Ferritin in Adult-Onset Still's Disease: Just a Useful Innocent Bystander?

Background. Adult-Onset Still's Disease (AOSD) is an immune-mediated systemic disease with quotidian-spiking fever, rash, and inflammatory arthritis. Hyperferritinemia is a prominent feature, often used for screening. Methods. The key terms “ferritin” and “hyperferritinemia” were used to search PubMed and Medline and were cross-referenced with “Still's Disease.” Results. Hyperferritinemia, although nonspecific, is particularly prevalent in AOSD. While most clinicians associate ferritin with iron metabolism, this is mostly true for the H isoform and not for the L isoform that tends to increase dramatically in hyperferritenemia. In these situations, hyperferritinemia is not associated with iron metabolism and may even mask an underlying iron deficiency. We review, in systematic fashion, the current basic science and clinical literature regarding the regulation of ferritin and its use in the diagnosis and management of AOSD. Conclusion. Serum hyperferritinemia in AOSD has been described for 2 decades, although its mechanism has not yet been completely elucidated. Regulation by proinflammatory cytokines such as interleukin (IL)-1b, IL-6, IL-18, MCSF, and INF-α provides a link to the disease pathogenesis and may explain rapid resolution of hyperferritinemia after targeted treatment and inhibition of key cytokines

Collaborations for the Community: The Partnership of Extension and Pharmacy

Through partnering of resources and expertise of Ohio State University Extension and the College of Pharmacy, programs that affect the health of Ohio consumers are being developed. Early collaborative projects involved medication consultation for seniors by Pharmacy faculty and students, and development of fact sheets on herbs and dietary supplements. The Ohio Extension/Pharmacy Alliance for Community Health (Ohio EPACH) is currently focusing on health literacy needs among child caregivers and among the elderly and their caregivers

Effective Modification of a Nonprescription Medicines Course to Optimize Learning of Millennial Generation Students

Objective: To describe examples of effective teaching strategies utilized within a required nonprescription therapeutics course, in order to accommodate learning characteristics of Millennials. Case Study: Instructors identified unique characteristics of Millennial generation students through literature review and focused educational workshops. These characteristics include the desire for active learning where didactic lectures make a connection to life, the incorporation of technology, and assignments that focus on team work. Course modifications were then made based on these characteristics including redesign of large group course lectures with incorporation of patient cases, inclusion of a variety of online components including the opportunity to provide course feedback, and active learning small group projects within workshop sections. Evaluation:Student evaluation of the course and instructors significantly improved after introducing changes to the course compared to previous years. Each component of the student evaluation resulted in a statistically significant change in mean score. Verbal and written evaluations indicated a very positive learning experience for students. Grade mean (3.3 vs. 3.8, p Conclusions: By identifying characteristics of Millennial generation student learners, traditional teaching methods can be modified in order to enhance retention of material and optimize their learning process. Course changes improved the learning experience for students and instructors. Instructors' willingness to evaluate generational differences and adapt teaching enhances the learning experiences in the classroom for both students and instructors.   Type: Case Stud

Effective Modification of a Nonprescription Medicines Course to Optimize Learning of Millennial Generation Students

Objective: To describe examples of effective teaching strategies utilized within a required nonprescription therapeutics course, in order to accommodate learning characteristics of Millennials. Case Study: Instructors identified unique characteristics of Millennial generation students through literature review and focused educational workshops. These characteristics include the desire for active learning where didactic lectures make a connection to life, the incorporation of technology, and assignments that focus on team work. Course modifications were then made based on these characteristics including redesign of large group course lectures with incorporation of patient cases, inclusion of a variety of online components including the opportunity to provide course feedback, and active learning small group projects within workshop sections. Evaluation:Student evaluation of the course and instructors significantly improved after introducing changes to the course compared to previous years. Each component of the student evaluation resulted in a statistically significant change in mean score. Verbal and written evaluations indicated a very positive learning experience for students. Grade mean (3.3 vs. 3.8, p Conclusions: By identifying characteristics of Millennial generation student learners, traditional teaching methods can be modified in order to enhance retention of material and optimize their learning process. Course changes improved the learning experience for students and instructors. Instructors' willingness to evaluate generational differences and adapt teaching enhances the learning experiences in the classroom for both students and instructors.   Type: Case Stud

Evaluation of Pharmacists' Knowledge of Centers for Medicare and Medicaid Services Medication Drug Plan Star Ratings

Objectives: 1) Evaluate Ohio pharmacists’ awareness about Centers for Medicare and Medicaid Service’s (CMS) Medication Drug Plan (MDP) Star Ratings, 2) identify gaps in knowledge about CMS MDP Star Ratings, and 3) determine interest in continuing education (CE) opportunities with CMS PDP Star Ratings. Methods: A cross-sectional, online survey was conducted in February 2015. The 16-question, pilot-tested survey targeted licensed pharmacists in Ohio practicing in the ambulatory care or community setting. Respondents were surveyed on their self-assessed and actual knowledge on CMS MDP Star Ratings. Respondent’s interest in and preferred source and delivery of CE were evaluated. Data were collected in aggregate; descriptive statistics, ANOVA and chi-square tests were used to characterize and evaluate data. Responses were summarized for all 16 questions using frequencies and percentages. Results: Of 13,235 licensed Ohio pharmacists, 913 pharmacists completed the survey (6.9% response rate). 454 (49.7%) respondents were eligible to complete the survey based on practice setting and of those, 390 (85.9%) were aware of CMS’s MDP Star Ratings. Respondents’ self-assessment of their knowledge regarding CMS Star Ratings aligned with their actual knowledge as defined by performance on three multi-statement knowledge-based assessments. Significant differences existed between self-assessed knowledge groups in their ability to answer greater than 50% of questions correctly (p < .001). The majority of respondents (81.2%) indicated interest in receiving further education on CMS Star Ratings. Conclusions: Survey respondents are aware of CMS MDP Star Ratings, yet few indicated high knowledge levels on the topic. Gaps in knowledge were identified in development and utilization of the rating system, identifying quality measures, and sources utilized to measure achievement of ratings. Respondents indicated interest in opportunities to improve knowledge on the subject and would prefer education provided by their employer with a live presentation.   Type: Student Projec

Evaluation of Pharmacists' Knowledge of Centers for Medicare and Medicaid Services Medication Drug Plan Star Ratings

Objectives: 1) Evaluate Ohio pharmacists’ awareness about Centers for Medicare and Medicaid Service’s (CMS) Medication Drug Plan (MDP) Star Ratings, 2) identify gaps in knowledge about CMS MDP Star Ratings, and 3) determine interest in continuing education (CE) opportunities with CMS PDP Star Ratings. Methods: A cross-sectional, online survey was conducted in February 2015. The 16-question, pilot-tested survey targeted licensed pharmacists in Ohio practicing in the ambulatory care or community setting. Respondents were surveyed on their self-assessed and actual knowledge on CMS MDP Star Ratings. Respondent’s interest in and preferred source and delivery of CE were evaluated. Data were collected in aggregate; descriptive statistics, ANOVA and chi-square tests were used to characterize and evaluate data. Responses were summarized for all 16 questions using frequencies and percentages. Results: Of 13,235 licensed Ohio pharmacists, 913 pharmacists completed the survey (6.9% response rate). 454 (49.7%) respondents were eligible to complete the survey based on practice setting and of those, 390 (85.9%) were aware of CMS’s MDP Star Ratings. Respondents’ self-assessment of their knowledge regarding CMS Star Ratings aligned with their actual knowledge as defined by performance on three multi-statement knowledge-based assessments. Significant differences existed between self-assessed knowledge groups in their ability to answer greater than 50% of questions correctly (p &lt; .001). The majority of respondents (81.2%) indicated interest in receiving further education on CMS Star Ratings. Conclusions: Survey respondents are aware of CMS MDP Star Ratings, yet few indicated high knowledge levels on the topic. Gaps in knowledge were identified in development and utilization of the rating system, identifying quality measures, and sources utilized to measure achievement of ratings. Respondents indicated interest in opportunities to improve knowledge on the subject and would prefer education provided by their employer with a live presentation. &nbsp; Type:&nbsp;Student Projec

Delivering a Pilot Smoking Cessation Program through the Patient Portal of an Electronic Medical Record (EMR) at a Patient-Centered Medical Home (PCMH)

Pharmacists are providing clinical services in nontraditional practice settings including the patient-centered medical home (PCMH). PCMHs strive to improve patient outcomes in a number of ways, including through innovative use of health information technology (HIT) and by encouraging patients to take an active role in their health care. This paper describes a pharmacist-directed smoking cessation program at a PCMH that utilizes HIT to engage patients in the smoking cessation process and lessons learned from implementation of the program to guide other pharmacists considering implementing a similar program. Secure messaging through the patient portal of the electronic medical record (EMR) can be an effective way to deliver a smoking cessation program for appropriately selected patients and aligns with PCMH standards as the program uses HIT to engage patients in self-management.   Type: Original Researc

Delivering a Pilot Smoking Cessation Program through the Patient Portal of an Electronic Medical Record (EMR) at a Patient-Centered Medical Home (PCMH)

Pharmacists are providing clinical services in nontraditional practice settings including the patient-centered medical home (PCMH). PCMHs strive to improve patient outcomes in a number of ways, including through innovative use of health information technology (HIT) and by encouraging patients to take an active role in their health care. This paper describes a pharmacist-directed smoking cessation program at a PCMH that utilizes HIT to engage patients in the smoking cessation process and lessons learned from implementation of the program to guide other pharmacists considering implementing a similar program. Secure messaging through the patient portal of the electronic medical record (EMR) can be an effective way to deliver a smoking cessation program for appropriately selected patients and aligns with PCMH standards as the program uses HIT to engage patients in self-management. &nbsp; Type:&nbsp;Original Researc

Evaluation of provider documentation of medication management in a Patient-Centered Medical Home (PCMH)

Purpose: The National Committee for Quality Assurance (NCQA) has standards for recognizing Patient-Centered Medical Homes (PCMH) including one for medication management. Study objectives were to identify if and how providers within a PCMH recognized under the 2008 guidelines were documenting components of medication management to meet NCQA’s 2011 requirements including: 1) providing information about new prescriptions to >80% of patients; 2) assessing understanding of medications for >50% of patients; and 3) assessing response and barriers to medication adherence for >50% of patients. Methods: Physician and pharmacist-led patient visits from a family medicine office, from February 1 to August 1, 2012 were assessed. Patients over 18 years old taking at least one medication were included. A retrospective chart review was performed to assess documented components of medication management. Descriptive statistics were used to analyze data. Results: A systematic sampling of 450 physician-led and 195 pharmacist-led patient visits, demonstrated providers did not meet documentation goals for providing patients information on new prescriptions (65% pharmacist, 24% physician, 36% of total provider notes) or for assessment of patients’ understanding of medications (9% pharmacist 12% physician, 11% of total provider notes). Individually each type of provider did not meet the goal of assessing patient response and barriers to adherence to medication, but with combined intervention by the pharmacists and the physicians, the site was able to surpass NCQA’s percentage goal (57% and 58%). Conclusions: No components of medication management are well documented. Using the electronic medical record, pharmacists may be able to develop documentation tools and assist sites to meet NCQA’s goals for medication management