Although a modest delay in ejaculation is seen when using an SSRI and PDE-5 inhibitor together, the combination also comes with increased risks for adverse drug reactions and is more expensive. SSRI monotherapy should continue to be first-line treatment for premature ejaculation due to a better adverse drug reaction profile, lower cost, and high efficacy. Combination therapy may be prescribed for those who fail SSRI monotherapy or have concomitant erectile dysfunction.
The number of novel treatment options for type 2 diabetes mellitus, including those with distinctive mechanisms of action, has risen sharply this decade, and health care providers must be aware of the drugs' safety and efficacy in order to provide patients with the best care possible. Guidelines for type 2 diabetes provide recommendations for initiating and continuing treatment that will enable patients to achieve glycemic control and maintain it over time. Several recently completed, large clinical trials have provided information pertaining to potential benefits and risks of achieving specific treatment goals, and medical professionals should consider applying the insights from these trials when optimizing care for their patients. The pharmacist plays an essential role in helping patients achieve and maintain tight glycemic control by assisting other health care providers in understanding and utilizing the guidelines as part of individualized treatment regimens.
Evidence-based interventions have been shown to improve the quality of patient care, reduce costs, and improve overall health outcomes; however, adopting new published research and knowledge into practice has historically been slow, and requires an active, systematic approach to engage clinicians and healthcare administrators in the required change. Pharmacists have been identified as important agents of change and can enhance care delivery in primary care settings through evidence-based interventions. Utilizing the Consolidated Framework for Implementation Research (CFIR) we identify, assess, and share barriers and facilitators to program development, as well as growth and expansion efforts across five discrete, university-subsidized, embedded-pharmacy practices in primary care. We identified two overarching modifiable factors that influence current and future practice delivery and highlight the role of academia as an incubator for practice change and implementation: Data collection and information sharing. Conceptual frameworks such as CFIR help establish a common vernacular that can be used to facilitate systematic practice site implementation and dissemination of information required to support practice transformation.
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