Philip E. Johnston

Bromfenac(Duract)-associated hepatic failure requiring liver transplantation

ABSTRACTBromfenac sodium (Duract) is a phenylacetic acid-derived nonsteroidal anti-inflammatory agent introduced in the United States in 1997 and withdrawn in 1998. We describe the first case of fulminant hepatic failure associated with this agent treated successfully with liver transplantation. Similarities to hepatotoxicity with related agents is discussed.

Behind-the-scenes of patient-centered care: content analysis of electronic messaging among primary care clinic providers and staff.

Background:Transitions to patient-centered health care, the increasing complexity of care, and growth in self-management have all increased the frequency and intensity of clinical services provided outside office settings and between visits. Understanding how electronic messaging, which is often used to coordinate care, affects care is crucial. A taxonomy for codifying clinical text messages into standardized categories could facilitate content analysis of work performed or enhanced via electronic messaging. Objective:To codify electronic messages exchanged among the primary care providers and the staff managing diabetes patients at an academic medical center. Research Design:Retrospective analysis of 27,061 electronic messages exchanged among 578 providers and staff caring for a cohort of 639 adult primary care patients with diabetes between April 1, 2003 and October 31, 2003. Subjects:Providers and staff using locally developed electronic messaging in an academic medical centers adult primary care clinic. Measures:Raw data included clinical text message content, message ID, thread ID, and user ID. Derived measures included user job classification, 35 flags codifying message content, and a taxonomy grouping the flags. Results:Messages contained diverse content: communications with patients, families, and other providers (47.2%), diagnoses (25.4%), documentation (33%), logistics and support functions (29.6%), medications (32.9%), and treatments (28.9%). All messages could be classified; 59.5% of messages addressed 2 or more content areas. Conclusions:Systematic content analysis of provider and staff electronic messages yields specific insight regarding clinical and administrative work carried out via electronic messaging.

The formulary : an educational tool for clinical pharmacology

Clinical Pharmacology and Therapeutics (1992) 51, 481–488; doi:10.1038/clpt.1992.51

Therapeutic advisory program: an opportunity for clinical pharmacology

Clinical Pharmacology and Therapeutics (1988) 43, 223–227; doi:10.1038/clpt.1988.24

Staging a reflective capstone course to transition PharmD graduates to professional life.

Objective. To develop and implement a capstone course that would allow students to reflect on their development as a professional, assess and share their achievement of the college’s outcomes, complete a professional portfolio, establish a continuing professional development plan, and prepare to enter the pharmacy profession. Design. Students were required to complete a hybrid course built around 4 online and inclass projects during the final semester of the curriculum. Assessment. Faculty used direct measures of learning, such as reading student portfolios and program outcome reflections, evaluating professional development plans, and directly observing each student in a video presentation. All projects were evaluated using standardized rubrics. Since 2012, all graduating students met the course’s minimum performance requirements. Conclusion. The course provided an opportunity for student-based summative evaluation, direct observation of student skills, and documentation of outcome completion as a means of evaluating readiness to enter the profession.