Atrial fibrillation (AF) and atrial flutter are common arrhythmias associated with an increased risk of stroke. Direct oral anticoagulants (DOACs), particularly apixaban, are widely used due to their lower bleeding risk, ease of initiation, and reduced monitoring requirements compared with warfarin. However, variability in pharmacokinetic parameters and multiple dosing criteria increase the likelihood of inappropriate prescribing. Prior studies suggest apixaban is the most common inappropriately dosed DOAC, with suboptimal dosing linked to higher rates of stroke, transient ischemic attack (TIA), bleeding, and mortality. The Food and Drug Administration (FDA) recommends a standard dose of 5 mg twice daily, with reduction to 2.5 mg twice daily only if at least two of the following are present: age ≥80 years, body weight ≤60 kg, or serum creatinine ≥1.5 mg/dL. This study aims to evaluate the prevalence of inappropriate apixaban dosing and identify contributing factors such as age, laboratory values, body weight, drug–drug interactions (DDIs), and bleeding risk among patients with AF or atrial flutter discharged from Memorial Hermann Greater Heights and Southeast Hospitals.

Use of continuous glucose monitors (CGM) has drastically increased as a method for self-monitoring glucose and has been associated with improved glycemic control and reduced episodes of hypoglycemia in patients with diabetes. In 2022, billing for personal CGM initiation and interpretation became available, offering providers an additional revenue stream for diabetes management. At our institution, pharmacists are embedded in primary care clinics and have historically utilized level one evaluation and management incident-to billing strategies to receive reimbursement for diabetes management. However, the implementation of a pharmacist-led CGM management program, including billing for services, had not been instituted. The aim of this study is to determine the impact of the initiation of a pharmacist-led CGM service on financial and clinical outcomes. 

Overview/Background: Colon cancer disproportionately affects older adults, with over 60% of new cases diagnosed in individuals aged 65 or older. However, this population remains underrepresented in clinical trials evaluating adjuvant chemotherapy, leading to a reliance on data from younger, fitter patients. While oxaliplatin combined with fluoropyrimidines improves disease-free survival in high-risk stage II and stage III colon cancer, its benefit in older adults (≥ 70 years old) is unclear due to inconsistent survival benefit and high rates of toxicity.
 

Background: High-cost medications and resource-intensive hospitalizations are major contributors to inpatient expenditures at academic medical centers (AMCs). Understanding how resource utilization aligns with clinical outcomes is essential for identifying value improvement opportunities. The University of Illinois Hospital & Health Sciences System (UI Health), a 340B-eligible safety-net AMC serving a diverse and predominantly low-income population, frequently manages complex medical and surgical cases. Assessing its performance relative to similar institutions can inform targeted strategies to optimize both cost and quality.