Curricular integration of the pharmacists' patient care process.

INTRODUCTION: The Accreditation Council for Pharmacy Education Standard 10 specifies the need to prepare students to provide patient-centered collaborative care. The aim of this study is to assess the impact of a newly introduced Pharmacists' Patient Care Process (PPCP) based laboratory course on students' perception of their preparedness to apply PPCP steps in introductory pharmacy practice experiences (IPPEs). METHODS: The PPCP was introduced into the Pharmaceutical Care and Dispensing Laboratory course during the second professional year. Students' self-perception of preparedness to apply the PPCP was assessed via a survey composed of questions related to PPCP skillsets. The pre-PPCP laboratory cohort (control group) took the survey after the completion of their IPPEs. The PPCP laboratory cohort (intervention group) took the same survey prior to taking the course, at the end of the course, and following the completion of their IPPEs. Pearson's and McNemar chi-square tests were used for statistical analyses. RESULTS: The findings indicate that the PPCP-based laboratory significantly improved students' perception of their preparedness to apply a standardized pharmacist care process to verify prescriptions, to collect relevant patient information, and to develop an individual patient-centered care plan. This significant impact of the PPCP-based laboratory course on students' perception was maintained through the following year when assessed after IPPEs. CONCLUSIONS: Introduction of the PPCP model within a dispensing laboratory course, prior to students' IPPEs, develops students' perception of preparedness. Incorporating the PPCP via active learning and simulation narrows the gap between the didactic and experiential curriculum.

Potentially inappropriate medications use in community-based aged patients: a cross-sectional study using 2012 Beers criteria.

BACKGROUND: Potentially inappropriate medications (PIMs) should be avoided by the aged population. The aim of this study was to assess the prevalence of PIMs among Lebanese aged outpatients using Beers criteria of 2012. The secondary objectives were to identify the correlates of the PIMs use and to compare the PIMs prevalence rates as per Beers criteria of 2003 and 2012. METHODS: This cross-sectional observational study was conducted among aged outpatients of different accredited community pharmacies across Lebanon. Data were collected through a validated questionnaire. The Beers criteria of 2012 were used to evaluate PIMs. The association between PIMs used and independent variables were analyzed by logistic regression. The differences between PIMs use according to Beers criteria 2003 and 2012 were calculated using chi-squared and McNemar's tests. RESULTS: A total of 248 outpatients were analyzed. We identified 112 (45.2%) out of 248 patients taking PIMs. The leading classes of medications identified to cause PIMs were those acting on the central nervous system (71.4%). The factors associated with PIMs use were age, osteoporosis, Alzheimer/dementia, diabetes, and alcohol consumption. PIMs use increased significantly between Beers criteria 2003 and 2012 (Chi-squared test, P<0.001; McNemar's test, P<0.001). CONCLUSION: Our study showed a high prevalence of PIMs use in Lebanon, which is associated with various correlates. Education of health care providers and medication review should be considered to improve medication safety of older adults.

Idarucizumab, a Humanized, Monoclonal Antibody Fragment for Immediate Reversal of Dabigatran.

OBJECTIVE: To evaluate the role of idarucizumab, a humanized monoclonal antibody fragment, as a specific reversal agent for the anticoagulant activity of dabigatran and to review the pharmacology, pharmacokinetic properties, efficacy, and safety of this agent. METHODS: A literature search was conducted consisting of a PubMed database using the MeSH term idarucizumab and the key word dabigatran antidote. Studies evaluating the pharmacology, pharmacokinetics, safety, and efficacy of idarucizumab for the reversal of the anticoagulant activity of dabigatran were included. RESULTS: Idarucizumab represents a novel treatment option as it is the only humanized, monoclonal antibody fragment that specifically binds to dabigatran. Studies evaluating reversal of dabigatran-induced anticoagulation have demonstrated immediate, complete, and sustained effects with idarucizumab. Idarucizumab did not overcorrect thrombin generation. Additionally, evaluations have shown that dabigatran can be safely reinitiated 24 hours after the administration of idarucizumab. The United States Food and Drug Administration granted priority review for the biologic license application and accelerated approval for idarucizumab. CONCLUSION: Idarucizumab represents an encouraging development in the reversal of dabigatran. Its novel mechanism of action, pharmacokinetics, tolerability, and lack of thrombotic events contribute positively to its use in patients who experience bleeding or for those who require emergent surgery or procedures.