Recent Publications on Medications and Pharmacy

Medication Access Differences among US Stroke Survivors

Results of a national survey were evaluated to identify the effects of medication access barriers on stroke survivors. The focus of the assessment was the inability to afford medication within the previous 12 months among 5,840 black or white stroke survivors older than 44 years of age from the National Health Interview from 1997 to 2004. US population-based estimates were extrapolated from survey data. Nine percent of the respondents were unable to afford medications. Inability to afford medications was reported more often among patients with the following characteristics: female (60% of respondents), 45 to 65 years of age (56%), residence in the South (49%), less than high school education (45%), and black (20%). Factors contributing to medication access barriers included household income less than $20,000 (66% vs 40% of respondents able to afford medications; P = 0.001), $2,000 or more in out-of-pocket medical expenses (35% vs 25%; P < 0.001), no health insurance (16% vs 3%; P < 0.001), and lack of transportation (15% vs 3%; P < 0.001).

Medical Conflicts of Interest

A commentary from Mayo Clinic addressed topics related to conflicts of interest within health care. Motivation, potential for harm, and management of various scenarios were discussed. Scenarios highlighted medication and device selection and clinical practice guideline development. National conflict of interest principles and institutional policy development were also addressed.

Antiretroviral Adherence Evaluation by Directly Observed Therapy in Children and Adolescents

Inpatient admission for directly observed therapy (DOT) was utilized to assess the potential for nonadherence in nine pediatric and adolescent patients at the University of Chicago Comer Children's Hospital. Most patients selected displayed evidence of nonadherence reflected by more than threefold increase in viral load over at least two laboratory assessments, despite laboratory evidence of susceptibility to the regimen, report by caregiver or patient of complete adherence, and no decrease in viral load despite intensive adherence interventions. Patient and caregiver education was provided by physicians, nurses, nutrition specialists, and social workers through a 7-day DOT admission. Each patient's antiretroviral therapy was administered as prescribed at home and directly observed by nursing staff. Three patients had two or three admissions for DOT throughout the study period. Evidence of nonadherence emerged for eight patients in 11 admissions who demonstrated lower viral loads at the end of DOT than on day 1.

Pharmacist Intervention Effects on Adherence to Heart Failure Medications

The effects of pharmacist intervention on adherence and exacerbations were assessed in 314 low-income heart failure patients of Wishard Health Services in Indianapolis, Ind. Patients were assigned randomly to usual care or pharmacist intervention for 9 months, followed by a poststudy phase for 3 months. Electronic prescription monitors were used to assess adherence. The intervention group exhibited 78.8% adherence during the intervention period, compared to 67.9% in the usual care group. However, intervention effects diminished in the poststudy period, which revealed adherence rates of 66.7% in the usual care group and 70.6% in the intervention group. Authors reported lower annual direct health care costs and 19.4% fewer exacerbations requiring hospitalization or emergency room visits among patients in the intervention group.

Quadriplegia After Childhood Vaccine

Transverse myelitis emerged in a child who had received measles, mumps, and rubella vaccine. The patient subsequently developed massive cervical spinal cord injury and quadriplegia, and a claim was filed with the National Vaccine Injury Compensation Program. According to this report, liability was established upon appeal, although a defense verdict was initially returned. A $43.1 million settlement was to be distributed over the child's life.

Measles, mumps, rubella vaccine blamed for child's quadriplegia-$43.1 million settlement under the National Vaccine Injury Compensation Program. Med Malpr Verd Settl Exp. 2007;23:26-27.

Postoperative Morphine and Fatal Respiratory Depression

A 58-year-old female hemodialysis patient with diabetes and hypertension received care for an ankle fracture in the emergency room. After receiving 20 mg morphine over 90 minutes, the patient's respiratory rate decreased to 4 breaths per minute. The patient's nephrologist ordered naloxone to reverse respiratory depression, but the episode was not documented in the medical record. The patient was discharged after surgical repair of her ankle, but was readmitted 10 days later with wound dehiscence requiring surgery. According to this report, nurses administered morphine at a dose higher than described in the surgeon's postoperative orders, and the patient was found unresponsive the day after surgery. The patient suffered irreversible brain damage, despite resuscitation attempts; life support was discontinued after 1 week. The plaintiffs accused the nephrologist of negligence in failing to document or communicate the episode of respiratory depression. The orthopedic surgeon was also accused of negligence in prescribing multiple medications with the potential for respiratory depression. The parties reached a $210,000 settlement, which included $100,000 from the orthopedic surgeon, $80,000 from the hospital, and $30,000 from the nephrologist, according to this report.

Failure to record respiratory depression following administration of morphine sulfate-Further morphine sulfate ordered following surgery-Death-$210,000 California settlement. Med Malpr Verd Settl Exp. 2007;23:23.

Adverse Drug Effects

Andersohn F, Konzen C, Garbe E. Systematic review: agranulocytosis induced by nonchemotherapy drugs. Ann Intern Med. 2007;146:657-665.

Arif H, Buchsbaum R, Weintraub D, et al. Comparison and predictors of rash associated with 15 antiepileptic drugs. Neurology. 2007;68:1701-1709.

Brasel KJ, Pham K, Yang H, Christensen R, Weigelt JA. Significance of contrast extravasation in patients with pelvic fracture. J Trauma. 2007;62:1149-1152.

Schafer JA, Mateo N, Parlier GL, Rotschafer JC. Penicillin allergy skin testing: what do we do now? Pharmacotherapy. 2007;27:542-545.

Bone Health

Black DM, Delmas PD, Eastell R, et al. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med. 2007;356:1809-1822.

Brufsky A, Harker WG, Beck JT, et al. Zoledronic acid inhibits adjuvant letrozole-induced bone loss in postmenopausal women with early breast cancer. J Clin Oncol. 2007;25:829-836.

Civitelli R, Napoli N, Armamento-Villareal R. Use of intravenous bisphosphonates in osteoporosis. Curr Osteoporos Rep. 2007;5:8-13.

Compston J. Treatments for osteoporosis - looking beyond the HORIZON. N Engl J Med. 2007;356(18):1878-1880.

Cummings SR, Schwartz AV, Black DM. Alendronate and atrial fibrillation. N Engl J Med. 2007;356:1895-1896.

Devogelaer JP, Brown JP, Burckhardt P, et al. Zoledronic acid efficacy and safety over five years in postmenopausal osteoporosis. Osteoporos Int. May 22, 2007; [Epub ahead of print].

Gnant MF, Mlineritsch B, Luschin-Ebengreuth G, et al. Zoledronic acid prevents cancer treatment-induced bone loss in premenopausal women receiving adjuvant endocrine therapy for hormone-responsive breast cancer: a report from the Austrian Breast and Colorectal Cancer Study Group. J Clin Oncol. 2007;25:820-828.

Poole KE, Loveridge N, Rose CM, Warburton EA, Reeve J. A single infusion of zoledronate prevents bone loss after stroke. Stroke. 2007;38:1519-1525.

Reginster JY, Malaise O, Neuprez A, Jouret VE, Close P. Intermittent bisphosphonate therapy in postmenopausal osteoporosis : progress to date. Drugs Aging. 2007;24:351-359.

Cardiovascular

Adams HP Jr, Del Zoppo G, Alberts MJ, et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Circulation. 2007;115:e478-e534.

Adrogue HJ, Madias NE. Sodium and potassium in the pathogenesis of hypertension. N Engl J Med. 2007;356:1966-1978.

Beohar N, Davidson CJ, Kip KE, et al. Outcomes and complications associated with off-label and untested use of drug-eluting stents. JAMA. 2007;297:1992-2000.

Campbell CL, Smyth S, Montalescot G, Steinhubl SR. Aspirin dose for the prevention of cardiovascular disease: a systematic review. JAMA. 2007;297:2018-2024.

Chase SL, Pickworth KK. Clinical and economic implications of new strategies for heart failure management in the managed care setting. Pharmacotherapy. 2007;27(4 Pt 2):29S-32S.

Choy CK, Spencer AP, Nappi JM. Prevalence of anemia in clinic patients with heart failure and cost analysis of epoetin treatment. Pharmacotherapy. 2007;27: 707-714.

Cucchiara BL, Jackson B, Weiner M, Messe SR. Usefulness of checking platelet count before thrombolysis in acute ischemic stroke. Stroke. 2007; 38:1639-1640.

Dager WE, Dougherty JA, Nguyen PH, Militello MA, Smythe MA. Heparin-induced thrombocytopenia: treatment options and special considerations. Pharmacotherapy. 2007;27:564-587.

Metso TM, Metso AJ, Helenius J, et al. Prognosis and safety of anticoagulation in intracranial artery dissections in adults. Stroke. May 10, 2007; [Epub ahead of print].

Morrow DA, Scirica BM, Karwatowska-Prokopczuk E, et al. Effects of ranolazine on recurrent cardiovascular events in patients with non-ST-elevation acute coronary syndromes: the MERLINTIMI 36 randomized trial. JAMA. 2007;297:1775-1783.

Rodgers JE, Stough WG. Underutilization of evidence-based therapies in heart failure: the pharmacist's role. Pharmacotherapy. 2007;27(4 Pt 2):18S-28S.

Tardif JC, Gregoire J, L'Allier PL, et al. Effects of reconstituted high-density lipoprotein infusions on coronary atherosclerosis: a randomized controlled trial. JAMA. 2007;297:1675-1682.

Tseng MY, Hutchinson PJ, Czosnyka M, Richards H, Pickard JD, Kirkpatrick PJ. Effects of acute pravastatin treatment on intensity of rescue therapy, length of inpatient stay, and 6-month outcome in patients after aneurysmal subarachnoid hemorrhage. Stroke. 2007;38:1545-1550.

Win HK, Caldera AE, Maresh K, et al. Clinical outcomes and stent thrombosis following off-label use of drug-eluting stents. JAMA. 2007;297:2001-2009.

Infectious Diseases

DAD Study Group, Friis-Moller N, Reiss P, et al. Class of antiretroviral drugs and the risk of myocardial infarction. N Engl J Med. 2007;356:1723-1735.

Elgouhari H, Othman M, Gerstein WH. Bacteroides fragilis vertebral osteomyelitis: case report and a review of the literature. South Med J. 2007;100:506-511.

Ogrendik M. Treatment of ankylosing spondylitis with moxifloxacin. South Med J. 2007;100:366-370.

Oncology

Jacobs EJ, Thun MJ, Bain EB, Rodriguez C, Henley SJ, Calle EE. A large cohort study of long-term daily use of adult-strength aspirin and cancer incidence. J Natl Cancer Inst. 2007;99:608-615.

Veronesi U, Maisonneuve P, Rotmensz N, et al. Tamoxifen for the prevention of breast cancer: late results of the Italian randomized ramoxifen prevention trial among women with hysterectomy. J Natl Cancer Inst. 2007;99:727-737.

Pediatrics

American Academy of Pediatrics Committee on Infectious Diseases. Antiviral therapy and prophylaxis for influenza in children. Pediatrics. 2007;119:852-860.

American Academy of Pediatrics Committee on Pediatric AIDS, Section on International Child Health, Havens PL, Gibb DM. Increasing antiretroviral drug access for children with HIV infection. Pediatrics. 2007;119:838-845.

Blyth CC, Palasanthiran P, O'Brien TA. Antifungal therapy in children with invasive fungal infections: a systematic review. Pediatrics. 2007;119:772-784.

Green M, Michaels MG. Infectious complications of immunosuppressive medications in organ transplant recipients. Pediatr Infect Dis J. 2007;26:443-444.

Huang SS, Rifas-Shiman SL, Kleinman K, et al. Parental knowledge about antibiotic use: results of a cluster-randomized, multicommunity intervention. Pediatrics. 2007;119:698-706.

Natarajan G, Botica ML, Thomas R, Aranda JV. Therapeutic drug monitoring for caffeine in preterm neonates: an unnecessary exercise? Pediatrics. 2007;119:936-940.

Schechter NL, Zempsky WT, Cohen LL, McGrath PJ, McMurtry CM, Bright NS. Pain reduction during pediatric immunizations: evidence-based review and recommendations. Pediatrics. 2007;119: e1184-e1198.

Pharmacy Practice

Bond CA, Raehl CL. Clinical pharmacy services, pharmacy staffing, and hospital mortality rates. Pharmacotherapy. 2007; 27:481-493.

Devine EB, Wilson-Norton JL, Lawless NM, et al. Characterization of prescribing errors in an internal medicine clinic. Am J Health Syst Pharm. 2007;64:1062-1070.

Epplen K, Dusing-Wiest M, Freedlund J, Harger N, Kathman S, Ivey MF. Stepwise approach to implementing ambulatory clinical pharmacy services. Am J Health Syst Pharm. 2007;64:945-951.

Gupta SR, Wojtynek JE, Walton SM, et al. Association between hospital size and pharmacy department productivity. Am J Health Syst Pharm. 2007;64:937-944.

Hoth AB, Carter BL, Ness J, et al. Development and reliability testing of the clinical pharmacist recommendation taxonomy. Pharmacotherapy. 2007;27:639-646.

Joy MS, Candiani C, Vaillancourt BA, Chin H, Hogan SL, Falk RJ. Reengineering clinical operations in a medical practice to optimize the management of anemia of chronic kidney disease. Pharmacotherapy. 2007;27:734-744.

Kuiper SA, McCreadie SR, Mitchell JF, Stevenson JG. Medication errors in inpatient pharmacy operations and technologies for improvement. Am J Health Syst Pharm. 2007;64:955-959.

Lizer MH, Brackbill ML. Medication history reconciliation by pharmacists in an inpatient behavioral health unit. Am J Health Syst Pharm. 2007;64:1087-1091.

Loughlin SM, Mortazavi A, Garey KW, Rice GK, Birtcher KK. Pharmacist-managed vaccination program increased influenza vaccination rates in cardiovascular patients enrolled in a secondary prevention lipid clinic. Pharmacotherapy. 2007;27:729-733.

Magee MF. Hospital protocols for targeted glycemic control: development, implementation, and models for cost justification. Am J Health Syst Pharm. 2007;64(10 suppl 6):S15-S20.

Nathan JP, Zerilli T, Cicero LA, Rosenberg JM. Patients' use and perception of medication information leaflets. Ann Pharmacother. 2007;41:777-782.

Phansalkar S, Hoffman JM, Nebeker JR, Hurdle JF. Pharmacists versus nonpharmacists in adverse drug event detection: a meta-analysis and systematic review. Am J Health Syst Pharm. 2007;64:842-849.

Pound MW, Miller SM. Written versus oral recommendations made by pharmacy students during internal medicine rotations. Ann Pharmacother. 2007;41:772-776.

Shrank W, Avorn J, Rolon C, Shekelle P. Effect of content and format of prescription drug labels on readability, understanding, and medication use: a systematic review. Ann Pharmacother. 2007; 41:783-801.

Sokos DR, Skledar SJ, Ervin KA, et al. Designing and implementing a hospital-based vaccine standing orders program. Am J Health Syst Pharm. 2007;64:1096-1102.

Terceros Y, Chahine-Chakhtoura C, Malinowski JE, Rickley WF. Impact of a pharmacy resident on hospital length of stay and drug-related costs. Ann Pharmacother. 2007;41:742-748.

Transplantation

Abbud-Filho M, Adams PL, Alberu J, et al. A report of the Lisbon Conference on the care of the kidney transplant recipient. Transplantation. 2007;83(8 suppl):S1-S22.

Cransberg K, Cornelissen M, Lilien M, Van Hoeck K, Davin JC, Nauta J. Maintenance immunosuppression with mycophenolate mofetil and corticosteroids in pediatric kidney transplantation: temporary benefit but not without risk. Transplantation. 2007;83:1041-1047.

Faguer S, Kamar N, Guilbeaud-Frugier C, et al. Rituximab therapy for acute humoral rejection after kidney transplantation. Transplantation. 2007;83: 1277-1280.

Trauma and Critical Care

Dirkes S, Hodge K. Continuous renal replacement therapy in the adult intensive care unit: history and current trends. Crit Care Nurse. 2007;27:61-66, 68-72, 74-80; quiz 81.

Kimbrell BJ, Yamzon J, Petrone P, Asensio JA, Velmahos GC. Intrapleural thrombolysis for the management of undrained traumatic hemothorax: a prospective observational study. J Trauma. 2007;62:1175-1179.

Perkins JG, Schreiber MA, Wade CE, Holcomb JB. Early versus late recombinant factor VIIa in combat trauma patients requiring massive transfusion. J Trauma. 2007;62:1095-1101.

Slavik RS, Chan E, Gorman SK, et al. Dalteparin versus enoxaparin for venous thromboembolism prophylaxis in acute spinal cord injury and major orthopedic trauma patients: ‘DETECT’ trial. J Trauma. 2007;62:1075-1081.

Voils SA, Harpe SH, Brophy GM. Comparison of darbepoetin alfa and epoetin alfa in the management of anemia of critical illness. Pharmacotherapy. 2007;27:535-541.

Miscellaneous

Bardia A, Nisly NL, Zimmerman MB, Gryzlak BM, Wallace RB. Use of herbs among adults based on evidence-based indications: findings from the national health interview survey. Mayo Clin Proc. 2007;82:561-566.

Ellison DH, Berl T. Clinical practice. The syndrome of inappropriate antidiuresis. N Engl J Med. 2007;356:2064-2072.

Gurcan HM, Ahmed AR. Efficacy of various intravenous immunoglobulin therapy protocols in autoimmune and chronic inflammatory disorders. Ann Pharmacother. 2007;41:812-823.

Taylor S. Electroconvulsive therapy: a review of history, patient selection, technique, and medication management. South Med J. 2007;100:494-498.