Electronic cigarettes (e-cigarettes; also known as e-cigs, electronic nicotine delivery systems, vapes, mods, pods, and vape pens) have surged in popularity since their market introduction in 2007. Some view e-cigarettes as a less harmful alternative to traditional cigarettes and a potential harm reduction strategy. Others worry about their addictive potential and see them as a setback in our quest for a tobacco-free society. Guest Authors: Elizabeth S. Yett, PharmD, BCACP, CTTS and Kirk E. Evoy, PharmD, BCACP, BC-ADM, CTTS Music by Good Talk

Asthma and chronic obstructive pulmonary disease (COPD) are underdiagnosed due to the underuse of spirometry, underreporting of symptoms, and economic barriers.  Is there an effective way to capture undiagnosed but symptomatic patients and route them for appropriately managing their respiratory symptoms?  That's what the UCAP study attempted to answer. Guest Authors:  Michelle Balli, PharmD, BCACP and Michelle Hernandez, PharmD Music by Good Talk

Despite advances in the management of acute myocardial infarction (MI), up to 38% of patients will experience signs of heart failure (HF) and many have a reduced left ventricular ejection fraction (LVEF). Sodium-glucose cotransporter 2 (SGLT2) inhibitors have well-documented cardiovascular benefits. However, data are limited regarding their use after an acute MI. Guest Authors: Amy Hu, PharmD and Kathleen Pincus, PharmD, BCPS, BCACP, CDCES Music by Good Talk

One of the most debilitating aspects of dementia is the behavioral and psychological symptoms of dementia (BPSD) that impact nearly 90% of patients. These symptoms significantly diminish the quality of life and functional abilities of those affected. To combat the most severe of these symptoms, antipsychotic medications are often prescribed, but not without possibly harmful consequences. A new study sheds additional light on these detrimental consequences. Guest Authors:  Melissa C. Palmer, PharmD, BCPS, BCPP and Jessa Marie Koch, PharmD, APh, BCPP Music by Good Talk

It is still difficult for patients to quit despite their best efforts. Of the nearly 70% of current smokers who want to quit smoking, only about 7.5% succeed.  Unfortunately, there is a lack of evidence to inform subsequent treatment strategies if the initial quit attempt is unsuccessful. Guest Authors:  Elizabeth Yett, PharmD, BCACP, TTS and Katherine Montag Schafer, PharmD, BCACP, CDCES Music by Good Talk

Reason for Visit: The patient is a 76-year-old Hispanic referred to the ambulatory care pharmacist for dyslipidemia management.  The patient has a remote history of an MI (15 years ago) but states he is unable to take statins. Guest Authors: Mayela Warner, PharmD and Maricar Conson, PharmD, BCPS Expert Panelists: Sara Wettergreen, PharmD, BCACP, BC-ADM and Tomasz Jurga, PharmD, BCPS, BCACP, BCCP, CDCES Music by Good Talk

Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are one of the established treatments used to slow the progression of CKD and improve outcomes.  Could perhaps the glucagon-like peptide 1 (GLP-1) receptor agonists provide similar, additive, or different benefits in patients with CKD?  Guest Author: John Swegle, PharmD, BCPS, BCACP  Music by Good Talk

Over the last several decades, the popularity of cannabis (aka marijuana, weed) has increased significantly, and the recognition of medical benefits is evolving. Cannabis is often celebrated in popular culture as a relaxation-promoting, pain-relieving, harmless substance, and its use among young adults and pregnant women is increasing steadily.  A recently published ancillary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b) aimed to characterize the association between maternal cannabis use and adverse pregnancy outcomes. Guest Author: Courtney Cameron, PharmD, BCACP Special Guest: Leah Sera, PharmD, MA, BCPS Music by Good Talk

This episode is a collaboration between the ACCP Ambulatory Care Practice and Research Network (PRN) ... and iForumRx.org. We speak with three panelists who describe the use of remote patient monitoring within their cardiology practices.  From measuring weight, blood pressure, heart rate, blood glucose, and even pulmonary artery pressure, the use of remote patient monitoring devices has the potential to revolutionize patient care by making more data available "real-time" and engaging patients more in their care.  Nonetheless, there are significant barriers too.  Panelists:  Christine Cadiz PharmD, BCPS; Rachel Klosko, PharmD, BCCP, and Aimon Miranda, PharmD, BCPS Produced by  Rebecca Khaimova, PharmD, BCACP, CDCES and Anna K Love, PharmD, BCACP Music by lemonmusicstudio from Pixabay

It is now uncommon to see warfarin therapy initiated for stroke prevention. However, quality patient care is never a “one-size-fits-all” approach.  New evidence from the FRAIL-AF trial suggests that some of our most vulnerable older adults might be better off maintained on a vitamin K antagonist rather than (automatically) switched to a direct oral anticoagulation (DOAC).   Guest Author:  Matthew Cantrell, PharmD, BCPS Music by Good Talk

Reason for Visit:  Patient presents today for routine follow-up in the heart failure clinic to optimize his medications. Guest Authors: Jushua W. Skaggs, PharmD, and Jessica Wooster Thomas, PharmD, BCACP Expert Panelists: Kristin Watson, PharmD, MS, BCCP and Robert DiDomenico, PharmD Music by Good Talk

Direct oral anticoagulants (DOACs) are the standard of care for stroke prevention in most patients with nonvalvular atrial fibrillation (NVAF). Data on the safety and efficacy of DOACS in patients with obesity are limited and, at times, contradictory.  What would you recommend for a patient with a BMI>40: warfarin, which requires periodic monitoring and dose adjustments, or a DOAC, which may not be as effective? Guest Authors: Taylor M. Benavides, PharmD, BCPS and Elizabeth B. Hearn, PharmD, BCACP Music by Good Talk

This episode is a collaboration between the ACCP Ambulatory Care Practice and Research Network (PRN) ... and iForumRx.org. The treatment of COPD has evolved significant over the past few years.  The GOLD classification system was recently changed with a greater focus on exacerbations, and the role of inhaled corticosteroids (ICS) is limited to those with evidence of inflammation.  Pharmacists can play a critical and positive role in the lives of people with COPD by encouraging lifestyle changes, administering vaccines to immunize against respiratory illnesses, ensuring proper inhaler technique, and assisting with medication access. Panelists:  Melissa Lipari, PharmD, BCACP; Thomas Levi Lancaster, PharmD, BCACP, BC-ADM; and Rachel Basinger, PharmD, BCACP, CTTS, DipACLM Produced by  Rebecca Khaimova, PharmD, BCACP, CDCES and Anna K Love, PharmD, BCACP Music by lemonmusicstudio from Pixabay

Patients with diabetes mellitus are at increased risk of dementia; therefore, knowledge about medications and their possible impact on the development of dementia is critical. Historically, metformin has been the most frequently prescribed medication for type 2 diabetes. Does metformin impact the risk of dementia? Should providers be hesitant to prescribe … or discontinue metformin therapy? Guest Authors:  Benjamin King, PharmD, BCACP, Amber Lilly, PharmD, and Jordan Cloonan, PharmD Music by Good Talk

Reason for Visit:  Referred by her community pharmacist to see a medical professional after frequent reports of low blood glucose readings. This is her first visit to this family medicine office — her previous PCP retired over a year ago. Guest Authors: Katherine A Owen, PharmD, and Allison Zeurn, PharmD, BCACP Expert Panelists: Jennifer N. Clements, PharmD, BCPS, BCACP, CDCES, BC-ADM and Stefanie Nigro, PharmD, BCACP, CDCES Music by Good Talk

Pharmacogenomics (PGx) is a rapidly evolving field of precision medicine that studies how genetic variability influences drug response. PGx testing can improve patient care through personalized medication adjustments for a variety of conditions, including pain, mental health, cardiology, and oncology. Guest Authors: Lauren Jackson, PharmD, MPH and Jacob Marler, PharmD, BCCCP Music by Good Talk

While driving autonomy plays a crucial role in supporting mobility, social connections, and access to healthcare, older adults face elevated risks on the road. Rigorously collected data would equip us to educate patients about potential dangers, help us engage in collaborative discussions with patients and providers about deprescribing, and improve road safety for this vulnerable demographic. Guest Authors: Mary Eva McClure, PharmD and Tavajay Campbell, PharmD, BCACP, CDCES Guest Expert:  Michael Brodeur, PharmD, BCGP Music by Good Talk

Emerging data suggests we may have been overzealous with systemic corticosteroid prescribing and that allowing patients to self-manage their exacerbations with steroid rescue therapy may be harmful. However, we can now identify a subgroup of COPD patients who might benefit from systemic corticosteroids to treat their exacerbation. Guest Authors:  Hope Shrader Sherman, PharmD and Maricar Conson, PharmD, BCACP Music by Good Talk

Identifying and addressing the social determinants of health (SDOH) influences health outcomes and can positively impact health equity in our society.  While health systems in the US are screening for SDOH more often, information on how to improve screening efficiency and effectiveness is lacking. A recently published study was designed to determine what patient and clinician factors are associated with early implementation of SDOH screening in primary care. Guest Author: Sharmon P. Osae, PharmD, BCACP, CDCES Music by: Good Talk

This episode is a collaboration between the ACCP Ambulatory Care Practice and Research Network (PRN) ... and iForumRx.org. Mental illness is very common - 1 in 5 adults in the United States will have a mental illness during their lifetime.  Every ambulatory care (and community) pharmacist should be confident in their ability to recognize mental health challenges and how to use medications in an optimal manner to treat them.  This is a FOLLOW-UP conversation from the ACCP Annual Meeting program entitled Ambulatory Care PRN Focus Session — Breaking Down Depression and Anxiety Management for the Ambulatory Care Pharmacist. Expert Panelists:  Richard Silvia, PharmD, BCPP and Jordan Baye, PharmD, BCPS Music by lemonmusicstudio from Pixabay