{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T05:42:58Z","timestamp":1732081378199,"version":"3.28.0"},"reference-count":11,"publisher":"American Association of Psychiatric Pharmacists (AAPP)","issue":"1","license":[{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"},{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n        <jats:sec>\n          <jats:title>Introduction<\/jats:title>\n          <jats:p>The Psychotropic Drug Safety Initiative (PDSI) is a national Veterans Affairs program that recommends obtaining cardiovascular vital signs semiannually and urine toxicology screening annually for veterans prescribed stimulants. The PDSI also recommends a risk review of concurrent central nervous system (CNS) depressants to ensure the benefits of coadministration with stimulants outweigh the risks. This project\u2019s purpose was to evaluate the occurrence of coprescriptions for CNS depressants and stimulants and encourage compliance with the PDSI recommendations to increase safe and appropriate management of veterans prescribed the combination. This study aimed to evaluate the occurrence of coprescriptions for CNS depressants and stimulants, evaluate compliance with stimulant monitoring recommendations, and measure the proportion of pharmacist recommendations implemented by the prescriber.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Methods<\/jats:title>\n          <jats:p>This quality improvement project identified veterans with an outpatient prescription for a stimulant and any coprescription(s) for benzodiazepines, sedative-hypnotics, and\/or opioids. A pharmacy intervention note was generated to request a risk review, provide recommendations for de-escalation, and notify the stimulant prescriber of overdue monitoring parameters. Impact was measured 60 days after intervention. Descriptive statistics and a McNemar test were used to compare preintervention and postintervention data.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Results<\/jats:title>\n          <jats:p>From the 61 patients included, there were 67 unique prescriptions for benzodiazepines (49.3%), sedative-hypnotics (34.3%), and opioids (16.4%) in combination with a stimulant. Pharmacist intervention resulted in de-escalation of coprescribing for 9 patients (16.1%) and was associated with statistically significant improvement in compliance to stimulant monitoring recommendations.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Discussion<\/jats:title>\n          <jats:p>Clinical pharmacists can assist in ensuring safe and appropriate monitoring and management of veterans prescribed stimulants.<\/jats:p>\n        <\/jats:sec>","DOI":"10.9740\/mhc.2024.02.017","type":"journal-article","created":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T11:12:11Z","timestamp":1707390731000},"page":"17-22","source":"Crossref","is-referenced-by-count":0,"title":["Clinical pharmacist intervention to ensure safe stimulant prescribing practices at a Veterans Affairs facility"],"prefix":"10.9740","volume":"14","author":[{"given":"Bailey B.","family":"Bass","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lacey J.","family":"Vann","sequence":"additional","affiliation":[{"name":"Mental Health Clinical Pharmacist Practitioner, Mental Health Department, Ralph H. Johnson Veterans Affairs Medical Center, Savannah, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4719","reference":[{"key":"i2168-9709-14-1-17-b01","unstructured":"Prescription stimulants drug facts [Internet].\nNational Institute on Drug Abuse[2018 Jun 6; cited 2022 Sep 7]. Available from: https:\/\/nida.nih.gov\/publications\/drugfacts\/prescription-stimulants","article-title":"National Institute on Drug Abuse"},{"key":"i2168-9709-14-1-17-b02","series-title":"Curr Top Behav Neurosci","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/7854_2022_330","article-title":"Current pharmacological treatments for ADHD","volume":"57","author":"Groom","year":"2022","unstructured":"Groom\n              MJ\n            ,\nCorteseS.\n          Current pharmacological treatments for ADHD.\nCurr Top Behav Neurosci.\n2022;\n57:\n19\u2013\n50."},{"issue":"(11)","key":"i2168-9709-14-1-17-b03","series-title":"PLoS One","first-page":"e0206100","article-title":"Trends in use of prescription stimulants in the United States and Territories, 2006 to 2016","volume":"13","author":"Piper","year":"2018","unstructured":"Piper\n              BJ\n            ,\nOgdenCL,\nSimoyanOM,\nChungDY,\nCaggianoJF,\nNicholsSD,\net al.\n          Trends in use of prescription stimulants in the United States and Territories, 2006 to 2016.\nPLoS One.\n2018;\n13(11):\ne0206100.\nDOI: 10.1371\/journal.pone.0206100. PubMed PMID: 30485268; PubMed Central PMCID: PMC6261411."},{"issue":"(1)","key":"i2168-9709-14-1-17-b04","series-title":"J Am Acad Child Adolesc Psychiatry","first-page":"21","article-title":"Misuse and diversion of stimulants prescribed for ADHD: a systematic review of the literature","volume":"47","author":"Wilens","year":"2008","unstructured":"Wilens\n              T\n            ,\nAdlerL,\nAdamsJ,\nSgambatiS,\nRotrosenJ,\nSawtelleR,\net al.\n          Misuse and diversion of stimulants prescribed for ADHD: a systematic review of the literature.\nJ Am Acad Child Adolesc Psychiatry.\n2008;\n47(1):\n21\u2013\n31.\nDOI: 10.1097\/chi.0b013e31815a56f1. PubMed PMID: 18174822."},{"issue":"(02)","key":"i2168-9709-14-1-17-b05","series-title":"J Clin Psychiatry","first-page":"253","article-title":"Blood pressure changes associated with medication treatment of adults with attention-deficit\/hyperactivity disorder","volume":"66","author":"Wilens","year":"2005","unstructured":"Wilens\n              TE\n            ,\nHammernessPG,\nBiedermanJ,\nKwonA,\nSpencerTJ,\nClarkS,\net al.\n          Blood pressure changes associated with medication treatment of adults with attention-deficit\/hyperactivity disorder.\nJ Clin Psychiatry.\n2005;\n66(02):\n253\u2013\n9.\nDOI: 10.4088\/JCP.v66n0215. PubMed PMID: 15705013."},{"issue":"(6)","key":"i2168-9709-14-1-17-b06","series-title":"Eur Neuropsychopharmacol","first-page":"534","article-title":"Meta-analysis of increased heart rate and blood pressure associated with CNS stimulant treatment of ADHD in adults","volume":"23","author":"Mick","year":"2013","unstructured":"Mick\n              E\n            ,\nMcManusDD,\nGoldbergRJ.\n          Meta-analysis of increased heart rate and blood pressure associated with CNS stimulant treatment of ADHD in adults.\nEur Neuropsychopharmacol.\n2013;\n23(6):\n534\u2013\n41.\nDOI: 10.1016\/j.euroneuro.2012.06.011. PubMed PMID: 22796229; PubMed Central PMCID: PMC3488604."},{"issue":"(7)","key":"i2168-9709-14-1-17-b07","series-title":"J Am Coll Cardiol","first-page":"858","article-title":"Cardiovascular effects of ADHD therapies: JACC review topic of the week","volume":"76","author":"Torres-Acosta","year":"2020","unstructured":"Torres-Acosta\n              N\n            ,\nO\u2019KeefeJH,\nO\u2019KeefeCL,\nLavieCJ.\n          Cardiovascular effects of ADHD therapies: JACC review topic of the week.\nJ Am Coll Cardiol.\n2020;\n76(7):\n858\u2013\n66."},{"key":"i2168-9709-14-1-17-b08","series-title":"Eur Psychiatry","first-page":"14","article-title":"Updated European Consensus Statement on diagnosis and treatment of adult ADHD","volume":"56","author":"Kooij","year":"2019","unstructured":"Kooij\n              JJS\n            ,\nBijlengaD,\nSalernoL,\nJaeschkeR,\nBitterI,\nBal\u00e1zsJ,\net al.\n          Updated European Consensus Statement on diagnosis and treatment of adult ADHD.\nEur Psychiatry.\n2019;\n56:\n14\u2013\n34.\nDOI: 10.1016\/j.eurpsy.2018.11.001. PubMed PMID: 30453134."},{"issue":"(9)","key":"i2168-9709-14-1-17-b09","series-title":"Am Fam Physician","first-page":"890","article-title":"Diagnosis and management of adult attention-deficit\/hyperactivity disorder","volume":"85","author":"Post","year":"2012","unstructured":"Post\n              RE\n            ,\nKurlansikSL.\n          Diagnosis and management of adult attention-deficit\/hyperactivity disorder.\nAm Fam Physician.\n2012;\n85(9):\n890\u2013\n6."},{"issue":"(35)","key":"i2168-9709-14-1-17-b10","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"1189","article-title":"Vital signs: characteristics of drug overdose deaths involving opioids and stimulants\u201324 states and the District of Columbia, January-June 2019","volume":"69","author":"O\u2019Donnell","year":"2020","unstructured":"O\u2019Donnell\n              J\n            ,\nGladdenRM,\nMattsonCL,\nHunterCT,\nDavisNL.\n          Vital signs: characteristics of drug overdose deaths involving opioids and stimulants\u201324 states and the District of Columbia, January-June 2019.\nMMWR Morb Mortal Wkly Rep.\n2020;\n69(35):\n1189\u2013\n97."},{"issue":"(2)","key":"i2168-9709-14-1-17-b11","series-title":"Fed Pract","first-page":"86","article-title":"Stimulant medication prescribing practices within a VA health care system","volume":"37","author":"Richmond","year":"2020","unstructured":"Richmond\n              C\n            ,\nButlerJ.\n          Stimulant medication prescribing practices within a VA health care system.\nFed Pract.\n2020;\n37(2):\n86\u2013\n91."}],"container-title":["Mental Health Clinician"],"original-title":[],"link":[{"URL":"https:\/\/mhc.kglmeridian.com\/view\/journals\/mhcl\/14\/1\/article-p17.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/mhc\/article-pdf\/14\/1\/17\/3326053\/i2168-9709-14-1-17.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/mhc.kglmeridian.com\/downloadpdf\/journals\/mhcl\/14\/1\/article-p17.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/mhc.kglmeridian.com\/downloadpdf\/journals\/mhcl\/14\/1\/article-p17.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:33:02Z","timestamp":1732062782000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhc.kglmeridian.com\/view\/journals\/mhcl\/14\/1\/article-p17.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":11,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.9740\/mhc.2024.02.017","relation":{},"ISSN":["2168-9709"],"issn-type":[{"type":"electronic","value":"2168-9709"}],"subject":[],"published":{"date-parts":[[2024,2]]}}}