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Optimal medication management is important during hospitalization and at discharge because post-discharge adverse drug events (ADEs) are common, often preventable, and contribute to patient harms, healthcare utilization, and costs. Conduct a cost analysis of a comprehensive pharmacist-led transitions-of-care medication management intervention for older adults during and after hospital discharge. Twelve intervention components addressed medication reconciliation, medication review, and medication adherence. Trained, experienced pharmacists delivered the intervention to older adults with chronic comorbidities at 2 large U.S. academic centers. To quantify and categorize time spent on the intervention, we conducted a time-and-motion analysis of study pharmacists over 36 sequential workdays (14 519 min) involving 117 patients. For 40 patients’ hospitalizations, we observed all intervention activities. We used the median minutes spent and pharmacist wages nationally to calculate cost per hospitalization (2020 U.S. dollars) from the hospital perspective, relative to usual care. Pharmacists spent a median of 66.9 min per hospitalization (interquartile range 46.1-90.1), equating to $101 ($86 to $116 in sensitivity analyses). In unadjusted analyses, study site was associated with time spent (medians 111 and 51.8 min) while patient primary language, discharge disposition, number of outpatient medications, and patient age were not. In this cost analysis, comprehensive medication management around discharge cost about $101 per hospitalization, with variation across sites. This cost is at least an order of magnitude less than published costs associated with ADEs, hospital readmissions, or other interventions designed to reduce readmissions. Work is ongoing to assess the current intervention’s effectiveness.

Abstract β‐islet cell transplantation is a promising proposed treatment for type 1 diabetes mellitus (T1DM) which can provide more physiological glucose control when compared to exogenous insulin therapy and reverse secondary consequences of diabetes. Unfortunately, β‐islet cell transplantation is not a permanent solution for patients with T1DM as 85–90% of β‐islet recipients return to exogenous insulin treatment within 5 years of the transplant. Despite its lack of success, β‐islet cell transplantation still has potential for the treatment of T1DM and significant work has been done to non‐invasively quantify β‐islet cell concentrations in transplantation to better understand the mechanism of β‐islet cell rejection. While several imaging modalities have been utilized, magnetic resonance imaging (MRI) remains at the forefront of β‐islet cell imaging due to its high resolution and lack of radiation exposure to patients. Several MRI contrast agents have been explored for the imaging of β‐islet cells including superparamagnetic iron oxide nanoparticles (SPIONs), gadolinium‐based contrast agents (GBCA), manganese (II), fluorine‐19, and theranostic agents, with SPIONs being the most extensively studied. In this review, we provide an overview of the history, recent progress, and challenges of MRI in islet transplantation with a focus on the molecular imaging agents used.