Educational card games to teach pharmacotherapeutics in an advanced pharmacy practice experience.

OBJECTIVE: To implement and assess the effectiveness of card games to teach pharmacotherapeutic topics to pharmacy students and to determine the relationship between students' assessment scores and their learning styles. DESIGN: Two card games, Cardiology Go Fish and Infectious Diseases Gin Rummy, were created and taught to pharmacy students enrolled in an advanced pharmacy practice experience (APPE). Students were required to play each game for 1 hour, 3 times over a 6-week period. ASSESSMENT: Forty-five students completed a 90-question assessment administered prior to and after the 6-week period in which the games were played. Students' cardiology and infectious diseases assessment scores improved significantly as compared with scores on pharmacy practice questions, 19.2% vs. 5.1%, (p < 0.001) and 10.3% vs. 5.1% (p = 0.006), respectively. Students learned from participating in the games regardless of their learning preference as determined by the VARK (visual, aural, read/write, kinesthetic) questionnaire; however, the cardiology assessment scores of students with a preference for kinetic learning improved the most. CONCLUSIONS: Incorporating innovative learning tools such as card games into the curriculum of APPEs can enhance the educational experience of pharmacy students.

Hyperlipidemia medication management in patients admitted for a myocardial infarction / Manejo de la medicación para hiperlipemia en pacientes ingresados por infarto de miocardio

Objectives: The purpose of this study is to determine the percentage of patients admitted for acute myocardial infarction currently prescribed a statin, with low-density lipoprotein (LDL) <100 mg/dL, and high-density lipoprotein (HDL) <50 mg/dL for men and <55 mg/dL for women and evaluate their medication management with a focus on niacin initiation. Methods: This was a retrospective study from 12/07 to 12/09, conducted at a private, community hospital. Inclusion criteria required patients to have an acute myocaridal infarction (AMI) ICD-9 code, troponin >=0.2 ng/dL and lipid panel performed within 96 hours of troponin. Patients with a triglyceride level > 400 mg/dL were excluded. The residual risk population consisted of patients currently taking a statin with LDL <100 mg/dL and HDL <50/55 mg/dL. Patients were excluded from the residual risk population if they were on niacin, had an allergy to or previously failed niacin therapy, or expired within 72 hours. Results: A total of 553 patients experiencing an AMI had lipid panels available for evaluation. The mean LDL was 97.3 +/- 36.0 mg/dL, mean HDL was 33.5 +/- 11.1 mg/dL, and mean triglycerides were 133.1 +/- 71.3 mg/dL. The majority of patients (n=521, 94.2%) had an HDL < 50 or 55 mg/dL respective of gender. Ninety-two (80.0%) residual risk patients had no change in their home lipid medications post AMI. Fifteen (13.0%) residual risk patients had their dose of statin medication increased. Seven (6.1%) residual risk patients were initiated on niacin. Conclusions: The study results confirm an existence of a residual risk population with nearly 25% of AMI patients meeting the criteria. The results also confirm a low incidence of medication intervention in the residual risk population post AMI (20.0%) regarding lipid therapy, including the initiation of niacin in only 6.1% of patients (AU)

Objetivos: El propósito de este estudio es determinar el porcentaje de pacientes ingresados por un infarto agudo de miocardio que tienen actualmente prescrita una estatina, con lipoproteínas de baja densidad (LDL) <100mg/dL, y lipoproteínas de alta densidad (HDL) <50 mg/dL para hombres y <55 mg/dL para mujeres, y evaluar el manejo de su medicación centrándose en la iniciación a niacina. Métodos: Este fue un estudio retrospectivo de 12/07 a 12/09, realizado en un hospital comunitario privado. Los criterios de inclusión requerían que los pacientes tuviesen un código CIE-9 de infarto agudo de miocardio (IAM), troponina >=0.2 ng/dL y un panel lipídico realizado en las 96 horas de la troponina. Los pacientes con nivel de triglicéridos >400 mg/dL fueron excluidos. La población de riesgo residual consistió en pacientes que tomaban actualmente estatinas con LDL<100 mg/dL y HDL<50/55 mg/dL. Se excluía a los pacientes de la población de riesgo residual si estaban con niacina, tenían alergia o fallo previo a la niacina, o fallecieron en las 72 horas. Resultados: Un total de 553 pacientes que sufrieron un IAM tenían un perfil lipídico disponible para evaluación. La media de LDL fue de 97,3 (DE=36,0) mg/dL, la media de HDL fue de 33,5 (DE=11,1) mg/dL, y la media de triglicéridos fue de 133,1 (DE=71,3) mg/dL. La mayoría de los pacientes (n=521, 94.2%) tenían HDL<50 o 55 mg/dL, respectivamente del su género. 92 (80,0%) pacientes de riesgo residual no tuvo cambios en su medicación domiciliaria de lípidos después del IAM. A 15 (13,0%) pacientes de riesgo residual se le aumentó la dosis de estatinas. En 7 (6,1) pacientes de riesgo residual se inició la niacina. Conclusiones: Los resultados del estudio confirman la existencia de una población de riesgo residual de cerca del 25% de pacientes con IAM que satisface los criterios. Los resultados también confirman la baja incidencia de intervención en la población de riesgo residual post-IAM (20,0%) en relación al tratamiento para los lípidos, incluyendo la iniciación de niacina en sólo el 6,1% de los pacientes (AU)

Hyperlipidemia medication management in patients admitted for a myocardial infarction.

OBJECTIVES: The purpose of this study is to determine the percentage of patients admitted for acute myocardial infarction currently prescribed a statin, with low-density lipoprotein (LDL) <100 mg/dL, and high-density lipoprotein (HDL) <50 mg/dL for men and <55 mg/dL for women and evaluate their medication management with a focus on niacin initiation. METHODS: This was a retrospective study from 12/07 to 12/09, conducted at a private, community hospital. Inclusion criteria required patients to have an acute myocaridal infarction (AMI) ICD-9 code, troponin ≥0.2 ng/dL and lipid panel performed within 96 hours of troponin. Patients with a triglyceride level > 400 mg/dL were excluded. The residual risk population consisted of patients currently taking a statin with LDL <100 mg/dL and HDL <50/55 mg/dL. Patients were excluded from the residual risk population if they were on niacin, had an allergy to or previously failed niacin therapy, or expired within 72 hours. RESULTS: A total of 553 patients experiencing an AMI had lipid panels available for evaluation. The mean LDL was 97.3 ± 36.0 mg/dL, mean HDL was 33.5 ± 11.1 mg/dL, and mean triglycerides were 133.1 ± 71.3 mg/dL. The majority of patients (n=521, 94.2%) had an HDL < 50 or 55 mg/dL respective of gender. Ninety-two (80.0%) residual risk patients had no change in their home lipid medications post AMI. Fifteen (13.0%) residual risk patients had their dose of statin medication increased. Seven (6.1%) residual risk patients were initiated on niacin. CONCLUSIONS: The study results confirm an existence of a residual risk population with nearly 25% of AMI patients meeting the criteria. The results also confirm a low incidence of medication intervention in the residual risk population post AMI (20.0%) regarding lipid therapy, including the initiation of niacin in only 6.1% of patients.