Smith, Nathan T.

Objectives: The primary objective of this article was to examine literature from the last 10 years surrounding cardiovascular risks associated with NSAID use. Methods: A systematic search was developed to include randomized control trials and systematic review meta-analyses that focused on the cardiovascular effects associated with NSAID use. Results: The search and screen identified 10 articles published in the last 10 years to be included in the review. Discussion: The most common cardiovascular risks studied in the included literature were hemodynamic effects and myocardial infarction. The evidence in the included studies suggests that concerns of adverse hemodynamic effects may be overstated with short-term NSAID use. Myocardial infarction was shown to be a very serious, but rare, side effect associated with NSAID use. Practitioners should weigh this risk when using NSAIDs in patients with an increased risk of MI at baseline. Other included studies described risks of Kounis syndrome, QTc prolongation, and potential reversal of right ventricular dysfunction in patients using NSAIDs.

AbstractBackgroundTransgender and gender‐diverse (TGD) patients experience challenges and disparities when seeking health care across a multitude of settings. Studies have demonstrated that TGD individuals experience bias when interacting with health care providers, including pharmacists in the community and hospital settings. Without proper training, pharmacists are less likely to be prepared to provide equitable and optimal patient care to TGD patients. This quality improvement initiative aimed to identify gaps in pharmacist knowledge and comfort with regard to TGD health care.MethodsA 29‐item reflective questionnaire was designed to collect information on pharmacist training and experiences in caring for TGD patients. The survey was distributed via email to all 490 pharmacists within a single health system and responses were collected from October 23, 2023 to November 3, 2023.ResultsA total of 116 pharmacists completed the survey, for a response rate of 24%. Although 77% of respondents reported caring for a TGD patient, only 21% reported receiving any formal education or training on TGD health care. While 83% of respondents agreed that formal education on TGD health care is important, and 90% indicated that education on gender‐affirming therapy is important, a majority of pharmacists disagreed that they were comfortable with making recommendations and providing counseling on gender‐affirming therapy. A majority of pharmacists were interested in formal education and engaging in departmental initiatives to improve TGD care.ConclusionsThere was a gap in confidence and education in caring for TGD patients among pharmacists practicing in a single academic institution. Pharmacists reported that more education is warranted to bridge current gaps in pharmacist comfort and TGD health care.