Tag Archives: PEO

PEO Project

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Currently, I am working on a directed studies project with a 4th year pharmacy student under the guidance of Dr. Aaron Tejani. We read articles on the inappropriate use of IV PPIs and are in the process of developing a protocol. This is my first time writing a protocol. During undergrad, I always thought it was a daunting task. I am glad I am getting exposed to it now as it would be very helpful when I start writing protocol for my residency project. Until last week I was unfamiliar of the different processes and steps involved in conducing an internal audit and research. For example, for our internal audit we had to submit Fraser Health -Data Access Application and Agreement. Any kind of research or audit requires a lot of planning and paperwork completion. It is a learning process and participating in the directed studies project and residency project is providing me with first hand experience.

I also got a chance to attend a presentation by Dr. Tejani focusing on the risks of proton pump inhibitors. Preparing for PEBCs, I came across fracture risk with use of PPIs, but association of PPIs with risk of Clostridium difficile infection, pneumonia risk and possible risk of acute interstitial nephritis is something I was unaware of. Aaron introduced us to different resources where we can look up generation information on PPIs: http://www.cadth.ca >> COMPUS reports>>Proton pump inhibitor therapy

Oregon Health Sciences University DERP Proton Pump Inhibitor class review

Cochrane Databases

It was interesting and surprising to find out that risk of C.difficile infection is 3 times more even if PPI was used within the past 90 days. Studies have found that use of H2RAs is associated with both Community-acquired pneumonia and Hospital acquired pneumonia whereas PPIs are only associated with community acquired pneumonia.

On Wednesday, we attended Academic Half-Day focusing on Introduction to Infectious Diseases. It was a good review of some concepts and also introduced me to new concepts like non-specific findings, organ/system-specific findings and identification and characterization of pathogen. For example, I was unaware of Kernig’s sign and Brudzinski’s sign (signs and symptoms of meningitis).

On Friday, I got a chance to meet my mentor Anna Yuen, in regards to learning how to use Electronic Medical Records and how to pull reports. We discussed the project and she asked me questions which stimulated me to think of some concepts that I probably won’t have on my own.

I am also working on creating a presentation to introduce other health care professionals to Health-Evidence.ca website.

PEO: Pharmacotherapy Evaluation and Optimization

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The past week I have been at Burnaby Hospital for my PEO (Pharmacotherapy Evaluation and Optimization) rotation with Dr. Aaron Tejani. It is mentioned as one of my elective rotation, however I did not pick this rotation as one of my electives. When I looked at my schedule, it just said ‘PEO’. I was not even aware what the abbreviation meant. But hopefully by the end of the rotation, I would be able to achieve all the objectives of the rotation. I am excited to learn something new and understate the roles of a Drug Use Evaluation Pharmacist. According to the description of the rotation posted on one 45, following are the goals of PEO rotation:

To understand and apply the concepts of drug use evaluation as a broad based systematic program that promotes and improves rational drug use in hospitals in Fraser Health. These concepts include:

1. Developing criteria for therapeutic appropriateness (reviewing and comparing evidence from clinical trials, assessing most appropriate indications for the drugs and evaluating their safety data)

2. Developing patterns of use of drugs, region wide or in individual institutions (overutilization, underutilization, incorrect dosage, inappropriate duration)

3. Pharmacoeconomic evaluation (cost utility, cost effectiveness, cost benefit, cost minimization, cost per quality adjusted life year gained)

One of my main objectives is to perform literature reviews and critically analyze the study design, methodology, bias, significance, and generalizability of results and conclusions of the trial and apply the acquired knowledge to my practice. Currently, I am assisting with the Directed Studies Project: Inappropriate use of IV PPIs in Fraser Health.
I read the past articles assessing the inappropriate use of IV PPIs and it was surprising to find out that over 60% of it is used inappropriately. We are in the process of writing the protocol which would be a very helpful when writing the protocol for my project.

I am also working on developing a survey to find out the reasons behind pharmacists not switching from IV to PO medications even though they have the authority to do so.

I am looking forward to the next three weeks and attaining the goals of this rotation. I am sure that the knowledge gained through this rotation would help me in becoming a competent pharmacist.