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  1. Article ; Online: Pharmacokinetic Drug-Drug Interactions Between Immunosuppressant and Anti-Infective Agents: Antimetabolites and Corticosteroids.

    Van Matre, Edward T / Satyanarayana, Gowri / Page 2nd, Robert L / Levi, Marilyn E / Lindenfeld, JoAnn / Mueller, Scott W

    Annals of transplantation

    2018  Volume 23, Page(s) 66–74

    Abstract: Infections account for 15-20% of deaths in transplant recipients, requiring rapid and appropriate therapeutic interventions. Many anti-infective agents interact with immunosuppressive regimens used in transplantation, placing patients at increased risk ... ...

    Abstract Infections account for 15-20% of deaths in transplant recipients, requiring rapid and appropriate therapeutic interventions. Many anti-infective agents interact with immunosuppressive regimens used in transplantation, placing patients at increased risk for adverse drug reactions and prolonged hospitalizations. There is established data regarding the level of evidence and magnitude of interactions between calcineurin inhibitors and mammalian target of rapamycin inhibitors with anti-infective agents. Less is known about the interactions with anti-proliferative agents and corticosteroids, with gaps in knowledge on the appropriate management of these interactions. The objective of this review was to highlight the pharmacokinetic drug-drug interactions between antimetabolites and corticosteroids with commonly used anti-infective agents.
    MeSH term(s) Adrenal Cortex Hormones/pharmacokinetics ; Adrenal Cortex Hormones/therapeutic use ; Anti-Infective Agents/pharmacokinetics ; Anti-Infective Agents/therapeutic use ; Antimetabolites/pharmacology ; Antimetabolites/therapeutic use ; Drug Interactions ; Graft Rejection ; Humans ; Immunosuppressive Agents/pharmacokinetics ; Immunosuppressive Agents/therapeutic use ; Infection/drug therapy ; Infection/etiology ; Organ Transplantation/adverse effects
    Chemical Substances Adrenal Cortex Hormones ; Anti-Infective Agents ; Antimetabolites ; Immunosuppressive Agents
    Language English
    Publishing date 2018-01-23
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1484710-3
    ISSN 2329-0358 ; 1425-9524
    ISSN (online) 2329-0358
    ISSN 1425-9524
    DOI 10.12659/aot.906164
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Applying Clinical Decision Support Design Best Practices With the Practical Robust Implementation and Sustainability Model Versus Reliance on Commercially Available Clinical Decision Support Tools

    Trinkley, Katy E / Kroehl, Miranda E / Kahn, Michael G / Allen, Larry A / Bennett, Tellen D / Hale, Gary / Haugen, Heather / Heckman, Simeon / Kao, David P / Kim, Janet / Matlock, Daniel M / Malone, Daniel C / Page 2nd, Robert L / Stine, Jessica / Suresh, Krithika / Wells, Lauren / Lin, Chen-Tan

    JMIR Medical Informatics, Vol 9, Iss 3, p e

    Randomized Controlled Trial

    2021  Volume 24359

    Abstract: BackgroundLimited consideration of clinical decision support (CDS) design best practices, such as a user-centered design, is often cited as a key barrier to CDS adoption and effectiveness. The application of CDS best practices is resource intensive; thus, ...

    Abstract BackgroundLimited consideration of clinical decision support (CDS) design best practices, such as a user-centered design, is often cited as a key barrier to CDS adoption and effectiveness. The application of CDS best practices is resource intensive; thus, institutions often rely on commercially available CDS tools that are created to meet the generalized needs of many institutions and are not user centered. Beyond resource availability, insufficient guidance on how to address key aspects of implementation, such as contextual factors, may also limit the application of CDS best practices. An implementation science (IS) framework could provide needed guidance and increase the reproducibility of CDS implementations. ObjectiveThis study aims to compare the effectiveness of an enhanced CDS tool informed by CDS best practices and an IS framework with a generic, commercially available CDS tool. MethodsWe conducted an explanatory sequential mixed methods study. An IS-enhanced and commercial CDS alert were compared in a cluster randomized trial across 28 primary care clinics. Both alerts aimed to improve beta-blocker prescribing for heart failure. The enhanced alert was informed by CDS best practices and the Practical, Robust, Implementation, and Sustainability Model (PRISM) IS framework, whereas the commercial alert followed vendor-supplied specifications. Following PRISM, the enhanced alert was informed by iterative, multilevel stakeholder input and the dynamic interactions of the internal and external environment. Outcomes aligned with PRISM’s evaluation measures, including patient reach, clinician adoption, and changes in prescribing behavior. Clinicians exposed to each alert were interviewed to identify design features that might influence adoption. The interviews were analyzed using a thematic approach. ResultsBetween March 15 and August 23, 2019, the enhanced alert fired for 61 patients (106 alerts, 87 clinicians) and the commercial alert fired for 26 patients (59 alerts, 31 clinicians). The adoption and ...
    Keywords Computer applications to medicine. Medical informatics ; R858-859.7
    Subject code 690
    Language English
    Publishing date 2021-03-01T00:00:00Z
    Publisher JMIR Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article: A phase Ib trial of pembrolizumab plus paclitaxel or flat-dose capecitabine in 1st/2nd line metastatic triple-negative breast cancer.

    Page, David B / Pucilowska, Joanna / Chun, Brie / Kim, Isaac / Sanchez, Katherine / Moxon, Nicole / Mellinger, Staci / Wu, Yaping / Koguchi, Yoshinobu / Conrad, Valerie / Redmond, William L / Martel, Maritza / Sun, Zhaoyu / Campbell, Mary B / Conlin, Alison / Acheson, Anupama / Basho, Reva / McAndrew, Philomena / El-Masry, Mary /
    Park, Dorothy / Bennetts, Laura / Seitz, Robert S / Nielsen, Tyler J / McGregor, Kimberly / Rajamanickam, Venkatesh / Bernard, Brady / Urba, Walter J / McArthur, Heather L

    NPJ breast cancer

    2023  Volume 9, Issue 1, Page(s) 53

    Abstract: Chemoimmunotherapy with anti-programmed cell death 1/ligand 1 and cytotoxic chemotherapy is a promising therapeutic modality for women with triple-negative breast cancer, but questions remain regarding optimal chemotherapy backbone and biomarkers for ... ...

    Abstract Chemoimmunotherapy with anti-programmed cell death 1/ligand 1 and cytotoxic chemotherapy is a promising therapeutic modality for women with triple-negative breast cancer, but questions remain regarding optimal chemotherapy backbone and biomarkers for patient selection. We report final outcomes from a phase Ib trial evaluating pembrolizumab (200 mg IV every 3 weeks) with either weekly paclitaxel (80 mg/m
    Language English
    Publishing date 2023-06-21
    Publishing country United States
    Document type Journal Article
    ISSN 2374-4677
    ISSN 2374-4677
    DOI 10.1038/s41523-023-00541-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Costs and outcomes associated with clopidogrel discontinuation in Medicare beneficiaries with acute coronary syndrome in the coverage gap

    Page RL 2nd / Ghushchyan V / Allen RR / Roper L / Beck D / Johnathan BH / Frech-Tamas F / Chan W / McQueen RB / Nair KV

    Drug, Healthcare and Patient Safety, Vol 2012, Iss default, Pp 67-

    2012  Volume 74

    Abstract: Robert Lee Page II,1,2 Vahram Ghushchyan,1 Richard R Allen,3 Lisa Roper,4 Don Beck,4 Bamrom H ...

    Abstract Robert Lee Page II,1,2 Vahram Ghushchyan,1 Richard R Allen,3 Lisa Roper,4 Don Beck,4 Bamrom H Jonathan,4 Feride Frech-Tamas,5 Wing Chan,5 R Brett McQueen,1 Kavita V Nair11School of Pharmacy, Department of Clinical Pharmacy, 2School of Medicine, Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 3Peakstat Statistical Services, Evergreen, CO, 4Universal American, Houston, TX, 5Novartis Pharmaceuticals, East Hanover, New Jersey, USABackground: Current guidelines for acute coronary syndrome recommend clopidogrel for an optimal period of 12 months in order to reduce the risk of reinfarction and mortality. Premature clopidogrel discontinuation has been associated with higher rates of rehospitalization, coronary stent thrombosis, and mortality. No data exist regarding the effect of the Medicare Part D coverage gap on medical costs and outcomes in Medicare beneficiaries who discontinue their clopidogrel upon entering the coverage gap.Methods: Beneficiaries with a Medicare Advantage plan in 2009 who had a diagnosis of acute coronary syndrome were taking clopidogrel 75 mg daily, and reached the gap in the same year representing the study sample. From this cohort, those who filled at least two prescriptions for clopidogrel (continued) versus those that did not (discontinued) while in the gap were compared with regard to outcomes related to acute coronary syndrome and expenditure 30 days after the last prescription was filled and during any time while in the gap. Descriptive and multivariate analyses were used to compare these differences.Results: A total of 1365 beneficiaries with acute coronary syndrome met the inclusion criteria, of which 705 beneficiaries entered into the coverage gap, wherein 103 (14.6%) and 602 (85.4%) of beneficiaries discontinued and continued clopidogrel, respectively. Compared with those who continued clopidogrel during the gap, beneficiaries who discontinued clopidogrel showed a higher trend in the number of hospitalizations related to acute coronary ...
    Keywords Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2012-07-01T00:00:00Z
    Publisher Dove Medical Press
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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