Browsing by Author "Leiser, Abraham"

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    Expanding Buprenorphine Use in Primary Care: Changing the Culture
    (The Permanente Federation, 2022) Leiser, Abraham; Robles, Maria; Medicine, School of Medicine
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    Impact of a clinical pharmacist on ultrasound-guided venous thromboembolism screening in hospitalized COVID-19 patients: a pilot prospective study
    (BMC, 2021) Gillespie, Laura; Khan, Rashid Z.; Stillson, John E.; Bunch, Connor M.; Shariff, Faisal Salim; Speybroeck, Jacob; Grisoli, Anne; Wierman Schmidt, Meredith; Phyu, Htay; Jablonski, Jason; Wells, Byars; Fulkerson, Daniel H.; Oancea, Lyndsay; Leiser, Abraham; Walsh, Mark; Medicine, School of Medicine
    Background The recognition, prevention and treatment of venous thromboembolism (VTE) remains a major challenge in the face of the recent COVID-19 pandemic which has been associated with significant cardiovascular, renal, respiratory and hematologic complications related to hypercoagulability. There has been little literature thus far on the utility of screening ultrasound and the role of the clinical pharmacist in treating these patients. Methods We present a prospective pilot program of thirty-one consecutive COVID-19 patients who were provided four extremity screening ultrasounds for VTE on admission. This was coordinated by a clinical pharmacist as part of a multidisciplinary approach. Quantitative and qualitative data were recorded with the goal of describing the utility of the clinical pharmacist in ultrasound screening. Data collected include demographics, information on clinical symptoms or signs at presentation, and laboratory and radiologic results during the hospitalization from each individual electronic medical record. Results Nine of the thirty-one patients presented with VTE. Of the nine patients, there were twenty-two total clotted vessels, all of which were asymptomatic. The clinical pharmacist, as the coordinator for a multidisciplinary COVID-19 associated coagulopathy management team, drafted a screening and treatment protocol for anticoagulation prophylaxis and therapy of VTE after ultrasound findings. Conclusion VTE screening of hospitalized COVID-19 patients reveals a significant number of asymptomatic VTEs and justifies diagnostic, prophylactic, and treatment measures coordinated by a clinical pharmacist.
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    The State of Point-of-Care Ultrasound Training in Undergraduate Medical Education: Findings From a National Survey
    (Wolters Kluwer, 2021-11) Russell, Frances M.; Zakeri, Bita; Herbert, Audrey; Ferre, Robinson M.; Leiser, Abraham; Wallach, Paul M.; Emergency Medicine, School of Medicine
    Purpose: The primary aim of this study was to evaluate the current state of point-of-care ultrasound (POCUS) integration in undergraduate medical education (UME) at MD-granting medical schools in the United States. Method: In 2020, 154 clinical ultrasound directors and curricular deans at MD-granting medical schools were surveyed. The 25-question survey collected data about school characteristics, barriers to POCUS training implementation, and POCUS curriculum details. Descriptive analysis was conducted using frequency and percentage distributions. Results: One hundred and twenty-two (79%) of 154 schools responded to the survey, of which 36 were multi-campus. Sixty-nine (57%) schools had an approved POCUS curriculum, with 10 (8%) offering a longitudinal 4-year curriculum. For a majority of schools POCUS instruction was required during the first (86%) and second year (68%). Forty-two (61%) schools were teaching fundamentals, diagnostic, and procedural ultrasound. One-hundred and fifteen (94%) schools identified barriers to implementing POCUS training in UME, which included lack of trained faculty (63%), lack of time in current curricula (54%), and lack of equipment (44%). Seven (6%) schools identified no barriers. Conclusions: Over half of the responding medical schools in the United States had integrated POCUS instruction into their UME curricula. Despite this, a very small portion had a longitudinal curriculum and multiple barriers existed for implementation, with the most common being lack of trained faculty. The data from this study can be used by schools planning to add or expand POCUS instruction within their current curricula.