What's it Worth? A Journal Club Podcast

🧠 Episode Summary Could a medication designed for weight loss change how we think about migraine prevention? In this episode, host Diana Langworthy sits down with returning guest Dr. Natalie Heinrich, PharmD and student contributor Nena Abosi, PharmD Candidate 2026 to unpack a 2025 Headache pilot study evaluating liraglutide as an add-on therapy for adults with obesity and high-frequency or chronic migraine. The team breaks down study design, results, and limitations while questioning whether the observed benefit stems from weight loss, intracranial-pressure changes, or something else entirely. 💬 Key Takeaways Study Design: Prospective open-label pilot (n = 31) using liraglutide 1.2 mg daily × 12 weeks in adults with BMI > 30 kg/m² and ≥ 8 headache days/month unresponsive to ≥ preventives. Results: Headache days decreased by ~9 per month (≈ 50 % reduction); disability scores improved significantly, but BMI change was minimal. Mechanism: Benefit appeared independent of weight loss—raising curiosity about GLP-1 effects on intracranial pressure and CGRP release. Tolerability: Mild GI symptoms (~40 %), no discontinuations. Caveats: Small sample, no control group, single center — results are hypothesis-generating, not practice-changing. Clinical Pearl: Pilot studies like this spark conversation and awareness for emerging mechanisms while reminding clinicians to stay evidence-curious. 🧩 Featured Study Braca S, Russo CV, Stornaiuolo A, et al. Effectiveness and tolerability of liraglutide as add-on treatment in patients with obesity and high-frequency or chronic migraine: A prospective pilot study. Headache. 2025; 00: 1–8. doi:10.1111/head.14991 🎙️ Guests Natalie Heinrich, PharmD, BCPS – Clinical Pharmacist in Neurology, M Health Fairview Nena Abosi, PharmD Candidate (2026) – University of Minnesota College of Pharmacy 🎙️ Host Diana Langworthy, PharmD, BCPS – Associate Professor, University of Minnesota College of Pharmacy 💬 Join the Conversation Have a study you'd like us to decode on a future episode? Send it our way at whatsitworthpodcast@gmail.com. We'd also love to hear your thoughts—drop a comment, share your takeaways, or let us know how you're using this evidence in practice.

New population-based study suggests SGLT2 inhibitors and GLP-1 receptor agonists may reduce COPD exacerbations in patients with type 2 diabetes. In this episode of What's It Worth?, we examine a large real-world study assessing whether glucose-lowering medications influence the risk of COPD exacerbations in patients with type 2 diabetes and chronic obstructive pulmonary disease. We focus on SGLT2 inhibitors and GLP-1 receptor agonists and discuss whether potential pulmonary benefits should influence drug selection in patients with both conditions. Guest: Ashley Wilke, PharmD — PGY2 Critical Care Pharmacy Resident at M Health Fairview East Bank Hospital. Study at a Glance Design: Retrospective cohort study using nationwide claims and registry data Population: Adults with type 2 diabetes and COPD initiating glucose-lowering therapy Exposures: SGLT2 inhibitors, GLP-1 receptor agonists, DPP-4 inhibitors Primary outcome: COPD exacerbations requiring hospitalization or systemic steroids Key Finding: SGLT2 inhibitors and GLP-1 receptor agonists were associated with a lower risk of COPD exacerbations compared with DPP-4's KEY Caveats: Results are observational and this study cannot prove causality - only association.  Tune in for our conclusions when we ask, "What's it Worth?"! Key teaching points 1. SGLT2 inhibitors and GLP-1 RAs may reduce pulmonary inflammation and fluid overload, potentially contributing to fewer exacerbations. 2. In a patient with both COPD and type 2 diabetes, these agents may offer meaningful extra-glycemic benefits. 3. This evidence supports shared decision-making, not mandatory therapy selection 4. Pharmacists can identify dual-benefit opportunities and tailor therapy based on comorbidities, cardiovascular risk, and exacerbation history. Citation:   Patorno E, Feldman HA, Bykov K, et al. Glucose-lowering medications and risk of chronic obstructive pulmonary disease exacerbations in type 2 diabetes. JAMA Intern Med. 2025;185(4):405-414. doi:10.1001/jamainternmed.2024.7811 🎧 If you find this episode helpful, follow and leave a quick rating—it helps other clinicians and learners find high-quality, evidence-based content. 🎧 Email me at whatsitworthpodcast@gmail.com if you have an article suggestion for me to decode!

Can stable patients with uncomplicated Staphylococcus aureus bacteremia finish therapy by mouth? The SABATO trial tested early oral switch versus full-course IV therapy. In this episode, we decode the SABATO trial - a randomized, open-label, non-inferiority study that compared continued intravenous (IV) antibiotics with an early oral switch in low-risk Staphylococcus aureus bacteremia (SAB). Guest: Dr. Jen Ross, PharmD, BCIDP — Clinical Infectious Diseases Pharmacist at M Health Fairview Study at a glance Design: Multicenter, randomized, open-label, non-inferiority trial Population: 213 adults with uncomplicated S. aureus bacteremia after > 5-7 days of IV therapy and no signs of complicated infection Intervention: Early oral switch (e.g., TMP-SMX, clindamycin, linezolid) Comparator: Continued full-course IV therapy Primary endpoint: SAB-related complications within 90 days  Results: Primary outcome occurred in 13% of patients in oral group vs 12% in IV group which met non-inferiority criteria KEY Caveats: Did not include patients with IV drug use; stopped study early which can skew towards a significant finding; changed NI margin midway through which leads to accepting a wider risk of difference. Tune in to hear our perspectives on what this study is worth!? Citation:   Kaasch AJ et al. Early Oral Switch vs Continued IV Therapy for Low-Risk Staphylococcus aureus Bacteremia (SABATO Trial). Lancet Infect Dis. 2024; 24(3): 310-320. DOI 10.1016/S1473-3099(24)00032-X. 🎧 If you find this breakdown helpful, follow and leave a quick rating—it helps other clinicians and learners find high-quality, evidence-based content. 🎧 Email me at whatsitworthpodcast@gmail.com if you have an article suggestion for me to decode!

Large Danish study finds no link between aluminum-containing childhood vaccines and chronic diseases — including autism and ADD/ADHD. In this episode, we unpack the 2025 Annals of Internal Medicine study evaluating whether early-life exposure to aluminum-adsorbed vaccines is associated with autoimmune, allergic, or neurodevelopmental outcomes such as autism spectrum disorder or ADHD. We review the data behind the headlines, explain the study design and data source, and discuss how clinicians can communicate this evidence to parents. Guest: Dr. Ann Philbrick, PharmD, FCCP, BCACP — Professor of Pharmaceutical Care & Health Systems at the University of Minnesota College of Pharmacy, with expertise in vaccine/immunization delivery and ambulatory care. Study at a glance - Design Nationwide Danish cohort, 1.2 million children (1997–2020) - Exposure Total aluminum (mg) from vaccines in first 2 years of life -Outcomes 50 chronic conditions (autoimmune, allergic, neurodevelopmental) - Results No increased risk; aHR 0.98 for autoimmune, 0.99 for atopic/allergic, 0.93 for neurodevelopmental disorders - Takeaway Findings were incompatible with moderate or large increases in risk and reinforce vaccine safety. Key teaching points 1. Policy-driven changes in Danish vaccine formulations allowed a natural quasi-experiment design. 2. Large registry-based cohorts can rule out moderate safety signals. 3. Epidemiologic evidence does not support prior theoretical aluminum toxicity concerns. Citation:   Andersson NW et al. Aluminum-Adsorbed Vaccines and Chronic Diseases in Childhood: A Nationwide Cohort Study. Ann Intern Med. 2025. doi:[10.7326/ANNALS-25-00997](https://doi.org/10.7326/ANNALS-25-00997) 🎧 If you find this breakdown helpful, follow and leave a quick rating—it helps other clinicians and learners find high-quality, evidence-based content. 🎧 Email me at whatsitworthpodcast@gmail.com if you have an article suggestion for me to decode!  

Welcome back to What's it Worth! Join your host, Dr. Diana Langworthy and returning co-host Dr. Meade Avery (2025 U of MN CoP Grad!!) as we PrEPare our clinical conclusions about a novel antiviral for HIV prevention. We also welcome an HIV expert, Dr. Daniel (Jude) Holt, who is a clinical pharmacist at North Memorial Health in the Infectious Diseases clinic.  The study we critique compares twice yearly lenacapavir with daily emtricitabine/tenofovir alafenamide (F/TAF) or emtricitabine/tenofovir disoproxil fumarate (F/TDF) in cisgender women for HIV prevention (PrEP).   Key Points HIV prevention is a critical step in the fight to end HIV There are many barriers to compliance with daily oral HIV preventative medications including access and compliance Twice yearly lenacapavir has been proven effective at preventing HIV in men who have sex with men and transgender women, but was yet to be studied in cisgender women A twice yearly regimen can help patients overcome barriers to compliance Will we find out "Where's "Wald"-o in our Stat Stop? ------> Tune in to find out! References [EPISODE TRIAL] Bekker LG, Das M, Abdool Karim Q, et al.  Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention in Cisgender Women. NEJM 2024;391(13):1179-1192. Kelley CF, Acevedo-Quinones M, Agwu AL, et al.  Twice yearly lenacapavir for HIV prevention in men and gender-diverse persons. NEJM 2024;392(13):1261-1276. Bekerman E, Hansen D, Lu B, et al. Long-acting capsid inhibitor effective as PrEP against vaginal SHIV transmission in macaques. In: Proceedings and Abstracts of the 11th IAS Conference on HIV Science, July 18–21, 2021. Virtual: International AIDS Society, 2021. abstract. Centers for Disease Control and Prevention. "HIV Prevention Research Synthesis Project." HIV Compendium of Best Practices. October 24, 2024, June 6, 2025, https://www.cdc.gov/hivpartners/php/hiv-treatment/index.htmlnters for Disease Control and Prevention   Contact Information Podcast email: whatsitworthpodcast@gmail.com Expert Guest Dr. Daniel (Jude) Holt, PharmD, AAHIVP, CSP Clinical Pharmacy Specialist - Infectious Disease Specialty Pharmacy Infectious Disease Support Daniel.Holt@northmemorial.com Host Information Dr. Diana R. Langworthy, PharmD, BCPS Clinical Associate Professor, University of Minnesota College of Pharmacy Clinical Pharmacist - Inpatient Internal Medicine, M Health Fairview East Bank Hospital Co-Host Information Meade Avery, PharmD 2025 Graduate, University of Minnesota College of Pharmacy

Welcome back to What's it Worth! Join your hosts, Dr. Diana Langworthy and Dr. Peyton Braun (PGY1 Pharmacy Resident), as we sift through strengths and limitations of at trial assessing the effects of empagliflozin on nonalcoholic fatty liver disease.  The authors sought to quantify the impact of Sodium Glucose Cotransporter 2 - inhibitors (SGLT2i's) on Metabolic Dysfunction Associated Liver Disease (MASLD).  This episode is full of EBP detective moments - dissecting trial language to get a clear picture of the story. Let's dive in and see what its worth!   Key Points MASLD is a condition marked by an accumulation of fat in the liver which can lead to inflammation and irreversible liver damage MASLD is often associated with conditions such as obesity, diabetes and hypertension  SGLT2i's are an evidence based therapy for the treatment of type II diabetes and have also shown to improve outcomes in heart failure and kidney disease Extraglycemic benefits of this class of agents are of particular interest, with an increasing number of clinical trials investigating their potential impact on a variety of diseases (including MASLD) Does a trial conducted with non-probability sampling have enough internal validity for empagliflozin in MASLD? ------> Tune in to find out! References [EPISODE TRIAL] Shojaei, F., Erfanifar, A., Kalbasi, S. et al. The effect of empagliflozin on non-alcoholic fatty liver disease-related parameters in patients with type 2 diabetes mellitus: a randomized controlled trial. BMC Endocr Disord 25, 52 (2025). https://doi.org/10.1186/s12902-025-01882-8 Zhang Y, Liu X, Zhang H, Wang X. Efficacy and safety of empagliflozin on nonalcoholic fatty liver disease: a systematic review and meta-analysis. Front Endocrinol 2022; doi: 10.3389/fendo.2022.836455 Rinella, Mary E.1; Neuschwander-Tetri, Brent A.2; Siddiqui, Mohammad Shadab3; Abdelmalek, Manal F.4; Caldwell, Stephen5; Barb, Diana6; Kleiner, David E.7; Loomba, Rohit8. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology 77(5):p 1797-1835, May 2023. | DOI: 10.1097/HEP.0000000000000323 Kanwal, Fasiha1,2,3; Neuschwander-Tetri, Brent A.4; Loomba, Rohit5; Rinella, Mary E.6. Metabolic dysfunction–associated steatotic liver disease: Update and impact of new nomenclature on the American Association for the Study of Liver Diseases practice guidance on nonalcoholic fatty liver disease. Hepatology 79(5):p 1212-1219, May 2024. | DOI: 10.1097/HEP.0000000000000670 Chen, Vincent L.1; Morgan, Timothy R.2,3; Rotman, Yaron4; Patton, Heather M.5,6; Cusi, Kenneth7; Kanwal, Fasiha8,9,10; Kim, W. Ray11. Resmetirom therapy for metabolic dysfunction-associated steatotic liver disease: October 2024 updates to AASLD Practice Guidance. Hepatology 81(1):p 312-320, January 2025. | DOI: 10.1097/HEP.0000000000001112 Stratton SJ. Purposeful Sampling: Advantages and Pitfalls. Prehospital and Disaster Medicine. 2024;39(2):121-122. doi:10.1017/S1049023X24000281 Contact Information Podcast email: whatsitworthpodcast@gmail.com Host Information Dr. Diana R. Langworthy, PharmD, BCPS Clinical Associate Professor, University of Minnesota College of Pharmacy Clinical Pharmacist - Inpatient Internal Medicine, M Health Fairview East Bank Hospital Co-Host Information Peyton Braun, PGY1 Pharmacy Resident University of Minnesota Medical Center - East Bank

Episode 2 of the Double Header with the Minnesota Twins! The first article, the SEQUOIA trial, was discussed in the preceding episode with Mckay Carstens... did you guess correctly for which twin was speaking? He's passing the baton to his brother Kane to discuss management of portal hypertension in patients with cirrhosis. We're looking back in time with a retrospective study that investigated whether carvedilol showed more effectiveness compared with classical NSBBs to prevent decompensation in patients with cirrhosis. Stick with us to see if the weight of portal hypertension is lifted in this cohort and explore the role of selection bias in retrospective cohort studies. Key Points Cirrhosis is a leading cause of liver-related morbidity worldwide and managing complications like portal hypertension is key to improving outcomes Progression to decompensated cirrhosis—marked by ascites, variceal bleeding, or encephalopathy—reduces median survival to approximately 2 years thus highlighting the importance of prevention of decompensating events. Carvedilol has gained attention for its added alpha-1 blockade, offering greater portal pressure reduction—though its long-term benefits and safety compared to traditional NSBBs remain under investigation Get curious about selection bias - can we confidently interpret and apply these trial results? ------> Tune in to find out! References [EPISODE TRIAL] Fortea JI, Alvarado-Tapias E, Simbrunner B, et al. Carvedilol vs. propranolol for the prevention of decompensation and mortality in patients with compensated and decompensated cirrhosis. Journal of Hepatology 2025; https://doi.org/10.1016/j.jhep.2024.12.017. Kaplan DE, Ripoll C, Thiele M, et al.  AASLD Practice Guidelines on risk stratification and management of portal hypertension and varices in cirrhosis. Hepatology 2024;79:1180-1211. Turco L, Reiberger T, Vitale G, La Mura V. Carvedilol as the new non-selective beta-blocker of choice in patients with cirrhosis and portal hypertension. Liver International 2023;43(6):1183-1194. Villanueva C, Torres F, Kumar Sarin S, et al.  Carvedilol reduces the risk of decompensation and mortality in patients with compensated cirrhosis in a competing-risk meta-analysis. Journal of Hepatology 2022;77(4):1014-1025. Austin PC, Stuart EA. Moving towards best practice when using inverse probability of treatment weighting (IPTW) using the propensity score to estimate causal treatment effects in observational studies. Statistics in Medicine 2015;34(28);3661-3679.   Contact Information Podcast email: whatsitworthpodcast@gmail.com Host Information Dr. Diana R. Langworthy, PharmD, BCPS Clinical Associate Professor, University of Minnesota College of Pharmacy Clinical Pharmacist - Inpatient Internal Medicine, M Health Fairview East Bank Hospital Co-Host Information Kane Carstens, PharmD PGY1 Resident, University of Minnesota Medical Center East Bank Mckay Carstens, PharmD PGY1 Resident, University of Minnesota Medical Center East Bank

Join us for a Double Header with the Minnesota Twins! No, we haven't converted to a sports podcast... I have PGY1 Residents (who are identical twins), Kane and Mckay Carstens joining me for back-to-back journal critiques! The first article, the SEQUOIA trial, was conducted to determine the efficacy and safety of aficamten, a novel cardiac myosin inhibitor, in patients with obstructive Hypertrophic Cardiomyopathy (HoCM).  Let's get into the weeds to see the forest for the trees - what is aficamten's possible place in therapy for HoCM? Key Points Hypertrophic Cardiomyopathy (HCM) is one of the most common genetic heart conditions worldwide Historical pharmacologic treatments are aimed at symptom resolution, but there have not been agents that directly target the mechanism of disease Cardiac myosin inhibitors are a new class of drugs on the block with promise for patients with HoCM But what do hierarchical secondary outcomes tell us? ------> Tune in to find out! References [EPISODE TRIAL] Maron MS, Masri A, Nassif ME, et al.  Aficamten for symptomatic obstructive hypertrophic cardiomyopathy [SEQUOIA-HCM]. NEJM 2024;390:1849-1861. Maron BJ. Clinical course and management of hypertrophic cardiomyopathy. NEJM 2018.379:655-668. Ommen SR, Ho CY, Asif IM, et al. 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation 2024;149:e1239-e1311. Laporte S, Divine M, Girault D, et al. What usage and what hierarchical order for secondary endpoints? Therapie 2016,71(1):35-41. CPR Certification Links American Heart Association CPR & First Aid: https://cpr.heart.org/en/course-catalog-search HeartCert: https://heartcertcpr.com/   Contact Information Podcast email: whatsitworthpodcast@gmail.com Host Information Dr. Diana R. Langworthy, PharmD, BCPS Clinical Associate Professor, University of Minnesota College of Pharmacy Clinical Pharmacist - Inpatient Internal Medicine, M Health Fairview East Bank Hospital Co-Host Information Kane Carstens, PharmD PGY1 Resident, University of Minnesota Medical Center East Bank Mckay Carstens, PharmD PGY1 Resident, University of Minnesota Medical Center East Bank

Welcome to What's it Worth! Join your host, Dr. Diana Langworthy and student guest host, Meade Avery, as we walk the tightrope of anticoagulation in elderly patients with Atrial Fibrillation (AFib). We'll be reviewing an article that evaluated frail, elderly patients with AFib and compared maintaining INR guided warfarin with switching to a direct acting oral anticoagulant (DOAC). Come along as we decide To Stay or Not To Stay with VKAs! Key Points Atrial fibrillation leads to an increased risk of stroke/systemic embolism (SSE) and maintenance anticoagulation is indicated for patients at elevated risk Guidelines recommend DOACs as first line for prevention of SSE in AFib patients however there is little data to determine whether frail elderly patients are better left on their INR guided warfarin Pragmatic, or real-world, studies can be helpful in special populations that are often excluded from key randomized controlled trials however may be limited by unmeasured confounders  Should more elderly patients stay on their INR guided warfarin? --> Tune in to find out! CHA₂DS₂-VASc Score for Atrial Fibrillation Stroke Risk Calculator: https://www.mdcalc.com/calc/801/cha2ds2-vasc-score-atrial-fibrillation-stroke-risk   Contact Information Podcast email: whatsitworthpodcast@gmail.com Host Information Dr. Diana R. Langworthy, PharmD, BCPS Clinical Associate Professor - University of Minnesota College of Pharmacy Clinical Pharmacist - Inpatient Internal Medicine, M Health Fairview East Bank Hospital Guest Host Information Meade Avery, Student Pharmacist  Class of 2025 - University of Minnesota College of Pharmacy   References [EPISODE TRIAL] Joosten, L. P. T., van Doorn, S., van de Ven, P. M., Köhlen, B. T. G., Nierman, M. C., Koek, H. L., Hemels, M. E. W., Huisman, M. V., Kruip, M., Faber, L. M., Wiersma, N. M., Buding, W. F., Fijnheer, R., Adriaansen, H. J., Roes, K. C., Hoes, A. W., Rutten, F. H., & Geersing, G. J. (2024). Safety of Switching From a Vitamin K Antagonist to a Non-Vitamin K Antagonist Oral Anticoagulant in Frail Older Patients With Atrial Fibrillation: Results of the FRAIL-AF Randomized Controlled Trial. Circulation, 149(4), 279–289. https://doi.org/10.1161/CIRCULATIONAHA.123.066485 McMahan, D. A., Smith, D. M., Carey, M. A., & Zhou, X. H. (1998). Risk of major hemorrhage for outpatients treated with warfarin. Journal of general internal medicine, 13(5), 311–316. https://doi.org/10.1046/j.1525-1497.1998.00096.x Joglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., Chyou, J. Y., Cronin, E. M., Deswal, A., Eckhardt, L. L., Goldberger, Z. D., Gopinathannair, R., Gorenek, B., Hess, P. L., Hlatky, M., Hogan, G., Ibeh, C., Indik, J. H., Kido, K., Kusumoto, F., Link, M. S., Linta, K. T., … Peer Review Committee Members (2024). 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 149(1), e1–e156. https://doi.org/10.1161/CIR.0000000000001193  Saviano, A., Brigida, M., Petruzziello, C., Candelli, M., Gabrielli, M., & Ojetti, V. (2022). Gastrointestinal Bleeding Due to NOACs Use: Exploring the Molecular Mechanisms. International journal of molecular sciences, 23(22), 13955. https://doi.org/10.3390/ijms232213955 Konicki R, Weiner D, Patterson JH, et al.  Rivaroxaban precision dosing strategy for real-world atrial fibrillation patients. Clin Transl Sci 2020;13(4):777-784. Mueck W, Lensing AW, Agnelli G, et al.  Rivaroxaban: population pharmacokinetic analyses in patients treated for acute deep-vein thrombosis and exposure simulations in patients with atrial fibrillation treated for stroke prevention. Clin Pharmacokinet 2011;50(10):675-686. Garcia, D. A., Lopes, R. D., & Hylek, E. M. (2010). New-onset atrial fibrillation and warfarin initiation: high risk periods and implications for new antithrombotic drugs. Thrombosis and haemostasis, 104(6), 1099–1105. https://doi.org/10.1160/TH10-07-0491  Healthiest Countries 2024. World Population Review. (n.d.). https://worldpopulationreview.com/country-rankings/healthiest-countries. Accessed September 17, 2024.

Welcome to What's it Worth! Join your host Dr. Diana Langworthy, with student co-host Rachel Cohen, as we hit the design dictionary to decode statistical language and simplify estimands and populations. Our expert guest for this episode is Dr. Kylee Funk, Assoiate Professor and Ambulatory Care Pharmacist. We're discussing a trial that compared oral semaglutide with subcutanous liraglutide, GLP-1 agonists, for the treatment of type 2 diabetes.   Key Points Non-inferiority (NI) trials are indicated when there are other effective treatment options or where it would be unethical to expose a group to placebo NI margins are important components to critique when reviewing these trials to determine clinical implications and whether the margin is clinically justifiable  Populations, like Intent to Treat, can sometimes be categorized as Estimands How can I describe Estimands and GLP1 Effectiveness to my preceptor? --> Tune in to find out! References [EPISODE TRIAL] Pratley R, Amod A, Hoff ST, et al.  Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes (PIONEER 4): a randomised, double-blind, phase 3a trial. The Lancet 2019;394:39-50. Davies M, Pieber TR,  Hartoft-Nielsen ML, et al.  Effect of oral semaglutide compared with placebo and subcutaneous semaglutide on glycemic control in patients with type 2 diabetes: a randomized clinical trial. JAMA 2017; 318:1460-1470. Karagiannis T, Avgerinos I, Liakos A, et al.  Management of type 2 diabetes with the dual GIP/GLP-1 receptor agonist tirzepatide: a systematic review and meta-analysis. Diabetologia 2022;65(8): 1251-1261. Contact Information Podcast email: whatsitworthpodcast@gmail.com Host Information Dr. Diana R. Langworthy, PharmD, BCPS Clinical Associate Professor, University of Minnesota College of Pharmacy Clinical Pharmacist - Inpatient Internal Medicine, M Health Fairview East Bank Hospital Co-Host Information Rachel Cohen, Student Pharmacist, Class of 2025  University of Minnesota Guest Host Information Dr. Kylee Funk, PharmD, BCACP Associate Professor, Pharmaceutical Care and Health Systems Ambulatory Care Pharmacist University of Minnesota College of Pharmacy

Welcome to What's it Worth! Join your host Dr. Diana Langworthy as we record live with our 2nd year Pharmacy Students for their EBP Pulse Check! We're exploring whether or not we should REDUCE our use of beta blockers in post MI patients who have a preserved ejection fraction by critiquing the REDUCE-AMI trial (NEJM 2024). Our expert guest for this episode is Dr. Anne Schullo-Feulner, Clinical Professor at the University of Minnesota College of Pharmacy and Cardiology Clinical Specialist at Methodist Hospital in St. Louis Park, MN. We discuss key concepts related to interpretation of results and how we can leverage our biostatistics knowledge to tackle Kaplan Meier Curves! Special shout out to our PD2 Student Participants in the podcast: Andrew Gabbitas, Natalie Pearson, and Emma Maudal! Key Points The majority of evidence to support beta blocker use post-MI comes from the pre-reperfusion era The REDUCE-AMI Trial aimed to determine whether or not patients with preserved ejection fraction after AMI should receive a beta blocker  Comparison of baseline characteristics from clinical trials to characteristics of your patient population is critical to determine generalizability of data to your practice  What are some hidden gems within these Kaplan Meier Curves? --> Tune in to find out! References [EPISODE TRIAL] Yndigegn T, Lindahl B, Mars K, et al. Beta-blockers after myocardial infarction and preserved ejection fraction. [REDUCE-AMI] NEJM 2024;390:1372-1381. Virani SS, Newby K, Arnold SV, et al.  2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Manatement of Patients with Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation 2023;148(9):e9-e119. Lewis GD, Gosch K, Cohen LP. Effect of dapagliflozin on 6-minute walk distance in heart failure with preserved ejection fraction: PRESERVED-HF. Circ Heart Fail 2023;16(11):e010633. Contact Information Podcast email: whatsitworthpodcast@gmail.com Host Information Dr. Diana R. Langworthy, PharmD, BCPS Clinical Associate Professor, University of Minnesota College of Pharmacy Clinical Pharmacist - Inpatient Internal Medicine, M Health Fairview East Bank Hospital Guest Host Information Dr. Anne Schullo-Feulner, PharmD, BCPS Clinical Professor, University of Minnesota College of Pharmacy Clinical Pharmacist - Cardiology, Methodist Hospital

Welcome to What's it Worth! Join your host Dr. Diana Langworthy and guest host Rachel Cohen (PharmD Candidate, 2025) as we take a look at how cannabis affects pregnancy outcomes.  Our guest, Dr. Ann Philbrick, PharmD, BCACP, will share her expertise with the current state of cannabis use and what it looks like to see patients who use cannabis in pregnancy. Key Points Existing evidence regarding cannabis in pregnancy has focused primarily on neonatal/fetal outcomes leaving a gap in maternal outcomes Discussions about the safety of cannabis are more common as more states begin to legalize medical and recreational use This is odd... Odds Ratio and Relative Risk can be similar but are not the same thing - when should we expect to see each of these?  Cannabis use in pregnancy was linked to increased maternal risk, however retrospective cohorts can present opportunity for unmeasured confounders---> TUNE IN to find out what those might be! References [EPISODE TRIAL] Young-Wolff KC, Adams SR, Alexeeff SE, et al. Prenatal Cannabis Use and Maternal Pregnancy Outcomes. JAMA Intern Med. Published online July 22, 2024. doi:10.1001/jamainternmed.2024.3270 Lo JO, Shaw B, Robalino S, et al. Cannabis Use in Pregnancy and Neonatal Outcomes: A Systematic Review and Meta-Analysis. Cannabis Cannabinoid Res. 2024;9(2):470-485. doi:10.1089/can.2022.0262 Baía I, Domingues RMSM. The Effects of Cannabis Use during Pregnancy on Low Birth Weight and Preterm Birth: A Systematic Review and Meta-analysis. Am J Perinatol. 2024;41(1):17-30. doi:10.1055/a-1911-3326  Contact Information Podcast email: whatsitworthpodcast@gmail.com Host Information Dr. Diana R. Langworthy, PharmD, BCPS Clinical Associate Professor, University of Minnesota College of Pharmacy Clinical Pharmacist - Inpatient Internal Medicine, M Health Fairview East Bank Hospital Guest Host Information Rachel Cohen, Student Pharmacist, Class of 2025  University of Minnesota Guest Expert Dr. Ann Philbrick, PharmD, BCACP, Associate Professor, University of Minnesota College of Pharmacy  

Welcome back to What's it Worth! Join your hosts, Dr. Diana Langworthy and P4 Garrison Avery, as we discuss the RENAL-AF trial comparing apixaban vs warfarin in hemodialysis patients.  These authors aimed to assess safety and efficacy in one of the first prospective trials comparing DOACs with warfarin in hemodialysis patients. Ever read a trial that didn't enroll their goal number of patients? Let's dig into patient recruitment considerations in trials and also pragmatic applications to medication selection, and properties of drugs that can be cleared by hemodialysis with real pharmacokinetic data to support! Key Points The prevalence of atrial fibrillation in patients on hemodialysis has been noted to be as much as nine times higher than the general population Warfarin presents a challenge as an anticoagulant in patients on hemodialysis due a heightened risk of bleeding and risk for vascular complications such as calciphylaxis Studies that are published with neutral or negative findings can still provide important clinical context for understudied populations like patients on hemodialysis What does this underpowered trial tell us? ------> Tune in to find out! References [EPISODE TRIAL] Pokorney SD, Chertow GM, Al-Khalidi HR, et al; RENAL-AF Investigators. Apixaban for Patients With Atrial Fibrillation on Hemodialysis: A Multicenter Randomized Controlled Trial. Circulation. 2022 Dec 6;146(23):1735-1745. doi: 10.1161/CIRCULATIONAHA.121.054990. Epub 2022 Nov 6. PMID: 36335914. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024 Apr;105(4S):S117-S314. doi: 10.1016/j.kint.2023.10.018. PMID: 38490803. Joglar JA, Chung MK, Armbruster AL, et al.  ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024 Jan 2;149(1):e1-e156. doi: 10.1161/CIR.0000000000001193. Epub 2023 Nov 30. Erratum in: Circulation. 2024 Jan 2;149(1):e167. Erratum in: Circulation. 2024 Feb 27;149(9):e936. PMID: 38033089. What's behind racial disparities in kidney disease? 2021. Harvard Health Publishing; Harvard Medical School. Accessed on March 10, 2024: https://www.health.harvard.edu/blog/whats-behind-racial-disparities-in-kidney-disease-2021020321842#:~:text=The%20most%20recent%20report%20from,per%20million%20for%20white%20Americans. Mavrakanas TA, Samer CF, Nessim SJ, et al. Apixaban Pharmacokinetics at Steady State in Hemodialysis Patients. J Am Soc Nephrol. 2017 Jul;28(7):2241-2248. doi: 10.1681/ASN.2016090980. Epub 2017 Mar 16. PMID: 28302754; PMCID: PMC5491286. Dialysis. National Kidney Foundation [Web]. 30 East 33rd Street, New York, NY 10016 © 2024 National Kidney Foundation Inc. Dialysis - Types, effectiveness, side effects | National Kidney Foundation Vázquez, E., Vázquez-Sánchez, T. Sánchez-Perales, C. Letter by Vázquez et al Regarding Article, "Apixaban for Patients With Atrial Fibrillation on Hemodialysis: A Multicenter Randomized Controlled Trial" Circulation. 2023;148:378. DOI:  10.1161/CIRCULATIONAHA.122.063700 © 2023 American Heart Association, Inc. Contact Information Podcast email: whatsitworthpodcast@gmail.com Host Information Dr. Diana R. Langworthy, PharmD, BCPS Clinical Associate Professor, University of Minnesota College of Pharmacy Clinical Pharmacist - Inpatient Internal Medicine, M Health Fairview East Bank Hospital Co-Host Information Garrison (Griest) Avery, Student Pharmacist, Class of 2024 University of Minnesota College of Pharmacy

Welcome back to What's it Worth! Join your hosts, Dr. Diana Langworthy and Garrison Avery, student PharmD, as we evaluate the 52 week reported outcomes of the ongoing Resmetirom Phase 3 trial. This trial is our first look at a medication currently seeking FDA approval to halt and reverse NASH and liver fibrosis. We also discuss Bonferroni statistical analysis, patients excluded from the trial, and bias in language.    Key Points The FDA accelerated approval process might get your pharmacist-spidey senses going, but is it a concern? Non-alcoholic steatohepatitis (NASH) is the most severe form of non-alcoholic fatty liver disease (NAFLD) and can progress to end stage liver disease if not managed properly Recognizing when manuscript language may be suggestive of an effect (when one has not been statistically proven) is important to keep top of mind when critiquing an article. Is there promise for patients with NAFLD to take their livers back in time? --> Tune in to find out! References [EPISODE TRIAL] Harrison SA, Bedossa P, Guy CD, et al; MAESTRO-NASH Investigators. A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis. N Engl J Med. 2024 Feb 8;390(6):497-509. doi: 10.1056/NEJMoa2309000. PMID: 38324483. Kanwal F, Neuschwander-Tetri BA, Loomba R, Rinella ME.  Metabolic dysfunction-associated steatotic liver disease: Update and impact of new nomenclature on the American Association for the Study of Liver Diseases practice fuidance on nonalcoholic fatty liver disease. Hepatology 2023;DOI: 10.1097/HEP.0000000000000670. Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al.  AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease Hepatology 2023;77(5):1797-1835. U.S. Food and Drug Administration. Accelerated Approval Program. Accessed March 8, 2024. https://www.fda.gov/drugs/nda-and-bla-approvals/accelerated-approval-program Contact Information Podcast email: whatsitworthpodcast@gmail.com Host Information Dr. Diana R. Langworthy, PharmD, BCPS Clinical Associate Professor, University of Minnesota College of Pharmacy Clinical Pharmacist - Inpatient Internal Medicine, M Health Fairview East Bank Hospital Co-Host Information Garrison (Griest) Avery, Student Pharmacist, Class of 2024 University of Minnesota College of Pharmacy

Did you miss us? We're back for Season 2 of What's it Worth! Join your host, Dr. Diana Langworthy, and co-host Garrison (Griest) Avery (back at the end of his APPE year for some more EBP fun!), as they find out if phenobarbital is beating benzos in severe alcohol withdrawal!  CI-WAt all the fuss is about in season two as we PAWSS and reflect on where single-site retrospective results and clinical takeaways can meet!   Key Points Alcohol withdrawal syndrome is a complex process involving acute imbalances in excitatory and inhibitory neurotransmitters in the CNS that can predispose patients to potentially life threatening complications like seizure and alcohol withdrawal delirium. Patients in vulnerable populations, like pregnant persons and imprisoned persons, represent a group that is often underrepresented in clinical trials - we discuss this from a retrospective and prospective angle. The Poisson regression is used for analysis of count data while the Wilcoxan rank sum test is a nonparametric test that assumes unknown or not-normally distrubuted data. Is phenobarbital back again for alcohol withdrawal syndrome? --> Tune in to find out! References [EPISODE TRIAL] D, Al-Hegelan M, Thompson J, Bronshteyn Y. Phenobarbital versus benzodiazepines in alcohol withdrawal syndrome. Neuropsychopharmacol Rep. 2023; 43: 532–541. https://doi.org/10.1002/npr2.12347 DiCenzo R. Clinical Pharmacist's Guide to Biostatistics and Literature Evaluation. ACCP. 2011. [Poisson and Wilcoxan information] The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management. American Society of Addiction Medicine, 2020. [Alcohol withdrawal management information, CIWA, PAWSS] Weaver M, Jewell C, Tomlinson J. Phenobarbital for Treatment of Alcohol Withdrawal. Journal of Addictions Nursing 2009;20:1-5. Contact Information Podcast email: whatsitworthpodcast@gmail.com Host Information Dr. Diana R. Langworthy, PharmD, BCPS Clinical Associate Professor, University of Minnesota College of Pharmacy Clinical Pharmacist - Inpatient Internal Medicine, M Health Fairview East Bank Hospital Co-Host Information Garrison (Griest) Avery, Student Pharmacist, Class of 2024 University of Minnesota College of Pharmacy

Welcome to What's it Worth - BONUS episode #2! Join your host Dr. Diana Langworthy and a come-back by P4 student co-host Marina Fahim as we get biosimilar! Our expert guest for this episode is Dr. Hannah Berg, Formulary Management Pharmacist at United Healthcare. We're discussing a trial that aimed to determine whether pegfilgrastim biosimilars were considered statistically equivalent to the pegfilgrastim originator product.  Biosimilars have the potential to offer cost-savings for patients requiring these expensive agents as they can introduce market competition and a potentially cheaper alternative to originator products.   This bonus episode also coincides with a Journal Club assignment that students in my Evidence Based Practice course completed last week - Hello PHAR6782 Students! Great work on your first official Journal Clubs! Key Points Biologic agents are key in managing or preventing certain disease states, however often they present cost challenges to patients and healthcare systems Febrile Neutropenia (FN) is a complication of high intensity chemotherapy regimens for patients with cancer The NCCN guidelines recommend that patients at high risk receive a granulocyte colony stimulating factor (G-CSF) such as pegfilgrastim for the prevention of FN Equivalence studies present an opportunity for pharmacists to critically evaluate historical data to determine clinical and statistical appropriateness of equivalence margins How can you best interpret equivalence margins? ---> Tune in to find out! References [EPISODE TRIAL] Wang CY, Vouri SM, Park H, et al.  Comparative effectiveness of pegfilgrastim biosimilars vs originator for prevention of febrile neutropenia: A retrospective cohort study.  J Manag Care Spec Pharm. 2023;29(2):119-127. Griffiths EA, Roy V, Bachiashvili K, et al.  Hematopoietic Growth Factors. NCCN Guidelines Version 1.2024. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/growthfactors.pdf. Casazza G, Solbiati M.  Can we trust equivalence and non-inferiority trials? Intern Emerg Med 2013;8:439-442. Biosimilar Regulatory Review and Approval. US Food and Drug Administration Guidance Document. Accessed at https://www.fda.gov/media/151061/download. Contact Information Podcast email: whatsitworthpodcast@gmail.com Host Information Dr. Diana R. Langworthy, PharmD, BCPS Clinical Associate Professor, University of Minnesota College of Pharmacy Clinical Pharmacist - Inpatient Internal Medicine, M Health Fairview East Bank Hospital Co-Host: Marina Fahim, P4 PharmD Student 2024, University of Minnesota Expert Guest Information Dr. Hannah Berg, PharmD Formulary Management Pharmacist UnitedHealthcare 

Welcome to What's it Worth! Join your host Dr. Diana Langworthy as we co-mingle with co-primary clues! Our expert guest for this episode is Dr. Natalie Heinrich, Medication Therapy Management Clinical Pharmacist in Neurology at M Health Fairview. We're discussing a trial evaluated the efficacy of zavegepant, a novel CGRP antagonist for nasal administration, for the treatment of acute migraine attack. Join us as we discuss the key points of co-primary outcomes, populations and power.   Key Points Migraine disease affects 1 in 6 Americans and is a leading cause of disability Triptan medications have been used for decades to treat migraine attacks, yet they have several contraindications due to vasoconstrictive effects CGRP inhibitors are a new class of medications that target a specific peptide involved in migraine disease pathophysiology Treatment for some disease states requires studies that involve two co-primary outcomes that are deemed equally important to determine true efficacy of an intervention Does migraine disease fit the co-primary mold and is zavegepant ready for the migraine toolbox? --> Tune in to find out! References [EPISODE TRIAL] Lipton RB, Croop R, Stock DA, et al.  Safety, tolerability, and efficacy of zavegepant 10mg nasal spray for the acute treatment of migraine in the USA: a phase 3, double-blind, randomised, placebo-controlled multicentre trial. Lancet Neurol 2023;22(3):209-217.    Croop R, Madonia J, Stock DA, et al.  Zavegepant nasal spray for the acute treatment of migraine: a phase 2/3 double-blind, randomized, placebo-controlled, dose-ranging trial. Headache 2022;62:1153-1163.  Product Information: Zavzpret(R), zavegepant 10mg/1 nasal spray. Pfizer Laboratories Div Pfizer Inc, New York, NY. 2023. Ailani J, Burch RC, Robbins MS, et al.  The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache 2021;61:1021-1039. Burch R, Rizzoli P, Loder E.  The Prevalence and Impact of Migraine and Severe Headache in the United States: Figures and Trends from Government Health Studies. Headache 2018;58(4):496-505. Contact Information Podcast email: whatsitworthpodcast@gmail.com Host Information Dr. Diana R. Langworthy, PharmD, BCPS Clinical Associate Professor, University of Minnesota College of Pharmacy Clinical Pharmacist - Inpatient Internal Medicine, M Health Fairview East Bank Hospital Expert Guest Information Dr. Natalie Heinrich, PharmD Medication Therapy Management Clinical Pharmacist, Neurology Clinics and Surgery Center, M Health Fairview

Welcome to What's it Worth! Join your host Dr. Diana Langworthy, & co-host Marina Fahim, as we ATTACK the critique of a non-inferiotiy study design. Our expert guest for this episode is Dr. Betsy Hirsch, Assoiate Professor and Infectious Diseases Translational Researcher. We're discussing a trial that compared a new beta-lactam antibiotic, sulbactam/durlobactam, with colistin for the treatment of Acinetobacter baumannii infections. Join us as we discuss the key points of a non-inferiority trial design as we determine what this article is worth!   Key Points Non-inferiority (NI) trials are indicated when there are other effective treatment options or where it would unethical to expose a group to placebo Acinetobacter baumannii-calcoaceticus (ABC) is seen in hospital acquired infections and presents a clinical challenge to practitioners given its increasing resistance patterns NI margins are important components to critique when reviewing these trials to determine clinical implications and whether the margin is clinically justifiable  How inferior is considered "non-inferior"? --> Tune in to find out! References [EPISODE TRIAL] Kaye KS, Shorr AF, Wunderink RG, et al.  Efficacy and safety of sulbactam-durlobactam versus colistin for the treatment of patients with serious infections caused by Acinetobacter baumannii-calcoaceticus complex:  a multicentre, randomised, active-controlled, phase 3, non-inferiority clinical trial (ATTACK).  Lanced Infect Dis 2023; Sep;23(9):1072-1084.  doi: 10.1016/S1473-3099(23)00184-6. Tamma PD, Aitken SL, Bonomo RA, et al.  Infectious Diseases Society of America 2023 Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections. CID 2023, ciad428,  https://doi.org/10.1093/cid/ciad428  Product Information: XACDURO(R) intravenous kit, sulbactam, durlobactam intravenous kit. La Jolla Pharmaceutical Company (per manufacturer), Waltham, MA, 2023. Tsuji BT, Pogue JM, Zavascki AP, et al.  International Consensus Guidelines for the Optimal Use of the Polymyxins: Endorsed by the American College of Clinical Pharmacy (ACCP), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), International Society for Anti-Infective Pharmacology (ISAP), Society of Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP).  Pharmacotherapy 2019;39(1):10-39.  https://accpjournals.onlinelibrary.wiley.com/doi/full/10.1002/phar.2209 Contact Information Podcast email: whatsitworthpodcast@gmail.com Host Information Dr. Diana R. Langworthy, PharmD, BCPS Clinical Associate Professor, University of Minnesota College of Pharmacy Clinical Pharmacist - Inpatient Internal Medicine, M Health Fairview East Bank Hospital Co-Host Information Marina Fahim, Student Pharmacist, Class of 2024  University of Minnesota Guest Host Information Dr. Betsy Hirsch, PharmD, FCCP, FIDSA Associate Professor, Experimental and Clinical Pharmacology Infectious Diseases Translational Researcher University of Minnesota College of Pharmacy

Welcome to What's it Worth! Join your host, Dr. Diana Langworthy and co-host Chelsea Bolier, PharmD, as we break down Delphi and learn more about analyzing qualitatitve data.  We're joined this month by Dr. Joel Farley, PhD and Dr. Pamela Phelps, PharmD, FASHP - two experts in the arena of determining the impact of clinical pharmacy services.    Key Points Determining the impact of clinical pharmacist interventions is a complex and site specific process The Delphi (or modified Delphi) process is intended for use to answer a qualitative research question through consensus building among experts Aligning health system patient care priorities with pharmacist clinical impact is key in gaining buy-in for all stakeholders How did Delphi shake out for pharmacist clinical impact? --> Tune in to find out! References [EPISODE TRIAL] Vest MN, Stout S, Waldron K. Implementation of a strategy for identification and monitoring of clinical outcome measures in a department of pharmacy. Am J Health Syst Pharm 2022;79:e135-142. Nasa P, Jain R, Juneja D. Delphi methodology in healthcare research: How to decide its appropriateness. World Journal of Methodology 2021;11(4):116-129. Contact Information Podcast email: whatsitworthpodcast@gmail.com Host Information Dr. Diana R. Langworthy, PharmD, BCPS Clinical Associate Professor, University of Minnesota College of Pharmacy Clinical Pharmacist - Inpatient Internal Medicine, M Health Fairview East Bank Hospital Guest Host Information Chelsea Bolier, PharmD, HSPAL PGY1 Pharmacy Resident, M Health Fairview Joel Farley, PhD, Professor and Associate Department Head, Department of Pharmaceutical Care & Health Systems, Univeristy of Minnesota College of Pharmacy Pamela Phelps, PharmD, FASHP, Director of Clinical Pharmacy at M Health Fairview

Welcome to What's it Worth! Join your hosts, Dr. Diana Langworthy & Garrison Griest as we go retro to tackle confounding variables! We'll be reviewing an article that aimed to determine the risk of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis who are using proton pump inhibitors (PPIs).   Key Points Retrospective studies produce more opportunities for confounding variables to impact study results Proton pump inhibitors are widely used and overused for acid reflux disease and have been associated with several risks Odds ratios calculated for retrospective cohort studies determine associations between an intervention and a risk How much confouding is too much? --> Tune in to find out! References [EPISODE TRIAL] Dahabra L, Kreidieh M, Abureesh M, et al.  Proton pump inhibitor use and increased risk of spontaneous bacterial peritonitis in chrrhotic patients: A retrospective cohort analysis.  Gastroenterol Res. 2022;15(4):180-187. Biggins SW, Angeli P, Garcia-Tsao G, et al.  Diagnosis, evaluation and management of ascites, spontaneous bacterial peritonitis and hepatorenal syndrome: 2021 practice guidance by the American Association for the Study of Liver Diseases. Hepatology.2021;74(2)1014-1048 Contact Information Podcast email: whatsitworthpodcast@gmail.com Host Information Dr. Diana R. Langworthy, PharmD, BCPS Clinical Associate Professor, University of Minnesota College of Pharmacy Clinical Pharmacist - Inpatient Internal Medicine, M Health Fairview East Bank Hospital Guest Host Information Garrison Griest, Student Pharmacist, Class of 2025  University of Minnesota