Roadblocks and successes in preparing COVID-19 vaccination clinics: Perspectives from pharmacy residents.

PURPOSE: To outline logistics challenges, barriers, and successes in the development of separate programs for mass COVID-19 vaccine distribution and administration to healthcare employees and community members. SUMMARY: In the face of the global coronavirus disease 2019 (COVID-19) pandemic, COVID-19 vaccine development and distribution became a worldwide priority. AdventHealth Orlando was selected as the central hub for vaccination efforts for central Florida. There was a need to quickly evaluate literature, patient safety, and institutional resources and logistics to coordinate the development of employee and community vaccination clinics. These efforts were driven by postgraduate year 2 residents in health-system pharmacy administration and leadership, medication-use safety and policy, and informatics. Clinic development focused on 4 key areas: vaccine quality control, secure inventory movement, safe preparation and administration, and consolidation of inventory. Healthcare worker vaccinations were administered on the health system's main campus, and community vaccination events were carried out at temporary clinic facilities set up in the parking lot of Orlando International Airport. CONCLUSION: In a mass COVID-19 vaccination initiative directed by the pharmacy enterprise leadership of a large Florida health system, postgraduate year 2 pharmacy residents played a key role in developing and implementing vaccination clinics targeting healthcare worker and community populations. During multiple vaccination events, a total of more than 50,000 COVID-19 vaccine doses were administered, with minimal to no vaccine wastage.

Pharmacogenomics and Opioid Use Disorder: Clinical Decision Support in an African American Cohort.

Opioid use disorder (OUD) constitutes a significant public health burden as opioid overdose deaths have continued to rise in the United States. Although treatment modalities are available to manage OUD, some patients experience challenges achieving their OUD management goals. Some of these challenges may be attributable to inherited genetic variations, or polymorphisms, on the genes that code for proteins impacting the pharmacokinetics or pharmacodynamics of medications used in OUD management. Clinical pharmacogenomics testing can elucidate these polymorphisms; however, a lack of real-world evidence for the use of pharmacogenomics in OUD management complicates the implementation process. We conducted a retrospective cohort study of 113 patients undergoing buprenorphine-based OUD management in Northeast Washington D.C. to determine if clinical pharmacogenomics testing for CYP3A4 and CYP3A5 would impact treatment outcomes. Data were collected from the electronic medical record (EMR) from December 30, 2015 to December 31, 2016. Study outcomes were based on presence of withdrawal symptoms, instances of unauthorized substances in urine drug tests (UDTs), and sublingual buprenorphine/naloxone (SBN) dose with standard-of-care (SOC) dosing versus pharmacogenomics (PGx)-based dosing. Pearson correlation tests, Wilcoxon signed rank tests, Wilcoxon rank sum tests, and one-way ANOVA tests were used. Linear and logistic regression analyses were used to assess predictors of withdrawal symptomatology. Kaplan-Meier survival analyses were used to assess time to first withdrawal. Our research suggests that patients with at least one copy of the CYP3A4*1B allele exhibit an accelerated rate of metabolism compared to the wild-type allele CYP3A4*1.