From the Editor

From Evidence to Practice Knowledge has to be improved, challenged, and increased constantly, or it vanishes. — Peter Drucker Management consultant and author

I

n 2001, the Institute of Medicine’s Committee on the Quality of Health Care in America recommended a redesign of the American health care system in a report, Crossing the Quality Chasm: A New Health System for the 21st Century.1 When discussing how new evidence is applied to practice, the report notes, “It now takes an average of 17 years for new knowledge generated by randomized controlled trials to be incorporated into practice, and even then application is highly uneven.” Researchers have studied the effect of this time gap as well as how rapidly evidence is adopted in different practice settings (e.g., academic vs. community). The publication of consensus guidelines, based on the results of clinical trials and expert opinion, is included in this publication phenomenon. In this issue, we are publishing two articles on recent updates to clinical practice. In the first, Tracy D. Mahvan and colleagues review the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of blood cholesterol to reduce the risk of future atherosclerotic disease. It has been almost a decade since the previous guidelines were published, which, although they were not universally followed by clinicians, were representative of the standard of care in most parts of North America. The scientific evidence has been applied differently in these new guidelines; hence, the treatment approach for high cholesterol is somewhat different. This article should get you up-to-date on the implications and use of this new treatment strategy. Atrial fibrillation, the most prevalent cardiac arrhythmia in older adults, can be effectively treated in most people. The evidence-based treatment options on

60

medications have evolved over the last decade, moving to a primary strategy of controlling heart rate. Unfortunately, practitioners do not consistently incorporate this new evidence into practice. The authors, Cassandra Erlich and Laura V. Tsu, provide an evidence-based review of the current literature, including recently published clinical practice guidelines. This article will help you to identify those who might be receiving less than ideal treatment, incurring unnecessary drug-related morbidity. The treatment of asthma and chronic obstructive pulmonary disease is dominated by inhaled medication therapies. The devices and medications differ by disease as well as by device. As noted by Adam J. Vanderman and colleagues, poor inhaler technique is associated with morbidity and poor disease control. This article looks at the rate of inhaler misuse and discusses factors related to misuse and the importance of evaluating inhaler technique. This is timely and important information, as a number of new inhaler devices have been approved in recent years. Medicare Part D is a benefit that many older adults take advantage of to receive prescription medications. Although the benefit has been available for a number of years, weeding through the different plan options each year still can be challenging. Joseph Woelfel and colleagues sought to gain some insight into the beneficiaries’ knowledge of various aspects of the Part D program as well as their satisfaction with the benefit. Our Student Forum columns address two noteworthy issues: the use of sulfonylureas in older adults and the connection between Alzheimer’s disease and diabetes. Please check out these brief but insightful articles. H. Edward Davidson, PharmD, MPH Editor-in-Chief

Doi:10.4140/TCP.n.2015.60.

References 1. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: Institute of Medicine; 2001.

The Consultant Pharmacist   february 2015   Vol. 30, No. 2

From evidence to practice.

From evidence to practice. - PDF Download Free
70KB Sizes 0 Downloads 8 Views