At the 2023 HIMSS meeting, Dr. Sandra Kane-Gill discussed a new alert system being developed at UPMC to improve care for patients at risk for drug-associated acute kidney injury (AKI). According to Dr. Kane-Gill, drugs are involved in approximately 30% of AKI cases in hospitalized patients, but imprecise alert systems mean that at-risk patients could be overlooked. To address this challenge, Dr. Kane-Gill led a consensus-building project to identify 20 drugs that are probably or definitely nephrotoxic with routine use. UPMC has developed a prototype alert tool for AKI that uses this list of nephrotoxic drugs to accurately detect AKI in patients. Preliminary results indicate that for every five alerts generated, there was one case of drug-associated AKI, a higher accuracy rate than for other alert systems. Dr. Kane-Gill plans to further refine the alert tool before deploying it in practice at UPMC and is also interested in using machine learning to prevent episodes of kidney injury.

A nonprofit group called the Institute for Safe Medication Practices (ISMP) collaborates closely with healthcare professionals and institutions, regulatory bodies, trade associations, and the pharmaceutical industry to promote education regarding drug errors and their avoidance. Practitioners and patients who voluntarily report medication errors to the ISMP National Medication Errors Reporting Program (ISMP MERP) are subject to an impartial review by ISMP. Actual or probable errors that have been reported to ISMP are those that are displayed in the tables.

A pharmacy-driven COPD TOC service did not significantly reduce the 30-day re-presentation rate, according to this study. It did discover that a sizable proportion of patients with COPD exacerbation who were admitted might require an inhaler change, and it illustrates the value of this kind of TOC service for seeing and fixing medication-related issues particular to this disease state. The percentage of patients receiving the entire intended intervention had room for improvement.

Single-tablet regimen (STR) coverage under qualified health plans (QHPs) varies widely across the US. Although bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) coverage has grown over time, many QHPs in priority jurisdictions for the Ending the HIV Epidemic (EHE) have coinsurance requirements. Delay in QHP coverage and benefit design may hinder access to new antiretroviral treatment (ART) regimens.

Pharmacogenomics (PGx) researches how germline (or inherited) alterations impact a person’s receptivity to medication. Almost everyone has a clinically significant variant of one or more pharmacogenes. Genetic variations in PK, PD, and HLA are linked to variations in drug response. Evidence only supports the utility of PGx testing for the four genes CYP2C19, CYP2D6, HLA-B15:02, and HLA-A31:01 in mental health. Fill out the CPE exam and submit it online at www.pharmacist.com/education if you’re interested in receiving 1 hour of CPE credit for this activity.

In the US, the use of biosimilars is becoming more and more important because of the potential for cost savings to increase patient access to biologic medicines and lower total healthcare expenditures. Healthcare professionals and patients have been the subjects of surveys on biosimilars, but recent comprehensive quantitative data about US pharmacists’ attitudes toward and comprehension of biosimilars are scarce. The majority of US pharmacists understood the fundamental ideas behind biosimilar drugs; however, certain knowledge gaps were concentrated in the areas of interchangeability and substitution. Only slightly more than half of those surveyed said they felt confident answering patients’ inquiries about biosimilars. To bridge these gaps and boost confidence in administering biosimilars, US pharmacists need additional and targeted instructional techniques.