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The Pharmacist’s News Source
pharmacypracticenews.com
Volume 36 • Number 7 • July 2009
Printer-friendly versions available online
Case for genetic screen debated
Is VKORC1 Test Needed In All Warfarin Patients? Miami—Genetic testing to determine an individual patient’s sensitivity to warfarin would make dosing of the agent more efficient and reduce the risk for bleeding or clotting events. But whether such testing should become routine is still a matter for debate. At the 2009 annual conference of the Hematology/Oncology Pharmacy Association (HOPA), Rowena N. Schwartz, PharmD, director of oncology pharmacy at The Johns Hopkins Hospital, Baltimore, argued that pharmacogenomic testing for vitamin K epoxide reductase (VKORC1), the gene that codes for the enzyme that is the site of action where warfarin exerts its effect, should be done in all patients receiving warfarin. Kelly Nystrom, PharmD, assistant professor of pharmacy practice at Creighton University, Omaha, Neb., took the opposite view, telling HOPA delegates that testing for VKORC1 should not be done in all patients because it is still not known whether the
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see WARFARIN DEBATE, page 17
McMahon Publishing
in this issue Operations & Mgmt
Finance Remote camera checks chemotherapy orders, saves time and money.
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Leadership in Action Ernie Anderson Jr., MS, RPh leaves the Lahey Clinic after 15 years of service.
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Clinical
Oncology HOPA President Phil Johnson, MS, RPh, on the need to tackle drug noncompliance.
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Should all HR+ breast cancer patients be tested for CYP2D6 prior to tamoxifen therapy?
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Medication reconciliation can help reduce ESA waste, save big dollars.
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Technology
Bar Coding BCMA tweaks nearly eliminate nurse overrides, boost patient safety.
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Recruiting, Retaining Pharmacists May Hinge on Depth of Offerings Rosemont, Ill.—Flexible work schedules and a willingness to match job responsibilities to the clinical passion of employees are among the strategies that a Montana hospital has used to eliminate staff turnover in its pharmacy department. Given the 22% rate of turnover that plagued the system several years ago, “we’re extremely pleased with the results,” Dominick A. Caselnova III, BS, MHA, director of pharmacy at Benefis Health System, a 516-bed facility based in Great Falls, said during a poster session at the American Society of Health-System Pharmacists (ASHP) Summer meeting.
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see TAMING TURNOVER, page 11
EHRs
Drug Noncompliance Still Driving Health Care Costs Cancer patients pose particular challenge Miami–Oncology patients who are nonadherent with their oral chemotherapy regimens not only have worse outcomes than their adherent counterparts, they are considerably more costly to the health care system. “Nonadherence is associated with increased consumption of health care resources, more physician visits, higher hospitalization rates and longer hospital stays. Up to 69% of medication-related hospital admissions are due to poor medication adherence at a cost of around $1 billion a year,” Christy S. Harris, PharmD, said at the fifth annual conference of the Hematology/Oncology Pharmacy Association (HOPA).
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see NONCOMPLIANCE, page 16
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Electronic smoking cessation reminders help patients quit.
27 Educational Review Contemporary Management Of Clostridium difficile Infection Insert after page
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Medication Safety and Quality, Part 4: Measurement and Reporting See pages 8-9
Mississippi Clinic Wins Fight Against Resistant Hypertension Rosemont, Ill.—More than twothirds of patients with resistant hypertension achieved blood pressure (BP) control by following regimens established by pharmacists and other caregivers in a collaborative hypertension clinic, according to a study presented at the American Society of Health-System Pharmacists (ASHP) Summer Meeting. The results—showing an increase from a baseline rate of 12%—are
particularly dramatic because they occurred in Mississippi, a state beset with both the highest prevalence of hypertension and the highest rate of cardiovascular disease mortality in the nation, noted co-investigator Deborah Minor, PharmD, an associate professor of medicine at the University of Mississippi Medical Center Hypertension Clinic, in Jackson.
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see BP CONTROL, page 18
New Product Hospira, Inc. gets FDA approval for Sterile Vancomycin Hydrochloride, USP. See page
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