iForumRx.org

Identifying and addressing the social determinants of health (SDOH) influences health outcomes and can positively impact health equity in our society. While health systems in the US are screening for SDOH more often, information on how to improve screening efficiency and effectiveness is lacking. A recently published study was designed to determine what patient and clinician factors are associated with early implementation of SDOH screening in primary care. Guest Author: Sharmon P. Osae, PharmD, BCACP, CDCES Music by: Good Talk

This episode is a collaboration between the ACCP Ambulatory Care Practice and Research Network (PRN) ... and iForumRx.org. Mental illness is very common - 1 in 5 adults in the United States will have a mental illness during their lifetime. Every ambulatory care (and community) pharmacist should be confident in their ability to recognize mental health challenges and how to use medications in an optimal manner to treat them. This is a FOLLOW-UP conversation from the ACCP Annual Meeting program entitled Ambulatory Care PRN Focus Session — Breaking Down Depression and Anxiety Management for the Ambulatory Care Pharmacist. Expert Panelists: Richard Silvia, PharmD, BCPP and Jordan Baye, PharmD, BCPS Music by lemonmusicstudio from Pixabay

Reason for Visit: Referred by primary care provider to pharmacy services for education and management; diabetes not responding to oral therapy. Guest Authors: Jillian Cerullo, PharmD and Michelle Gauvin, PharmD, BCACP, BCGP, CDCES Expert Panelists: Jennifer Trujillo, PharmD, BCPS, CDCES, BC-ADM and Joshua Neumiller, PharmD, CDCES Music by Good Talk

Weight extremes, a body-mass index (BMI) either very underweight or obese, are associated with increased all-cause mortality. Mortality attributable to obesity is caused by many secondary conditions like metabolic disorders and cardiovascular (CV) disease. Enter the glucagon-like peptide-1 (GLP-1) receptor agonists—initially approved in the treatment of type 2 diabetes— which induce significant weight loss regardless of diabetes status. But can a weight loss drug decrease CV mortality? Guest Authors: Gregory Castelli, PharmD, BCPS, BC-ADM, CDCES and Drake Meaney, PharmD, BCPS Music by Good Talk

Pharmacists are the most accessible health professionals and can play a vital role in screening and managing hypertension. But would an expanded scope of practice that enabled pharmacists to prescribe and manage antihypertensive therapies be cost-effective? Guest Authors: Stefania Cian, PharmD and Candice Garwood, PharmD, FCCP, BCPS, BCACP Special Guest: Dave Dixon, PharmD, BCACP, CLS Music by Good Talk

Omeprazole ranks among the top 10 most prescribed medications in the United States, and many patients take proton pump inhibitors (PPIs) for years. Widespread PPI use persists despite data about potential serious adverse effects. Some worry that PPI use increases the risk of dementia. Are those worries supported by data? Guest Authors: Molly M. Corder, PharmD, BCPS, BCACP and Ryan S. Ades, PharmD, BCPS Music by Good Talk

Most clinical settings now use oscillometric BP devices to measure patients’ BP, and over half of people with hypertension (HTN) use a home BP monitor. Can we trust these BP readings if an inappropriate cuff size was used? How will this impact the way we assess BP control? Guest Authors: Vincent Lam, PharmD and Kathleen Pincus, PharmD, BCPS, BCACP, CDCES Music by Good Talk

Over 75% of heart failure with preserved ejection fraction (HFpEF) patients have a comorbid diagnosis of obesity. Obesity is an independent risk factor for the development of HFpEF and contributes to disease progression. Obese patients with HFpEF have greater symptom burden, reduced functional capacity, and impaired quality of life when compared to those without obesity. We know that patients often struggle to adhere to lifestyle modifications long enough to see meaningful weight loss, but the benefits of GLP-1 agonists for patients with HFpEF who are obese are not yet clear. Guest Authors: Alicia M. Nordberg-Payne, PharmD; Rebecca Munger, PharmD, BCACP; Jason Zupec, PharmD, BCACP Music by Good Talk

As people living with HIV age, the risk of cardiovascular disease becomes the greatest threat to their health and quality of life. Not only does inflammation from HIV infection contribute to atherosclerotic cardiovascular disease (ASCVD), but dyslipidemia from the antivirals commonly used to treat HIV further enhances that risk. But does statin therapy reduce ASCVD risk in patients living with HIV? That's the question that the REPRIEVE study attempted to answer. Guest Authors: Laura Lerner, PharmD and Joseph Nardolillo, PharmD, BCACP Music by Guest Talk

Respiratory syncytial virus (RSV) is a common respiratory virus that typically causes mild cold-like symptoms but can potentially cause severe illness in children and older adults. Every year, thousands of older adults and infants are hospitalized due to RSV, and 10,000 or more die. In 2023, two vaccines (Abrysvo and Arexvy) and a monoclonal antibody (Beyfortus) became available to help prevent lower respiratory tract disease (LRTD) associated with RSV.

Reason for Visit: JT was referred by his PCP to the ambulatory care pharmacist for hypertension management. Chief complaint: “My medication is making my mouth dry. I want to stop it.” Guest Authors: Sabrina Silviera, PharmD and Megan Scalia, PharmD, BCACP Expert Panelists: Eric MacLaughlin, PharmD, BCPS and Joseph Saseen, PharmD, BCPS, BCACP, CLS Music by Good Talk

Can supplements marketed for cardiovascular health be used in place of statin therapy? Health professionals have long been wary of nutraceuticals and dietary supplements due to the lack of safety and efficacy regulations. The SPORT trial attempts to provide robust data, to practitioners and patients, on how common supplements perform compared to statin therapy. Guest Authors: Kaitlyn Phillips, PharmD, Lindsey Pitt, PharmD, and Anna Love, PharmD, BCACP Music by Good Talk

Do pharmacists providing remote care using telehealth technologies to patients who self-monitor their blood pressure perform as well as physicians and care managers providing care face-to-face? Is BP control better (or worse)? What about patient satisfaction? The Hyperlink 3 study provides more evidence the telehealth is safe and effective ... and patients prefer it. Guest Authors: Elizabeth Yett, PharmD, BCACP, TTS, and Jessica Wooster, PharmD, BCACP Music by Good Talk

Less than 1 in 4 patients with hypertension in the United States have achieved their blood pressure (BP) goal, according to the CDC. Many clinicians only think of changing medications if a patient is having an intolerance to the current regimen. However, individual patients might respond differently to each of the four major anti-hypertensive medication classes and, if we could determine in advance which class(es) would lower the blood pressure the most, we could minimize the number of medications eventually needed to attain control. Guest Author: Anthony Ishak, PharmD, BCPS Music by Good Talk

Approximately 1 in 6 adults in the United States report some trouble with their hearing. Despite the prevalence and implications of hearing loss, hearing aid use is strikingly low due to cost and accessibility. In late 2022, the FDA finalized regulations for over-the-counter hearing aids to be sold without medical evaluation or the services of a hearing professional. But will self-fitting OTC hearing aids be as effective as audiologist-fitted prescription hearing aids? Guest Authors: Lucas A. Berenbrock, PharmD, MS, BCACP and Elaine Mormer, PhD, CCC-A Music by Good Talk

More than 46 million people in the US met diagnostic criteria for a substance use disorder (SUD) in 2021. These numbers are staggering and suggest that SUD is more common than diabetes in the United States. However, only 6% received treatment. Expanding the care delivery model is essential to improving treatment access and enhancing physical, mental, and social/societal outcomes. Pharmacists can play a key role. Guest Authors: Melissa C. Palmer, PharmD, BCPS, BCPP and Amanda Stahnke, PharmD, BCACP Music by Good Talk

Did you know that iForumRx has resource pages related to a wide range of therapeutic areas, patient populations, and practice management issues? Each resource page provides a succinct annotated list of key clinical trials, clinical practice guidelines, and websites. A content expert manages each resource page, and the materials are regularly updated to reflect the latest evidence and guidance. Our newest resource page — Gender Affirming Care — was released in August 2023. Guest Authors: Alex Mills, PharmD, BCACP, AAHIVP and Jordan Rowe, PharmD, BCACP, BC-ADM Music by Good Talk

Thiazide diuretics are a first-line treatment for patients with high blood pressure (BP), either as monotherapy or, more often, in combination with other first-line agents, but which one should clinicians use? Chlorthalidone was used in several landmark clinical trials and has a favorable pharmacokinetic profile. But hydrochlorothiazide is the most commonly used (and cheapest) thiazide. Guest Authors: Brian T Terrell, PharmD, BCACP and Eric J MacLaughlin, PharmD, BCPS Music by Good Talk

This episode is a collaboration between the ACCP Ambulatory Care Practice and Research Network (PRN) ... and iForumRx.org. The treatment of dyslipidemia has gotten a lot more complex in recent years as we now have several non-statins that can substantially lower LDL cholesterol and reduce cardiovascular event rates - including PCSK9 monoclonal antibodies, ezetimibe, bempedoic acid, and inclisiran. When and how should we be using these agents? Panelists: David Dixon, PharmD, BCACP, CDCES, CLS; Kathryn Litten, PharmD, BCACP; and Tomasz Jurga, PharmD, BCPS, BCACP, BCCP, CDCES Produced by Jonathan Hughes, PharmD, BCPS, BCACP and Anna Love, PharmD, BCACP Music by lemonmusicstudio from Pixabay

There has been a long-standing debate about the optimal approach to statin use, including whether we should initiate therapy using a “fixed-dose”, high-potency statin, or whether we should “start low and go slow” by titrating the dose to a specific LDL-C target. The LODESTAR study was designed to determine if treating LDL-C to a target level produces similar cardiovascular outcomes when compared to a fixed-dose approach. Guest Authors: Dawn Fuke, PharmD, BCPS and Catherine Behret, PharmD, BCACP Music by Good Talk