Guideline-recommended opioid management practices were infrequently documented overall but were documented more often for higher risk patients who had indicators of potential opioid misuse. The relationship between guideline-concordant opioid management and high-quality care has not been established, so our findings should not be interpreted as evidence of poor quality opioid management. Research is needed to determine optimal methods of monitoring opioid therapy in primary care.

Objectives. To identify and assess changes made to the Indiana Pharmacy Resident Teaching Certificate program over 10 years to adapt to the growing number and changing needs of pharmacy educators in the next generation. Design. In 2011, all resident program participants and directors were sent an electronic survey instrument designed to assess the perceived value of each program component. Assessment. Since 2003, the number of program participants has tripled, and the program has expanded to include additional core requirements and continuing education. Participants generally agreed that the speakers, seminar topics, seminar video recordings, and seminar offerings during the fall semester were program strengths. The program redesign included availability of online registration; a 2-day conference format; retention of those seminars perceived to be most important, according to survey results; implementation of a registration fee; electronic teaching portfolio submission; and establishment of teaching mentors. Conclusion. With the growing number of residents and residency programs, pharmacy teaching certificate programs must accommodate more participants while continuing to provide quality instruction, faculty mentorship, and opportunities for classroom presentations and student precepting. The Indiana Pharmacy Resident Teaching Certificate program has successfully evolved over the last 10 years to meet these challenges by implementing successful programmatic changes in response to residency program director and past program participant feedback.

Background and Purpose:We examined blood pressure 1 year after stroke discharge and its association with treatment intensification. Methods:We examined the systolic blood pressure (SBP) stratified by discharge SBP (<140; 141 to 160; or >160 mmHg) among a national cohort of Veterans discharged after acute ischemic stroke. Hypertension treatment opportunities were defined as outpatient SBP >160 mm Hg or repeated SBPs >140 mm Hg. Treatment intensification was defined as the proportion of treatment opportunities with antihypertensive changes (range 0 to 100%, where 100% indicates that each elevated SBP always resulted in medication change).Results: Among 3153 ischemic stroke patients, 38% had at least one elevated outpatient SBP eligible for treatment intensification in the 1 year post stroke. Thirty percent of patients had a discharge SBP <140mmHg; and an average 1.93 treatment opportunities and treatment intensification occurred in 58% of eligible visits. Forty seven percent of patients discharged with SBP 141 to160 mmHg had an average of 2.1 opportunities for intensification and treatment intensification occurred in 60% of visits. Sixty three percent of the patients discharged with an SBP >160mmHg had an average of 2.4 intensification opportunities, and treatment intensification occurred in 65% of visits. Conclusion:Patients with discharge SBP >160mmHg had numerous opportunities to improve hypertension control. Secondary stroke prevention efforts should focus on: initiation and review of antihypertensives prior to acute stroke discharge; management of antihypertensives and titration; and patient medication adherence counseling.