Proton-pump inhibitors (PPIs) are a widely prescribed class of medications used to treat acid-related disorders and use has significantly increased over the last few decades. PPIs are often inappropriately prescribed and since they have been on the market, a number of post-marketing studies have been published demonstrating associations between longer duration of PPI therapy and a number of adverse effects that are a concern in older adults. The objective of this review is to discuss the existing literature of potential adverse effects with long-term PPI use in older adults and to summarize the implications in clinical practice. A search was conducted to identify studies evaluating the potential long-term adverse effects of PPI therapy in older adults, and publications were selected based on relevant criteria. PPIs have been associated with an increased risk of a number of adverse effects including osteoporotic-related fractures, infection, community-acquired pneumonia, vitamin B12 deficiency, kidney disease, and dementia, demonstrated by a number of case-control, cohort studies, and meta-analyses. Older adults should be periodically evaluated for the need for continued use of PPI therapy given the number of potential adverse effects associated with long-term use.
BackgroundIn Spring 2020 many academic institutions transitioned to remote learning in response to the developing COVID‐19 pandemic. These changes affected skills‐based training, as schools of pharmacy were forced to transition traditionally in‐person assessments to a remote setting. The purpose of this article is to describe the experience of pharmacy skills lab coordinators when transitioning summative skills‐based assessments (SSBA).MethodsA web‐based survey instrument administered through QualtricsXM was sent to all institutions in the Big Ten Academic Alliance‐Performance Based Assessment Collaborative. Only one member from each institution completed the survey on behalf of the institution. The survey consisted of four sections: changes made to skills evaluated; changes made to the delivery of those evaluations; challenges to and strategies used by the skills lab program when switching to remote learning; and recommendations for incorporating remote learning within future SSBAs. Survey respondents were invited to participate in an optional unstructured interview regarding survey answers.ResultsNine of ten invited institutions responded to the survey. Of the nine respondents, three participated in the post‐survey interview. Overall, 79.5% (93/117) of skills planned to be assessed were assessed with or without modification, with 8.5% (10/117) of skills canceled and 10.3% (12/117) of skills assessments postponed. The most common challenges mentioned were the lack of preparation time, inability to assess certain skills virtually, and student barriers. The most common recommendations made were to prioritize lab components and incorporate flexibility in planning and scheduling.DiscussionThe results indicate that most skills were still assessed during the Spring 2020 semester. Though the transition to remote learning was challenging and unique for each institution, common strategies and recommendations identified here provide opportunities for academics to analyze and prioritize learning objectives and to rethink how to develop and deliver SSBAs as remote assessments.
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