Pharmacists' role in glycemic management in the inpatient setting: An opinion of the endocrine and metabolism practice and research network of the American College of Clinical Pharmacy

Abstract

The objective of this opinion paper was to identify and describe the role of pharmacists in ensuring safe and optimal management of patients with glycemic excursions in the inpatient setting. The role of the pharmacist includes involvement in admission medication history and reconciliation, formulary management of glucose‐lowering medications and devices, individual patient medication management, discharge transition of care, and interprofessional collaboration with other health care providers. Recommendations are based on review of published guidelines and literature focusing on the management of patients with hypo‐ and hyperglycemia in the hospital as well as during the time of transition to and from the inpatient setting.

Positive Patient Postoperative Outcomes with Pharmacotherapy: A Narrative Review including Perioperative-Specialty Pharmacist Interviews

“…Pharmacists attached to various surgical services have provided consultation to anesthesiologists at the service and individual patient levels regarding local anesthetic systemic toxicity (LAST) and enhanced recovery analgesic/anesthetic pathways (in light of the recent move toward increased local anesthetic use to reduce opioid exposure) as well as evolving surgical techniques. Collaboration with surgeons has often focused on risk assessments and treatment recommendations for preoperative and pharmacokinetic-based antimicrobial optimization [ 157 ], VTE and PONV prophylaxis [ 144 , 147 ], postoperative pain management, POI mitigation, and electrolyte replacement and nutrition support, including glycemic control [ 158 ]. In one 20-month pre-/post-study in which clinical pharmacists were directly involved, pre-implementation colonic SSIs were reduced from 10% to 2%, VTE rate decreased from 0.6% to 0%, and postoperative readmission rate decreased from 4.8% to 1.3% [ 111 ].…”

Real-world community hospital hyperglycemia management in noncritically ill, type 2 diabetic patients: a comparison between basal-bolus insulin and correctional insulin

“…can affect blood glucose (BG) levels. Multiple studies of pharmacy-led inpatient hyperglycemic management have demonstrated success in improving patient outcomes [ 4 – 8 ]. However, most hospitals do not have a designated team ( i.e.…”

“…can affect blood glucose (BG) levels. Multiple studies of pharmacy-led inpatient hyperglycemic management have demonstrated success in improving patient outcomes [4][5][6][7][8]. However, most hospitals do not have a designated team (i.e., diabetes stewardship) to assess and adjust insulin regimens (e.g., sliding scale intensity, dose, etc.…”

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“…can affect blood glucose (BG) levels. Multiple studies of pharmacy-led inpatient hyperglycemic management have demonstrated success in improving patient outcomes [4][5][6][7][8]. However, most hospitals do not have a designated team (i.e., diabetes stewardship) to assess and adjust insulin regimens (e.g., sliding scale intensity, dose, etc.…”