Evaluation of a microlearning module on hypertension in Canada

Objectives: To use a microlearning platform to evaluate pharmacists’ knowledge and behaviour related to hypertension. Methods: Pharmacy 5in5 is an online microlearning platform designed to help pharmacy professionals develop skills and acquire a deeper understanding of a variety of clinical and professional practice topics. Each topic includes a fact-based quiz, six case-based quizzes, six reflection questions, animated videos, infographics and flash cards. In April 2019, a hypertension module was released to engage pharmacists in managing hypertension and improving current practice behaviours. The module was developed using Canadian and American hypertension guidelines, landmark trials, and tertiary drug resources. The hypertension module was accessible on the Pharmacy5in5 website. Preliminary data were collected over 8 weeks between April-June 2019. User performance was analyzed with a binomial regression model. Results: Overall, 600 users accessed the Pharmacy 5in5 platform in the first two months, 81% of which were in Ontario. Licensed pharmacists performed significantly better than other registered users (β = −0.56, t (3362) =−2.15, p = 0.03), with users working in hospitals performing the best. The quiz resulting in the highest average focused on proper techniques for home blood pressure monitoring (mean score of 87%; SD 17%), while the quiz resulting in the lowest average focused on choosing medication therapy (mean score of 59%; SD 22%). In the reflection questions for behaviour in the last three months, 68% of users reported counselling a patient on home blood pressure monitoring and 62% had educated patients on their blood pressure targets, but only 18% had contacted a prescriber to optimize pharmacotherapy. Conclusion: The Pharmacy5in5 hypertension module is an engaging method of continuing education which can be used to rapidly reach many healthcare professionals in a short time. More education is needed to support pharmacists in working with prescribers to proactively optimize hypertension therapy

Prevention and management of adverse events of novel agents in multiple myeloma: a consensus of the European Myeloma Network

During the last few years, several new drugs have been introduced for treatment of patients with multiple myeloma, which have significantly improved the treatment outcome. All of these novel substances differ at least in part in their mode of action from similar drugs of the same drug class, or are representatives of new drug classes, and as such present with very specific side effect profiles. In this review, we summarize these adverse events, provide information on their prevention, and give practical guidance for monitoring of patients and for management of adverse events

Possible Enhancement of the Effect of Warfarin Secondary to Oral Prednisone Therapy

Alarge number of medications have been reported to either increase or decrease the effect of warfarin on the international normalized ratio (INR).1 Therefore, knowledge of medications that may interact with warfarin is essential to ensure safe and effective use of this drug. Patients taking warfarin should undergo more frequent testing of INR upon introduction of new medications that may interact with warfarin. In a recent systematic review of medications and foods that may interact with warfarin, oral corticosteroids were not listed as having clinically significant interactions. 1 In fact, interactions between methylprednisolone and warfarin were described as “highly improbable”.1 We report here a clinically significant increase in INR associated with the initiation of oral prednisone therapy in a patient whose condition had previously been stabilized with warfarin therapy.