Virtual Reality in Pharmacy: Opportunities for Clinical, Research, and Educational Applications.

Virtual reality (VR) has been widely studied and applied in numerous medical applications.1 In pharmacy, VR can potentially be applied as follows: adjunctively or as a replacement for pharmacotherapy; in drug design and discovery; in pharmacist education; and in patient counseling and behavior modification.1-6 Research applying VR in pharmacy is currently limited; however, interest in these applications is increasing. The majority of studies conducted during the past decade have found VR to be safe and effective, and to promote a high degree of user satisfaction.4 VR technology has become increasingly affordable, flexible, and portable, enabling its use for therapeutic purposes in both inpatient and outpatient environments.4 But despite the compelling features of VR, a number of challenges exist, such as validation of clinical efficacy, cost/accessibility and usability issues, technical capabilities, and acceptance.1-5 This article discusses the potential for the use of VR in pharmacy for clinical, research, and educational applications.

Big Data and Pharmacovigilance: Data Mining for Adverse Drug Events and Interactions.

Adverse drug events (ADEs), including drug interactions, have a tremendous impact on patient health and generate substantial health care costs. A "big data" approach to pharmacovigilance involves the identification of drug-ADE associations by data mining various electronic sources, including: adverse event reports, the medical literature, electronic health records, and social media. This approach has been useful in assisting the Food and Drug Administration and other regulatory agencies in monitoring and decision-making regarding drug safety. Data mining can also assist pharmaceutical companies in drug safety surveillance efforts, adhering to risk management plans, and gathering real-world evidence to supplement clinical trial data. The use of data mining for pharmacovigilance purposes provides many unique benefits; however, it also presents many challenges. This paper explores the methods and sources of "big data" and how this is contributing to pharmacovigilance efforts.

Progress in Nanomedicine: Approved and Investigational Nanodrugs.

Nanomedicine is a relatively new and rapidly evolving field combining nanotechnology with the biomedical and pharmaceutical sciences.1-3 Nanoparticles (NPs) can impart many pharmacokinetic, efficacy, safety, and targeting benefits when they are included in drug formulations.1-5 Many nanodrugs have entered clinical practice, and even more are being investigated in clinical trials for a wide variety of indications.2 However, nanopharmaceuticals also face challenges, such as the need for better characterization, possible toxicity issues, a lack of specific regulatory guidelines, cost-benefit considerations, and waning enthusiasm among some health care professionals. 4,5 For these reasons, expectations regarding nanodrugs that are in early stages of development or clinical trials need to remain realistic.4.

Cancer Immunotherapy, Part 3: Challenges and Future Trends.

Despite dramatic breakthroughs, obstacles remain for the field of immunotherapy in cancer. These include the inability to predict treatment efficacy and patient response; the need for improved biomarkers; the development of resistance to immunotherapies; the lack of optimized clinical study designs; and high costs. Are solutions in sight?

Cancer Immunotherapy, Part 2: Efficacy, Safety, and Other Clinical Considerations.

This article, the second in a series of three, provides an overview of the efficacy and safety of cancer immunotherapies ranging from monoclonal antibodies to vaccines, including additional clinical considerations regarding immune checkpoint blockers.

Cancer Immunotherapy, Part 1: Current Strategies and Agents.

This article, the first in a series of three, introduces cancer immunology, cancer immunotherapy strategies, and the classes of anticancer therapeutic agents.

Immunization in the United States: Recommendations, Barriers, and Measures to Improve Compliance: Part 2: Adult Vaccinations.

Despite annual recommendations, American adults remain inadequately vaccinated. The author outlines how compliance may be improved through health care professional interventions, as well as government and community-based programs.

Immunization in the United States: Recommendations, Barriers, and Measures to Improve Compliance: Part 1: Childhood Vaccinations.

Childhood vaccination is one of the most effective public health strategies to control and prevent disease, but some parents decline or delay vaccinating their children. A variety of measures have been suggested to overcome vaccine noncompliance.

Evaluation of Biosimilars for Formulary Inclusion: Factors for Consideration by P&T Committees.

P&T committees will play a key role in driving the adoption of biosimilars, which have unique characteristics compared with small-molecule generic drugs. Key elements of formulary review will include clinical parameters, product characteristics, and institutional considerations, which are among the issues covered in this article.

The antibiotic resistance crisis: part 2: management strategies and new agents.

Controlling antibiotic-resistant bacteria calls for widespread adoption of antibiotic stewardship programs; better diagnosis, tracking and prescribing practices; optimized therapeutic regimens; prevention of infection transmission-and new drugs.

The antibiotic resistance crisis: part 1: causes and threats.

Decades after the first patients were treated with antibiotics, bacterial infections have again become a threat because of the rapid emergence of resistant bacteria-a crisis attributed to abuse of these medications and a lack of new drug development.

Epilepsy management: newer agents, unmet needs, and future treatment strategies.

Drug therapy aids most epilepsy patients, but unmet challenges include drug-resistant epilepsy, adverse reactions, drug interactions, the need to better identify epileptic syndromes, and a lack of agents to prevent epilepsy and its comorbidities.

Medical Applications for 3D Printing: Current and Projected Uses.

3D printing is expected to revolutionize health care through uses in tissue and organ fabrication; creation of customized prosthetics, implants, and anatomical models; and pharmaceutical research regarding drug dosage forms, delivery, and discovery.

Social media and health care professionals: benefits, risks, and best practices.

Health care professionals can use a variety of social media tools to improve or enhance networking, education, and other activities. However, these tools also present some potential risks, such as unreliable information and violations of patients' privacy rights.

Mobile devices and apps for health care professionals: uses and benefits.

Health care professionals' use of mobile devices is transforming clinical practice. Numerous medical software applications can now help with tasks ranging from information and time management to clinical decision-making at the point of care.

Role of pharmacogenomic biomarkers in predicting and improving drug response: part 1: the clinical significance of pharmacogenetic variants.

As genotyping and genetic testing become more sophisticated, accessible, and costeffective, these tools hold great promise for predicting and improving responses to medications.

Biosimilars: part 1: proposed regulatory criteria for FDA approval.

Biosimilars, although not identical to their originator product, are expected to become essential in reducing health care costs and improving access to lifesaving drugs. The FDA must find a way to balance rigorous testing to ensure quality, as is done for generic chemical drugs, with providing a cost-efficient way to expedite approvals of these products.

Biosimilars: part 2: potential concerns and challenges for p&t committees.

P&T committee members need a lot more information before they can evaluate the efficacy and safety, interchangeability, and cost-effectiveness of biosimilar products for inclusion on formularies.

The role of pharmacogenomic biomarkers in predicting and improving drug response: part 2: challenges impeding clinical implementation.

Many obstacles currently limit the ability to apply our knowledge of gene-drug associations in pharmacy practice. However, steps are gradually being taken toward the goal of incorporating genetic testing into routine patient care.

The nanomedicine revolution: part 3: regulatory and safety challenges.

Before the FDA can set up safety guidelines for nanomedicines, it needs to establish valid testing criteria. The goal is to strike a balance between underregulation (which can lead to questionable approvals) and overregulation (which can inhibit innovation).