Evaluation of a Fourth-Year Student Pharmacist Research Process at a Community Teaching Health System.

Objective. To evaluate a process developed to support research by fourth-year student pharmacists enrolled in an advanced pharmacy practice experience at a health system affiliated with a school of pharmacy.Methods. In 2017, clinical, non-tenure track faculty transitioned from facilitating a fourth-year research elective to implementing a new student research process that matches students to research preceptors at the beginning of the academic year and provides training and resources to them throughout the year. This pre-post study evaluated student pharmacist research participation, dissemination, and placement into a residency or job position at the time of graduation, and then compared data for the three years before the new process was implemented to data for the three years after implementation.Results. Thirty-three fourth-year students assigned to the health system graduated from 2015 to 2017, and 31 graduated from 2018 to 2020. The percentage of students in each cohort who completed research projects increased significantly (48.5% vs 87.1%), the number of projects increased significantly (18 vs 35), the number of presentations increased significantly (29 vs 63), and the number of publications increased significantly (9 vs 20). The percentage of research students who pursued postgraduate training increased (68.8% vs 96.3%), as did their rate of placement into training programs (81.8% vs 92.3%). Of those students who did not participate in research, the percent who pursued training also increased (17.6% vs 75%), but the rate of placement remained the same (66.7%).Conclusion. Matching fourth-year student pharmacists to research preceptors at the beginning of the academic year and providing them with training and resources throughout the year was associated with increased research productivity.

A review of indications and comorbidities in which warfarin may be the preferred oral anticoagulant.

WHAT IS KNOWN AND OBJECTIVE: Direct oral anticoagulants (DOACs) are increasingly prescribed instead of warfarin for chronic anticoagulation for ease of dosing, fewer interactions, and less stringent monitoring. However, it is important to consider indications and comorbidities for which warfarin is still the preferred anticoagulant. This review aims to capture these clinical scenarios in which warfarin may still be preferred over DOACs. METHODS: We undertook a comprehensive literature search using the PubMed database. Key search terms were based on DOAC clinical trial exclusion criteria, as well as indications and conditions in which the use of DOACs for anticoagulation has suggested harm. Society guidelines and tertiary literature were used to inform expert opinion where necessary. Studies were included if they investigated the use of DOACs or warfarin in the identified indications or conditions. RESULTS AND DISCUSSION: Currently, evidence for the use of warfarin over DOACs for anticoagulation is strongest for patients with prosthetic valves, antiphospholipid syndrome, or a high risk of gastrointestinal bleeding. For several clinical situations, including mitral stenosis, obesity, altered gastrointestinal anatomy, pulmonary arterial hypertension, renal or hepatic impairment, and left ventricular thrombus, evidence is lacking but may eventually support the use of DOACs. Depending on indication and condition, appropriateness of DOAC use may vary by agent. WHAT IS NEW AND CONCLUSION: New evidence continues to support new indications and conditions in which DOACs may be appropriate to use for anticoagulation. There are key clinical scenarios, however, in which emerging literature continues to support warfarin as the preferred anticoagulant.

Piecing the puzzle together: Docetaxel cycles and current considerations in the treatment of metastatic castration-resistant prostate cancer.

Docetaxel is the current first line therapy for metastatic castration-resistant prostate cancer (mCRPC), but there is no standard number of docetaxel cycles given to patients. In their post hoc analysis of the Mainsail study, de Morrée et al. show that the number of docetaxel cycles administered to a patient is a significant factor contributing to overall survival. These findings warrant further investigation into the standardization of the number of docetaxel cycles administered.