Sharon K. Park

Vitamin D Supplementation: What's Known, What to Do, and What's Needed

The use of vitamin D supplements to prevent and treat a wide range of illnesses has increased substantially over the last decade. Epidemiologic evidence links vitamin D deficiency to autoimmune disease, cancer, cardiovascular disease, depression, dementia, infectious diseases, musculoskeletal decline, and more. The Institute of Medicine published an exhaustive report in 2010 that concluded that vitamin D supplementation for indications other than musculoskeletal health was not adequately supported by evidence and that most North Americans receive sufficient vitamin D from their diet and sun exposure. These conclusions are at odds with some clinical practice guidelines; thus, we sought to summarize the best available evidence regarding the benefits of vitamin D supplementation, to examine the potential risks, and to provide practical dosing advice. The adequacy of vitamin D stores is determined by measuring the 25‐hydroxyvitamin D serum concentrations. The demarcations between deficiency (< 20 ng/ml), insufficiency (20–30 ng/ml), and optimal (30–80 ng/ml) serum concentrations are controversial. Vitamin D in doses of 800–5000 IU/day improve musculoskeletal health (e.g., reduces the rate of fractures and falls in older adults (aged ≥ 65 yrs). In patients with documented vitamin D deficiency, a cumulative dose of at least 600,000 IU administered over several weeks appears to be necessary to replenish vitamin D stores. Single large doses of 300,000–500,000 IU should be avoided. Vitamin D supplementation should not be offered routinely to other patient populations. Although results from some prospective clinical trials are promising, most have not been robustly designed and executed. The decision by young, otherwise healthy adults to take vitamin D in doses of 2000 IU/day or lower is unlikely to cause harm. For patients who are not at risk for developing vitamin D deficiency, sensible sun exposure is an inexpensive and enjoyable way to maintain vitamin D stores.

Preference and Frequency of Mobile Phone App Use for Drug Information Among Student Pharmacists

Background: Health care professionals commonly use mobile devices to retrieve drug information (DI) in clinical practice. The preference and frequency of such use by student pharmacists are not well understood. Objective: To investigate the preference and frequency of mobile phone application (app) use for retrieving DI among student pharmacists. Methods: DI specialists from 3 pharmacy schools generated a 13-question survey relating to students’ preference and frequency of DI app use via their mobile phone. The survey was tested and electronically disseminated to all current P1 through P4 students from all 3 schools. Data were collected for student demographics, availability of mobile phone and DI apps, frequency of using DI apps, and whether DI apps were purchased. Data were analyzed descriptively and statistically. Results: About 74% (n = 221) of students reported using their mobile phone apps for retrieving DI. About 95% of the students used 1 to 3 apps for DI purposes and more than 85% used them a few times a week or more. About 17.6% of the students reported purchasing apps for the purpose of finding DI and that purchased apps are more accurate (27.6%), more comprehensive (36.2%), and more current (26.2%), compared with free apps. Conclusions: Student pharmacists used 1 to 3 mobile apps, at least a few times a week for DI. Some students purchased apps for DI use in addition to free subscriptions from their school. Students perceived purchased DI apps being more accurate, more comprehensive, and more up to date than the free apps.

The Report of the 2017-2018 Professional Affairs Standing Committee: The Development of the Preceptor Self-Assessment Tool for Entrustable Professional Activities for New Graduates

EXECUTIVE SUMMARY The 2017-2018 AACP Professional Affairs Committee addressed the charges of (1) developing a self-reflection/self-assessment tool for pharmacy faculty and preceptors to allow them to assess their capability and confidence with Center for the Advancement of Pharmacy Education (CAPE) Educational Outcomes, the Pharmacists’ Patient Care Process (PPCP), and the Entrustable Professional Activities (EPAs) for New Pharmacy Graduates and (2) creation of a plan for AACP to utilize in the development of preceptor continuing education and training programs. This report describes the framework, rationale and process for the development of the Preceptor Self-Assessment Tool for Entrustable Professional Activities for New Pharmacy Graduates (PSAE Tool), the pre-test for the PSAE tool, and the online pilot test and its results for the PSAE Tool. The committee provides recommendations for AACP in the continued development and distribution of the PSAE Tool to the schools of pharmacy. Considerations for AACP and the schools of pharmacy to consider in the continuing professional development (CPD) for all preceptors are also discussed. The committee provides a policy statement, adopted by the AACP House of Delegates, regarding the commitment of AACP regarding the CPD for all preceptors. The committee also provides several recommendations to AACP and suggestions to schools of pharmacy and other stakeholder groups pertaining to the committee charges.

Women’s health issues: 2014 update

When it comes to health care, men really could be from Mars and women from Venus. Women are more likely to seek medical care and use health care regularly than men are. They have unique and very different needs regarding their anatomical and hormonal makeup. Women also have unique psychological issues; they experience twice the rate of depression as men, regardless of race or ethnic background.

Top of mind at APA meeting: Adherence, opioids, PTSD

The largest meeting for experts in psychiatric disorders, this months 167th annual meeting of the American Psychiatric Association (APA) delivered information on several key issues related to managing patients with psychiatric disorders. Many important topics on the agenda are reviewed in this article: medication adherence (including how pharmacists can help), new antidepressants, opioid therapy, medical and recreational use of marijuana, management of posttraumatic stress disorder, and use of antipsychotics in vulnerable children.

Joint research: Implications for treating diseases in rheumatology

In 2014, a leading journal in bone and joint disorders changed its name. Arthritis & Rheumatism became Arthritis & Rheumatology .

Can you feel it? Neurology treatments moving forward

C such as multiple sclerosis (MS), epilepsy, Parkinson disease (PD), and dementia are receiving more attention now than ever because of their prevalence, the debilitating nature of disease courses, and negative outcomes associated with suboptimal medication therapy. Pharmacists can guide patients with MS and epilepsy in choosing from among several new therapeutic options. Pharmacists also can help patients with PD to manage medications for nonmotor symptoms, and an issue to watch is the association between statin use and cognitive function in older patients.

Helping patients feel good in their own skin

Although skin is the largest organ of the human body, dermatologic disorders do not necessarily receive the attention they deserve. Treating dermatological problems may not be as simple as it seems. Fortunately, pharmacists now have at their fingertips new therapies for dermatologic diseases, including melanoma, and topical and transdermal formulations that will increase the utility of currently available medications.

Take a deep breath: Flu season ahead

Abstract With infiuenza season ahead, pharmacists need to prepare for the common respiratory illnesses, such as asthma and chronic obstructive pulmonary disease, and be familiar with how to optimize treatment with all the available medications. An additional challenge is smoking cessation.

No snooze button on treating sleep disorders

[thereby] treating the patient’s whole well-being just like [the recommendations for] nutrition and exercise.” Many of the advances of modern life contribute to the different sleep problems clinicians fi nd in an estimated 30% to 40% of Americans. Air travel, shift work, smartphones buzzing and vibrating in the night, television and the internet—all contribute to insomnia, hypersomnia (sleeping during the day), parasomnia (disruptive sleep), circadian rhythm disturbances, narcolepsy, or sleep apnea. One-half of patients have chronic sleep disturbance. For people who sleep for far less than 8 hours each night or who have jobs or lifestyles that require them to sleep during the day, physiologic or psychological problems may ensue eventually in the form of fatigue, headache, irritability, inattentiveness, or narcolepsy. More serious health problems can also develop, including hypertension and other cardiovascular disorders.