Symposium on roles of and cooperation between academic- and practice-based pharmacy clinicians.

PURPOSE: The findings of an academic symposium as they relate to the history and role of the academic pharmacy clinician, the strengths and limitations of the academic pharmacy clinician model, and the framework for future synergistic work relations among clinical pharmacy practitioners are summarized. SUMMARY: On April 23, 2008, a symposium was convened to bring key thought leaders together to discuss the relationship of the academic-based pharmacy clinician and the practice-based pharmacy clinician. Participants included clinical faculty and administrators from two colleges of pharmacy, practice-based clinical pharmacists and pharmacy managers from seven health care institutions, and representatives from the American Association of Colleges of Pharmacy, the American College of Clinical Pharmacy, and the American Society of Health-System Pharmacists. Symposium participants discussed the roles and expectations of clinical pharmacists based on primary affiliation within the contemporary practice model for academic- and practice-based pharmacy clinicians and identified sources of conflict for academic- and practice-based pharmacy clinicians. Symposium participants agreed that in order to succeed, the academic-based and the practice-based pharmacy clinicians must function in a true partnership as each individual has strengths, resources, and benefits to bring to the relationship. Furthermore, knowledge, consideration, and an understanding of the potentially different goals and objectives of each institution are critical. CONCLUSION: A symposium attended by clinical faculty members and administrators from two colleges of pharmacy, practice-based clinical pharmacists and pharmacy managers from seven health care institutions, and representatives from three national pharmacy organizations was conducted to discuss the roles of and cooperation between academic- and practice-based pharmacy clinicians.

Factors associated with discharge lipid-lowering drug prescription in patients hospitalized for coronary artery disease (from the Get With the Guidelines database).

Lipid-lowering therapy prevents morbidity and mortality in patients with coronary artery disease (CAD), but little is known regarding ordering practices in patients hospitalized with CAD events. Patients at participating hospitals of Get with The Guidelines-CAD, a hospital performance improvement program, were entered into a registry. Factors associated with discharge lipid-lowering therapy prescription were identified and the effect of in-hospital low-density lipoprotein cholesterol measurement on therapy prescription was evaluated. A total of 98,880 patients were enrolled at 405 hospitals. At discharge, lipid-lowering therapy was prescribed in 84.7% of patients and was associated with percutaneous coronary intervention and angiotensin-converting enzyme inhibitor, aspirin, and beta-blocker therapies at discharge, but not cardiac rehabilitation referral or coronary artery bypass grafting (all p<0.0001). After adjustment for patient characteristics, men were more likely (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.18 to 1.29; p<0.0001) and patients with heart failure were less likely to be prescribed lipid-lowering therapy (OR 0.64, 95% CI 0.59 to 0.69, p<0.0001). Patients who had low-density lipoprotein cholesterol measured during hospitalization were more likely to be prescribed lipid-lowering therapy (OR 1.56, 95% CI 1.48 to 1.65, p<0.0001). Lipid-lowering therapy prescription was associated positively with higher body mass index, history of dyslipidemia, and previous myocardial infarction and negatively with history of renal insufficiency, stroke, and hypertension. In conclusion, despite consistent benefits of lipid-lowering therapy in patients hospitalized for CAD events, discharge prescription varied by patient characteristics, in-hospital assessment, and treatment decisions. Additional efforts are needed to improve evidence-based lipid-lowering therapy prescription for eligible patients.

Key articles, guidelines, and consensus papers relative to the treatment of dyslipidemias--2005.

Hypercholesterolemia is a major risk factor for development of coronary heart disease. Proper diagnosis and adequate treatment are vital to reducing morbidity and mortality associated with elevated serum lipid levels. The amount of literature in this area is overwhelming. To aid practitioners and educators in organizing this large body of information, we compiled key articles, guidelines, and consensus papers relative to the treatment of dyslipidemias. Research articles were chosen based on the significance of findings, relevance to practice, quality of research, and timeliness; recent articles were given priority over earlier ones unless they demonstrated groundbreaking findings.