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Health care professionals often don’t think twice about adding a new medication when a patient is not at goal. But we’re reluctant to stop a medication for a chronic condition when the patient appears to be stable and doing well.  Polypharmacy in older adults is a significant problem.  It’s costly and increases the likelihood of adverse effects. Several observational studies have suggested that lower blood pressure and multiple antihypertensive medications may be harmful in the elderly. Is it possible to discontinue medications without causing serious harm?

Guest Authors: Keturah Weaver Pharm D, BCPS and Daniel Longyhore Pharm D, M.S., BCACP

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Sales of cannabinoid-containing products continue to rise. In 2020 it became a billion-dollar industry. With the increased use and popularity of CBD products, every clinician needs to critically appraise the evidence to determine if CBD should play a role in pain management and help educate patients about the potential risks.

Guest Author:  Alex R. Mills, PharmD, BCACP, AAHIVP

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Nearly 1 in 8 Americans older than 12 used illicit substances in 2018, including misuse of prescription medications. In addition, more than 80% of those who would benefit from substance use treatment in the past year did not receive it. Thus, the importance of identifying and offering treatment should be a priority — particularly in primary care settings. However, there are many barriers to implementing unhealthy substance use screening including pervasive stigma, lack of clinician comfort, logistics, and limited knowledge of or avenues for treatment when unhealthy drug use is uncovered. The US Preventative Services Task Force (USPSTF) recently published updated recommendations on drug use screening.

Guest Authors: Melissa C. Palmer, PharmD, BCPS, BCPP; Jordan Cooler, PharmD, BCPP; and Amanda Stahnke, PharmD, BCACP

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Pharmacists providing effective comprehensive medication management (CMM) services in interprofessional care settings can contribute to improved patient outcomes. Core components of a successful practice include a clearly articulated philosophy of practice, a systematically implemented process of care, and an effective practice management system.  Although much has been written about the first two components, less is known about what is required to create an effective practice management system.

Guest Authors:  Elizabeth Cook, PharmD, BCACP, AE-C, CDE and Leslie Walters, PharmD, BCACP

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Peripheral artery disease (PAD) impacts 8.5 million Americans age 40 years or older, often leading to acute limb ischemia, amputation, hospitalization, revascularization, major adverse cardiac events (MACE), and death. In addition to being at very high risk of MACE, more than 10% of PAD patients who had revascularization surgery are hospitalized for major adverse limb events, including acute limb ischemia leading to amputation. Could combination therapy, an antithrombotic regimen comprised of a direct oral anticoagulant and an antiplatelet agent, help prevent limb ischemia and cardiovascular (CV) events in these high-risk patients?

Guest Authors:  Navya Varshney, PharmD, BCPS and Rachel Lowe, PharmD, BCPS

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