Joseph T. DiPiro's research while affiliated with Virginia Commonwealth University and other places

Publications (177)

Article
EXECUTIVE SUMMARY The 2020-21 AACP Argus Commission was charged to 1) review the 2019-2020 standing committee reports; 2) describe the impact of COVID-19 on healthcare delivery with an emphasis on health equity and social justice, 3) identify strategies to work with other health professions associations to advance interprofessional education and pr...
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Objective: The Outcomes and Assessment Committee at the Virginia Commonwealth University School of Pharmacy was tasked with refining the school's key performance indicators (KPIs) to improve programmatic assessment by focusing on the most important measures. Methods: Initially, 56 KPIs were tracked, nine of which were university mandated, divide...
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The Argus Commission examined changes that should be considered by colleges and schools of pharmacy to meet the bold aim of better integrating pharmacists' and physicians' practices articulated by President Sorensen. The Commission assessed the readiness of pharmacy educators to contribute to the acceleration of practice transformation. The primary...
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The COVID-19 pandemic has highlighted the limitations of the current health care workforce. As health care workers across the globe have been overwhelmed by the crisis, oversight entities and training programs have sought to loosen regulations to support ongoing care. Notably, however, workforce challenges preceded the current crisis. Now may be th...
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To address the changes in health care and the needs of society related to medicines, we must redefine the profession of pharmacy. We have defined the next generation pharmacists (NGP) as “a health care provider and change agent on the interprofessional health care team, personalizing medication use, managing safe and effective medication systems, a...
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The Argus Commission examined the history and current status of progressive pharmacy patient care services across several federal branches of government, including the Veterans Administration, Department of Defense, and the U.S. Public Health Service where officers and civilian pharmacists practice in the Indian Health Service, Bureau of Prisons, A...
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Objective. To develop and assess the usefulness of a structured onboarding process and tool at a school of pharmacy to improve the overall onboarding experience for new faculty members. Methods. An assessment of a previously existing, informal onboarding process was conducted from January 1 to February 28, 2017. A structured onboarding tool was dev...
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The Argus Commission examined the National Academy of Medicine's publication "Vital Directions for Health and Health Care" and engaged with six guests from outside academic pharmacy to identify the salience of the key issues and recommendations for pharmacy education and practice. To be part of the changing health care system we must prepare gradua...
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Objective: To enhance the achievement of a college of pharmacy's goals for education, research, and service missions by implementing an excellence program based on the Studer Group model for continuous quality improvement. Methods: The Studer model was combined with university strategic planning for a comprehensive quality-improvement program th...
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Pharmacy education has changed much for the better over the past few decades and we can expect many more changes as societal expectations of pharmacists increase and the healthcare system evolves to patient-focused, team-based care. We now produce excellent generalist graduates who are effective as community and health-system pharmacists almost fro...
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Following the centennial celebration activity of AACP the Journal returned to its normal operating tempo. A sufficient number of manu- scripts were submitted to allow for a good representation of the activ- ity in our academy. A total of seventy-six papers were submitted and reviewed for publication in the year 2000. Fifty-two papers were pub- lish...
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To assess the current status of multi-campus colleges and schools of pharmacy within the United States. Data on multi-campus programs, technology, communication, and opinions regarding benefits and challenges were collected from Web sites, e-mail, and phone interviews from all colleges and schools of pharmacy with students in class on more than 1 c...
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The strength and vitality of publications in our profession and pharmaceutical science disciplines are centered on the premise of a high-quality manuscript peer review process. Peer review is the essential element in promoting quality and excellence in the papers published in our scientific, educational, and professional journals. Peer review provi...
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Recommendations for vaccination of injured patients against infection are evolving. Newly-recognized infections, safety considerations, changing epidemiology, and redefinition of patient groups at risk are factors that may influence vaccine development priorities and recommendations for immunization. However, recommendations must often be formulate...
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Tumor necrosis factor-alpha (TNF-alpha) is a proinflammatory cytokine involved in a wide range of important physiologic processes. This cytokine has a pathologic role in some diseases, and TNF-alpha antagonists are effective in treating inflammatory conditions. Given the putative role of TNF-alpha in host defense against tuberculosis and other infe...
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Prescription drug prices with and without the use of Medicare-approved drug discount card programs (MADDCs) to purchase medications were studied. The Medicare.gov Web site was used to determine if the 200 most frequently prescribed drugs in the United States in 2003 were covered by a MADDC. The lowest and highest MADDC prices at local and mail-orde...
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The purpose of this study is to determine if there is a difference in renal transplant patients' (RTPs) adherence to cyclosporine compared to tacrolimus when medications are supplied free to the RTPs. Adult primary RTPs were included in the study if they received a renal transplant at the Medical College of Georgia (MCG) from June 1998 through Augu...
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These guidelines, from the Infectious Diseases Society of America (IDSA), the Surgical Infection Society, the American Society for Microbiology, and the Society of Infectious Disease Pharmacists, contain evidence-based recommendations for selection of antimicrobial therapy for adult patients with complicated intra-abdominal infections. Complicated...
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Objectives. The implementation of a required third-year introductory pharmacy practice experience (IPPE) in the University of Georgia College of Pharmacy's professional curriculum is described, and outcomes associated with the experience are evaluated. The IPPE involved fourth-year advanced pharmacy practice experience students facilitating the pat...
Chapter
• Antimicrobial therapy is an adjunct to primary source control procedures in treating patients with intra-abdominal infections. • Therapeutic antimicrobials (those given for longer than 24 h) are required only for patients with established intra-abdominal infections. Patients with limited exposure to contamination from a perforated viscus and thos...
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New communication technology brings both promise and problems. Some see technology as a potentially great positive force in our universities. Application of new technology to teaching has been supported because it is perceived to be more efficient, convenient, flexible, accessible, and attractive to the younger generation, while giving faculty a ne...
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The objective of this study was to determine if African-American renal transplant patients who received direct patient care from a clinical pharmacist had better blood pressure control compared to African-American renal transplant patients who did not have clinical pharmacy services. Renal transplant patients were prospectively randomized into an i...
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A literature search was conducted to examine the safety and effectiveness of low-dosage methotrexate for treatment and maintenance of remission in patients with inflammatory bowel disease. Nine published articles indicated that for patients with Crohn's disease, oral or intramuscular methotrexate 20-25 mg/week is safe and effective to induce remiss...
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While there have been many public discussions concerning Medicare covering outpatient prescription medications, currently, Medicare does not pay for most outpatient prescriptions. Meanwhile, costs associated with prescription medications as well as the number of underinsured patients are rapidly increasing. Many pharmaceutical companies offer assis...
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The Surgical Infection Society last published guidelines on antimicrobial therapy for intra-abdominal infections in 1992 (Bohnen JMA, et al., Arch Surg 1992;127:83-89). Since then, an appreciable body of literature has been published on this subject. Therefore, the Therapeutics Agents Committee of the Society undertook an effort to update the previ...
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Aminoglycosides, combined with antianaerobic agents, have been used widely for the treatment of intra-abdominal infection. However, some prospective randomized controlled trials and other data suggested that aminoglycosides were less efficacious than newer comparators for the treatment of these infections. We therefore performed a meta-analysis of...
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Revised guidelines for the use of antimicrobial therapy in patients with intra-abdominal infections were recently developed by the Therapeutic Agents Committee of the Surgical Infection Society (Mazuski et al., Surg Infect 2002;3:161-173). These were based, insofar as possible, on evidence published over the past decade. The objective of this docum...
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Non-compliance with immunosuppressive medications may result in allograft rejection and is regarded as an important impediment to post-transplant care. This randomized, controlled trial evaluates the impact of clinical pharmacy services on renal transplant patients' compliance with immunosuppressive agents. Patients who received a renal transplant...
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Noncompliance with immunosuppressive medications after renal transplantation is believed to be a major cause of allograft rejection and graft loss, with the impressive costs of these agents considered a significant reason for noncompliance. Our purpose was to determine the compliance rates of renal transplant patients who received their immunosuppr...
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Medicare pays for 80% of the cost of immunosuppressant agents needed within the first 3 years of solid organ transplantation; however, many patients cannot afford the remaining 20%. Furthermore, many patients who are beyond 3 years post-transplantation and have prescription coverage cannot afford the co-payment for these medications. Other patients...
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Pharmaceutical manufacturers have programs available to supply medications to indigent patients at little or no cost. Enrolling needy patients into these programs should increase patient compliance to medications, minimize patient and institution financial burdens, and decrease adverse events associated with medication noncompliance. However, acces...
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Pharmaceutical company-sponsored medication assistance programs and the pharmacist's role in obtaining medications for indigent patients are discussed. Information about enrolling in medication assistance programs can be obtained through a variety of sources, including the Internet. Although some eligibility criteria may be common to many programs,...
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Postoperative infections are not consistently controlled by current practice measures. From a recent study of 12,384 patients, postoperative infection occurred in 22% of colorectal procedures and 25% of upper gastrointestinal procedures. Infections were associated with a higher death rate, longer hospitalization, and more intense post-discharge car...
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The purpose of this study was to determine the value of prepharmacy GPA, PCAT scores, and prior attainment of a four-year college degree in predicting the academic performance ranking of first-year pharmacy students. Specific objectives of the study were to: (i) identify the value of prepharmacy GPA, prepharmacy math/science GPA, PCAT scores and th...
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Therapeutic drug monitoring is commonly used in both the ambulatory and hospital patient care settings. Routine measurement of concentrations of therapeutic agents in biological fluids is critical for certain drugs to maintain therapeutic benefit with minimizing drug-associated toxicities. Many analytical laboratory techniques are currently availab...
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In-hospital mortality, length of stay (LOS), and level of postdischarge care in infected and noninfected surgical patients were studied. An analysis was conducted of a database that included diagnostic, procedure, and drug data collected when surgical patients were discharged from the hospital. Hospitals consisted of 90 nongovernment, nonspecialty,...
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To determine the time course of plasma immunoglobulin E (IgE) concentration increases after traumatic injury, if increased IgE concentrations were related to clinical events or complications, and if increased peripheral eosinophil counts could be related to trauma, sepsis, or organ-specific complications. Data relating to severity of injury, clinic...
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Our objective was to determine the effects of anticoagulants and blood loss on hemodynamic, hematologic, and coagulation parameters following autotransfusion in an animal model of intraabdominal hemorrhage. We performed a prospective, randomized observational animal study at an animal research laboratory at a university medical center. Eight Landra...
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Distinct cytokine profiles are clearly associated with and relate to the severity of several types of infections. Cytokine networks are apparent with selected human infectious diseases, such as mycobacterial infections (leprosy, tuberculosis), the parasitic infection leishmaniasis, human immunodeficiency virus (HIV) infection, and gram-negative sep...
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"Pharmacodynamics" refers to the relationship of drug concentrations in serum or tissues to effects on biologic systems. Concepts used to describe antimicrobial pharmacodynamics include the minimal inhibitory concentration (MIC), the minimal bactericidal concentration (MBC), and serum bactericidal titers (SBT), as well as post-antibiotic effect. Pe...
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Extracorporeal membrane oxygenation (ECMO) is a widely used therapy for neonates with respiratory failure. Because of sepsis, many of these infants require antibiotics like vancomycin during ECMO treatment. ECMO transiently alters renal function and increases the circulating blood volume by 75%. Initial vancomycin pharmacokinetics were determined i...
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Interleukin-10 (IL-10) is a potent regulator of proinflammatory cytokines, including tumor necrosis factor-alpha, IL-1, IL-6, and interferon-gamma. We retrospectively evaluated 66 severely injured patients for detectable plasma IL-10. The presence or absence of IL-10 was correlated with clinical parameters. Forty of 66 patients had detectable level...
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Interleukin-10 (IL-10) is a potent regulator of proinflammatory cytokines, including tumor necrosis factor-alpha, IL-1, IL-6, and interferon-gamma. We retrospectively evaluated 66 severely injured patients for detectable plasma IL-10. the presence or absence of IL-10 was correlated with clinical parameters. Forty of 66 patients had detectable level...
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Reconstituted human high-density lipoprotein (HDL) can inhibit lipopolysaccharide effects in vivo. The major objectives of this study were to characterize the pharmacokinetics of reconstituted HDL in a stressed large-animal model and to provide preclinical tolerance information in support of use of reconstituted HDL in humans. A randomized, blinded...
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To determine if interleukin-4 (IL-4) could be detected in plasma of trauma patients and if IL-4 activity is associated with patterns of clinical events, complications, or outcomes. A prospective case series conducted in a tertiary care referral center with a level I trauma center. One hundred patients admitted to the trauma intensive care unit for...
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As space flight becomes more commonplace, the influence of physiologic changes associated with the microgravity environment become of greater concern. Exposure to weightlessness has been shown to have numerous effects on body composition and organ function in animals and humans. However, studies examining possible alterations in drug metabolism and...
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Plasma triglyceride analyses to evaluate the clearance of IV fat emulsion are necessary in patients receiving parenteral nutrition. Enzymatic kits for triglyceride analysis measure the glycerol that is hydrolyzed from triglyceride. This study investigates the effect of fat emulsion free glycerol on plasma triglyceride determination. Venous blood fr...
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We conducted a prospective surveillance study of 80 hospitals across the United States to determine the incidence of sepsis syndrome and its associated sequelae in hospitalized patients over age 18 years who were administered antibiotics for suspected or documented gram-negative infection. A sample of 1754 hospitalized patients were followed from o...
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Intraabdominal infections are a wide range of diseases that include penetrating abdominal trauma, appendicitis, peritonitis, and abscess. Most are polymicrobic, involving aerobic and anaerobic bacteria. The primary treatment is surgery, but important issues regarding administration of antimicrobials may affect patient outcome. Evaluation of an anti...