The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines were recently updated with a focus on kidney health in patients with diabetes.  The updated guidelines include recommendations on screening, prevention, and treatment of chronic kidney disease (CKD), including the use of SGLT2 inhibitors, finerenone, and ACE inhibitors or ARBs.  The written commentary posted on the iForumRx website provides a succinct summary of the Top Ten Things Every Clinician Should Know. Guest Authors:  Kara Olstad, PharmD; Gurminder Sanghera, BSc, PharmD; and Darren Grabe, PharmD Music by Good Talk

The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines were recently updated with a focus on kidney health in patients with diabetes.  The updated guidelines include recommendations on screening, prevention, and treatment of chronic kidney disease (CKD), including the use of SGLT2 inhibitors, finerenone, and ACE inhibitors or ARBs.  The written commentary posted on the <a href="http://iforumrx.org/" rel="nofollow" target="_blank">iForumRx website</a> provides a succinct summary of the <a href="http://iforumrx.org/marker/top-ten/" rel="nofollow" target="_blank">Top Ten Things Every Clinician Should Know</a>. Guest Authors:  Kara Olstad, PharmD; Gurminder Sanghera, BSc, PharmD; and Darren Grabe, PharmD Music by Good Talk

Top Ten Things Every Clinician Should Know About the KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease

If we’ve learned anything from the COVID-19 pandemic, it’s that delivering healthcare to patients at a distance is possible. Telehealth can help increase access to care for patients in medically underserved communities and for those who have transportation, cost, and time barriers.  But one question has not been adequately answered—is telehealth an effective method to deliver primary care?    Guest Authors:  Keaton Thomas, PharmD and Haley M. Klassing, PharmD,  Music by Good Talk

If we’ve learned anything from the COVID-19 pandemic, it’s that delivering healthcare to patients at a distance is possible. Telehealth can help increase access to care for patients in medically underserved communities and for those who have transportation, cost, and time barriers.  But one question has not been adequately answered—is telehealth an effective method to deliver primary care?    Guest Authors:  Keaton Thomas, PharmD and Haley M. Klassing, PharmD,  Music by Good Talk

Is In-Personal Care Better than Care Delivered at a Distance?

Several studies have shown the benefits of involving pharmacists in the primary care setting.  And there are some recommendations regarding an appropriate physician-patient panel size per pharmacist.  But what's the ideal ambulatory care pharmacist-patient panel size? Guest Authors: Benjamin King, PharmD, BCACP, Jubilee Winar, PharmD, and Jasmin Ortiz, PharmD Music by Good Talk

Several studies have shown the benefits of involving pharmacists in the primary care setting.  And there are some recommendations regarding an appropriate physician-patient panel size per pharmacist.  But what's the ideal ambulatory care pharmacist-patient panel size? Guest Authors: Benjamin King, PharmD, BCACP, Jubilee Winar, PharmD, and Jasmin Ortiz, PharmD Music by Good Talk

How Many Patients Can a Pharmacist Reasonably Manage? Estimating An Appropriate Panel Size

There are a variety of non-statin lipid-lowering medications with proven cardiovascular benefits; however, most of the evidence supporting their use has been as an adjunct with a statin. Bempedoic acid offers a novel mechanism of action to treat hypercholesterolemia. But is there a CLEAR role for bempedoic acid in the treatment and prevention of ASCVD in statin-intolerant patients? Guest Authors: Sarah B. Edwards, PharmD and Briana Williams, PharmD, BCPS, BCACP Special Guest: Joseph Saseen, PharmD, BCPS, BCACP Music by Good Talk

There are a variety of non-statin lipid-lowering medications with proven cardiovascular benefits; however, most of the evidence supporting their use has been as an adjunct with a statin. Bempedoic acid offers a novel mechanism of action to treat hypercholesterolemia. But is there a CLEAR role for bempedoic acid in the treatment and prevention of ASCVD in statin-intolerant patients? Guest Authors: Sarah B. Edwards, PharmD and Briana Williams, PharmD, BCPS, BCACP Special Guest: Joseph Saseen, PharmD, BCPS, BCACP Music by Good Talk

Is There a CLEAR Role for Bempedoic Acid in Cardiovascular Risk Reduction?

One in five people in the U.S. report suffering from anxiety in the past year, and one in three will experience an anxiety disorder in their lifetime, but 40% of patients go untreated. Perhaps patients are disinterested (or distrust) in traditional pharmacotherapy ... or perhaps it is due to a lack of availability of services (like cognitive behavioral therapy – CBT). Many patients (and clinicians) are interested in exploring and using alternative treatment approaches, but are they effective? Guest Authors:  Cindy King, PharmD, BCACP and Chris Paxos, PharmD, BCPP, BCPS, BCGP Music by Good Talk *MBSR = Mindfulness-base Stress Reduction

One in five people in the U.S. report suffering from anxiety in the past year, and one in three will experience an anxiety disorder in their lifetime, but 40% of patients go untreated. Perhaps patients are disinterested (or distrust) in traditional pharmacotherapy ... or perhaps it is due to a lack of availability of services (like cognitive behavioral therapy – CBT). Many patients (and clinicians) are interested in exploring and using alternative treatment approaches, but are they effective? Guest Authors:  Cindy King, PharmD, BCACP and Chris Paxos, PharmD, BCPP, BCPS, BCGP Music by Good Talk *MBSR = Mindfulness-base Stress Reduction

Is MBSR* as Good as Meds for Anxiety Disorders?

The cost of diabetes in the United States has nearly doubled over the past decade in part due to rising prices and the cost of newer medications used to manage the disease.  With new, improved, but costly alternatives available, it’s going to be challenging for ambulatory care practitioners to evaluate if the potential benefits of using these newer medication classes as first-line therapy (instead of metformin) outweigh their big price tag. Guest Authors:  Amanda Smith, PharmD and Nicole Slater, PharmD, BCACP Music by Good Talk

The cost of diabetes in the United States has nearly doubled over the past decade in part due to rising prices and the cost of newer medications used to manage the disease.  With new, improved, but costly alternatives available, it’s going to be challenging for ambulatory care practitioners to evaluate if the potential benefits of using these newer medication classes as first-line therapy (instead of metformin) outweigh their big price tag. Guest Authors:  Amanda Smith, PharmD and Nicole Slater, PharmD, BCACP Music by Good Talk

GLP-1 Receptor Agonists and SGLT2 Inhibitors:  Don’t Sugarcoat the Costs!

Several medication classes can be used to treat diabetic peripheral neuropathic pain (DPNP); however, many patients have a suboptimal response or experience dose-limiting side effects. Treatment guidelines suggest several first-line options but, in the absence of compelling evidence, offer no direction as to which agent to try first or if we should consider combination therapy. Guest Authors: Shilpa Klocke, PharmD, BCPS and Nicole Hahn, PharmD, BCACP Music by Good Talk

Several medication classes can be used to treat diabetic peripheral neuropathic pain (DPNP); however, many patients have a suboptimal response or experience dose-limiting side effects. Treatment guidelines suggest several first-line options but, in the absence of compelling evidence, offer no direction as to which agent to try first or if we should consider combination therapy. Guest Authors: Shilpa Klocke, PharmD, BCPS and Nicole Hahn, PharmD, BCACP Music by Good Talk

Is Combination Therapy Superior to Monotherapy for Painful Diabetic Peripheral Neuropathy?

You’ve probably encountered many patients who have experienced muscle symptoms after starting a statin.  Statin-associated muscle symptoms (SAMS) contribute to treatment discontinuation and significantly increase cardiovascular (CV) adverse events and mortality. What strategies do you recommend to increase statin tolerance?  Guest Author:  Rick Hess, PharmD, CDCES, BCACP Music by Good Talk

You’ve probably encountered many patients who have experienced muscle symptoms after starting a statin.  Statin-associated muscle symptoms (SAMS) contribute to treatment discontinuation and significantly increase cardiovascular (CV) adverse events and mortality. What strategies do you recommend to increase statin tolerance?  Guest Author:  Rick Hess, PharmD, CDCES, BCACP Music by Good Talk

How VITAL is Vitamin D in Preventing Statin Associated Muscle Symptoms (SAMS)?

This episode is a collaboration between the ACCP Ambulatory Care Practice and Research Network (PRN) ... and iForumRx.org. Measuring blood pressure (BP) and managing hypertension are among the essential roles that pharmacists play in ambulatory care and community-based practice environments.  This program is a question-and-answer session as a follow-up to the Ambulatory Care PRN program at the 2022 ACCP Global Conference on Clinical Pharmacy.  The panelists answer YOUR questions about the role of manual vs. automated BP readings, using self-monitored BP readings to make clinical decisions, 24-hour ambulatory care BP monitoring, and bedtime administration of antihypertensive agents. Guests:  Andrew Hwang, PharmD, BCPS; Dr. Anthony Ishak, PharmD, BCPS, and Dr. Lalita Prasad-Reddy, PharmD, BCPS, BCACP Produced by Jonathan Hughes, PharmD, BCPS, BCACP and Anna Love, PharmD, BCACP Music by lemonmusicstudio from Pixabay

This episode is a collaboration between the ACCP Ambulatory Care Practice and Research Network (PRN) ... and <a href="http://iForumRx.org" rel="nofollow" target="_blank">iForumRx.org</a>. Measuring blood pressure (BP) and managing hypertension are among the essential roles that pharmacists play in ambulatory care and community-based practice environments.  This program is a question-and-answer session as a follow-up to the Ambulatory Care PRN program at the 2022 ACCP Global Conference on Clinical Pharmacy.  The panelists answer YOUR questions about the role of manual vs. automated BP readings, using self-monitored BP readings to make clinical decisions, 24-hour ambulatory care BP monitoring, and bedtime administration of antihypertensive agents. Guests:  Andrew Hwang, PharmD, BCPS; Dr. Anthony Ishak, PharmD, BCPS, and Dr. Lalita Prasad-Reddy, PharmD, BCPS, BCACP Produced by Jonathan Hughes, PharmD, BCPS, BCACP and Anna Love, PharmD, BCACP Music by lemonmusicstudio from Pixabay

Under Pressure: Measuring and Managing Hypertension

Patient for pharmacists' patient care services remains a challenge.  While provider status at the federal level has not yet been realized, there has been a steady growth of payers and programs covering services provided by pharmacists in recent years. Guest Author: E. Michael Murphy, PharmD, MBA Music by Good Talk

Patient for pharmacists' patient care services remains a challenge.  While provider status at the federal level has not yet been realized, there has been a steady growth of payers and programs covering services provided by pharmacists in recent years. Guest Author: E. Michael Murphy, PharmD, MBA Music by Good Talk

Top Ten Things Every Clinician Should Know About Payment for Pharmacists’ Patient Care Services

We explore the evidence that informs ambulatory care pharmacy practice. Check out our website &amp; podcasts, &amp; consider submitting a commentary!

Reason for Visit: The patient is here today for hypotension and diabetes follow-up. The primary care physician has consulted the clinical pharmacist regarding hypotension. Chief Complaint: “I feel dizzy when I stand up and feel like my heart is racing. I have never passed out, but it feels like I might, and I usually have to sit back down." Guest Authors:  Kellie Ball, PharmD and Johnathon Proctor, PharmD Expert Panelists:  Morgan Weaver Godfrey, PharmD, BCPS and Richard J. Silvia, PharmD, BCPP

Reason for Visit: The patient is here today for hypotension and diabetes follow-up. The primary care physician has consulted the clinical pharmacist regarding hypotension. Chief Complaint: “I feel dizzy when I stand up and feel like my heart is racing. I have never passed out, but it feels like I might, and I usually have to sit back down." Guest Authors:  Kellie Ball, PharmD and Johnathon Proctor, PharmD Expert Panelists:  Morgan Weaver Godfrey, PharmD, BCPS and Richard J. Silvia, PharmD, BCPP

Complex Patient Case 2 - Managing Adverse Effects

Currently, there are no known safe, effective, and inexpensive ways that can prevent or reduce the risk of developing autoimmune diseases. Any strategy that could reduce the chances of developing an autoimmune disorder would be welcomed by practitioners and patients alike.  Perhaps vitamin D and omega 3 fatty acid supplementation can get the job done. Guest Authors: Rileigh Provenza, PharmD and Nicole Slater, PharmD, BCACP Music by Good Talk

Currently, there are no known safe, effective, and inexpensive ways that can prevent or reduce the risk of developing autoimmune diseases. Any strategy that could reduce the chances of developing an autoimmune disorder would be welcomed by practitioners and patients alike.  Perhaps vitamin D and omega 3 fatty acid supplementation can get the job done. Guest Authors: Rileigh Provenza, PharmD and Nicole Slater, PharmD, BCACP Music by Good Talk

Preventing Autoimmune Disease: Can Supplements Get the Job Done?

Obesity is a chronic, progressive, multi-factorial, neurobehavioral disease characterized by excessive adipose tissue.  Here are some things every clinician should know about treating overweight and obesity but be sure to read the written commentary posted on iForumRx.org Guest Authors:  Jennifer N. Clements, PharmD, BCPS, BCACP, CDCES, BC-ADM and Seena L. Haines, PharmD., BCACP, NBC-HWC, CHWC Music by Good Talk

Obesity is a chronic, progressive, multi-factorial, neurobehavioral disease characterized by excessive adipose tissue.  Here are some things every clinician should know about treating overweight and obesity but be sure to read the <a href="https://iforumrx.org/top-ten-obesity/" rel="nofollow" target="_blank">written commentary</a> posted on <a href="http://iForumRx.org" rel="nofollow" target="_blank">iForumRx.org</a> Guest Authors:  Jennifer N. Clements, PharmD, BCPS, BCACP, CDCES, BC-ADM and Seena L. Haines, PharmD., BCACP, NBC-HWC, CHWC Music by Good Talk

Top Ten Things Every Clinician Should Know About Treating Obesity

Hyperkalemia is a common electrolyte disorder in patients with CKD that can be exacerbated by renin-angiotensin-aldosterone system (RAAS) inhibitors. While hyperkalemia poses potential risks to patients with CKD, the potentially negative impact of discontinuing RAAS inhibitor therapy on long-term renal and cardiovascular outcomes in CKD patients is unclear. Guest Author: Michelle A. Fravel, PharmD, BCPS Music by Good Talk

Hyperkalemia is a common electrolyte disorder in patients with CKD that can be exacerbated by renin-angiotensin-aldosterone system (RAAS) inhibitors. While hyperkalemia poses potential risks to patients with CKD, the potentially negative impact of discontinuing RAAS inhibitor therapy on long-term renal and cardiovascular outcomes in CKD patients is unclear. Guest Author: Michelle A. Fravel, PharmD, BCPS Music by Good Talk

Managing RAAS-Inhibitor-Associated Hyperkalemia in Patients with CKD – A Balancing Act

Reason for Visit: JS was referred by her PCP to the ambulatory care pharmacist for contraceptive counseling.  Chief Complaint: “I think I’m leaning more towards the pill, but I’m really open to anything. It’s also itchy again down there, probably another yeast infection.” Guest Author:  Elizabeth Salisbury, PharmD Expert Panelists:  Ashley Meredith, PharmD, MPH, BCACP; Rebecca Stone, PharmD, BCACP, and Sally Rafie, PharmD, BCPS   Wanna earn continuing pharmacy education (CPE) for this program?  Be sure to log-in to the iForumRx website, review the case, listen to the podcast, and scroll to the bottom of the page to claim CE.   Check out the Birth Control Pharmacist website. --------

Reason for Visit: JS was referred by her PCP to the ambulatory care pharmacist for contraceptive counseling. Chief Complaint: “I think I’m leaning more towards the pill, but I’m really open to anything. It’s also itchy again down there, probably another yeast infection.” Guest Author:  Elizabeth Salisbury, PharmD Expert Panelists:  Ashley Meredith, PharmD, MPH, BCACP; Rebecca Stone, PharmD, BCACP, and Sally Rafie, PharmD, BCPS Wanna earn continuing pharmacy education (CPE) for this program?  Be sure to log-in to the <a href="https://iforumrx.org/complex-case-1/" rel="nofollow" target="_blank">iForumRx website</a>, review the case, listen to the podcast, and scroll to the bottom of the page to claim CE. Check out the <a href="https://birthcontrolpharmacist.com" rel="nofollow" target="_blank">Birth Control Pharmacist</a> website. --------

Complex Patient Case - Women’s Health + Contraception

What is the secret to staying up to date with clinical updates, tips for flourishing in your practice and life, and inspirational stories about pharmacist entrepreneurs…all at the click of a button? No, it is not magic. It is a podcast! Guest Authors: Elizabeth Yett, PharmD, BCACP, TTS and Elizabeth Hearn, PharmD, BCACP Music by Good Talk

What is the secret to staying up to date with clinical updates, tips for flourishing in your practice and life, and inspirational stories about pharmacist entrepreneurs…all at the click of a button? No, it is not magic. It is a podcast! Guest Authors: Elizabeth Yett, PharmD, BCACP, TTS and Elizabeth Hearn, PharmD, BCACP Music by Good Talk

Top Ten Podcasts Every Ambulatory Care Clinician Should Know About

Would you be willing to pay three times more for a brand-name levothyroxine product than a generic equivalent? Clinical practice guidelines recommend against switching between products. As a result, levothyroxine has higher brand-name product dispensing rates than other medications, costing patients and the healthcare system much more money. Guest Authors:  Connie Liang, PharmD and Kathleen Pincus, PharmD, BCPS, BCACP Music by Good Talk

Would you be willing to pay three times more for a brand-name levothyroxine product than a generic equivalent? Clinical practice guidelines recommend against switching between products. As a result, levothyroxine has higher brand-name product dispensing rates than other medications, costing patients and the healthcare system much more money. Guest Authors:  Connie Liang, PharmD and Kathleen Pincus, PharmD, BCPS, BCACP Music by Good Talk

The Generic Levothyroxine Conundrum

The landmark REDUCE-IT trial demonstrated that icosapent ethyl (IPE) 4 g daily significantly reduced cardiovascular events in high-risk patients when added to statin therapy, but is a fancy fish oil supplement really worth our coin? Guest Authors:  Joseph Nardolillo, PharmD, BCACP and Vivian Cheng, PharmD, BCPS, BCACP Music by Good Talk

The landmark REDUCE-IT trial demonstrated that icosapent ethyl (IPE) 4 g daily significantly reduced cardiovascular events in high-risk patients when added to statin therapy, but is a fancy fish oil supplement really worth our coin? Guest Authors:  Joseph Nardolillo, PharmD, BCACP and Vivian Cheng, PharmD, BCPS, BCACP Music by Good Talk

Is Icosapent Ethyl a QALY-ty Investment?

Smoking remains a habit for many people, even among those who are motivated to quit. Historically, most smoking cessation interventions have targeted individuals who are ready to quit smoking in the next 30 days, overlooking those who are not yet ready to quit.  Perhaps an abstinence game, Take a Break, can move people in pre-contemplation and contemplation toward quitting. Guest Authors:  Anna Rhett, PharmD and Ha K. Pham, PharmD, BCACP Music by Good Talk

Smoking remains a habit for many people, even among those who are motivated to quit. Historically, most smoking cessation interventions have targeted individuals who are ready to quit smoking in the next 30 days, overlooking those who are not yet ready to quit.  Perhaps an abstinence game, Take a Break, can move people in pre-contemplation and contemplation toward quitting. Guest Authors:  Anna Rhett, PharmD and Ha K. Pham, PharmD, BCACP Music by Good Talk

Level Up!  An Abstinence Game for Smoking Cessation

It is well established that overuse of short-acting beta-agonists (SABA) increases the risk of poor asthma control, exacerbations, and increased mortality.  Several studies have combined a beta-agonist with an inhaled corticosteroid (ICS). The combination provides symptom relief and decreases the risk of poor outcomes.  The days of using albuterol monotherapy should be coming to an end; two drugs are better than one! Guest Authors:  Katherine Montag Schafer, PharmD, BCACP, CDCES and Stefanie C. Nigro, PharmD, BCACP, CDCES Music by Good Talk

It is well established that overuse of short-acting beta-agonists (SABA) increases the risk of poor asthma control, exacerbations, and increased mortality.  Several studies have combined a beta-agonist with an inhaled corticosteroid (ICS). The combination provides symptom relief and decreases the risk of poor outcomes.  The days of using albuterol monotherapy should be coming to an end; two drugs are better than one! Guest Authors:  Katherine Montag Schafer, PharmD, BCACP, CDCES and Stefanie C. Nigro, PharmD, BCACP, CDCES Music by Good Talk

Breaking the SABA-only Rescue Habit: Two Drugs Are Better Than One

iForumRx.org

Until recently, glucagon-like-peptide-1 (GLP-1) receptor agonists were only available as injectable products. Some clinicians and patients are reluctant to use injectable agents because they require additional patient education and can be intimidating.  If a GLP-1 receptor agonist were available in an oral dose form, it would be welcomed treatment option. But would the cardiovascular safety and benefits of oral GLP-1 receptor agonists be better, similar, or worse than their injectable siblings? Guest Authors:  Sally Earl, PharmD, BCPS and Megan Supple, PharmD, BCACP Music by Good Talk

Until recently, glucagon-like-peptide-1 (GLP-1) receptor agonists were only available as injectable products. Some clinicians and patients are reluctant to use injectable agents because they require additional patient education and can be intimidating.  If a GLP-1 receptor agonist were available in an oral dose form, it would be welcomed treatment option. But would the cardiovascular safety and benefits of oral GLP-1 receptor agonists be better, similar, or worse than their injectable siblings? Guest Authors:  Sally Earl, PharmD, BCPS and Megan Supple, PharmD, BCACP Music by Good Talk

Will Oral Semaglutide PIONEER the Way to Lower Cardiovascular Risk?

Several guidelines now recommend direct oral anticoagulants (DOACs) as the preferred anticoagulants for patients with non-valvular atrial fibrillation (a-fib). However, the landmark clinical trials focused largely on the primary prevention of stroke.  Moreover, real-world data using DOACs for secondary prevention is lacking. Many have argued that warfarin might be a better choice in these high-risk patients because it requires routine monitoring and increases the patient’s contact with the healthcare system. Does the choice of anticoagulant make a difference in preventing recurrent stroke? Guest Authors: Blaire White, PharmD; Amber Cizmic, PharmD, BCACP; and Tish Smith, PharmD, BCACP Music by Good Talk

Several guidelines now recommend direct oral anticoagulants (DOACs) as the preferred anticoagulants for patients with non-valvular atrial fibrillation (a-fib). However, the landmark clinical trials focused largely on the primary prevention of stroke.  Moreover, real-world data using DOACs for secondary prevention is lacking. Many have argued that warfarin might be a better choice in these high-risk patients because it requires routine monitoring and increases the patient’s contact with the healthcare system. Does the choice of anticoagulant make a difference in preventing recurrent stroke? Guest Authors: Blaire White, PharmD; Amber Cizmic, PharmD, BCACP; and Tish Smith, PharmD, BCACP Music by Good Talk

Secondary Stroke Prevention in A-Fib: Do DOACs PROSPER in High-Risk Patients?

Heart failure with reduced ejection fraction (HFrEF) is associated with significant morbidity and mortality. Current guidelines recommend a renin-angiotensin inhibitor, beta-blocker, and aldosterone antagonist to reduce morbidity and mortality in these patients. Despite the use of multiple drug classes, 5-year mortality rates hover near 50% in patients with heart failure (HF). Despite the numerous medications available, mortality and the risk of HF hospitalizations remains high. Sodium-glucose cotransporter-2 inhibitors (SGLT2-I) have been shown to reduce HF hospitalizations in patients with diabetes. Could this medication class be useful for HF treatment even in patients without diabetes? Guest Authors:  John Andraos, PharmD; Alexa Zeiger, PharmD; and Michael S. Kelly, PharmD, BCACP Music by Good Talk

Heart failure with reduced ejection fraction (HFrEF) is associated with significant morbidity and mortality. Current guidelines recommend a renin-angiotensin inhibitor, beta-blocker, and aldosterone antagonist to reduce morbidity and mortality in these patients. Despite the use of multiple drug classes, 5-year mortality rates hover near 50% in patients with heart failure (HF). Despite the numerous medications available, mortality and the risk of HF hospitalizations remains high. Sodium-glucose cotransporter-2 inhibitors (SGLT2-I) have been shown to reduce HF hospitalizations in patients with diabetes. Could this medication class be useful for HF treatment even in patients without diabetes? Guest Authors:  John Andraos, PharmD; Alexa Zeiger, PharmD; and Michael S. Kelly, PharmD, BCACP Music by Good Talk

Is Dapagliflozin aDAPtAble to Treating HFrEF in Patients Without Diabetes?  

Antiplatelet therapy is a mainstay treatment for the prevention of recurrent cardiovascular events in patients with stable coronary artery disease (CAD). Anticoagulation therapy is the cornerstone of therapy for most patients with atrial fibrillation (AF). AF and CAD are frequent comorbid conditions, occurring in 20-30% of patients with stable CAD. Unfortunately, combining antiplatelet and anticoagulation therapy increases the risk of major bleeding over 50% compared to anticoagulation alone. Recent real-world observational data suggest that direct oral anticoagulation (DOACs) therapy can reduce cardiovascular event rates. This begs the question: In patients with stable CAD and AF, is combination therapy necessary or is anticoagulation monotherapy sufficient?  The AFIRE study attempted to address this important clinical question. Guest Authors: Alina Kukin, PharmD and Zachary R. Noel, PharmD, BCCP Music by Good Talk

Antiplatelet therapy is a mainstay treatment for the prevention of recurrent cardiovascular events in patients with stable coronary artery disease (CAD). Anticoagulation therapy is the cornerstone of therapy for most patients with atrial fibrillation (AF). AF and CAD are frequent comorbid conditions, occurring in 20-30% of patients with stable CAD. Unfortunately, combining antiplatelet and anticoagulation therapy increases the risk of major bleeding over 50% compared to anticoagulation alone. Recent real-world observational data suggest that direct oral anticoagulation (DOACs) therapy can reduce cardiovascular event rates. This begs the question: In patients with stable CAD and AF, is combination therapy necessary or is anticoagulation monotherapy sufficient?  The AFIRE study attempted to address this important clinical question. Guest Authors: Alina Kukin, PharmD and Zachary R. Noel, PharmD, BCCP Music by Good Talk

Up in Flames: Antiplatelet Therapy in Patients with Stable Ischemic Heart Disease Receiving Anticoagulation for A-fib

Heart failure (HF) affects at least 5.7 million people in the United States alone and requires a strict self-care regimen to avoid hospitalizations. Patients with HF have high readmission rates, high medical costs, and many experience a poor quality of life. But what if patients with HF do not understand or are not capable of carrying out the recommended HF “self-care regimen”? Subjective questionnaires are often used to assess HF symptoms and self-care behaviors but may not accurately depict a patient’s functional capabilities. The FRAIL-HF study attempted to objectively evaluate patients’ ability to perform HF self-care tasks and correlate self-care ability with readmissions rates and one-year mortality. Guest Authors: Holly Porras, PharmD and Emily Prohaska, PharmD, BCACP, BCGP Music by Good Talk

Heart failure (HF) affects at least 5.7 million people in the United States alone and requires a strict self-care regimen to avoid hospitalizations. Patients with HF have high readmission rates, high medical costs, and many experience a poor quality of life. But what if patients with HF do not understand or are not capable of carrying out the recommended HF “self-care regimen”? Subjective questionnaires are often used to assess HF symptoms and self-care behaviors but may not accurately depict a patient’s functional capabilities. The FRAIL-HF study attempted to objectively evaluate patients’ ability to perform HF self-care tasks and correlate self-care ability with readmissions rates and one-year mortality. Guest Authors: Holly Porras, PharmD and Emily Prohaska, PharmD, BCACP, BCGP Music by Good Talk

Are Older Adults with Heart Failure Self-Care Aware?

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