Factors influencing professional state association membership decisions among recent pharmacy graduates.

INTRODUCTION: State pharmacy association membership levels have remained stagnant in recent years despite active student organization involvement among student pharmacists and an increased number of pharmacy schools producing new pharmacy graduates in the United States. The objective of this project was to examine factors considered by recent pharmacy graduates when deciding to join state pharmacy associations. METHODS: A 16-item cross sectional survey of recent pharmacy graduates collected respondents' demographic profile, professional student organization involvement, association memberships, and membership decision factors. RESULTS: The most influential factors in membership decisions included continuing education (62.8%), opportunity to advance pharmacy practice (51.1%), email updates (39.4%), and networking opportunities (37.2%). State pharmacy association meeting attendance (p = 0.004 and p = 0.028 for the Kentucky Society of Health-System Pharmacists and the Kentucky Pharmacists Association respectively), student organization membership (p = 0.038), committee service (p = 0.025), and state association board participation (p = 0.021) during pharmacy education increases the likelihood of membership in state associations. CONCLUSIONS: Early engagement in state pharmacy associations during pharmacy school improves the likelihood of new practitioner membership. Pharmacy schools should engage with state association leaders to promote student committee participation, association board participation, and attendance at state meetings to ensure the continued success of state pharmacy associations.

Pharmacokinetics of vancomycin in extremely obese patients with suspected or confirmed Staphylococcus aureus infections.

STUDY OBJECTIVE: To estimate vancomycin pharmacokinetic parameters and dosing requirements in a cohort of extremely obese patients. DESIGN: Prospective pharmacokinetic study. SETTING: Acute care community teaching hospital. PATIENTS: Thirty-one extremely obese (body mass index [BMI] ≥ 40 kg/m(2) ) men and women who were receiving vancomycin for at least 3 days for suspected or confirmed Staphylococcus aureus infections. MEASUREMENTS AND MAIN RESULTS: Population pharmacokinetic parameters were used to determine vancomycin doses that target trough concentrations of 10-20 µg/ml. Three serum vancomycin concentrations (peak, trough, and midpoint) were measured at steady state for each patient. A 24-hour urine collection was performed to determine creatinine clearance (Clcr ). A one-compartment intravenous infusion model was fit to the serum vancomycin concentrations by using nonlinear mixed-effects modeling. Covariates that affect the volume of distribution and clearance of vancomycin were explored. Patients had a median weight of 147.9 kg, BMI of 49.5 kg/m(2) , and a Cockcroft-Gault Clcr of 124.8 ml/minute/1.73 m(2) . Patients received a median vancomycin dose of 4000 mg/day that provided a median 24-hour area under the concentration-time curve (AUC) of 582.9 (interquartile range 513.8-726.2) mg·hour/L. The population mean volume of distribution was 0.51 L/kg, and clearance was 6.54 L/hour. Simulations indicated that 4000-5000 mg/day of vancomycin provided ≥ 93% probability 24-hour AUC/minimum inhibitory concentration (MIC) ratio of ≥ 400 for an MIC of 1 µg/ml. CONCLUSION: Total body weight and Clcr influenced volume of distribution and vancomycin clearance, respectively. Vancomycin can be initiated in extremely obese patients at dosages determined based on renal function and pharmacokinetic parameter estimates from this study. Vancomycin serum concentrations should be monitored to ascertain attainment within the therapeutic range.

Evaluation of a Pharmacist-Managed Heart Failure Education Project: Empowering Patients to Self-Manage Their Disease.

Background: Recent reimbursement cuts for hospitals with higher 30-day heart failure (HF)-related readmission rates call for means of reducing those readmissions. Objective: To determine if pharmacist-initiated education increases HF knowledge and assess if an increase in HF knowledge decreases HF readmission. Methods: This was a prospective interventional study. Participants were ≥18 years old admitted through the emergency department of a 322-bed community hospital with a diagnosis and/or past medical history of HF. Terminal/palliative care patients, patients residing in an assisted-living environment, or patients with a mental illness that deemed them incapable of participating were excluded. Forty-eight patients received pharmacist-initiated HF education on HF pathophysiology and its pharmacologic and nonpharmacologic treatment. Medication assistance and ancillary services were consulted when necessary. Patients' knowledge of HF was assessed using the same questionnaire prior to education and through a follow-up phone call within 7 days postdischarge. Results: Posteducation HF knowledge scores were 13.7 points higher than preeducation scores (P < .05). Twenty-five patients (52%) had HF as a primary discharge diagnosis. Of those patients, 9 (36%) were readmitted within 30 days for any cause. Only 3 patients (12%) had a HF-related diagnosis at readmission. There was a statistical difference in the level of knowledge but that was not translated into a statistical difference in readmission rates. Conclusion: Patients' HF knowledge scores increased after pharmacist education. Improvements in HF knowledge could not be correlated with readmission rates. However, the majority of HF patients in this study did not have a HF-related diagnosis at the time of readmission.