Vibhuti Arya

Role of interleukin-1 inhibitors in the management of gout.

Interleukin‐1 (IL‐1) inhibitors potentially have a role as antiinflammatory agents in refractory gout or for patients who are unable to tolerate conventional therapy, such as nonsteroidal antiinflammatory drugs (NSAIDs), colchicine, or glucocorticoids, for acute attacks. Additionally, IL‐1 inhibitors may also help patients with polyarticular and tophaceous gout by making them less vulnerable to breakthrough attacks during initiation of chronic urate‐lowering treatment, the mainstay of gout therapy. Because evidence highlights the role of proinflammatory cytokine IL‐1 in the inflammation process during an acute gouty attack, IL‐1 inhibitors are used to modulate the pathogenesis of a variety of autoinflammatory diseases, providing support for its potential role in the inflammatory process of gout. After NSAIDs, colchicine, and steroids, IL‐1 inhibitors are beneficial as fourth‐line therapy for acute gout attacks due to their high cost and limited clinical experience. The IL‐1 inhibitors used in gout are anakinra, canakinumab, and rilonacept. Based on published evidence, anakinra has limited support in the form of anecdotal case reports to justify its use for treating gout. Canakinumabs toxic profile in clinical trials precludes its use in treating patients for gout, and rilonacept shows promise with a few well‐designed studies to support its use in gout patients initiating urate‐lowering treatment. When combined with current traditional therapies, these newer agents present clinicians and patients with more potential treatment options in the difficult‐to‐treat gout population.

An analysis of quality improvement education at US colleges of pharmacy

Objective. Analyze quality improvement (QI) education across US pharmacy programs. Methods. This was a two stage cross-sectional study that inspected each accredited school website for published QI curriculum or related content, and e-mailed a questionnaire to each school asking about QI curriculum or content. T-test and chi square were used for analysis with an alpha a priori set at .05. Results. Sixty responses (47% response rate) revealed the least-covered QI topics: quality dashboards /sentinel systems (30%); six-sigma or other QI methodologies (45%); safety and quality measures (57%); Medicare Star measures and payment incentives (58%); and how to implement changes to improve quality (60%). More private institutions covered Adverse Drug Events than public institutions and required a dedicated QI class; however, required QI projects were more often reported by public institutions. Conclusion. Despite the need for pharmacists to understand QI, it is not covered well in school curricula.

Educating Pharmacists in Quality (EPIQ): Recipient, Academy for Healthcare Improvement 2015 Duncan Neuhauser Award for Curricular Innovation.

The Duncan Neuhauser Award for curriculum Innovation is presented annually at the Academy for Healthcare Improvement meeting. The award recognizes education providers that show innovation and improvement in advancing skills in health care. Duncan B. Neuhauser, PhD, a Senior Editor with the Quality Management in Health Care journal is a Professor of Health Services Research and the Charles Elton Blanchard Professor of Health Management at Case Western Reserve University. Dr Neuhauser has devoted his working life to the science of the improvement of health care and has served as a pioneer in the development of curriculum to promote health care improvement. The 2015 first place recipient was Educating Pharmacists in Quality (EPIQ) developed by the Pharmacy Quality Alliance. EPIQ was developed as a quality improvement education resource for use by pharmacy faculty and other professionals to teach students pharmacists, pharmacists, and other stakeholders about measuring, reporting, and improving quality in pharmacy practice. EPIQ has been integrated into more than 20 doctor of pharmacy curricula and has been used as part of employee training programs. Students and faculty members who have used the program have indicated via surveys that the program has a positive impact on awareness and knowledge of quality improvement in pharmacy.

Patient engagement on a smartphone

challenges users to resolve public health outbreaks based on real events. What about the second half of that hypothetical? Could scientists and gamers come together to solve problems while also contributing to strategies for future real-life situations? That is exactly what Jane McGonigal, game designer and Director of Games Research and Development at the Institute for the Future, strives for in her work. In McGonigal’s world, gamers from across the globe collaborate on real issues, such as depression, chronic pain, and anxiety. Pharmacists on the frontlines, especially in community pharmacies, unknowingly gather rich troves of data seldom used outside of conversations with patients. Can we use our patient interactions to help improve the quality of care by communicating our valuable insights back to patients, other providers, and the rest of the health care system? Perhaps pharmacists, too, can harness our power through apps that engage patients and create a truly patient-centered approach to treatment and care.

Cigarettes in a digital age

You’ve seen them—at the mall, on the street, in a bar, even inside the classroom. They are sold in a variety of fl avors in almost every grocery store. Marketed as the safer alternative to tobacco products, electronic cigarettes—known as e-cigarettes—are quickly gaining popularity among consumers of all demographics. The close resemblance to the original cigarette that became iconic in American culture makes the e-cigarette so appealing that even previous nonsmokers venture to try them. Meanwhile, seasoned smokers turn to these devices to get their “fi x” of nicotine without inhaling the other toxic components of regular cigarettes, or even to quit smoking. Lack of regulation of these products, however, may set the scene for creating a new generation of addicts. With much stigma surrounding this fairly new technological delivery of nicotine, will e-cigarettes ever be found on pharmacy shelves?

What’s trendy? Ask Google

What do hemorrhoids, One Direction, and Big Bird all have in common? According to Google Trends, they were among 2012s most popular Internet search terms with the highest sustained traffic.

HIT: Opportunity for pharmacists

The confluence of a technologic revolution, universal doctoral training in pharmacy, and the needs of a diverse and aging American population have combined to create new horizons for our profession. In recognition of the importance of technology in todays world and the critical role it plays as pharmacists transition to medication therapy management (MTM) roles, Pharmacy Today this month launches this column on health information technology (HIT).

Patient portal: Centralized information hub

Internet portals provide a secure way for patients to log in and interact more readily with their providers. Through an asynchronous exchange of information, patients and providers can share pertinent health information, such as lab results and medication lists. Patients may enter their own information, complete required paperwork, conduct Web consults with providers, schedule appointments, and pay bills. Patient portals shift most such nonurgent communications from telephone and face-to-face visits to seamless online interactions.

Show me the data

At the 2012 APhA Annual Meeting & Exposition, keynote speaker Thomas Goetz, MPH, told the audience that meaningful use of data would be “the next huge breakthrough of health care.” Goetz emphasized the importance of data analysis and usability for various audiences, including patients, health care providers, and policy makers. In a system where pharmacists are blazing a trail for the advancement of practice, how do we transition from bar graphs, pie charts, and tables to present data so it is easy to read?

The pharmacist will see you now

About a year ago, I walked into an Apple Store and was greeted by a young and enthusiastic associate who helped me obtain an item I asked for. Like many New York City shoppers, I quickly paced into the store, obtained what I needed, and scanned the long line to assess how long this purchase would take me. The associate immediately offered an express checkout using a device attached to his iPhone. No line, no wait, no fuss. In less than 2 minutes, the transaction was done, and I was back out on the street.