the field of social, administrative, clinical pharmacy and practice research. METHODS: This study was a retrospective, observational analysis of articles published in three leading journals. Per article Google Scholar citations was the dependent variable. Predictor variables were extracted from all articles published from 2013 to 2015. The dependent variable was dichotomized using sample's median Google Scholar citations. Logistic regression analysis was performed to identify independent predictors of citations ≥ median. RESULTS: The median number of citations per article was 17 (range 0-341), with a mean of 24.2 (SD 27.6). The number of references included in the articles (OR 1.03, CI 1.02-1.04), the year of publication (OR 0.31 CI 0.21-0.46 for articles published 2015), article social media mentions (OR = 1.01, CI 1.01-1.03 and OR 1.10 CI 1.04-1.18 for Facebook and X, respectively), the topic area of research namely pharmacy services (OR 1.65, CI 1.06-2.57) and medication adherence (OR 2.22 CI 1.13-4.33) were independently associated with article having citations ≥ median. CONCLUSIONS: The number of references, the year of publication, social media mentions and the topic area of research, namely pharmacy services and medication adherence, were associated with citations above median in the leading journals of social and administrative pharmacy research. Authors may consider providing a thorough literature review in their articles, while researchers, editors, and publishers are advised to use social media to promote newly published work. This article complements the Granada Statements and may contribute to fostering wider dissemination of the discipline's outputs.

3.
Contraception ; 128: 110138, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37544574

RESUMO

OBJECTIVES: This study aimed to characterize awareness of a 2017 Massachusetts (MA) law that ensures access to a 12-month supply of short-acting contraceptive methods (e.g., pill, patch, and vaginal ring) among short-acting contraceptive users in MA and to identify perceived benefits and concerns of a 12-month supply. STUDY DESIGN: An online survey was administered to a Qualtrics panel of MA women who were using short-acting contraceptive methods and were insured by an eligible health plan. The survey's primary outcome was general awareness of the law; interest in, receipt of, and perceived benefits and risks of a 12-month supply were also elicited. Analysis included descriptive statistics and bivariate and multivariable analyses examining factors associated with awareness of the law. RESULTS: Among the 207 survey respondents, 76% were aware of the law, and 93% expressed interest in receiving a 12-month supply of a short-acting method; however, only 9% received it. Respondents identified as White (66%), privately insured (59%), and pill users (44%). Concerns about a 12-month supply included privacy, product expiration, and change in personal medical status. Perceived benefits included avoiding multiple trips to pharmacy and increased compliance. Multivariable analyses showed general awareness of the law was only associated with employer-based insurance, with those respondents having 75% lower odds of being aware of the law than respondents with Medicaid coverage. CONCLUSION: Although a high percentage of women surveyed were aware of the law and most were interested in receiving a 12-month supply of their short-acting method, the low percentage who have received a 12-month supply suggests barriers to policy uptake. IMPLICATIONS: This study describes perceptions of the 12-month supply provision of the contraception Act Advancing Contraceptive Coverage and Economic Security in our State law. Addressing consumer concerns may be important to improve the implementation and dissemination of this state policy change.


Assuntos
Anticoncepcionais Femininos , Dispositivos Anticoncepcionais Femininos , Estados Unidos , Feminino , Humanos , Anticoncepção/métodos , Inquéritos e Questionários , Massachusetts
4.
Curr Pharm Teach Learn ; 15(10): 854-860, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37544784

RESUMO

INTRODUCTION: We have evaluated two approaches of monitoring schools and colleges of pharmacy based on North American Pharmacist Licensure Examination (NAPLEX) passage rates. Historically, the Accreditation Council for Pharmacy Education (ACPE) has cited programs for passage rate ≥2 SD below the national average. Since the National Association of Boards of Pharmacy (NABP) no longer reports scores, this procedure is being reconsidered. Our supposition is that the failure rate of ≥2 SD below the average should be retained, but now be based on the national average passage rate rather than score. Yet, we further suggest this is not sufficient due to major variations in class size. COMMENTARY: We suggest the establishment of a "maximum acceptable failure count," likely in the range of 20 to 25 failing graduates per class. Analyses of data from 2017 to 2019 indicate that this approach would lead to monitoring approximately 15% of existing programs that graduate approximately 40% of individuals failing NAPLEX vs. monitoring only 5% of programs that graduate approximately 9% of individuals failing NAPLEX. IMPLICATIONS: The historical method of monitoring pharmacy programs with NAPLEX passage rates ≥2 SD below the national average is not sufficient, primarily due large variations in class size. Since accreditation standards are currently being revised ("Standards 2025"), this would be an ideal time to update methods for selecting programs that warrant monitoring based on inadequate NAPLEX passage rates. We suggest the concept of "maximum acceptable failure count" should be considered when identifying programs to be cited.


Assuntos
Farmácia , Estudantes de Farmácia , Humanos , Farmacêuticos , Avaliação Educacional/métodos , Licenciamento em Farmácia , Universidades
5.
Farm Hosp ; 47(3): T133-T138, 2023.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37198084

RESUMO

Pharmacy and pharmaceutical sciences embrace a series of different disciplines. Pharmacy practice has been defined as "the scientific discipline that studies the different aspects of the practice of pharmacy and its impact on health care systems, medicine use, and patient care". Thus, pharmacy practice studies embrace both clinical pharmacy and social pharmacy elements. Like any other scientific discipline, clinical and social pharmacy practice disseminates research findings using scientific journals. Clinical pharmacy and social pharmacy journal editors have a role in promoting the discipline by enhancing the quality of the articles published. As has occurred in other health care areas (i.e., medicine and nursing), a group of clinical and social pharmacy practice journal editors gathered in Granada, Spain to discuss how journals could contribute to strengthening pharmacy practice as a discipline. The result of that meeting was compiled in these Granada Statements, which comprise 18 recommendations gathered into six topics: the appropriate use of terminology, impactful abstracts, the required peer reviews, journal scattering, more effective and wiser use of journal and article performance metrics, and authors' selection of the most appropriate pharmacy practice journal to submit their work. © 2023 The Author(s) Published by Elsevier Inc, Springer Nature, Brazilian Society of Hospital Pharmacy and Health Services, Elsevier Inc, Royal Pharmaceutical Society, Biomedcentral, Sociedad Española de Farmacia Hospitalaria (S.E.F.H), Pharmaceutical Care España Foundation, European Association of Hospital Pharmacists, Faculty of Pharmacy.


Assuntos
Farmácias , Serviço de Farmácia Hospitalar , Farmácia , Humanos , Espanha , Farmacêuticos
6.
Explor Res Clin Soc Pharm ; 9: 100229, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36866074

RESUMO

Pharmacy and pharmaceutical sciences embrace a series of different disciplines. Pharmacy practice has been defined as "the scientific discipline that studies the different aspects of the practice of pharmacy and its impact on health care systems, medicine use, and patient care". Thus, pharmacy practice studies embrace both clinical pharmacy and social pharmacy elements. Like any other scientific discipline, clinical and social pharmacy practice disseminates research findings using scientific journals. Clinical pharmacy and social pharmacy journal editors have a role in promoting the discipline by enhancing the quality of the articles published. As has occurred in other health care areas (i.e., medicine and nursing), a group of clinical and social pharmacy practice journal editors gathered in Granada, Spain to discuss how journals could contribute to strengthening pharmacy practice as a discipline. The result of that meeting was compiled in these Granada Statements, which comprise 18 recommendations gathered into six topics: the appropriate use of terminology, impactful abstracts, the required peer reviews, journal scattering, more effective and wiser use of journal and article performance metrics, and authors' selection of the most appropriate pharmacy practice journal to submit their work.

7.
Int J Pharm Pract ; 31(2): 119-125, 2023 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-36933233

RESUMO

Pharmacy and pharmaceutical sciences embrace a series of different disciplines. Pharmacy practice has been defined as 'the scientific discipline that studies the different aspects of the practice of pharmacy and its impact on health care systems, medicine use, and patient care'. Thus, pharmacy practice studies embrace both clinical pharmacy and social pharmacy elements. Like any other scientific discipline, clinical and social pharmacy practice disseminates research findings using scientific journals. Clinical pharmacy and social pharmacy journal editors have a role in promoting the discipline by enhancing the quality of the articles published. As has occurred in other healthcare areas (i.e. medicine and nursing), a group of clinical and social pharmacy practice journal editors gathered in Granada, Spain to discuss how journals could contribute to strengthening pharmacy practice as a discipline. The result of that meeting was compiled in these Granada Statements, which comprise 18 recommendations gathered into 6 topics, namely the appropriate use of terminology, impactful abstracts, the required peer reviews, journal scattering, more effective and wiser use of journal and article performance metrics and authors' selection of the most appropriate pharmacy practice journal to submit their work.


Assuntos
Assistência Farmacêutica , Farmácias , Pesquisa em Farmácia , Farmácia , Humanos , Espanha
8.
Farm Hosp ; 47(3): 133-138, 2023.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36963994

RESUMO

Pharmacy and pharmaceutical sciences embrace a series of different disciplines. Pharmacy practice has been defined as "the scientific discipline that studies the different aspects of the practice of pharmacy and its impact on health care systems, medicine use, and patient care". Thus, pharmacy practice studies embrace both clinical pharmacy and social pharmacy elements. Like any other scientific discipline, clinical and social pharmacy practice disseminates research findings using scientific journals. Clinical pharmacy and social pharmacy journal editors have a role in promoting the discipline by enhancing the quality of the articles published. As has occurred in other health care areas (i.e., medicine and nursing), a group of clinical and social pharmacy practice journal editors gathered in Granada, Spain to discuss how journals could contribute to strengthening pharmacy practice as a discipline. The result of that meeting was compiled in these Granada Statements, which comprise 18 recommendations gathered into six topics: the appropriate use of terminology, impactful abstracts, the required peer reviews, journal scattering, more effective and wiser use of journal and article performance metrics, and authors' selection of the most appropriate pharmacy practice journal to submit their work.


Assuntos
Farmácias , Serviço de Farmácia Hospitalar , Farmácia , Humanos , Espanha
9.
J Pharm Policy Pract ; 16(1): 43, 2023 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-36899408

RESUMO

Pharmacy and pharmaceutical sciences embrace a series of different disciplines. Pharmacy practice has been defined as "the scientific discipline that studies the different aspects of the practice of pharmacy and its impact on health care systems, medicine use, and patient care". Thus, pharmacy practice studies embrace both clinical pharmacy and social pharmacy elements. Like any other scientific discipline, clinical and social pharmacy practice disseminates research findings using scientific journals. Clinical pharmacy and social pharmacy journal editors have a role in promoting the discipline by enhancing the quality of the articles published. As has occurred in other health care areas (i.e., medicine and nursing), a group of clinical and social pharmacy practice journal editors gathered in Granada, Spain to discuss how journals could contribute to strengthening pharmacy practice as a discipline. The result of that meeting was compiled in these Granada Statements, which comprise 18 recommendations gathered into six topics: the appropriate use of terminology, impactful abstracts, the required peer reviews, journal scattering, more effective and wiser use of journal and article performance metrics, and authors' selection of the most appropriate pharmacy practice journal to submit their work.

10.
Eur J Hosp Pharm ; 2023 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-36914239

RESUMO

Pharmacy and pharmaceutical sciences embrace a series of different disciplines. Pharmacy practice has been defined as 'the scientific discipline that studies the different aspects of the practice of pharmacy and its impact on healthcare systems, medicine use, and patient care'. Thus, pharmacy practice studies embrace both clinical pharmacy and social pharmacy elements. Like any other scientific discipline, clinical and social pharmacy practice disseminates research findings using scientific journals. Clinical pharmacy and social pharmacy journal editors have a role in promoting the discipline by enhancing the quality of the articles published. As has occurred in other healthcare areas (ie, medicine and nursing), a group of clinical and social pharmacy practice journal editors gathered in Granada, Spain to discuss how journals could contribute to strengthening pharmacy practice as a discipline. The result of that meeting was compiled in these Granada Statements, which comprise 18 recommendations gathered into six topics: the appropriate use of terminology, impactful abstracts, the required peer reviews, journal scattering, more effective and wiser use of journal and article performance metrics, and authors' selection of the most appropriate pharmacy practice journal to submit their work.

11.
Int J Clin Pharm ; 45(2): 285-292, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36920737

RESUMO

Pharmacy and pharmaceutical sciences embrace a series of different disciplines. Pharmacy practice has been defined as "the scientific discipline that studies the different aspects of the practice of pharmacy and its impact on health care systems, medicine use, and patient care". Thus, pharmacy practice studies embrace both clinical pharmacy and social pharmacy elements. Like any other scientific discipline, clinical and social pharmacy practice disseminates research findings using scientific journals. Clinical pharmacy and social pharmacy journal editors have a role in promoting the discipline by enhancing the quality of the articles published. As has occurred in other health care areas (i.e., medicine and nursing), a group of clinical and social pharmacy practice journal editors gathered in Granada, Spain to discuss how journals could contribute to strengthening pharmacy practice as a discipline. The result of that meeting was compiled in these Granada Statements, which comprise 18 recommendations gathered into six topics: the appropriate use of terminology, impactful abstracts, the required peer reviews, journal scattering, more effective and wiser use of journal and article performance metrics, and authors' selection of the most appropriate pharmacy practice journal to submit their work.


Assuntos
Farmácias , Pesquisa em Farmácia , Serviço de Farmácia Hospitalar , Farmácia , Humanos , Espanha
12.
Res Social Adm Pharm ; 19(5): 830-835, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36804321

RESUMO

Pharmacy and pharmaceutical sciences embrace a series of different disciplines. Pharmacy practice has been defined as "the scientific discipline that studies the different aspects of the practice of pharmacy and its impact on health care systems, medicine use, and patient care". Thus, pharmacy practice studies embrace both clinical pharmacy and social pharmacy elements. Like any other scientific discipline, clinical and social pharmacy practice disseminates research findings using scientific journals. Clinical pharmacy and social pharmacy journal editors have a role in promoting the discipline by enhancing the quality of the articles published. As has occurred in other health care areas (i.e., medicine and nursing), a group of clinical and social pharmacy practice journal editors gathered in Granada, Spain to discuss how journals could contribute to strengthening pharmacy practice as a discipline. The result of that meeting was compiled in these Granada Statements, which comprise 18 recommendations gathered into six topics: the appropriate use of terminology, impactful abstracts, the required peer reviews, journal scattering, more effective and wiser use of journal and article performance metrics, and authors' selection of the most appropriate pharmacy practice journal to submit their work.


Assuntos
Medicina , Farmácias , Pesquisa em Farmácia , Serviço de Farmácia Hospitalar , Farmácia , Humanos
13.
Int J Pharm Pract ; 31(1): 95-101, 2023 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-36367376

RESUMO

OBJECTIVE: This study aims to identify factors influencing students' decision to pursue a doctorate in pharmacy (PharmD). METHODS: Focus-group interviews and quantitative surveys were used in sequence to investigate pharmacy students' motivations. A total of 36 current PharmD students from two US colleges of pharmacy participated in five focus groups. The resulting qualitative findings, along with existing literature, informed the development of a survey questionnaire, which was then administered to two cohorts of first-year pharmacy students at one of the participating colleges. KEY FINDINGS: Identified themes include prestige of a doctorate, patient interaction, career versatility, and pharmacy school's lower intensity vis-à-vis medical school. A total of 110 first-year pharmacy students from a 4-year program (average (SD) age 23 (5); 65% female) completed the survey (98.5% response rate). The order of factors that respondents ranked as important or somewhat important for choosing pharmacy include: financial stability (n = 107 (97%)), prestige of a doctorate degree ((n = 97 (88%)), good work-life balance ((n = 96 (87%)), the opportunity to use critical thinking skills ((n = 93 (85%)), having patient interaction and communication ((n = 91 (83%)), and being in a profession or service ((n = 91 (83%)). CONCLUSIONS: US PharmD students are mainly drawn by job and financial stability, prestige of a doctorate, and a good work-life balance.


Assuntos
Educação em Farmácia , Farmácia , Estudantes de Farmácia , Humanos , Feminino , Adulto Jovem , Adulto , Masculino , Motivação , Inquéritos e Questionários , Grupos Focais , Faculdades de Farmácia
14.
Diabetes Spectr ; 35(4): 476-483, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36561648

RESUMO

Objectives: The primary objective of this study was to determine sharps disposal practices among people with diabetes in a community care clinic. Secondary objectives were to identify patterns of sharps use and barriers to proper use. Methods: Surveys were distributed to patients at a community care clinic in person and via mail. Survey questions focused on how sharps are used and disposed of, the frequency of sharps changes, sharps disposal training, sharps identification, and confidence in sharps disposal. Participant demographics and diabetes profiles were also collected. Findings: Among 89 respondents, mean age was 60 years (range 29-93 years), 61.8% were Caucasian, 88.8% had type 2 diabetes, and 60.7% had had a diabetes diagnosis for ≤10 years, with diverse diabetes management methods; 57.3% did not receive or were unsure of sharps training, 25.8% discarded used sharps without a designated sharps container, and 37.1% properly disposed of sharps containers at sharps disposal facilities. Barriers to proper sharps practices included perceived safety of reusing sharps and waste with single use, cost, and the hassle of disposal. Those with prior sharps training were more likely to properly use and discard sharps; however, gaps in knowledge were still evident in this population. Conclusion: Results indicate gaps in proper sharps use and disposal knowledge among people with diabetes. Responses revealed sharps practices that are inconsistent with current federal and state regulations and are potentially dangerous for those handling improperly discarded sharps. Targeted sharps usage and disposal education resources are needed for individuals with and without prior sharps training.

15.
Life (Basel) ; 12(10)2022 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-36294904

RESUMO

Microalgae are increasingly being used for capturing carbon dioxide and converting it into valuable metabolites and biologically active compounds on an industrial scale. The efficient production of microalgae biomass requires the optimization of resources, including CO2. Here, we estimated the productivity of Chlorella sorokiniana IPPAS C-1 depending on CO2 concentrations and the ventilation coefficient of the gas-air mixture (GAM) in flat-panel photobioreactors (FP-PBRs) at laboratory (5 L) and pilot (18 L) scales. For the laboratory scale, the PBRs operated at 900 µmol quanta m-2 s-1 and 35.5 ± 0.5 °C; the optimal CO2 flow rate was estimated at 3 mL CO2 per 1 L of suspension per minute, which corresponds to 1.5% CO2 in the GAM and an aeration rate of 0.2 vvm. These parameters, being scaled up within the pilot PBRs, resulted in a high specific growth rate (µ ≈ 0.1 h-1) and high specific productivity (Psp ≈ 1 g dw L-1 d-1). The principles of increasing the efficiency of the intensive cultivation of C. sorokiniana IPPAS C-1 are discussed. These principles are relevant for the development of technological regimes for the industrial production of Chlorella in flat-panel PBRs of various sizes.

16.
Life (Basel) ; 12(9)2022 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-36143346

RESUMO

Flat-panel photobioreactors are effective systems for microalgae cultivation. This paper presents the growth characteristics of the microalgae Chlorella sorokiniana IPPAS C-1 as a result of three-stage scale-up cultivation in a specially designed cultivation system. First, C. sorokiniana was grown aseptically in 250 mL glass vessels; then, it was diluted and inoculated into a 5-liter flat-panel horizontal photobioreactor; and, at the last stage, the culture was diluted and inoculated into a 70-liter flat-panel vertical photobioreactor. In the presented cycle, the cultured biomass increased by 326 times in 13 days (from 0.6 to 195.6 g dw), with a final biomass concentration of 2.8 g dw L-1. The modes of semi-continuous cultivation were considered. The biomass harvest and dilution of the suspension were carried out either every day or every 3-4 days. For C. sorokiniana IPPAS C-1, a conversion coefficient of optical density values to dry biomass (g L-1) was refined through a factor of 0.33. The key parameters of the photobioreactors tested in this work are discussed.

17.
J Am Pharm Assoc (2003) ; 62(4): 1296-1303.e2, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35307310

RESUMO

BACKGROUND: Oral contraceptives and other short-acting reversible contraceptive (SARC) methods such as the patch, vaginal ring, and medroxyprogesterone injections are used by approximately 30% of people using contraception. People may face barriers in obtaining a timely and adequate supply of their SARCs. It is well established that dispensing more than 1-month supply at a time is more convenient for patients, improves continuation, and decreases the risk of unintended pregnancy. Given the potential for public health impact, 20 states, including Massachusetts, have expanded access to a 12-month supply of SARCs. OBJECTIVES: The goal of this qualitative study was to explore Massachusetts pharmacists' general awareness and specific knowledge of the state's 2017 Act Advancing Contraceptive Coverage and Economic Security in Our State (ACCESS) law, explore barriers to the implementation of the law, and elicit recommendations to improve uptake of this practice. METHODS: Semistructured interviews were conducted with a purposeful sample of community pharmacists in Massachusetts between September 2020 and May 2021 using a pretested interview guide. Interviews were audio recorded and professionally transcribed. Data collection ceased when theoretical saturation was achieved. Data were analyzed using modified grounded theory, including code book development and line-by-line and axial coding. RESULTS: Sixteen pharmacists from diverse practice settings participated in the interviews. All the pharmacists (100%) reported that they had received no training on the ACCESS law, and only 1 pharmacist reported having complete knowledge of the specifics of the law. We identified key themes and subthemes related to pharmacists' concerns about implementation of the law at the system, pharmacy, and patient level, including insurance coverage, communication of new laws, stocking, supply, and misuse by patients. CONCLUSION: Addressing the need for pharmacist training and communication regarding new regulations may improve provision of an extended supply of SARC methods.


Assuntos
Serviços Comunitários de Farmácia , Farmacêuticos , Atitude do Pessoal de Saúde , Anticoncepção , Anticoncepcionais , Feminino , Humanos , Gravidez , Papel Profissional
18.
J Clin Pharmacol ; 62(3): 359-365, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34542174

RESUMO

The use of population pharmacokinetics (PK) to optimize cefepime dosing could be an effective strategy, given the increasing prevalence of resistant gram-negative organisms. The objective of this study is to retrospectively compare dosing using a PK approach (intervention) vs traditional dosing (control) for cefepime in patients with hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP). Adult hospitalized patients with HAP or VAP receiving cefepime for ≥72 hours were screened first from August 2018 to January 2019 to be included in the intervention group, then screened during the preintervention period from August 2017 to July 2018 for the control group. Clinical improvement on day 7 of cefepime therapy was achieved in 72% of the patients in the intervention group and 70% of the patients in the control group (P = .8110). However, the clinical cure rate in the intervention group was higher than that of the control group (50% vs 36.5%; P = .0034). Cefepime dosing using population PK appears to be a novel, effective, and safe dosing strategy for patients with HAP or VAP.


Assuntos
Antibacterianos/administração & dosagem , Antibacterianos/farmacocinética , Cefepima/administração & dosagem , Cefepima/farmacocinética , Pneumonia Associada à Ventilação Mecânica/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Cefepima/uso terapêutico , Creatinina/sangue , Cálculos da Dosagem de Medicamento , Feminino , Meia-Vida , Humanos , Masculino , Taxa de Depuração Metabólica , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Estudos Retrospectivos
19.
Hum Mol Genet ; 31(3): 440-454, 2022 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-34505148

RESUMO

Recently, others and we identified de novo FBXO11 (F-Box only protein 11) variants as causative for a variable neurodevelopmental disorder (NDD). We now assembled clinical and mutational information on 23 additional individuals. The phenotypic spectrum remains highly variable, with developmental delay and/or intellectual disability as the core feature and behavioral anomalies, hypotonia and various facial dysmorphism as frequent aspects. The mutational spectrum includes intragenic deletions, likely gene disrupting and missense variants distributed across the protein. To further characterize the functional consequences of FBXO11 missense variants, we analyzed their effects on protein expression and localization by overexpression of 17 different mutant constructs in HEK293 and HeLa cells. We found that the majority of missense variants resulted in subcellular mislocalization and/or reduced FBXO11 protein expression levels. For instance, variants located in the nuclear localization signal and the N-terminal F-Box domain lead to altered subcellular localization with exclusion from the nucleus or the formation of cytoplasmic aggregates and to reduced protein levels in western blot. In contrast, variants localized in the C-terminal Zn-finger UBR domain lead to an accumulation in the cytoplasm without alteration of protein levels. Together with the mutational data, our functional results suggest that most missense variants likely lead to a loss of the original FBXO11 function and thereby highlight haploinsufficiency as the most likely disease mechanism for FBXO11-associated NDDs.


Assuntos
Proteínas F-Box , Deficiência Intelectual , Transtornos do Neurodesenvolvimento , Proteínas F-Box/genética , Células HEK293 , Células HeLa , Humanos , Deficiência Intelectual/genética , Mutação de Sentido Incorreto/genética , Transtornos do Neurodesenvolvimento/genética , Proteína-Arginina N-Metiltransferases/genética
20.
J Gen Intern Med ; 36(1): 114-120, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32885368

RESUMO

BACKGROUND: Cash prices for prescription drugs vary among community pharmacies in the USA. GoodRx is a discount platform that provides coupons for use in community pharmacies without a membership requirement. Analytical pharmacy is a new type of pharmacy that tests drugs before dispensing to verify medication quality. OBJECTIVE: To compare undiscounted and GoodRx-discounted cash prices for common cardiovascular (CV) drugs by pharmacy type. DESIGN: A cross-sectional study. SETTING: GoodRx-discounted and GoodRx-undiscounted cash price data; analytical pharmacy cash price data (all data collected in July 2020). MEASUREMENTS: GoodRx cash price data for 30 units of 41 generic and 16 brand-name common cardiovascular medications at mass merchandiser, regional supermarket, two national chains, and analytical pharmacy (only one of its kind in the USA). RESULTS: The average (SD) undiscounted generic CV medication cash price was $42.41 (44.1). The average GoodRx-discounted generic CV medication cash prices were $11.01 (8.6), $9.88 (6.7), $17.85 (10.5), and $21.73 (14.1) in mass merchandiser, supermarket, and two national chain pharmacies, respectively. The average generic CV medication cash price was $20.84 (25.7) at the analytical pharmacy. The average (SD) undiscounted brand-name CV medication cash price was $368.33 (127.00). The average GoodRx-discounted brand-name CV medication cash prices were $269.16 (118.1), $258.84 (108.6), $270.28 (118.4), and $274.60 (122.50) for mass merchandiser, supermarket, and two national chain pharmacies, respectively. The average (SD) brand-name CV medication cash price was $365.12 (116.20) at the analytical pharmacy. CONCLUSIONS: GoodRx-discounted cash prices of generic CV medications were significantly lower than undiscounted cash prices at supermarket, mass merchandiser, and national chain pharmacies. Analytical pharmacy cash prices too were significantly lower than traditional pharmacy undiscounted cash prices. GoodRx-discounted prices for brand-name CV medications did not differ significantly from undiscounted cash prices and between pharmacy types.


Assuntos
Fármacos Cardiovasculares , Farmácias , Medicamentos sob Prescrição , Estudos Transversais , Custos de Medicamentos , Medicamentos Genéricos , Humanos
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