Preparing for implementation of a medication reconciliation measure for dialysis: Expanding the role of pharmacy technicians Christopher Codd, BS, Christopher Codd, BS University of Michigan College of Pharmacy, Ann Arbor, MI Search for other works by this author on: Oxford Academic Google Scholar Daniel Martinusen, PharmD, ACPR, FCSHP, Daniel Martinusen, PharmD, ACPR, FCSHP British Columbia Renal Network, Vancouver, Canada Search for other works by this author on: Oxford Academic Google Scholar Katie E Cardone, PharmD, BCACP, FASN, FCCP, FNKF, Katie E Cardone, PharmD, BCACP, FASN, FCCP, FNKF Albany College of Pharmacy and Health Sciences, Albany NY Search for other works by this author on: Oxford Academic Google Scholar Katherine Cho, PharmD, Katherine Cho, PharmD University of Michigan College of Pharmacy, Ann Arbor, MI Search for other works by this author on: Oxford Academic Google Scholar Amy Barton Pai, PharmD, MHI, FASN, FCCP, FNKF Amy Barton Pai, PharmD, MHI, FASN, FCCP, FNKF University of Michigan College of Pharmacy, Ann Arbor, MI Address correspondence to Dr. Pai (amypai@med.umich.edu) Search for other works by this author on: Oxford Academic Google Scholar American Journal of Health-System Pharmacy, Volume 77, Issue 11, 1 June 2020, Pages 892–896, https://doi.org/10.1093/ajhp/zxaa077 Published: 18 May 2020

Objectives: Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause community-acquired acute kidney injury, especially in high-risk populations. Both the U.S. Food and Drug Administration (FDA) medication guide and over-the-counter labeling vaguely describe kidney risks of NSAIDs and do not provide information for patients to evaluate their risk for kidney problems. The purpose of this study was to use a mobile application to evaluate the impact of patient choice of media delivering NSAID avoidance education on patient knowledge about kidney risks associated with NSAIDs. Design: Prospective cohort study. The mobile application was used to deliver either a redesigned FDA medication guide or a video focused on NSAID risks (selected by the patient), followed by patient knowledge questions (PKQs) and a kidney risk assessment. Setting and participants: One hundred fifty adult primary care patients in southeast Michigan. Main outcome measures: The primary outcome was the score on 5 NSAID PKQs between the media selected. Secondary outcomes included characterization of media choice among different demographic and NSAID kidney risk groups. The relationship between kidney risk assessment and self-reported NSAID avoidance behavior also was evaluated. Results: The majority of participants (72.7%) chose to review print material. Those that chose print had significantly higher PKQ scores (5 total points) compared with participants who selected the video: mean scores 4.2 +/- 0.9 with print and 3.8 +/- 1.0 with video (P = 0.034). Older patients (>65 years) had significantly lower PKQ scores compared with other age groups. Forty-four percent of individuals (n = 66) reported current NSAID use, and 65% stated that they would avoid NSAIDs after the selected education material. Conclusion: Scores for questions related to NSAID kidney risk knowledge were higher among participants who chose print compared with video education material. Education regarding NSAID kidney risks encouraged patients to limit their use. Targeted education may be beneficial in high-risk (e.g., older) patients and should be further studied. (C) 2019 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.

M. bovis strain Bacillus Calmette-Guérin (BCG) has been the only licensed live attenuated vaccine against tuberculosis (TB) for nearly one century and has also been approved as a therapeutic vaccine for bladder cancer treatment since 1990. During its long time usage, different adverse events (AEs) have been reported. However, the AEs associated with the BCG preventive TB vaccine and therapeutic cancer vaccine have not been systematically compared. In this study, we systematically collected various BCG AE data mined from the US VAERS database and PubMed literature reports, identified statistically significant BCG-associated AEs, and ontologically classified and compared these AEs related to these two types of BCG vaccine. From 397 VAERS BCG AE case reports, we identified 64 AEs statistically significantly associated with the BCG TB vaccine and 14 AEs with the BCG cancer vaccine. Our meta-analysis of 41 peer-reviewed journal reports identified 48 AEs associated with the BCG TB vaccine and 43 AEs associated with the BCG cancer vaccine. Among all identified AEs from VAERS and literature reports, 25 AEs belong to serious AEs. The Ontology of Adverse Events (OAE)-based ontological hierarchical analysis indicated that the AEs associated with the BCG TB vaccine were enriched in immune system (e.g., lymphadenopathy and lymphadenitis), skin (e.g., skin ulceration and cyanosis), and respiratory system (e.g., cough and pneumonia); in contrast, the AEs associated with the BCG cancer vaccine mainly occurred in the urinary system (e.g., dysuria, pollakiuria, and hematuria). With these distinct AE profiles detected, this study also discovered three AEs (i.e., chills, pneumonia, and C-reactive protein increased) shared by the BCG TB vaccine and bladder cancer vaccine. Furthermore, our deep investigation of 24 BCG-associated death cases from VAERS identified the important effects of age, vaccine co-administration, and immunosuppressive status on the final BCG-associated death outcome.