Purdue College of Pharmacy Experience with Blood Pressure Screenings at the Indiana State Fair

The objective of this community outreach initiative is to develop and implement a student-led blood pressure screening at the Indiana State Fair in conjunction with the Purdue College of Pharmacy and the Hook’s Drug Store Museum. Under the mentorship of two pharmacy faculty members, third- and fourth-year professional PharmD students and pharmacy fellows hold a nine-hour blood pressure screening at the Indiana State Fair each year. The screening is held at the Hook’s Drug Store Museum and the students and fellows sign-up in teams of 3-4 to host the event. Fair-goers visiting the screening have their blood pressure taken using automated blood pressure devices and the readings are recorded into one of three categories: ≤140 mmHg/≤90 mmHg, \u3e140 mmHg/\u3e90 mmHg, or \u3e150 mmHg/\u3e100 mmHg. All patients receive a card with their blood pressure reading, are counseled on hypertension management and possible health complications, and receive a sticker that reads “I had my blood pressure checked at the Indiana State Fair/Purdue College of Pharmacy.” Students complete a reflection following their involvement. Data from the last five years was analyzed. Over the five years, a total of 838 fairgoers have utilized the opportunity to have their blood pressure checked. In addition, 50 pharmacy students, two fellows, and two faculty members have participated in hosting the screening. There has been growing involvement over the years, with 213 individuals visiting the booth in 2019. There has been a steady increase in the percentage of patients with a blood pressure reading in the lowest category. Participation in the Indiana State Fair has become a tradition for the College of Pharmacy as students enjoy and are grateful for such learning opportunities. This initiative allows students to develop and apply their clinical knowledge and communication skills while improving health and awareness of community members

Incidence of Adverse Drug Reactions in Adult Medical Inpatients

ABSTRACTThis study was a prospective observational study of ADR occurrence and evaluation in adult internal medicine inpatients conducted over a 120-day period. Clinical pharmacists screened for ADRs at a county hospital in Indianapolis, IN. Patient information was reviewed on admission, every four days during hospitalization, and at discharge. ADRs occurring after hospital admission were assessed for causality, severity, pharmacological type (i.e., augmented pharmacology versus idiosyncratic reaction) and affected organ system. Nurse and pharmacist reports, incident reports, physician consults, patient transfers to critical care units, and serum drug concentration reports were additional means of ADR identification.Overall, 23.1 % of patients experienced an ADR while 2.6% of the 11,702 drug exposures resulted in an ADR. Patients aged greater than 65 years (29. 6% vs. 20.5% for younger patients) and females (26.2% vs. 20% for males) were at higher risk for ADR development (p<0.05). Length of hospital stay was longer (13.3 days vs. 6.7 days; p<0.05) and drug exposures more frequent for patients experiencing ADRs (p<0.001).Furosemide elicited the most ADRs with 36 in 244 patient exposures (14.7% ). Diltiazem, enalapril, heparin, trimterene/hydrochlorothiazide combination and captopril were also frequently implicated. ADRs were classified as mild (35.9%), moderate (52.6%), and severe (10.2%). Organ systems most commonly affected were the metabolic/hematologic (32.9%), gastrointestinal (17.8%), genitourinary (11.8%), and cardiovascular (10.5%). Over 30% of events were idiosyncratic reactions. ADR incidence was consistent with previous literature. Many frequently implicated medications were newer agents and the severity of events was less than previously reported.RÉSUMÉCette étude, menée sur une période de 120 jours, consistait en une étude prospective d'observation de la survenue des réactions indésirable (R.l.) et de leur évaluation chez les patients adultes hospitalisés en médecine interne. Des pharmaciens en pharmacie clinique ont observé les patients, dans un hôpital régional d'Indianapolis, en Indiana, à la recherche de R.I. Les renseignements recueillis sur les patients ont été revus à l'admission, puis tous les quatre jours durant le séjour à l'hôpital, et avant le congé. Les R.l. qui sont survenues après l'admission à l'hôpital ont été évaluées afin de déterminer leur cause, leur gravité, le lien pharmacologique (c.-à-d. un effet pharmacologique accru vs une réaction idiosyncrasique) et les fonctions ou le ou les systèmes ou appareils touchés. Les rapports des pharmaciens et des infirmières, les rapports d'événements indésirables, les consultations medicales, les informations sur les transferts des patients à l'unité de soins intensifs et les rapports sur les concentrations sériques des médicaments constituaient un moyen additionnel d'identifier les réactions indésirables.Dans l'ensemble, 23,1 % des patients ont éprouvé des R.l.; 2,6 % des 11 702 expositions des patients à un médicament ont été associées à une R.I. Les patients de plus de 65 ans (29,6 % vs 20,5 % pour les patients plus jeunes) et ceux de sexe féminin (26,2 % vs 20 % de sexe masculin) présentaient un risque accru d'éprouver des R.l. (p<0,05). Le séjour à l'hôpital était plus long (13,3 jours vs 6,7 jours; p<0,05) et la fréquence d'administration des médicaments était plus élevée chez les patients qui ont éprouvé des R.l. (p<0,001).Le furosémide a entraîné une plus grande fréquence de R.l., soit 36 cas de R.I. sur 244 expositions (14,7 %). Le diltiazem, l'énalapril, l'héparine, l'association triamtérène-hydrochlorothiazide et le captopril ont aussi été fréquemment mis en cause. Les R.I. ont été classées comme légères (35,9 %), modérées (52,6 %) ou graves (10,2 %). Les fonctions, systèmes ou appareils les plus couramment touchés étaient les fonctions métabolique/hématologique (32,9 %), l'appareil digestif (17,8 %), l'appareil génito-urinaire (11,8 %) et l'appareil cardio-vasculaire (10,5 %). Plus de 30 % des réactions indésirables étaient de type idiosyncrasique. L'incidence des R.l. corroborait les résultats déjà cités dans la littérature. Un grand nombre de médicaments qui ont entraîné les réactions indésirables était moindre que ce qui avait déjà été rapporté