2026 Poster Session Abstracts

April 11, 2026

TYPES AND ACCEPTANCE RATES OF STUDENT PHARMACIST CLINICAL INTERVENTIONS IN AN INPATIENT GERIATRIC BEHAVIORAL HEALTH UNIT: A TWO-YEAR RETROSPECTIVE REVIEW

Juliette M. Acquisto, PharmD Candidate, 2027 and Talisa M. Marchese, PharmD, BCPS, BCPP
D’Youville University School of Pharmacy, Buffalo, New York

• INTRODUCTION: A clinical pharmacy faculty member precepts approximately 12 learners per academic year on a decentralized inpatient geriatric behavioral health unit at Erie County Medical Center (ECMC). Learners include fourth-year student pharmacists completing a 6-week advanced pharmacy practice experience and PGY-1 pharmacy practice residents completing a 5-week elective rotation. All clinical pharmacy interventions discussed with the interprofessional treatment team and/or provided directly to patients are documented in the electronic medical record using a standardized process.
• Existing literature demonstrates that psychiatric pharmacists provide a wide range of inpatient clinical services, most commonly including medication discontinuation, laboratory monitoring, identification of adverse drug reactions, identification of drug–drug interactions, and identification of untreated indications, with reported provider acceptance rates approaching 100%. However, limited data describe the real-world clinical contributions and acceptance of interventions made specifically by pharmacy learners in these settings. Characterizing these interventions over a two-year period may help justify and expand pharmacy services on behavioral health units and inform future investigations evaluating the impact of learner involvement on patient outcomes.
• OBJECTIVE: To evaluate the types and acceptance rates of clinical interventions documented by student pharmacists and residents over a two-year period on an 18-bed acute inpatient geriatric behavioral health unit.
• METHODS: A retrospective chart review will be conducted using the Erie County Medical Center electronic medical record (Meditech) for the period of January 1, 2024, through December 31, 2025. The review will include interventions documented on 5 Zone 1, an 18-bed inpatient geriatric behavioral health unit. Interventions will be categorized by type and associated medication(s), when applicable, and analyzed using descriptive statistics in Microsoft Excel. The frequency and provider acceptance rate of each intervention category will be recorded. Exclusion criteria include admissions outside the specified timeframe and patients younger than 18 years of age.

ONCOFERTILITY: PHARMACIST ROLE IN TUMOR DIRECTED THERAPIES AND FERTILITY PRESERVATION

Seonga Melody Song, Lilia, Davenport, Samantha Paone, Jamie Chin-Hon
NYU, Northwell, Baptist Health

• INTRODUCTION: An oncofertility program includes an interdisciplinary team who provides fertility preservation to patients undergoing tumor-directed therapy.  Within our neighboring institutions, four clinical oncology pharmacists collaborate and share experiences from their respective oncofertility practice. Each service’s goals are to evaluate and protect reproductive health prior to receiving tumor-directed therapy. Clinical oncology pharmacists in the acute and ambulatory care settings work with providers to assess the treatment modality’s fertility risk, counsel patients, and manage treatment-related toxicities.
• BACKGROUND: Cancer treatment selection is individualized to provide the most effective therapy while minimizing toxicity. Antineoplastic treatments have varying effects that can impact future fertility. Pharmacists on the interdisciplinary team identify patients at risk of gonadotoxic therapies to refer oncofertility specialists to align with survivorship goals. Measures of an oncofertility program include evaluating patient access, clinical outcomes, and psychosocial support. Key metrics include percentage of eligible patients receiving referrals and consultations, time from referral to fertility preservation treatment, success rates of cryopreserved specimens, and patient-reported satisfaction with decision-making support.  
• ADAPTABILITY: Major academic medical centers have established oncofertility programs to address survivorship goals, which can provide guidance to cancer centers who are developing a program. Key workflows include stratifying antineoplastic treatment modalities’ risks of fertility, fertility evaluation, and discuss fertility preservation options prior to and after completion of cancer therapy. An interdisciplinary team collaborates with oncofertility specialists and reproductive endocrinologists to deliver fertility preservation and follow-up care during survivorship.
• SIGNFICANCE: Oncology pharmacists are specialized to understand tumor-directed therapy, identify gonadotoxic therapy, stratify fertility risk, and work with providers to choose effective tumor-directed treatment while monitoring and managing treatment-related toxicities. As medication regimens continue to evolve, the pharmacist’s role in integrating pharmacologic knowledge with reproductive health considerations is essential to optimizing both oncologic and survivorship outcomes, particularly through medication management and patient counseling into comprehensive cancer care.

ANTIHOSTILITY EFFECTS OF XANOMELINE AND TROSPIUM CHLORIDE IN ADULTS WITH SCHIZOPHRENIA: POST HOC POOLED ANALYSES OF EMERGENT-1, EMERGENT-2, AND EMERGENT-3 TRIALS

Leslie Citrome,¹ Scott Vuocolo,² Ronald N. Marcus,^2,* James Appio,² Pierre Nicolas,² Amy Claxton^2,*
¹New York Medical College, Valhalla, NY, USA; ²Bristol Myers Squibb, Princeton, NJ, USA

• INTRODUCTION: In addition to hallucinations and delusions, people with schizophrenia may exhibit hostility, which is associated with aggressive and violent behavior during acute exacerbations. Prior research has demonstrated the specific antihostility effects of several atypical antipsychotics. Xanomeline/trospium (KarXT) has a novel mechanism of action. KarXT combines a dual M₁/M₄ muscarinic receptor agonist with a pan-muscarinic receptor antagonist and does not directly block D₂ dopamine receptors.
• OBJECTIVE: The objective of this post hoc analysis of 3 acute trials was to assess the efficacy of KarXT in reducing hostility in adults with schizophrenia.
• METHODS: Pooled data from the 5-week, randomized, double-blind, placebo-controlled, inpatient EMERGENT-1 (NCT03697252), EMERGENT-2 (NCT04659161), and EMERGENT-3 (NCT04738123) trials were assessed. Participants aged 18-65 years experiencing acute exacerbation of psychotic symptoms received placebo or KarXT titrated over 7 days to 125 mg/30 mg twice daily. Mean change in the Positive and Negative Syndrome Scale (PANSS) hostility item (P7) score was assessed, and pseudospecificity was addressed by adjusting for positive symptom change and somnolence. The protocol and consent form were reviewed and approved by an independent ethics committee and central institutionalized review board. Informed written consent was obtained from all participants prior to the start of trial procedures.
• RESULTS: Participant demographics and disease characteristics were similar across groups. In individuals with baseline PANSS hostility scores ≥2, ≥3, or ≥4, improvement in hostility from baseline to week 5 was greater among those receiving KarXT than in those receiving placebo. This improvement was maintained when adjusted for PANSS positive symptom change and somnolence.
• CONCLUSIONS: This post hoc analysis of data pooled from the short-term EMERGENT trials demonstrates that KarXT has a specific antihostility effect compared with placebo in adults experiencing an acute exacerbation of schizophrenia.

RESULTS FROM A PHASE 4, SLOW-TITRATION AND FOOD EFFECT TRIAL TO ASSESS THE SAFETY AND EFFICACY OF XANOMELINE AND TROSPIUM CHLORIDE IN SCHIZOPHRENIA

Jenna Hoogerheyde,¹ David P. Walling,² Kimball Johnson,³ Rachel Dyme,¹ Allison Gaudy,¹ Rasika Suryawanshi,¹ Andrew C. Miller,^1,* Ranjan Tiwari,¹ Ken Kramer^1
1Bristol Myers Squibb, Princeton, NJ, USA; ²CenExel—Collaborative Neuroscience Research, Los Alamitos, CA, USA; ³CenExel—iResearch, Atlanta, GA, USA

• INTRODUCTION: In pharmacokinetic studies of xanomeline and trospium chloride (KarXT), dosing with food reduced trospium bioavailability, potentially impacting tolerability.
• OBJECTIVE: This study was designed to assess whether taking KarXT with food after a slow up-titration is safe and tolerable.
• METHODS: An inpatient, open-label, multicenter, 2-cohort trial (NCT06572449) enrolled adults with schizophrenia and Positive and Negative Syndrome Scale (PANSS) total score ≤80. In period 1 (4 weeks), participants began KarXT BID treatment on an empty stomach at 50 mg/20 mg and uptitrated to a maximum 125 mg/30 mg (cohort 1) or 100 mg/20 mg (cohort 2). In period 2 (4 weeks), treatment was administered within 30 minutes of food intake. Safety, efficacy, and KarXT pharmacokinetics pooled from both cohorts in both periods were assessed. The study was approved by the institutional review board/independent ethics committee at each study site; all participants provided informed consent.
• RESULTS: During periods 1 and 2, 64.2% and 39.0% of participants, respectively, reported ≥1 treatment-emergent adverse event (TEAE). The most common TEAEs (≥5%) in period 1 were nausea (22.5%), dyspepsia (15.6%), headache (15.0%), constipation (12.7%), and vomiting (11.6%); the incidence of all new onset TEAEs was less in period 2 when taken with food. All TEAEs were mild or moderate in intensity; none were serious. PANSS total score decreased over periods 1 and 2; CGI-S score decreased over period 1 with no further change over period 2. Dose-normalized AUC and C_max of trospium pooled from cohorts 1 and 2 decreased by 36% and 43%, respectively, when taken with food versus fasting. No clinically significant differences were observed in xanomeline exposure.
• CONCLUSIONS: After slow uptitration on an empty stomach, there was no increase in the incidence or severity of TEAEs when taking KarXT with food; efficacy was maintained.

SYMPTOM STABILITY DURING TREATMENT TRANSITION TO XANOMELINE AND TROSPIUM CHLORIDE: POST HOC ANALYSIS OF AN INPATIENT TRIAL IN SCHIZOPHRENIA

Rachel Dyme,¹ Jenna Hoogerheyde,¹ Ayesha Pavithran,¹ Ranjan Tiwari,¹ James Appio,¹ Scott Vuocolo^1
1Bristol Myers Squibb, Princeton, NJ, USA

• INTRODUCTION: Individuals with schizophrenia often switch antipsychotics, which can affect symptom stability.
• OBJECTIVE: A trial of xanomeline and trospium chloride (KarXT) requiring washout of prior antipsychotics (pAP) provided an opportunity to examine safety and disease symptom stability during this transition.
• METHODS: An open-label, 2-cohort inpatient trial (NCT06572449) enrolled symptomatically stable adults with schizophrenia with Positive and Negative Syndrome Scale (PANSS) total scores ≤80. Following a washout period, participants began treatment with KarXT BID on an empty stomach for 4 weeks starting at 50 mg/20 mg and uptitrating to a maximum 125 mg/30 mg (cohort 1) or 100 mg/20 mg (cohort 2). Treatment continued for an additional 4 weeks at the maximum tolerated dose with food. PANSS total scores from the 2 cohorts were pooled and analyzed by pAP and washout duration (WOD) during the transition from pAP to KarXT. The study was approved by the institutional review board/independent ethics committee at each study site; all participants provided informed consent.
• RESULTS: A total of 168 participants had calculable washout periods at baseline. Median (min, max) WOD was 3 (1, 6) days. Mean±SD PANSS total scores were stable from screening (63.4±10.9) to baseline (64.1±10.7) and independent of WOD (r=0.05). Mean±SD changes from screening to baseline in PANSS total score for individuals previously on aripiprazole, olanzapine, quetiapine, or risperidone were 1.5±4.8 (n=11), −0.4±3.2 (n=36), 0.9±6.2 (n=48), and 0.8±3.5 (n=35), respectively. PANSS total score improved from baseline to day 56 with KarXT regardless of pAP and WOD.
• CONCLUSIONS: Overall, increases in PANSS total scores from screening to baseline were not seen when switching individuals from pAP to KarXT. These data suggest that stable individuals can be safely transitioned from pAP to KarXT without destabilization of schizophrenia symptoms.

EVALUATION OF INFUSION-RELATED REACTIONS WITH DARATUMUMAB VS. DARATUMUMAB-HYALURONIDASE

De La Cruz F*, Lombardi C

• BACKGROUND: Daratumumab is an anti-CD38 monoclonal antibody used for the treatment of relapsed or refractory multiple myeloma and light chain amyloidosis. Daratumumab is available in both intravenous and subcutaneous formulations; the subcutaneous version incorporates hyaluronidase to facilitate rapid absorption, whereas the intravenous route requires significantly longer infusion times. Clinical data from the Phase III COLUMBA trial shows the rate of infusion related reactions (IRR) was approximately 13% for the subcutaneous group, compared to 34.5% for the IV group while meeting primary non-inferiority endpoints for efficacy and pharmacokinetics.
• OBJECTIVES: This medication use evaluation (MUE) aims to determine if real-world data aligns with clinical trials by comparing the incidence of IRR between IV and subcutaneous formulations of daratumumab.
• METHODS: The evaluation has been reviewed and determined exempt by Trinity Health New York Investigational Review Board. This single center retrospective MUE will assess the rates of IRR amongst both IV and subcutaneous formulations of daratumumab at St. Peter's Cancer Care Center from May 2021 to November 2025. Eligible patients must have had an FDA-approved diagnosis and have received either formulation of daratumumab. Pertinent data collected will be demographics, treatment formulation, and any incidence of IRR by utilizing pharmacy records, provider notes, and adverse event reports. Patients will be excluded from the analysis if they received either formulation for a non-FDA approved indication or there is no documentation available regarding administration or tolerability of the medication. The primary outcome will utilize the chi-square test of independence to determine the difference in IRR between the two study groups. Descriptive statistics will be utilized to provide a descriptive analysis of the subcutaneous group.     
• RESULTS: In progress
• CONCLUSIONS: In progress 

EVALUATION OF PHENOBARBITAL USE FOR ALCOHOL WITHDRAWAL FOLLOWING MULTIDISCIPLINARY EDUCATION

Jenna Langdon, PharmD, BCPS, CDCES, Wayne Strong, PharmD, BCPS

• INTRODUCTION: Phenobarbital is a treatment option for severe or complicated alcohol withdrawal. At our 171-bed community teaching hospital, phenobarbital was added to the standardized alcohol withdrawal protocol in November 2024 for all admission types. Following addition, an increase in reported medication errors was observed. In response, education was provided to various medicine disciplines, nursing, and pharmacy. This study evaluates the impact of this multidisciplinary education on the safe and efficacious use of phenobarbital for alcohol withdrawal.
• OBJECTIVES: The primary safety outcome was number of medication error reports associated with phenobarbital use. The primary efficacy outcome was need for higher level of care during admission.
• METHODS: This retrospective chart review was exempt from ethics committee review. Patients aged 18 years or greater with a diagnosis of alcohol withdrawal who received one dose of phenobarbital between March 1^st and September 30^th 2025 (pre-intervention, n = 42) and October 15^th 2025 and January 15^th 2026 (post-intervention, n = 30) were included. Patients transferred to alternative facilities were excluded. Data collection included patient demographics, medication use, and safety events.
• RESULTS: Baseline characteristics were similar between groups. There was a statistically significant reduction in medication error reports following multidisciplinary education (7 vs. 0, p < 0.05). There was a numerical reduction in number of patients requiring transfer to a higher level of care post-intervention (15 vs. 5, p > 0.05)
• CONCLUSIONS: Multidisciplinary education to medicine, nursing, and pharmacy regarding phenobarbital use in alcohol withdrawal resulted in a significant reduction in reported medication errors.

IMPACT OF USING FIRSTLINE, A MOBILE ACCESSIBLE HEALTH TECHNOLOGY PLATFORM, ON ACHIEVEMENT OF DOCTOR OF PHARMACY CURRICULAR OUTCOMES AND ENTRUSTABLE PROFESSIONAL ACTIVITIES (COEPA) AND STUDENT PERSPECTIVES

Esther Lee

• PURPOSE: The American Society of Health-System Pharmacists (ASHP) encourages integrating information technology and experiential training into pharmacy education to provide students with adequate antimicrobial stewardship training. Firstline is a mobile phone-accessible health technology platform and antimicrobial stewardship tool for institutional purchase that allows users easy access to hospital-specific antibiograms, clinical infectious diseases guidelines, and other key features. Firstline was implemented at an NYC hospital in Summer 2024 as part of ongoing antimicrobial stewardship efforts. The purpose of this study is to evaluate APPE student perspectives on Firstline as an antimicrobial-stewardship tool.
• METHODS: A 14-question survey was created using Microsoft forms to assess the impact of use of Firstline on student achievement of Doctor of Pharmacy Curriculum Outcomes and Entrustable Professional Activities (COEPA). Likert style questions were used to assess student achievement across the three key COEPA domains - knowledge, skills, and attitudes, and included additional questions regarding student perception of the tool and overall impressions. The survey was distributed to students after completion of a 160-hour APPE rotation, which included a longitudinal antimicrobial stewardship requirement where students followed a protocoled template for utilization of the Firstline tool in stewardship reviews.
• RESULTS: Thirty-seven students completed the survey, the majority of which graduated in 2025. 100% of students agreed or strongly agreed that Firstline was a helpful stewardship resource that supported their APPE rotation learning experience. 100% of students reported that Firstline increased their critical thinking skills by interpreting guidelines as applied to patient care as well as their awareness of additional resources to guide their use of antibiotics. 95% of participants would further recommend the use of Firstline for antimicrobial stewardship activities to all APPE students. 98% agreed or strongly agreed that use of Firstline increased their foundational knowledge of antibacterial medications and the treatment of infectious diseases (COEPA 1.1). Additionally, 92% of students agreed or strongly agreed that Firstline allowed them to play a role in providing individualized comprehensive care (COEPA 2.4). 97% of students agreed or strongly agreed that Firstline helped them to promote the best care of the patients by adhering to local guidelines (COEPA 2.8).
• CONCLUSIONS: Results from the survey indicate that Firstline is a valuable tool in helping APPE students achieve COEPA objectives. Use of the tool aligns with ASHP’s goal of incorporating new information technology and antimicrobial stewardship into experiential education.

EVALUATION OF THE USE OF PHYTONADIONE FOR NON-WARFARIN RELATED COAGULOPATHIES

Adam Murphy

• PURPOSE: Phytonadione is utilized in practice for reversal of warfarin induced INR elevations or bleeding events. In chronic liver disease, these same factor deficiencies are often present, leading to an elevated INR as well. The purpose of this study is to determine the effect of phytonadione on INR in patients with chronic liver disease. There is currently no standard practice for phytonadione in this patient population, therefore leading to variance in overall patient care.
• METHODS: The institutional review board approved this retrospective, multicenter, electronic medical chart review between May 2024 and May 2025. Men and women aged 18 and older, with chronic liver disease, and an INR greater than 2 were included in the study. Those taking warfarin or direct oral anticoagulants prior to hospital admission were excluded. The patients were separated into two groups: those who received phytonadione and those who did not.
• The primary objective is the comparison in mean INR change from baseline, between the phytonadione group and the group that did not receive phytonadione, 48 hours after phytonadione administration or inpatient admission respectively. Secondary outcomes include total phytonadione dose and route differences in effect on INR, rate of bleeding events and severity in both groups, rate of reported adverse events between groups, and comparison of the requirement of additional agents (i.e. fresh frozen plasma) to treat coagulopathy while inpatient.
• RESULTS: Patients who received at least one dose of phytonadione, on average, saw decreases of 0.38 in INR from baseline within 48 hours of administration. Those who did not receive a dose of phytonadione saw an increase in INR of 0.34 within the first 48 hours of admission, on average.
• CONCLUSION: On average, patients receiving IV phytonadione received a lower total dose and had greater decreases in INR when compared to those only receiving oral phytonadione.

DETERMINING THE IMPACT OF PHARMACIST EDUCATION AND FOLLOW-UP FOR PATIENTS INITIATED ON ANTICOAGULATION IN THE EMERGENCY DEPARTMENT (ED) FOR UNCOMPLICATED DVT/PE

John Noviasky

• BACKGROUND: Outpatient management of uncomplicated acute deep vein thrombosis (DVT) and low-risk pulmonary embolism (PE) with direct oral anticoagulants (DOACs) falls within guideline-recommendations. However, barriers such as medication access, dosing errors, and inadequate follow-up may limit safe use as an outpatient. Pharmacist involvement at discharge from the ED may improve safety and adherence and continuity of care.
• OBJECTIVE: To evaluate the impact of ED pharmacist discharge counseling and structured follow-up on anticoagulation access, dosing accuracy, outpatient follow-up compliance, and 30-day VTE-related ED revisits.
• METHODS: This quality improvement study included adult patients discharged from a community hospital ED with a new diagnosis of uncomplicated DVT or low-risk PE and prescribed a DOAC. Baseline data from January–June 2024 was retrospectively reviewed to assess medication acquisition and dosing accuracy. Following implementation of pharmacist-led discharge counseling and follow-up phone calls, outcomes of interest include successful medication procurement, appropriate DOAC dosing, follow-up appointment completion or extended prescribing at discharge, and 30-day ED return visits for VTE-related complications.
• RESULTS: During the baseline period, sixteen patients were discharged on apixaban; 2 patients (12.5%) did not obtain therapy due to insurance prior authorization barriers. Six patients were discharged on rivaroxaban; all obtained medication, though 1 patient (16.7%) experienced a dosing error requiring correction. After implementation of pharmacist counseling and follow-up, all patients successfully obtained anticoagulation therapy, received appropriate dosing, and either completed outpatient follow-up or were prescribed a 90-day supply at discharge. No patients experienced VTE-related ED admissions within 30 days.
• CONCLUSION: ED pharmacist discharge counseling and follow-up were associated with improved medication access, elimination of dosing errors, and reduced short-term VTE-related ED utilization, supporting an expanded role for pharmacists in outpatient VTE management.

IMPROVED EFFECTIVENESS OF CELL-BASED VERSUS EGG-BASED QUADRIVALENT INFLUENZA VACCINES IN PREVENTING INFLUENZA IN CHILDREN DURING THE 2023-2024 SEASON

Alicia Stein¹, Anusorn Thanataveerat ², Kimberly McDermott², Alex Dean², Stephanie Wall², Cory Pack², Ian McGovern³, Sheena Sullivan⁴, Mendel Haag^5
1CSL Seqirus, Australia; ²Veradigm, USA; ³CSL Seqirus, USA; ⁴School of Clinical Sciences, Monash University, Australia; ⁵CSL Seqirus, Netherlands

• BACKGROUND:  Egg-adaptive mutations during egg-based influenza vaccine manufacturing may reduce vaccine effectiveness. Cell-based quadrivalent influenza vaccines (QIVc) have been developed to address this limitation. This study evaluates the relative effectiveness (rVE) of QIVc versus egg-based vaccines (QIVe) in pediatric patients.
• OBJECTIVE: To estimate the rVE of QIVc versus QIVe in preventing laboratory-confirmed influenza among children aged 6 months to 17 years during the 2023–2024 influenza season in the United States.
• METHODS:  A retrospective test-negative design was applied using a US real-world dataset linking electronic health records, medical and pharmacy claims, and laboratory tests. Pediatric patients (6 months–17 years) who received QIVc or QIVe and were tested for influenza within 7 days of acute respiratory or febrile illness were included. rVE was calculated using doubly robust methods combining inverse probability of treatment weighting and multivariable adjustment.
• RESULTS:  Among 60,990 vaccinated and tested pediatric patients, QIVc  was significantly more effective in preventing laboratory-confirmed influenza compared to QIVe (rVE: 19.6%, 95% CI: 13.6–25.3%). Relative effectiveness estimates were consistent across pediatric age subgroups and when restricted to the outpatient setting.
• CONCLUSIONS:  Cell-based influenza vaccines demonstrated improved effectiveness compared to egg-based vaccines in pediatric patients during the 2023–2024 season. These findings support the use of QIVc to help reduce influenza burden in children.
• ENCORE DISCLOSURE: This abstract was previously presented at the Sociedad Latinoamericana de Infectología Pediátrica (SLIPE) 2025 and the European Society for Paediatric Infectious Diseases (ESPID) 2025.

ENHANCING PATIENT OUTCOMES: EVALUATION OF AN INHALER TEACHING CLINIC FOR CHRONIC RESPIRATORY DISEASES

Anyelis Rosario, James Thurston, Hanlin Li, Nadia Liyanage-Don
NewYork-Presbyterian Hospital 

• BACKGROUND: Although inhaled medications form the cornerstone of asthma and chronic obstructive pulmonary disease (COPD) treatment, many patients do not use their inhalers as prescribed due to accessibility issues and the complexity of medication instructions. Within NYC, particularly Upper Manhattan, there is an increased prevalence of these conditions due to poor air quality, sub-standard housing conditions, and economic inequity. To address these healthcare disparities, the Associates in Internal Medicine (AIM) Clinic at Columbia University Irving Medical Center (CUIMC) launched its own pharmacist-led inhaler clinic in December 2023. Within our healthcare system, pharmacy residents can provide clinical services that include medication education, affordability assistance, and medication management. Thus, an ambulatory care PGY2 pharmacy resident was deemed appropriate to lead this new service. During clinic visits, the pharmacy resident evaluated patients identified by their primary care provider as high-risk for inhaler nonadherence or poor inhaler technique.  The goal of this service was to provide patients with comprehensive inhaler and disease education specific to asthma and COPD to ultimately improve health outcomes. The other goal of this service was to enhance interdisciplinary education by incorporating medical residents and students as learners during these sessions, which has not been previously reported in the literature.    
• OBJECTIVE: The aim of this study was to evaluate the implementation and clinical impact of the AIM Inhaler Clinic.
• METHODS: This is a single-center, retrospective chart review of adults (≥ 18 years) with a diagnosis of asthma or COPD, who take one or more inhaled medications, and were referred and attended at least two in-person visits at the AIM Inhaler Clinic between December 2023 and June 2025. Pertinent data collected will include key implementation measures (e.g., feasibility, reach), clinical outcomes (e.g., improvement in inhaler adherence and technique, improvement in symptoms, changes to inhaler regimen), and sociodemographic characteristics of patients.
• RESULTS: In progress  
• CONCLUSION: In progress 

SAFETY OF INTRAVENOUS SODIUM FERRIC GLUCONATE 250 MG VERSUS 125 MG DOSES IN NON-HEMODIALYSIS ADULT PATIENTS

Heewon (Claire) Seo, PharmD; Kendra Yum, PharmD, BCOP; Mohammad A. Rattu, PharmD, BCOP, BCPS, BCGP; Alla Melamed Khaytin, PharmD

• BACKGROUND: Sodium ferric gluconate (SFGC) 125 mg doses are FDA-approved as intravenous (IV) iron replacement for hemodialysis patients. Limited data describe tolerability of SFGC 250 mg in non-hemodialysis populations. Within Mount Sinai Health System (MSHS), hospitalized patients may receive SFGC 125 mg or 250 mg doses. This evaluation determines safety differences between dosing regimens.
• METHODS: Retrospective chart review of non-hemodialysis adults (age ≥18 years) receiving ≥1 dose of SFGC 125 mg or 250 mg within MSHS from January 1, 2015 to October 31, 2025. Primary objective evaluated incidence of infusion-related reactions (IRRs; hypersensitivity, hypotension, fever, myalgia) within 48 hours post-administration. Secondary endpoints included IRR severity (Common Terminology Criteria for Adverse Events [CTCAE v5]), time-to-onset, duration, acute management, infusion duration, cumulative iron exposure, red blood cell transfusions prior to SFGC, and hemoglobin changes at 2 and 4 weeks. Baseline demographics collected: age, gender, body weight, indication (iron-deficiency anemia, chronic kidney disease, heart failure, blood loss anemia), and lab values (hemoglobin, ferritin, transferrin saturation, creatinine, eGFR, ejection fraction). Statistical analysis used Fisher's exact and Chi-squared tests; p<0.05 indicated significance.
• RESULTS: Total 535 doses (266 of 125 mg, 269 of 250 mg) across 200 patients were evaluated. Four IRRs occurred with 250 mg (1.5%), all Grade 1-2; zero with 125 mg (p=0.124). IRR rates varied by infusion duration: 2.5% (3/119) over 60 minutes (250 mg/hr), 0.7% (1/149) over 120 minutes (125 mg/hr), 0% (0/1) over 180 minutes. Median onset: 5 hours (range 1.5-7.5). Symptoms included myalgias, burning/swelling, nausea, chills, malaise; managed with antihistamines±corticosteroids. No severe reactions, epinephrine use, or ICU transfers occurred.
• CONCLUSIONS: Both SFGC doses demonstrated low IRR rates in non-hemodialysis adults without statistically significant safety differences. Faster infusion rates (250 mg/hr) associated with higher reactions. SFGC 250 mg may be safely administered at ≤125 mg/hr over ≥2 hours, supporting this dosing strategy for hospitalized patients.

SAFETY OF RAPID IV PUSH ADMINISTRATION OF BALFAXAR

Ronit Shamuilov, PharmD; Mina Michael, PharmD; Sara Radparvar, PharmD, BCPS, BCCCP

• BACKGROUND: Balfaxar®, a 4-factor prothrombin complex concentrate (4F-PCC), was approved for the urgent reversal of acquired coagulation factor deficiencies caused by vitamin K antagonist therapy requiring invasive procedures or life-threatening hemorrhage. The package insert recommends administration at 0.12 mL/kg/min. Kcentra®, another 4F-PCC with longer US market experience, has data supporting faster administration but such data is lacking for Balfaxar®. When the Mount Sinai Health System adopted Balfaxar®, it maintained a faster infusion rate; however, the safety of this approach remains uncertain.
• OBJECTIVE: This evaluation aims to assess outcomes with accelerated administration.
• METHODS: This multicenter retrospective study analyzes the safety of administration of Balfaxar® at a rate of 2000 units/3 minutes. The study evaluates 200 adult patients requiring the administration of IVP Balfaxar®. The primary endpoint is the overall rate of ADRs after administration of Balfaxar®. Specific reactions include administration site reactions, wound complications, asthenia, dysuria, vomiting, catheter site related reaction, and thromboembolism. Secondary endpoints include the rate of individual ADRs, time to administration and post-infusion INR in patients receiving Balfaxar® for warfarin reversal. Thromboembolism was assessed based on documentation of new venous thromboembolism, stroke, myocardial infarction within seven days post-Balfaxar® administration. The rate of disseminated intravascular coagulation was also assessed.
• RESULTS: Within 7 days, adverse reactions were reported in 17 patients (10.4%). This study found that administering Balfaxar® as a rapid IV push was associated with a higher rate of thromboembolic events compared to the recommended infusion rate of ~3 units/kg/min, with an observed incidence of 4.8%, versus the 2.9% reported in the package insert for standard administration. Disseminated intravascular coagulation was observed in 3 patients
• CONCLUSIONS: Rapid IV push administration of Balfaxar® was associated with a slightly higher incidence of thromboembolic events compared to the recommended infusion rate. This is potentially attributable to the limited sample size. Overall adverse event profile remained similar.

CEFIDEROCOL AND CONCOMITANT CEFTAZIDIME/AVIBACTAM AND AZTREONAM: USE IN MULTI-DRUG RESISTANT ORGANISMS ACROSS A HEALTH SYSTEM

Wong J*, Ondrush N, Lerner P
The Mount Sinai Hospital

• BACKGROUND: Metallo-beta-lactamase (MBL)–producing Gram-negative organisms are a subset of multi-drug resistant bacteria that exhibit resistance to nearly all beta-lactam antibiotics, including carbapenems, resulting in limited therapeutic options. Due to this, these pathogens are associated with significant morbidity and mortality. The Infectious Diseases Society of America (IDSA) recommends combination therapy with aztreonam and ceftazidime/avibactam or cefiderocol monotherapy as preferred first-line treatment options.  Both regimens are available on formulary within our health system. This medication use evaluation (MUE) aims to analyze utilization, assess clinical outcomes, and evaluate prescribing adherence to guideline-directed therapy for MBL-producing organisms.
• METHODS: Utilizing a clinical surveillance platform, patients who received either concomitant ceftazidime/avibactam and aztreonam or cefiderocol across five institutions within a health system will be reviewed. Adult patients who received at least one dose of either regimen between January 2023 and September 2025 will be included. Patients who expired within 24 hours of receiving these agents will be excluded. The primary outcome is to identify factors associated with the selection of cefiderocol or concomitant ceftazidime/avibactam and aztreonam for empiric versus definitive therapy within our health system. Secondary outcomes include assessing rate of compliance for use, based on dosing regimen as defined by IDSA, describing rate of treatment failure requiring alternative therapy, and 30-day and 90-day all-cause mortality. Data regarding patient demographics, prior and current microbiological data (if available), susceptibility results (if available), dosing regimens, and duration of therapy, will be reviewed. Descriptive statistics will be used to summarize findings.
• RESULTS: In progress
• CONCLUSIONS: In progress

 
THE ACCURATE STUDY: ADMISSION CARE BY CLINICAL PHARMACY UNDERGRADUATE RECONCILIATION AND TRANSITION EXPERTS

Matthew Piccolino

• BACKGROUND: Medication discrepancies during transitions of care are common and contribute to patient harm. Pharmacy interns represent a scalable workforce to improve medication reconciliation accuracy and have demonstrated eƯectiveness comparable to pharmacists; however, widespread implementation remains limited.
• OBJECTIVES: To quantify the frequency and types of medication discrepancies and evaluate the impact of pharmacy intern–led medication reconciliation, performed within 24 hours of admission, on discrepancy burden and patient-level outcomes.
• METHODS: This retrospective comparative study evaluated hospitalized patients receiving usual care medication reconciliation (comparator arm, n = 201) versus pharmacy intern–led medication reconciliation (intervention arm, n = 199). Discrepancies were categorized as omissions, commissions/duplications, or incorrect dose, frequency, or route. Primary outcomes included the number and type of discrepancies per patient. Secondary outcomes included the proportion of patients with ≥1 and ≥5 discrepancies, associations with demographic and clinical factors, and 3- , 7-, and 30-day readmission rates.
• RESULTS: A total of 810 medication discrepancies were identified among patients in the comparator arm, compared with 600 discrepancies identified and resolved in the intervention arm. Discrepancies identified in the intervention arm reflect errors intercepted through structured reconciliation rather than unresolved inaccuracies. The intervention arm identified a higher proportion of commission-type discrepancies and fewer incorrect dose, frequency, or route discrepancies compared with usual care. Patients with ≥5 discrepancies were less common in the intervention arm (23.4% vs 30.5%). Discrepancy burden increased with higher pre-admission medication counts and older age; pharmacy intern involvement was associated with fewer discrepancies across all medication-burden categories, particularly among patients with complex regimens. No significant diƯerences were observed in 3-, 7-, or 30-day readmission rates.
• CONCLUSIONS: Pharmacy intern–led medication reconciliation reduced overall medication discrepancy burden, particularly among patients with complex regimens. These findings support integrating pharmacy interns into medication reconciliation workflows as a scalable strategy to enhance medication safety

REDUCTION IN EMERGENCY DEPARTMENT DISCHARGE PRESCRIPTION DURATION OF THERAPY

Rupangi Rastogi

TRANQ: PERCEPTIONS OF XYLAZINE AND HARM REDUCTION PRACTICES AMONG PEOPLE RECEIVING TREATMENT FOR SUBSTANCE ABUSE DISORDERS

Aaron Salwan