No outside funding supported this study. The authors have nothing to disclose. Study concept and design were principally contributed by Bagwell and Newman, along with the other authors. Lee took the lead in data collection, along with Carver, Bagwell, Kelley, and Newman. Data interpretation was performed by Carver, Kelley, Lee, and Bagwell, with assistance from Newman. The manuscript was written by Bagwell, Carver, Kelley, and Lee and revised primarily by Bagwell, along with the other authors.

Linezolid desensitization can be a viable option in patients requiring antimicrobial therapy for complicated gram-positive skin infections.

Objective: Assess the effect of intensive clinical and educational interventions aimed at reducing risk factors for Cardiovascular Disease (CVD), implemented by clinical pharmacists, on modifying risk factors in targeted patients at high risk for CVD. Design: Patients with at least two risk factors for CHD were identified at two clinics by conducting a pre-intervention survey and were monitored over a period of 6 months with follow up conversations conducted every 4 weeks by phone and at subsequent physician visits. A post-intervention survey was conducted at the end of the study period to detect modified risk factors. Setting: The Jefferson County Public Health Department (JCHD) Participants: We followed a total of 47 patients over 6 months. The average age at baseline was 51 years old and 80% of the participants were female. The baseline average number of modifiable cardiovascular disease risk factors was 3.7. Measurements: We assessed total number of CVD risk factors, smoking behavior, blood pressure, LDL, A1C, weight, and level of physical activity (major modifiable risk factors by the American Heart Association). Results: Over a 6 month follow-up of 47 patients, statistically significant reductions occurred in total number of CVD risk factors, systolic and diastolic blood pressures, and A1C. Reductions also occurred in LDL level, weight, and changes in smoking behavior and physical activity were identified. Conclusions: Results showed that increased patient counseling on adherence and lifestyle changes along with increased disease state monitoring and medication adjustment led by a clinical pharmacist can decrease risk factors in patients with multiple risk factors for cardiovascular disease.   Type: Student Project

After enrollment in an HIV pharmacotherapy clinic, a significant decrease in viral load was seen, as were improvements in secondary end points of CD4 T cells and adherence. These data demonstrate the clinical benefits of pharmacy resident involvement on a multidisciplinary team in caring for patients with HIV.

Background Despite emerging hepatitis C virus (HCV) treatments, barriers remain within the cascade of care (CoC) that limit impact in real-world practice. Assessing breakdown in the HCV CoC will provide targets for interventions to facilitate improved access and treatment. The objective of this study was to identify factors associated with movement through the HCV CoC after referral to a multidisciplinary infectious diseases (ID) clinic, including both general and historically difficult to treat populations.Methods This is a single-center, retrospective, cohort study of patients receiving care at the Vanderbilt University Medical Center (VUMC) ID Clinic between July 2015 and September 2016. Data were collected from the electronic medical record used for patient care. For the purposes of this study, the defined CoC started with referral to the VUMC ID clinic and followed progression through HCV evaluation, prescription, approval, initiation, and completion of treatment, and achievement of sustained virologic response at least 12 weeks after treatment completion (SVR12). The primary endpoint was completion of treatment. Secondary endpoints were achievement of each stage in the CoC. Univariate analyses were used to identify patient groups less likely to advance through the CoC.ResultsOf the 182 patients referred to the VUMC ID clinic during our study period, 101 (55.5%) achieved the primary endpoint of treatment completion. Having Medicaid insurance was associated with a lower rate of treatment approval compared with those with other forms of insurance or no insurance (76.2% compared with 97.8%, P < 0.001). The largest loss of patients in the CoC occurred from referral to an evaluation (37.7%). Of those patients completing an evaluation, 88.6% completed treatment, and 81.5% achieved an SVR12. The presence of HIV coinfection, psychiatric disorder, cirrhosis, or ongoing illicit drug use was not found to impact the primary endpoint.Conclusion This study shows overall high rates of HCV CoC completion within a multidisciplinary ID Clinic. The primary barrier to treatment completion identified was having Medicaid insurance. Based on our results, emphasis should be placed on improving patient engagement in care from referral to HCV evaluation.Disclosures C. Chastain, Gilead Sciences: Grant Investigator and Research Contractor, Grant Recipient, Research Grant and Research Support.

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