Kevin T. Fuji

The patient safety problem has been well established for over 20 years in the United States (U.S.), and there is a recognized focus on ensuring that health professions’ trainees receive explicit education in various patient safety principles and practices. While the literature provides examples of different approaches towards patient safety education for pharmacy students, there are few that focus on first-year pharmacy students. This educational observational study describes the implementation and evaluation of two 20 min patient safety learning activities integrated into a required pharmacy skills lab course. The first learning activity utilized a mock prescription and patient safety checklist that had students identify patient safety problems on the prescription, followed by a group discussion of implications for the patient. The second learning activity used images of common safety problems with a facilitated group discussion to have students identify systems-based solutions to those problems. Our study’s findings revealed that students were able to identify basic patient safety problems and safety solutions, although some additional foundational information may be needed, particularly for students who may not have pharmacy work experience. Additional research is needed to continue building a literature base on patient safety education approaches, particularly for first-year pharmacy students.

The financial difficulties of parents have a negative impact on the health of their children. This problem is more pronounced in single mother families. There is limited research on low-income, single mothers and how interventions to help them address financial difficulties may also benefit their children. The purpose of this study was to evaluate the effect of a year-long financial education and coaching program on school absenteeism and health care utilization of children in employed, low-income, single mother households. This was a post hoc analysis of the Finances First study, a randomized controlled trial conducted in 2017–2020 examining the impact of a financial coaching and education program on economic stability and health outcomes in 345 low-income, single mothers. Either generalized estimating equations (GEEs) or generalized linear mixed models (GLMMs) were used to account for relationships between participants. For the continuous outcomes of child absenteeism, physician visits, emergency room visits, and hospitalization days, a linear mixed-effects model was used. The Finances First study demonstrated improvements in various financial strain measures. Compared to the control group, children of intervention group participants experienced 1 fewer day of school absence (p = 0.049) and 1 fewer physician visit (p = 0.032) per year, but no impact was seen on emergency room visits (p = 0.55) or hospitalizations (p = 0.92). Addressing social determinants of health in parents is necessary for improving child health outcomes.

Continuous glucose monitoring (CGM) is used to help patients with diabetes and their healthcare providers more effectively manage care. CGM use is expanding to all healthcare settings where pharmacists practice and new pharmacy graduates may increasingly be asked to assist patients utilizing CGM devices and assess diabetes management through the interpretation of CGM data. The purpose of this study was to describe CGM education across Doctor of Pharmacy (Pharm.D.) programs in the United States. An online survey was administered to 139 accredited Pharm.D. programs. Information was solicited about CGM education, including curricular placement, course type, hands-on experience, and credential(s) of faculty providing the education. Fifty-seven programs responded with 51 (89.5%) providing CGM education for a median of 1.0 h. Of programs providing detailed responses, content was delivered in required (60.4%) or elective (45.8%) lectures as well as experiential settings (41.7%). Education occurred most frequently in the third year (58.3%), followed by the second (43.8%) and fourth (37.5%) years. Thirty-one (66.0%) programs were taught by a faculty member with an advanced diabetes credential. The results from this study confirm that there is an ongoing need to examine optimal amount, timing, and methods for providing CGM education.

Pharmacists are expected to participate in the conduction of research to advance the profession and health care broadly. Additional opportunities for pharmacist research engagement have emerged with the increased integration of clinically trained pharmacists into interprofessional care teams. Research conducted over the past four decades has demonstrated an increasing trend of pharmacist-authored publications in medical journals. The purpose of this study was to build upon this work and investigate trends in pharmacist-authored original research publications within the JAMA Network over the past 20 years. A descriptive study design was used to retrospectively evaluate trends in the numbers of pharmacist-authored publications and authorship within those publications in nine JAMA Network journals. Data were aggregated into ten-year time periods (2000–2009 and 2010–2019) and compared using chi-square and Fisher’s exact tests. Overall, pharmacist-authored publications significantly increased over the ten-year period (2.0% to 3.0%, p < 0.001), including in five specific journals: JAMA, JAMA Dermatology, JAMA Neurology, JAMA Ophthalmology, and JAMA Surgery. There was no change in first—and senior-authored publications. While the overall pharmacist publication trend was positive, room for significant growth remains. A deeper understanding of the barriers and facilitators to pharmacist engagement in research is needed, along with strategies to enhance pharmacist research training.

ESRD patients receiving hemodialysis (HD) were excluded from landmark trials evaluating direct-acting oral anticoagulants (DOACs) in atrial fibrillation (AF). The objective was to evaluate prescribing and bleeding with DOACs compared to warfarin in AF patients with chronic HD. A retrospective, observational study of patients receiving warfarin or DOAC from April 2010-April 2016 from area health system hospitals and Dialysis Clinics, Inc. records. Data was analyzed using descriptive statistics, ANOVA, and chi-square. Ninety-one patients were included with warfarin as the initial OAC in most patients (n = 76) at average dose of 29 mg/week. Fifteen patients were initially prescribed apixaban (n = 12) or dabigatran (n = 3). Most switches in OAC therapy were to apixaban. When the initial OAC was a DOAC, it was not dosed appropriately in five with one bleed, two dosed appropriately had bleeds. When initial warfarin was switched to a DOAC, it was not dosed appropriately in seven with five bleeds. More bleeds occurred with warfarin alone (n = 18) vs. those on warfarin switched to DOAC (n = 5) vs. DOAC alone (n = 3), p = 0.022. All but four patients that bled had HAS-BLED scores three or higher. Warfarin was most often prescribed and associated with a higher incidence of bleeding compared to DOACs in this population of patients at high risk for bleeding. Larger studies should be conducted to analyze the impact of DOAC dose appropriateness on safety and clinical outcomes.