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Introduction Antimuscarinics should be used with caution in older adults with overactive bladder (OAB) due to anticholinergic adverse events (AEs). Systematic reviews and meta-analyses (SRMAs) have analyzed safety-related outcomes but have not specified risk in the elderly, the population at highest risk for AEs. The aim of this review is to explore and evaluate AEs and treatment discontinuations in adults 65 or older taking antimuscarinics for OAB. Methods Keywords were searched in MEDLINE, EMBASE, SCOPUS, and Cochrane Central Register for Controlled Trials. Randomized controlled trials (RCTs) along with sub-analyses and pooled analyses that compared antimuscarinics to placebo or another antimuscarinic were performed in February 2015. Studies assessing AEs or treatment discontinuations in a population of adults 65 or older were included. The Jadad Criteria and McHarm Tool were used to assess the quality of the trials. Results A total of 16 studies met the inclusion criteria. Eighty AEs and 27 reasons for treatment discontinuation were described in the included studies and further explored. Anticholinergic AEs were more common in antimuscarinics compared to placebo. Incidence of dizziness, dyspepsia, and urinary retention with fesoterodine, headache with darifenacin, and urinary tract infections with solifenacin were significantly higher compared to placebo. Treatment discontinuation due to AEs and dry mouth were higher in the antimuscarinics when compared to placebo in older adults. Conclusions Treatment for overactive bladder using antimuscarinics in adults aged 65 or older resulted in significant increases in risk for several AEs compared to placebo including anticholinergic and non-anticholinergic AEs.

Objective: Nonprescription or over-the-counter (OTC) medications play a crucial role in a patient's ability to make choices to manage his or her own health care. Often these nonprescription choices are unknown to health care practitioners and thus are often not included as part of patients' health records. The exclusion of these therapies can pose risks to patient safety. There is a significant need to address the capture of OTC medication use in both the physician and pharmacy electronic health records (EHRs) and during the practitionerepatient medication history and reconciliation process. Data sources: On October 26, 2016, the National Association of Chain Drug Stores Foundation hosted a forum for a select group of health care industry professionals to work on a series of recommendations to improve the documentation of OTC medication use by patients. This diverse group of more than a dozen stakeholders included community pharmacy leaders from multiple chain pharmacies, pharmacy system vendors, e-prescribing vendors, health information technology experts, and multiple industry representatives, including individuals from the public sector. This commentary is a summary of the insights and suggestions where the group was in general agreement. Summary: Successful OTC medication EHR integration will require system-level buy-in across multiple layers of the health care industry to improve patient safety. Forum participants suggested incremental steps that could be taken by multiple stakeholders to lay the foundation for integration within an appropriate regulatory structure. Conclusion:Based on the results of the stakeholder forum, an agreement formed around one approach that the group supported as feasible: the creation of a consistent and uniform identification method for OTC medications in cooperation with government regulatory authorities.

Objective. To develop a comprehensive instrument specific to student pharmacist-patient communication skills, and to determine face, content, construct, concurrent, and predictive validity and reliability of the instrument. Methods. A multi-step approach was used to create and validate an instrument, including the use of external experts for face and content validity, students for construct validity, comparisons to other rubrics for concurrent validity, comparisons to other coursework for predictive validity, and extensive reliability and inter-rater reliability testing with trained faculty assessors. Results. Patient-centered Communication Tools (PaCT) achieved face and content validity and performed well with multiple correlation tests with significant findings for reliability testing and when compared to an alternate rubric. Conclusion. PaCT is a useful instrument for assessing student pharmacist communication skills with patients.Keywords: communication tools; provider-patient relationship; patient-centered; pharmacist-patient instrument INTRODUCTIONEffective communication requires active participation by patients and health care providers to ensure that messages are received and interpreted accurately by all parties. This is especially true for pharmacists as evidenced by a World Health Organization (WHO) report indicating that one of the seven roles of the pharmacist is "communicator."1 The 2016 Accreditation Council for Pharmacy Education (ACPE) guidelines for Doctor of Pharmacy degree programs explicitly define expectations for communication in the standards.2 Standard 3 (Approach to Practice and Care), Key Element 3.6 outlines that "graduates must be able to effectively communicate verbally and nonverbally when interacting with individuals, groups, and organizations." Additionally, professional communication is described as a required element of the didactic curriculum in Appendix 1 of the Standards. 2 The Center for the Advancement of Pharmacy Education (CAPE) is recognized by schools and colleges of pharmacy, the American Association of Colleges of Pharmacy (AACP), and ACPE as the foundational driver for curricular design, mapping, and setting program expectations. Updated outcomes were released by CAPE in 2013 that specifically mention communication in Domain 3 (3.6 Communicator) and indirectly within the description of collaboration (3.4 Collaborator). 3Studies have shown that pharmacist communication skills can be improved with education and training.4,5 A recent literature review of communications training and assessment in pharmacy education by Wallman and colleagues revealed that the majority of education and training occurs with patient-focused communication activities, such as learning interviewing techniques, patient counseling or public health promotion.6 Several published articles describe objective assessment of student pharmacist oral communication with a patient, such as structured exam, pre/post evaluations, and expert/professor assessment of skills. Other articles describe subjective a...