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Created by CPA's team of experienced clinical pharmacists using FDA Center for Drug Evaluation and Research (CDER) and other supplemental expert resources.
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IN THIS ISSUE |
April 2012 |
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Journal Review
A critical review of important journal articles from healthcare experts.
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Glycemic Control and Preventive Care Measures of Indigent Diabetes Patients Within a Pharmacist-Managed Insulin Titration Program vs Standard Care
Salvo MC and AM Brooks
The Annals of Pharmacotherapy 2012;46:29-34
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Lansoprazole for Children with Poorly Controlled Asthma
Writing Committee for the American Lung Association Asthma Clinical Research Centers
Journal of the American Medical Association (JAMA) 2012;307(4):373-381
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P&T on DemandSM
CPA provides complete examples of our independent proprietary analytics with committee ready reports and analyses.
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New Drug Evaluation / Monograph
LINAGLIPTIN (TRADJENTA)
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Highlights of Safety-Related Drug Labeling Changes
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Commentary Spotlight
Authoritative reports to assist healthcare professionals make decisions and solve problems
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Medication Reconciliation = Medication Safety, Care Improvement, and Cost Savings
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CPA Journal Club |
April 2012 |
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Journal Review
Glycemic Control and Preventive Care Measures of Indigent Diabetes Patients Within a Pharmacist-Managed Insulin Titration Program vs Standard Care
Salvo MC and AM Brooks.
The Annals of Pharmacotherapy 2012;46:29-34
The collaborative therapeutic efforts of the pharmacist and primary care provider can lead to significant clinical improvement in hemoglobin A1C (A1C) reduction and adherence to the American Diabetes Association’s recommended preventive care measures compared to standard care in a medically underserved diabetes population. In this program, pharmacists continuously manage underserved diabetic patients collaboratively with their primary care physicians.
Lansoprazole for Children with Poorly Controlled Asthma
Writing Committee for the American Lung Association Asthma Clinical Research Centers
Journal of the American Medical Association (JAMA) 2012;307(4):373-381
Asthma is a chronic respiratory disease that affects more than 22 million people in the United States. Nearly 6.2 million of these patients are under the age of 18. Gastroesophageal reflux (GER) disease and asthma frequently occur in children. It is postulated that untreated GER may be a cause inadequate asthma control in children despite corticosteroid therapy. Previous clinical trials have shown success with proton pump inhibitors in the improvement of asthma symptoms and airway reactivity in children with symptomatic GER. In this study, the role of lansoprazole for inadequately controlled asthma in children is examined.
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P&T on DemandSM
New Drug Evaluation / Monograph
LINAGLIPTIN (TRADJENTA)
Linagliptin tablets are indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Do not use linagliptin in patients with type 1 diabetes or for treating diabetic ketoacidosis since it is not effective. Linagliptin has not been studied together with insulin.
Highlights of Safety-Related Drug Labeling Changes
This report is an ongoing notice of FDA approved Safety-Related drug labeling changes produced in P&T Committee usable tabular format. The Safety-Related changes informs healthcare professionals regarding the latest changes to package labeling that can impact patient care and includes Boxed warnings, contraindications, precautions, adverse reactions and interactions, and patient and professional risk evaluation and mitigation strategies (REMS) as directed by the FDA. This report serves as a preventative alert for improving individual patient drug therapy and helps organizations meet The Joint Commission standard MM.02.01 element 9 “Medications… are reviewed at least annually based on emerging safety and efficacy information”.
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Commentary Spotlight
Medication Reconciliation = Medication Safety, Care Improvement, and Cost Savings
As new and complex drugs have improved and extended life for patients confronting an array of diseases and medical conditions that had previously eluded treatment, and as the number of medications used by patients – particularly seniors – has risen significantly, the challenge for health care practitioners is to manage medications in a way that can reduce adverse events and eliminate medication errors.
When it comes to medication reconciliation, what really matters is timely expertise. Data must be coupled with information from traditional sources (e.g. patient, family, referring physician) to give the caregiver maximum knowledge.
Clinical Pharmacy Associates (CPA) recently partnered with Sibley Memorial Hospital, a member of Johns Hopkins Medicine in Washington, D.C., to assess a new enhancement in medication reconciliation that it had designed. The results from this assessment demonstrated a better way to approach the medication reconciliation process, one that may be less complicated and less difficult to implement than you would think. Our efforts have led to the development of a pilot program that combines virtual and on-site collaboration with integration to the hospital’s emergency department (ED) electronic health record, which may ultimately lead to broad-scale implementation at the hospital.
Read the Commentary | ACHE CEO Newsletter Q&A
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CPA Safety News and Notes
Essential issues in medication safety
Warning Against Multiple Patient Use of Insulin Pen
Although fervent warnings have been issued by the Institute for Safe Medication Practices (ISMP), the Center for Disease Control and Prevent (CDC), and the Food and Drug Administration (FDA) and the device manufacturer concerning the risk of cross-contamination, transmission of blood-borne diseases when insulin pens are used for multiple patients, the ISMP continues to receive reports of this practice. There appears to be widespread misunderstanding that affixing a fresh needle can maintain sterility in the pens. For inpatient use, ISMP recommends that insulin pens be assigned and labeled for each individual patient. Timely staff and patient education and ongoing monitoring in the inpatient setting is extremely important.
Click here to read HAZZARD ALERT
Large Decline in Lower-Limb Amputations in US Adults Diagnosed with Diabetes
A study by the Centers for Disease Control and Prevention (CDC) showed that lower-limb (leg and foot) amputations caused by circulatory problems among US adults aged 40 and older with diagnosed diabetes declined by 65 percent between 1996 and 2008. The study authors credit improvements in blood sugar control, foot care and diabetes management, along with declines in cardiovascular disease, as likely contributors to this decline. Diabetes is the leading cause of these amputations in addition to being the leading cause of kidney failure and new cases of blindness among adults. It is also the seventh leading cause of death in the United States.
Click here for article
Aspirin for Reducing Risk of Blood Flow Problems, Heart Attack and Strokes
Some people, but not all, will benefit from aspirin’s ability to lower the risk of heart attack, clot-related strokes and other blood flow problems. For certain people, the risks outweigh aspirin’s benefits. In addition, labeling information does not include directions for safe use for these purposes and aspirin can have harmful side effects, especially when combined with other products. Therefore, it is important to consult with a medical health professional for advice regarding whether aspirin will benefit the individual and, if so, for specific directions (e.g. dosage, frequency) for safe use.
Click here for article |
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