Includes bibliographical references.

Defining the Role of the Advanced Pharmacy Technician: Perspective Dissonance -- Assessing the Quality of Life in Patients With Polyarthralgia Based on 25-Hydroxycholecalciferol Levels -- Increasing Naloxone Knowledge and Use Through Direct-to-Patient Education -- Ervebo (Ebola Zaire Vaccine, Live/rVSVΔG-ZEBOV-GP): The First Licensed Vaccine for the Prevention of Ebola Virus Disease -- Treatment of Chronic Refractory Cough in Adults: Focus on Neuromodulators and Other Therapeutic Modalities -- Implications of Glycopeptide and Lipopeptide Antibiotics on Asthma Exacerbations in a Patient With Hyper-IgE Syndrome and Chronic Severe Asthma: A Case Report -- Exploration of Body Habitus and Fluid Overload in Critically Ill Patients.

[Article Title: Defining the Role of the Advanced Pharmacy Technician: Perspective Dissonance/ Allison M. Dering-Anderson, Madeline E. Blaha and Judith L. Neville, p. 223-230]

Abstract:

Background: Pharmacy technicians serve as pharmacist extenders. Attempts at advancing their practice have not been as rapid as the profession would prefer. We postulated that a barrier to this advancement is lack of agreement between pharmacists and technicians on how advancement should occur and on what it means.

Objective: The objectives were to evaluate the differences in definitions and expectations of “technician advancement” between pharmacists and pharmacy technicians as potential impediments to advancement.

Methods: Multimodal: An initial questionnaire for pharmacy technicians was collected during the American Association of Pharmacy Technicians Annual Convention to identify major topics for further survey. From those data, a survey was developed to ask pharmacists and pharmacy technicians about “technician advancement.” Surveys were provided to technicians in seminar settings; to members of the Nebraska Pharmacists Association; and via online platforms such as Facebook. Additionally, face-to-face targeted interviews were conducted with pharmacy technicians attending American Association of Pharmacy Technicians conventions and with the pharmacy technician and pharmacist leaders at the Nebraska Pharmacists Association.

Results: Responses show that pharmacists’ expectations for advancing the practice of pharmacy technicians and the expectations of the technicians themselves vary widely. A notable finding is that 96% of all technicians responding see technician payment as a significant issue in advancement, while less than 4% of pharmacists commented on rate of pay.

Conclusion: While both pharmacists and pharmacy technicians are hopeful for pharmacy technician role advancement, there is substantial disagreement about the definition of advancement that may be a barrier to the process.

https://doi.org/10.1177/8755122520947637

[Article Title: Assessing the Quality of Life in Patients With Polyarthralgia Based on 25-Hydroxycholecalciferol Levels/ Tejaswini Baral, D. Vijaya Laxmi, Mounika Pedada, Neelima Krishna Veni Ganta and Wasim Feroz, p. 231-236]

Abstract:

Background
Vitamin D deficiency is widespread, yet it is the most underdiagnosed and undertreated nutritional deficiency and has a very crucial clinical importance in today’s medical field.
Objective
To assess quality of life in patients with polyarthralgia based on 25-hydroxycholecalciferol (25-(OH)D) levels, which will help understand the importance of vitamin D in a broader sense.
Methodology
Our panel study was carried out in the department of orthopedics of a tertiary care hospital in southern India between October 1, 2018, and February 28, 2019. A total of 114 patients with polyarthralgia from the outpatient department were included in the study.
Results
In our study, there was a predominance of female patients (77.2%). Overall, 92.10% of our study population were aged between 21 and 60 years. The highest percentage of low vitamin D status was detected in unexplained polyarthralgia cases (52.63%), who did not have any comorbid condition except a low serum level of 25-(OH)D level. There was a strong association between quality of life, before and after supplementation of vitamin D (P < .0001), for every domain of the 36-item Short Form Survey.
Conclusion
The 36-item Short Form Survey analysis showed that the patients with polyarthralgia whose serum level of 25-(OH)D was found below the optimal range had dramatic improvement in their symptoms after vitamin D supplementation. Based on the findings of our study, we strongly recommend screening for vitamin D deficiency in those who are at risk, as features of low vitamin D are mostly reversible with proper supplementation.

https://doi.org/10.1177/8755122520952048

[Article Title: Increasing Naloxone Knowledge and Use Through Direct-to-Patient Education/ Kathryn Litten, Lucas G. Hill,Aida Garza and Maaya Srinivasa, p. 237-242]

Abstract:

Background: In the United States, opioid overdoses account for 130 deaths daily. Barriers to obtaining naloxone, the drug-of-choice for opioid overdose reversal, include limited education, access, and perceptions of provider judgement.

Objectives: This study aimed to assess the efficacy of mailed education about naloxone, with or without a live teaching seminar, to patients at risk for opioid overdose.

Methods: This observational study was conducted in a federally qualified health system. A phone presurvey was administered to patients on long-term opioid therapy or with a diagnosis of opioid use disorder to assess opioid overdose-related knowledge. Subjects were mailed a handout about naloxone and an invitation to receive naloxone at no cost at a seminar. Three-month phone postsurveys were conducted. The primary outcome was change in mean knowledge score from presurvey to postsurvey. Secondary outcomes included scores on individual survey items, naloxone prescriptions provided, and overdose reversals reported.

Results: Ninety-four patients received mailed education. Sixty-two subjects took presurveys and 23 took 3-month follow-up surveys. Five subjects attended the live seminar. The mean cumulative knowledge score improved by 8.7% from the presurvey to the postsurvey. During the study period, one new naloxone prescription was written and one overdose reversal was reported.

Conclusion: Direct-to-patient mailed education slightly improved knowledge regarding naloxone and opioid overdose response, and it may have led to one successful overdose reversal. Mailing education to a larger population of patients at risk for opioid overdose may be necessary to observe a substantial clinical impact.

https://doi.org/10.1177/8755122520954218

[Article Title: Ervebo (Ebola Zaire Vaccine, Live/rVSVΔG-ZEBOV-GP): The First Licensed Vaccine for the Prevention of Ebola Virus Disease/ Christopher R. Piszczatoskiand John G. Gums, p. 243-250]

Abstract:

Objective: To review the clinical data regarding the safety and efficacy of the Ervebo (Ebola Zaire vaccine, live/rVSVΔG-ZEBOV-GP) vaccine for the prevention of the Ebola virus disease.

Data Sources: A literature search through PubMed, MEDLINE, and Cochrane Library was conducted for clinical trials published between January 2014 and June 2020 in the English language using the keywords Ervebo, rVSVΔG-ZEBOV, rVSVΔG-ZEBOV-GP, Ebola Zaire, and vaccine.

tudy Selection and Data Extraction: Articles were selected if they were related to the Food and Drug Administration (FDA) approval of Ervebo (Ebola Zaire vaccine, live/rVSVΔG-ZEBOV-GP) or provided novel data regarding this entity. Twelve articles noted in the FDA approval were chosen, along with 2 additional articles identified as providing novel information.

Data Synthesis: The findings of the review show that Ervebo (Ebola Zaire vaccine, live/rVSVΔG-ZEBOV-GP) is a safe, immunogenic, and likely effective vaccine for the prevention of Ebola virus disease.

Relevance to Patient Care and Clinical Practice: Ebola virus disease is highly infectious and often fatal. There have been multiple large outbreaks in the past 5 years, with no licensed treatments or vaccines. An effective vaccine could largely curtail current outbreaks and prevent further ones.

Conclusion: The recent FDA approval of Ervebo (Ebola Zaire vaccine, live/rVSVΔG-ZEBOV-GP) offers the first approved vaccine for the prevention of Ebola virus disease. It has been shown to be safe, immunogenic, and likely effective for use in real-world applications for those at risk of contracting the disease.

https://doi.org/10.1177/8755122520950692

[Article Title: Treatment of Chronic Refractory Cough in Adults: Focus on Neuromodulators and Other Therapeutic Modalities/ Caroline O’Hare, Tashrique Rahman and Nancy Toedter Williams, p. 261-264]

Abstract: Objective: To evaluate the literature and educate health care professionals about the different management options for chronic refractory cough (CRC).

Data Sources: Searches were performed through MEDLINE (1966 to July 2020) using OVID and EBSCOhost and EMBASE (1947 to July 2020) using OVID. Search terms included chronic cough, neurogenic cough, neuromodulators, chronic cough management, and chronic cough treatment. References of all relevant articles were further used to obtain additional articles.

Study Selection and Data Extraction: This review includes articles in the English language and human trial literature. Twenty-three trials explored the use of oral neuromodulators in the management of CRC.

Data Synthesis: CRC is a poorly understood disease that may have a complex neuropathic etiology. Oral neuromodulators, such as amitriptyline, baclofen, gabapentin, and pregabalin, continue to be the most commonly used agents for the management of CRC. Alternative pharmacological therapies such as botulinum toxin, anesthetic agents (benzonatate, lidocaine), and narcotic agents have efficacy data, and further research into effective doses and routes of administration is warranted. Alternative nonpharmacologic therapies more commonly used included speech pathology treatment.

Conclusion: Several medication and alternative treatment interventions may be effective in managing CRC. Current studies used wide dosing and titration strategies, making it challenging to standardize therapy. No consistent method of assessing cough reflex was used between studies, as well as a lack of consistent randomization and small sample sizes. Additional research is needed to standardize treatment durations, optimum doses, and place in therapy of the available interventions in the management of CRC.

https://doi.org/10.1177/8755122520954866

[Article Title: Implications of Glycopeptide and Lipopeptide Antibiotics on Asthma Exacerbations in a Patient With Hyper-IgE Syndrome and Chronic Severe Asthma: A Case Report/ Justin P. Reinert and Kevin Burnham, p. 265-269]

Abstract:

Objective: To review and consider the immunomodulatory ramifications of glycopeptide and lipopeptide antibiotics in a patient with severe asthma, hyper-immunoglobulin E (IgE) syndrome, and osteonecrosis of the jaw.

Case Summary: A 36-year-old male patient with a pertinent past medical history of hyper-IgE syndrome, severe asthma, and osteonecrosis of the jaw attributed to steroid use initially presented to the emergency department, where imaging of the jaw suggested an infectious process. Following months of vancomycin therapy as an outpatient, the patient was switched to daptomycin to facilitate once-daily infusions. Following this change, the patient experienced significantly less asthma exacerbations and fewer admissions to the hospital for asthma-related issues.

Discussion: Though daptomycin is associated with eosinophilia, and this patient’s eosinophil counts did increase while on the drug, an inverse relationship developed concerning the number of hospital admissions for asthma exacerbations. A review of the literature indicates that select glycopeptides, such as vancomycin, have pro-inflammatory effects, while other related drugs, such as the lipopeptide daptomycin, may not result in clinical manifestations of an inflammatory process. Tumor necrosis factor-α, interleukin-1β, and interleukin-6 have been implicated in this process. This patient may have been particularly susceptible to the effects of the glycopeptides due to his diagnosis of hyper-IgE syndrome, which has been independently associated with reactive airway diseases.

Conclusion: Cytokine migration and activation by select glycopeptide and lipopeptide antibiotics warrant consideration from clinicians when determining the most appropriate treatment regimens. Further research is required to elucidate whether the pro-inflammatory properties of vancomycin warrant a change in first-line therapy to daptomycin in select cases.

https://doi.org/10.1177/8755122520949589

[Article Title: Exploration of Body Habitus and Fluid Overload in Critically Ill Patients/ Peyton E. Moon, Andrea Sikora Newsome, W. Anthony Hawkins and Susan E. Smith, p. 270-271]

Abstract: Intravenous fluids (IVFs) are the most common drugs used in critically ill patients.1 Because an optimal weight-based fluid dose has not been defined, inappropriate fluid dosing is common and may result in significant adverse effects.2 Furthermore, obesity is present in approximately 40% of the American population.3 This study investigated the influence of body habitus on fluid dosing and outcomes.

https://doi.org/10.1177/8755122520957629