Results and lessons learned from a virtual multi-institutional problem-based interprofessional learning approach: The VIPE program.

The importance of interprofessional collaborative practice has come into focus over the past decade as coordination and delivery of health care becomes increasingly complex. The need for students to acquire collaboration-building skills to prepare them to work effectively within diverse healthcare teams to improve patient outcomes is a goal of interprofessional education (IPE). Accrediting bodies across healthcare professions require IPE as part of a robust curriculum to build collaborative skill sets and create a practice ready workforce. To respond to this need, an online healthcare program developed an innovative model for student collaboration across professions and institutions through a virtual interprofessional education (VIPE) program. The VIPE model aims to simulate clinical practice via an asynchronous and synchronous pedagogical approach that combines PBL/CBL with psychological safety. VIPE demonstrated statistically significant gains in knowledge and positive attitudes toward interprofessional collaborative practice as a result of participation in the VIPE program. During COVID-19, the demand for high quality IPE for health professions' students in virtual settings has grown, VIPE has the potential to be a solution for this. VIPE requires a dedicated committee and technical lead. Further research could involve longitudinal studies and nonaggregate models.

Herpes zoster subunit vaccine for the prevention of herpes zoster.

PURPOSE: Published literature on the efficacy and safety of the herpes zoster (HZ) subunit vaccine (HZ/su vaccine) in reducing the risks of HZ and postherpetic neuralgia (PHN) in adults 50 years of age and older, as well as the vaccine's properties and efficacy relative to live attenuated vaccine, is reviewed. SUMMARY: HZ/su vaccine (Shingrix, GlaxoSmithKline) is a recently Food and Drug Administration (FDA)-approved vaccine indicated for the prevention of HZ in adults 50 years of age and older. Based on several Phase III trials, the Advisory Committee on Immunization Practices has preferentially recommended HZ/su vaccine over a live attenuated vaccine previously approved by FDA. Reported overall HZ/su vaccine efficacy in preventing HZ in Phase III trials ranged from 89.8% to 97.2%. Compared with placebo use, HZ/su vaccine in those trials was associated with higher rates of transient local and systemic adverse events (AEs) but similar rates of serious vaccine-related AEs. Other clinical trials of HZ/su vaccine have yielded favorable results in various populations, including adults with a history of HZ, older adults who previously received live attenuated zoster vaccine, adults with human immunodeficiency virus infection, and stem cell transplant recipients. CONCLUSION: HZ/su vaccine is a recently approved, preferred option to reduce the risks of HZ and PHN in adults 50 years of age or older. Pain at the injection site is the most common AE associated with use of the vaccine.

Patiromer: a clinical review.

IMPORTANCE: Patiromer FOS (for oral suspension), formerly known as RLY5016, is pending FDA approval for the treatment of hyperkalemia. Once approved, patiromer, as well as a second agent known as sodium zirconium cyclosilicate (ZS-9), will be among the new therapeutic options available to treat hyperkalemia in over 50 years. OBJECTIVE: The primary objective of this review is to analyze the efficacy and safety of patiromer to treat hyperkalemia and compare its pharmacokinetics to currently available sodium polystyrene sulfonate (SPS) therapy. Patiromer was studied in patients with chronic kidney disease and/or heart failure for both acute and chronic therapy. EVIDENCE REVIEW: Studies of patiromer were obtained via a literature search of PubMed database and Google Scholar (2000 to the present) using 'patiromer', 'RLY5016', and 'hyperkalemia management' as keywords. Additional references were identified from fda.gov, clinicaltrials.gov, and the pharmaceutical manufacturer, Relypsa Inc. FINDINGS: Three published clinical trials, ten posters, one clinical trial commentary, three editorials and one oral presentation were obtained. The materials discussed three main clinical trials (PEARL-HF, OPAL-HK and AMETHYST-DN) and examined the safety and efficacy of patiromer in patients with hyperkalemia or at risk for hyperkalemia who have chronic kidney disease (CKD), type 2 diabetes mellitus (T2DM), hypertension and/or heart failure (HF) while receiving renin-angiotensin-aldosterone system inhibitors (RAASis). All three studies achieved their primary endpoints and reduced serum potassium. The PEARL-HF study increased the proportion of patients able to titrate their spironolactone dose from 25 mg/day to 50 mg/day in patients with normokalemia who had a history of hyperkalemia or an estimated glomerular filtration rate of <60 mL/min. The OPAL-HK study allowed patients receiving patiromer to remain on their RAASi therapy. The AMETHYST-DN study demonstrated that patiromer reduced and maintained mean serum potassium ≤5.0 mEq/L for up to 1 year, with a low rate of hypokalemia. Adverse events (AEs) were similar between studies. The most commonly reported adverse event was constipation. CONCLUSIONS AND RELEVANCE: Patiromer is effective in decreasing serum potassium, preventing recurrence of hyperkalemia, and reducing RAASi discontinuation. Compared to current SPS therapy, patiromer may be the preferred option to treat hyperkalemia, once approved. Patiromer is well tolerated and is not associated with serious AEs.