Jennifer R. Martin

A 5-Year Analysis of Peer-Reviewed Journal Article Publications of Pharmacy Practice Faculty Members

Objectives. To evaluate scholarship, as represented by peer-reviewed journal articles, among US pharmacy practice faculty members; contribute evidence that may better inform benchmarking by academic pharmacy practice departments; and examine factors that may be related to publication rates. Methods. Journal articles published by all pharmacy practice faculty members between January 1, 2006, and December 31, 2010, were identified. College and school publication rates were compared based on public vs. private status, being part of a health science campus, having a graduate program, and having doctor of pharmacy (PharmD) faculty members funded by the National Institutes of Health (NIH). Results. Pharmacy practice faculty members published 6,101 articles during the 5-year study period, and a pharmacy practice faculty member was the primary author on 2,698 of the articles. Pharmacy practice faculty members published an average of 0.51 articles per year. Pharmacy colleges and schools affiliated with health science campuses, at public institutions, with NIH-funded PharmD faculty members, and with graduate programs had significantly higher total publication rates compared with those that did not have these characteristics (p<0.006). Conclusion. Pharmacy practice faculty members contributed nearly 6,000 unique publications over the 5-year period studied. However, this reflects a rate of less than 1 publication per faculty member per year, suggesting that a limited number of faculty members produced the majority of publications.

Effectiveness and Safety of Non–vitamin K Antagonist Oral Anticoagulants for Atrial Fibrillation and Venous Thromboembolism: A Systematic Review and Meta-analyses

PURPOSE The findings from the observational studies comparing the effectiveness and safety of non-vitamin K antagonist oral anticoagulants (NOACs) versus vitamin K antagonists (VKAs) for atrial fibrillation (AF) and venous thromboembolism (VTE) are inconsistent. We conducted separate meta-analyses examining the efficacy/effectiveness and safety of NOACs versus VKAs by disease (AF vs VTE), study design (randomized controlled trials [RCTs] vs observational studies), and NOAC (dabigatran, rivaroxaban, apixaban, and edoxaban). METHODS The main data sources included PubMed/MEDLINE, EMBASE, Web of Science, CINAHL, and Scopus from January 1, 2005, to February 15, 2016. We searched for Phase III RCTs and observational studies comparing NOACs versus VKAs. The primary outcomes were stroke/systemic embolism (SE) for AF; recurrent VTE/fatal pulmonary embolism (PE) for VTE; and major bleeding for both conditions. Secondary outcomes included stroke and myocardial infarction (MI) for AF, recurrent deep vein thrombosis (DVT)/PE for VTE, and mortality, intracranial hemorrhage (ICH), and gastrointestinal bleeding for both conditions. Pooled hazard ratios (HRs) were reported by using inverse variance-weighted random effects models. FINDINGS A total of 13 RCTs and 27 observational studies (AF, n = 32; VTE, n = 8) were included. For AF, dabigatran and VKAs were comparable for stroke/SE risk in 1 RCT (HR, 0.77 [95% CI, 0.57-1.03]) and 6 observational studies (HR, 1.03 [95% CI, 0.83-1.27]). Rivaroxaban had a 20% decreased risk of stroke/SE in 3 RCTs (HR, 0.80 [95% CI, 0.67-0.95]) compared with VKA, but the effect was nonsignificant in 3 observational studies (HR, 0.78 [95% CI, 0.59-1.04]). Apixaban decreased stroke/systemic embolism risk (HR, 0.79 [95% CI, 0.66-0.95]) compared with VKA in 1 RCT, but edoxaban was comparable to VKA (HR, 0.99 [95% CI, 0.77-1.28]) in 1 RCT (no observational studies available for apixaban/edoxaban). Dabigatran, apixaban, and edoxaban decreased the risk of hemorrhagic stroke, mortality, major bleeding, and ICH by 10% to 71% compared with VKAs but not rivaroxaban. For VTE, NOACs and VKAs were comparable for recurrent VTE/fatal PE/DVT/PE risk in 7 RCTs and 1 observational study. The 7 RCTs demonstrated a 32% to 69% decreased risk of major bleeding for dabigatran, rivaroxaban, and apixaban compared with VKAs. No difference was shown in 1 rivaroxaban observational study (HR, 0.77 [95% CI, 0.40-1.49]) and 1 edoxaban RCT (HR, 0.84 [95% CI, 0.59-1.20]). Except for dabigatran, the NOACs had a 61% to 86% decreased risk of ICH and gastrointestinal bleeding. IMPLICATIONS Overall, NOACs were comparable or superior to VKAs. Although no observational studies are currently available for apixaban/edoxaban, a few notable inconsistencies exist for dabigatran (ischemic stroke, MI) and rivaroxaban (stroke/SE, major bleeding in VTE) between RCTs and observational studies. Individualizing NOAC/VKA therapy based on benefit/safety profiles and patient characteristics is suggested.

The Newly Embedded Librarian: Pharmacy Information Liaison Service

Embedded librarianship has emerged as one approach to meeting the ever-evolving information needs of our clients. The University of Arizona Health Sciences Library has endeavored to become more proactive by embedding librarians within each of the four colleges it serves. Although the process of establishing visibility, recognition, and developing needed services has been a constant challenge, efforts have led to collaborations with faculty in both research and instruction. This article describes the successes and challenges of the library liaison in the College of Pharmacy, and how being embedded provided opportunities to build successful partnerships.

Impact of Diabetes Care by Pharmacists as Part of Health Care Team in Ambulatory Settings: A Systematic Review and Meta-analysis:

Objective: To conduct a comprehensive systematic review and meta-analyses examining the impact of pharmacist interventions as part of health care teams on diabetes therapeutic outcomes in ambulatory care settings. Data Sources: PubMed/MEDLINE, EMBASE, Cochrane Library, International Pharmaceutical Abstracts, Web of Science, Scopus, WHO’s Global Health Library, ClinicalTrials.gov, and Google Scholar were searched (1995 to February 2017). Search terms included pharmacist, team, and diabetes. Study Selection: Full-text articles published in English with comparative designs, including randomized controlled trials, nonrandomized controlled trials, and pretest-posttest studies evaluating hemoglobin A1C (A1C), were assessed. Data Extraction and Synthesis: Two reviewers independently screened for study inclusion and extracted data. Quality of the studies was assessed using tools developed based on the framework of the Cochrane Collaboration’s recommendations. Data Synthesis: A total of 1908 studies were identified from the literature and reference searches; 42 studies were included in the systematic review (n = 10 860) and 35 in the meta-analyses (n = 7417). Mean age ranged from 42 to 73 years, and 8% to 100% were male. The overall standardized mean difference (SMD) for A1C for pharmacist care versus comparison was 0.57 (P < 0.01), a moderate effect representing a mean difference of 1.1% (95% CI = 0.88-1.27). The effects for systolic blood pressure and low-density lipoprotein cholesterol were between small and moderate (SMD = 0.31 and 0.32; P < 0.01). The heterogeneity was high for all outcomes (>83%), indicating functional differences among the studies. No publication bias was detected. Conclusion: Pharmacists’ interventions as part of the patient’s health care team improved diabetes therapeutic outcomes, substantiating the important role of pharmacists in team-based diabetes management.

Ketamine for Analgosedation in the Intensive Care Unit A Systematic Review

Objective: To evaluate the evidence for the use of intravenous ketamine for analgosedation in the intensive care unit. Methods: MEDLINE and EMBASE were queried from inception until July 2015. Search terms used included ketamine, intensive care, and critical care. The search retrieved 584 articles to be screened for inclusion. The intent was to include randomized controlled studies using sustained intravenous infusions (>24 hours) of ketamine in the critically ill patients. Results: One trial evaluated opioid consumption as an outcome in postoperative critically ill patients who were randomized to ketamine or saline infusions. The mean cumulative morphine consumption at 48 hours was significantly lower in the ketamine group (58 ± 35 mg) compared to the morphine-only group (80 ± 37 mg; P < .05). Other trials showed the potential safety of ketamine in terms of cerebral hemodynamics in patients with traumatic brain injury, improved gastrointestinal motility, and decreased vasopressor requirements. The observational study and case reports suggest that ketamine is safe and effective and may have a role in patients who are refractory to other therapies. Conclusion: Ketamine use may decrease analgesic consumption in the intensive care unit. Additional trials are needed to further delineate the role of ketamine for analgosedation.

Effect of Pharmacy-Supported Transition-of-Care Interventions on 30-Day Readmissions: A Systematic Review and Meta-analysis

Objective: To describe pharmacy-supported transition-of-care (TOC) interventions and determine their effect on 30-day all-cause readmissions. Data Sources: MEDLINE/PubMed, EMBASE, International Pharmaceutical Abstracts, ABI Inform Complete, PsychINFO, Web of Science, Academic Search Complete, CINHAL, Cochrane library, OIASTER, ProQuest Dissertations & Theses, ClinicalTrials.gov, and relevant websites were searched from January 1, 1995, to December 31, 2015. Study Selection and Data Extraction: PICOS+E criteria were utilized. Eligible studies reported pharmacy-supported TOC interventions compared with usual care in adult patients discharged to home within the United States. Studies were required to evaluate postdischarge outcomes (eg, rate of readmissions, hospital utilization). Randomized controlled trials, cohort studies, or controlled before-and-after studies were included. Two reviewers independently extracted data and evaluated study quality. Data Synthesis: A total of 56 articles were included in the systematic review (n = 61 858), of which 32 reported 30-day all-cause readmissions and were included in the meta-analysis. A taxonomy was developed to categorize targeted patients, intervention types, and pharmacy personnel as sole intervener. The meta-analysis demonstrated about a 32% reduction in the odds of readmission (odds ratio [OR] = 0.68; 95% CI = 0.61 to 0.75) observed for pharmacy-supported TOC interventions compared with usual care. Heterogeneity was identified (I2 = 55%; P < 0.001). A stratified meta-analysis showed that interventions with patient-centered follow-up reduced 30-day readmissions relative to studies without follow-up (OR = 0.70; CI = 0.63 to 0.78). Conclusions: Pharmacy-supported TOC programs were associated with a significant reduction in the odds of 30-day readmissions.

A Systematic Review of Extramural Presentations and Publications from Pharmacy Student Research Programs

Objective. To conduct a systematic review of reports of pharmacy student research programs that describes the programs and resulting publications or presentations. Methods. To be eligible for the review, reports had to be in English and indicate that students were required to collect, analyze data, and report or present findings. The outcome variables were extramural posters/presentations and publications. Results. Database searches resulted in identification of 13 reports for 12 programs. Two-thirds were reports of projects required for a course or for graduation, and the remaining third were elective (participation was optional). Extramural posters resulted from 75% of the programs and publications from 67%. Conclusion. Although reporting on the outcomes of student research programs is limited, three-quarters of the programs indicated that extramural presentations, publications, or both resulted from student research. Additional research is needed to identify relevant outcomes of student research programs in pharmacy.

An Embedded Librarian Program: Eight Years On.

ABSTRACT This article examines an embedded librarian program eight years after implementation in a large academic health center. Librarians were physically moved into the colleges of pharmacy, public health, and nursing. Statistics are reported as well as comments from the participating librarians and faculty members. Strong relationships have been built between librarians, faculty members, and students. Locating the librarians among faculty and students led to a better understanding of client needs and an increased awareness of librarian competencies and services resulting in partnerships and greater utilization of library services.

Effectiveness of a Liaison Program in Meeting Information Needs of College of Pharmacy Faculty

This article describes the creation and implementation of focus groups to evaluate the effectiveness of a health sciences librarys liaison program of the College of Pharmacy faculty and to better understand the facultys information needs in order to design new and improved library services. The liaison services support the teaching and research needs of faculty and students through literature research, classroom teaching, and an extensive library collection of pharmacy literature. Focus group results demonstrated a high level of satisfaction with library liaison services and collections. Opportunities exist for expanded interaction with graduate students and greater marketing of library services to increase faculty awareness of specific library programs.

Collaborate and Innovate: The Impact of Academic Librarians on the Commercialization of University Technology

ABSTRACT The University of Arizona Library, in collaboration with the campus commercialization unit, created a partnership that contributes to the early development of inventions in the commercialization pipeline. The library-commercialization business-intelligence workgroup was incorporated into the overall campus commercialization business-development workflow in 2014 and is comprised of librarians and commercialization professionals working together to provide insight and decision support for development of commercialization strategies for inventions emerging from university research that aligns with market drivers. These efforts are recognized by university leadership as critical to the strategic plan of the university. This article discusses the impact of the workgroup and how the group of librarians contributed to the development of new companies, new licenses, and financial impact of economic development at a large land-grant university and larger community.