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Current Issue
Volume 3, Issue 1 | March / April 2024

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Claire Meredith, PharmD, CarepathRx | Leita Frey, PharmD, BCPS, CarepathRx, | Shelby George, PharmD, CarepathRx | Megan K. Zielke, PharmD, BCCCP, CarepathRx

Vancomycin is widely used to treat gram-positive infections. Vancomycin therapy is accompanied by the clinical monitoring of trough levels in order to maintain therapeutic efficacy and patient safety….
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Julia K. Nguyen, PharmD Kaiser Permanente, Southern California Home Infusion Pharmacy | Rulin Hechter, MD, PhD, MS Kaiser Permanente, Department of Research and Evaluation, Southern California Permanente Medical Group, Kaiser Permanente Bernard J. Tyson School of Medicine, Department of Health Systems Science | Deborah Ling Grant, PhD, MPH, MBA Kaiser Permanente Department of Research and Evaluation, Southern California Permanente Medical Group | Jiaxiao Shi, PhD Kaiser Permanente Department of Research and Evaluation,…
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Vy Dang Karp, PharmD, BCSCP Optum Infusion Services | Eunjung Kim, PharmD, BCSCP Optum Infusion Services | Lisa Schrade, PharmD Optum Infusion Services | Nidhi Thaker-Mehta, PharmD Optum Infusion Services

Hemophilia is an X-linked recessive coagulation disorder which is characterized by factor VIII deficiency….

from the editor

Michelle Simpson, PharmD, BCSCP, MWC | Editor-in-Chief, Infusion Journal

This issue of Infusion Journal brings you 3 articles highlighting diverse ways pharmacist professional services have been applied in home infusion and it continues a pattern of publishing research articles studying the value pharmacists have on patient outcomes. Pharmacists can be found at the center of the prescription process collaborating and adapting to a seemingly infinite number of individual patient scenarios and clinical task workflows.

Research published in the article, A Retrospective Quality Improvement Study of Pharmacist-Directed Vancomycin Dosing Among Adult Home Infusion Patients, demonstrated the value pharmacists provide through therapeutic monitoring and interventions. Pharmacists were central to the study variables. They were a direct connection point for organizing medication treatment for home infusion patients prescribed outpatient parenteral anti-infective therapy.

Home infusion pharmacist professional services related to the research published in the article, A Retrospective Descriptive Study of Remdesivir Treatment in the Home or Outpatient Setting Among Adult Patients Diagnosed with Coronavirus Disease 2019 (COVID-19), noted a benefit of home infusion pharmacists’ ability to procure remdesivir in conjunction with the health system pharmacy. The home infusion pharmacists were the bridge for patients completing their daily infusions at home for 1,776 patients from 5 medical centers during the pandemic when diverting as many appropriate patients as possible from acute care settings was critical.

These 2 articles exemplify the necessity of the pharmacist remaining centrally involved despite differences in professional pharmacy services task categories. Home infusion pharmacists answer yes to the question of who wants to be responsible for the infusion medication plan of care and the collaborative communication the plan of care requires. Putting clinical tasks into standard categories was a first step in moving this type of research forward. A prior issue of Infusion Journal featured an article covering home infusion pharmacist professional services studied through time motion reports of clinical tasks in standardized categories. The authors described professional pharmacy services as being organized by a pharmacy and delivered by a pharmacist who applies their specialized knowledge to optimize patient care with the goal to improve health outcomes.1,2 After reading the studies here and others, we are able to compare results because the tasks are similarly defined and measured. The therapeutic monitoring and interventions collected by the authors studying pharmacist-driven vancomycin dosing were defined by the same terms as those in prior studies.

Being a central point of contact and responsibility for pharmacy services leads pharmacists to being involved in a large volume of daily tasks and workflows. This can look like web of communication and documentation between pharmacists, providers, patients, and differing technologies. When measured in terms of individual tasks divided into categories, the amount of pharmacist professional time spent for each task was small, but the number of tasks was enormous. By separating out and analyzing pharmacist time devoted to assessments and interventions in managing medications with clinical monitoring, researchers can determine these task activities averaged 8:16 min/sec in one study and 6:82 min/ sec in another.1,3 What happens when individual tasks occur concurrently with other tasks is what becomes the framework of keeping the pharmacist centrally located and the organizer of professional pharmacy services.

How pharmacists spend their time and resources makes a big impact and Infusion Journal proudly publishes research where the results provide evidence to support the value of pharmacist professional services. This issue even includes a case report where the author described a patient diagnosed with hemophilia A who contracted HIV from contaminated plasma more than 40 years ago and continues to live independently with the support of pharmacist professional services from their home infusion provider.

Infusion Journal’s mission is to share original research in infusion therapy conducted by a broad range of infusion specialists that will advance evidence-based practice and shape industry standards. We are dedicated to publishing content that reflects the interest and needs of all professions and represents infusion research. Infusion Journal welcomes submissions from authors on topics relevant to infusion therapy administered in the home, clinic, suite, or other outpatient setting.

If you have a patient case or idea for writing a case report or questions about submitting a manuscript to Infusion Journal, contact: infusionjournal@nhia.org.

Learn more about the journal and review information on manuscript submission.

1. Haines D, Garst R, Sullivan C, Charron J. A Multi-Center Time Study of Home Infusion Pharmacist Professional Services. Infusion Journal, (2022). 1(1),1-9.

2. Moullin JC, Sabater-Hernandez D, Fernandez-Llimos F, et al. Defining Professional Pharmacy Services in Community Pharmacy. Res Social Adm Pharm,(2013). 9(6),989-995.

3. Chung D, Efta J, Brunsman A, et al. Evaluation of Pharmacist Time Dedicated to Vancomycin Dosing in Adult Patients Using a 24-Hour Auc Nomogram or Trough Monitoring Approach: A Time Motion Study. Am J Health Syst Pharm,
(2022). 79(14), 1173-1179.

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