JAPhA Practice Innovations最新文献

{"title":"Identifying secondary stroke prevention treatment gaps in older patients with nonvalvular atrial fibrillation","authors":"Kevin Le,&nbsp;Amber Mercuro,&nbsp;Maureen Brady,&nbsp;Ashley Child,&nbsp;Jaclynne Gowen","doi":"10.1016/j.japhpi.2025.100035","DOIUrl":"10.1016/j.japhpi.2025.100035","url":null,"abstract":"<div><h3>Background</h3><div>Current guidelines for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF) recommend oral anticoagulation (OAC). The risk of stroke is particularly increased in older patients and those with a history of stroke. Previous studies suggested up to 67% of eligible patients with NVAF are not prescribed OAC.</div></div><div><h3>Objective</h3><div>This study aimed to identify gaps in OAC prescribing patterns for older patients with NVAF and previous stroke to allow for optimization of OAC prescribing.</div></div><div><h3>Methods</h3><div>This single-center retrospective cohort study was conducted from a multispecialty group practice affiliated with a 178-bed community hospital. The sites are located in the Seacoast region of New Hampshire and Southern Maine. Participants included older adults aged 65-89 years with NVAF and previous stroke who were not prescribed OAC with at least1 ambulatory encounter between July 1, 2022, and June 30, 2023. Pharmacists identified patients using existing databases of ICD-10 codes, medication lists, and ambulatory clinic encounters. The primary outcome was to identify the cohort of patients not prescribed OAC.</div></div><div><h3>Results</h3><div>Among 391 eligible patients, 48 (12.3%) were not prescribed OAC therapy. Of the 48 elderly patients with NVAF and stroke history without OAC, 21 (43.5%) did not have a guideline-directed indication for OAC omission. Rationale for OAC omission included cost (6.3%), patient refusal (29.2%), bleeding from isolated trauma or procedural complication (4.2%), falls (18.8%), previous intracranial or intraspinal hemorrhage (8.3%), severe bleeding owing to nonreversible cause (4.2%), and transient NVAF (25%). Patients with Medicare were more likely to lack OAC (60%).</div></div><div><h3>Conclusion</h3><div>Not all patients who were indicated for OAC were prescribed OAC highlighting opportunity to improve prescribing practices. Uncovering real-world rationales for OAC omission equips pharmacists with valuable insights to address patient concerns effectively and highlights the critical role of pharmacist-led patient education in improving prescribing practices.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"2 3","pages":"Article 100035"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of antifungal prophylaxis in pediatric patients with acute lymphoblastic leukemia or acute myeloid leukemia","authors":"Ashley Galbreath,&nbsp;Mary Kathryn Vance,&nbsp;Caleb McMinn,&nbsp;Morgan Odom,&nbsp;Arunkumar Modi,&nbsp;Amanda Elchynski","doi":"10.1016/j.japhpi.2025.100043","DOIUrl":"10.1016/j.japhpi.2025.100043","url":null,"abstract":"<div><h3>Background</h3><div>Invasive fungal disease (IFD) is a leading cause of morbidity and mortality in patients with hematologic malignancies. The most recent practice guidelines, last updated in 2020, recommend using a mold-active azole or echinocandin when antifungal prophylaxis is warranted; however, there has historically been a lack of standardized prescribing practices at our institution.</div></div><div><h3>Objective</h3><div>This study’s primary aim is to characterize our institution’s current prescribing patterns by comparing the incidence of IFD among pediatric patients with acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML) with or without antifungal prophylaxis.</div></div><div><h3>Methods</h3><div>This single-center, retrospective chart review evaluated patients with ALL or AML treated at Arkansas Children’s Hospital from January 1, 2020, to August 31, 2023. Secondary analyses included evaluating IFD in high-risk patients, incidence of adverse events, and use of therapeutic drug monitoring. Descriptive statistics were calculated and statistical significance was determined using chi-square, Fisher’s exact, and Mann-Whitney U tests.</div></div><div><h3>Results</h3><div>A total of 114 patients were included, with 54 patients receiving antifungal prophylaxis. Patients receiving antifungal prophylaxis with fluconazole had a higher incidence of IFD than other prophylaxis agents and no prophylaxis (<em>P</em> &lt; 0.01). Among high-risk patients, 62.9% received antifungal prophylaxis. There was a lower incidence of IFD in those who received mold-active prophylaxis than those who did not (17.4% vs. 35.1%, <em>P</em> = 0.03) and in those who received guideline-directed prophylaxis than those who received fluconazole prophylaxis (19.7% vs. 57.1%, <em>P</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>We found considerable variability in prescribing practices at our institution, particularly among high-risk patients. In addition, patients who received fluconazole prophylaxis had a statistically significant higher incidence of fungal infections and elevated QTc than those who received other prophylaxis agents and no prophylaxis. Overall, this study highlights the importance of evaluating institutional practices and using guideline-based prophylaxis agents in children at high risk of IFD.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"2 3","pages":"Article 100043"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous glucose monitoring based glycemic control among underserved populations with type 2 diabetes at a health system of federally qualified health centers","authors":"Samantha M. Tiano,&nbsp;Leticia R. Moczygemba,&nbsp;April J. Hinds,&nbsp;Jason Jokerst,&nbsp;Kathryn Litten,&nbsp;Chelsey A. Roscoe,&nbsp;Roopali Sharma","doi":"10.1016/j.japhpi.2025.100045","DOIUrl":"10.1016/j.japhpi.2025.100045","url":null,"abstract":"<div><h3>Background</h3><div>Disparities and healthcare inequities exist among marginalized ethnic and racial groups with continuous glucose monitoring (CGM) use. Current evidence surrounding the impact of CGM use on hemoglobin A1C (HbA1c) reduction beyond 6 months among underserved populations, including non-English speakers with type 2 diabetes in the Federally Qualified Health Center (FQHC) setting, is limited.</div></div><div><h3>Objective</h3><div>To evaluate the impact of CGM use on the first HbA1c measured between 12 and 24 months after CGM initiation among underserved populations with type 2 diabetes at a health system of FQHCs.</div></div><div><h3>Methods</h3><div>A retrospective, cross-sectional study was conducted among adults with type 2 diabetes participating in a FQHCs’ CGM program. Patients were eligible if they received CGM supplies between July 2020 to 2022 at an in-house pharmacy via indigent care coverage and had an HbA1c more than 8% within three months prior to CGM initiation. The primary outcome was the impact of CGM use on the first HbA1c measured between 12 and 24 months after CGM initiation. A post-hoc analysis was conducted to assess the change in HbA1c from baseline over time, in 6-month increments, up to 24 months. Descriptive and bivariate statistics were used for data analysis.</div></div><div><h3>Results</h3><div>Of 205 patients who were initially screened, 46 met study inclusion criteria. Baseline characteristics included 65% female, mean age 56 ± 11.2 years, 76% Hispanic/Latino/a ethnicity, and 54% Spanish-speaking. The primary outcome resulted in a statistically significant decrease in HbA1c (%) from 10.6 ± 1.7 at baseline to 8.6 ± 1.9 (<em>P</em> &lt; 0.001) at the follow-up HbA1c measured between 12 and 24 months after CGM initiation.</div></div><div><h3>Conclusion</h3><div>In this analysis, CGM use led to a statistically significant and sustained reduction in HbA1c for up to 24 months among underserved populations with type 2 diabetes in the FQHC setting. Study findings suggest CGM use may offer long-term benefits in HbA1c reduction among underserved populations.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"2 3","pages":"Article 100045"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of diltiazem versus metoprolol for patients with atrial fibrillation presenting to the emergency department with rapid ventricular rate","authors":"Brittany McCoy,&nbsp;Jason Arevalo,&nbsp;Ashley Oliver,&nbsp;Katelyn Corcoran,&nbsp;Christopher R. Frei","doi":"10.1016/j.japhpi.2025.100029","DOIUrl":"10.1016/j.japhpi.2025.100029","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) is one of the most common cardiac dysrhythmias and one of the most commonly encountered dysrhythmias in emergency departments (EDs). Rate control is vital to relieve symptoms and prevent complications in patients who present with AF and a rapid ventricular rate (RVR), defined as a heart rate (HR) &gt; 120 beats per minute (bpm). Both metoprolol and diltiazem are recommended for the management of RVR in AF; however, the comparative effectiveness of these medications is unclear.</div></div><div><h3>Objectives</h3><div>The primary objective of this quality improvement project was to evaluate the achievement of rate control, defined as a HR &lt; 110 bpm or an HR reduction &gt; 20%, within 30 minutes of the first dose of IV diltiazem or metoprolol. The secondary objectives were rate control within 60 minutes of the first dose, rate control within 180 minutes of the first dose, occurrence of repeat dosing, additional medications required for rate control, worsening heart failure (HF) symptoms, admission and discharge diagnoses, hospital readmission within 7 days of discharge, and length of hospital stay. We also assessed the incidence of hypotensive and bradycardic events within 60 minutes of the first dose.</div></div><div><h3>Methods</h3><div>A total of 571 patient charts were screened for inclusion in this quality improvement project and 151 patients were included.</div></div><div><h3>Results</h3><div>In a multivariate logistic regression model, with controls for patient age, rate control within 180 minutes of the first dose, and repeat dosing of medication given, there was no statistically significant difference in the primary outcome of rate control within 30 minutes between IV diltiazem (77%) and metoprolol (65%) (odds ratio 0.56 [95% CI 0.22-1.39], <em>P</em> = 0.27). We also found no statistically significant differences in the multivariate models for the incidence of worsening HF, hypotension, or bradycardia. Minimal adverse effects were observed.</div></div><div><h3>Conclusions</h3><div>The results of this study expand upon previous literature that suggested that diltiazem is likely to be safe and effective in the acute management of AF with RVR, given that there was no statistically significant difference between the 2 study drugs in the achievement of rate control or documentation of worsening HF.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"2 3","pages":"Article 100029"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a community pharmacist referral on the completion of annual wellness visits","authors":"Cody Beldon,&nbsp;Stacey Frede,&nbsp;Sarah Blackburn,&nbsp;Brenda Barnes,&nbsp;Andrea Brookhart,&nbsp;Katelyn Johnson","doi":"10.1016/j.japhpi.2025.100041","DOIUrl":"10.1016/j.japhpi.2025.100041","url":null,"abstract":"<div><h3>Background</h3><div>Annual Wellness Visits (AWV) are preventive care visits designed to promote overall health and well-being for older adults, but patient completion is well behind the anticipated rate. Community pharmacists are accessible health care professionals who routinely provide preventive care education and could educate patients on AWV importance.</div></div><div><h3>Objectives</h3><div>The primary objective of this study was to evaluate the impact of a community pharmacist referral on acceptance and completion of Medicare AWVs. The secondary objectives were to describe the source of AWV completion, compare study results to Centers for Medicare and Medicare Services (CMS) AWV completion rate, and evaluate referral declination reasons.</div></div><div><h3>Methods</h3><div>Patients were eligible for study participation if they were at least 66 years of age, had active Medicare coverage, and were active pharmacy patients. During the referral intervention, pharmacists assessed the patient’s AWV completion status, provided AWV education, and referred the patient to complete an AWV if appropriate. A follow-up intervention was completed 8 to 12 weeks after referral intervention completion. Descriptive statistics were used to evaluate primary and secondary objectives, and a chi-square test was used compare the study AWV completion rate to the national CMS rate, which was 45.0% in 2020.</div></div><div><h3>Results</h3><div>Of the 3,171 completed interventions, 2,745 patients (86.6%) self-reported they completed an AWV in the past 12 months. Pharmacists identified 315 patients eligible for an AWV, with 238 accepted referrals. During the follow-up intervention, 146 patients reported completing an AWV, and 24 patients scheduled an appointment, for a completion rate of 54.0%, which was statistically significant compared to national CMS data (<em>P</em> = 0.026).</div></div><div><h3>Conclusion</h3><div>The community pharmacist AWV referral process increased the number of patients who completed an AWV, resulting in a higher completion rate compared to national CMS data. Pharmacists were well equipped to complete referrals, and real-time patient identification supported completion. Anecdotal evidence suggests there is still an opportunity to improve patients’ understanding of AWVs.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"2 3","pages":"Article 100041"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacists prescribing COVID-19 therapeutics (nirmatrelvir/ritonavir) in a community pharmacy: An observational time and motion study","authors":"Yelim Joung,&nbsp;Richard H. Dang,&nbsp;Michelle Hormozian,&nbsp;Allison Chacon,&nbsp;Wendy Mack","doi":"10.1016/j.japhpi.2025.100026","DOIUrl":"10.1016/j.japhpi.2025.100026","url":null,"abstract":"<div><h3>Background</h3><div>Nirmatrelvir/ritonavir (NMV/r) (Paxlovid) was the first oral therapeutic agent available for outpatient treatment of mild-to-moderate coronavirus disease 2019, reducing morbidity and mortality. As part of the emergency use authorization (EUA), pharmacists were granted the authority to prescribe NMV/r subject to the conditions and eligibility criteria of the EUA. Owing to the additional steps required for pharmacists to prescribe NMV/r, widespread adoption of pharmacist-led NMV/r services may have been hindered.</div></div><div><h3>Objective</h3><div>This study aimed to assess the feasibility of a pharmacist-led NMV/r prescribing service by quantifying the procedural time spent to prescribe NMV/r and to identify obstacles to service integration.</div></div><div><h3>Methods</h3><div>A direct observational time-motion study of a pilot program was conducted at a community pharmacy in an academic medical center in Southern California from December 1, 2022, to March 31, 2023. Each encounter was tracked from the initial patient request to the prescription of NMV/r, and the time spent to complete each step was recorded. Data were collected using the Research Electronic Data Capture tool.</div></div><div><h3>Results</h3><div>Twenty-two patients were observed, 8 of whom were eligible for NMV/r. The median time from patient outreach to prescription generation was 22 minutes (interquartile range [IQR] = 15, 84) and 5 minutes (IQR = 3, 11) for referral to a physician for ineligible patients. Patient screening to comply with the EUA criteria took 10 minutes (IQR = 7, 10) for eligible patients and 4 minutes (IQR = 2, 6) for ineligible patients. Barriers such as multitasking and the mode of initial patient outreach affected or delayed service provision.</div></div><div><h3>Conclusion</h3><div>This study suggests that the NMV/r prescribing service adds a manageable amount of time to pharmacist workflow at this site, comparable with other clinical services in pharmacy settings. Feasibility may vary depending on the pharmacy setting and patient volume.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"2 3","pages":"Article 100026"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing ambulatory care clinical pharmacy services in an obstetrics and gynecology clinic in a safety net health system","authors":"Morgan M. Okafor,&nbsp;Todd A. Walroth,&nbsp;Jessica S. Triboletti,&nbsp;Lauren M. Pence,&nbsp;Krista M. Powers,&nbsp;Ashley H. Meredith","doi":"10.1016/j.japhpi.2025.100027","DOIUrl":"10.1016/j.japhpi.2025.100027","url":null,"abstract":"<div><h3>Background</h3><div>The United States is facing a maternal health crisis with 23.5 maternal deaths for every 100,000 births. Ambulatory care clinical pharmacists are uniquely positioned and skilled to help increase access to care before, during, and after pregnancy through chronic disease management. However, there are gaps in the current literature regarding pharmacists’ independent prescribing of medications, development of a collaborative practice agreement (CPA), and integration into an obstetrics and gynecology (OBGYN) clinic within a safety net health system.</div></div><div><h3>Objective</h3><div>This study aimed to describe the implementation of an OBGYN clinic pilot program.</div></div><div><h3>Methods</h3><div>This was a pilot program implemented by a second-year ambulatory care pharmacy resident from November 2023 to June 2024. The implementation steps included identifying key stakeholders, creating a CPA, and establishing clinic presence.</div></div><div><h3>Results</h3><div>The pharmacy resident provided services such as answering drug information questions, conducting one-on-one patient appointments, and helping with sustainable medication access once they were integrated into the clinic. The resident received 5 referrals, which led to 7 scheduled appointments. Of these scheduled appointments, 3 patients did not show up, 3 initial appointments were completed, and 1 follow-up appointment was completed. The 3 completed appointments were for contraception management, hyperemesis management during pregnancy, and postpartum diabetes management.</div></div><div><h3>Conclusion</h3><div>Developing clinical pharmacy services within a clinic requires several steps, including meeting with key stakeholders, creating a CPA, and providing education on the service. More information is needed to provide a model for the sustainability of pharmacist services within OBGYN clinics.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"2 3","pages":"Article 100027"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access and acceptance of pharmacist recommendations through an eConsult service","authors":"Molly Bachman,&nbsp;Julie MacDougall,&nbsp;Amanda G. Kennedy,&nbsp;Marie Sandoval,&nbsp;Michaela Heysler","doi":"10.1016/j.japhpi.2025.100032","DOIUrl":"10.1016/j.japhpi.2025.100032","url":null,"abstract":"<div><h3>Background</h3><div>An important aspect of health care quality is access to care from providers and pharmacists. The University of Vermont Health Network (UVMHN) Pharmacy eConsult service was established in October 2021 as a way for primary care clinicians without colocated pharmacists to have access to pharmacy services. Previous studies have shown the value of pharmacy eConsult services.</div></div><div><h3>Objectives</h3><div>The primary objective was to describe acceptance of pharmacy eConsult recommendations by primary care clinicians within our health system.</div></div><div><h3>Methods</h3><div>A retrospective chart review study of UVMHN Pharmacy eConsults was completed from October 2021 to August 2023. Pharmacy eConsults related to formulary coverage, prior authorization, or cost assessment were excluded. eConsults were categorized based on consult question type and evaluated for acceptance of recommendation. The data were categorized by type of recommendation to better understand pharmacist recommendation patterns and intervention types. eConsults were considered accepted if the ordering clinician endorsed part or all of the pharmacist’s primary or contingency recommendation in a patient encounter. Recommendations that were not implemented or the outcome that was unable to be determined based on documentation was considered not accepted.</div></div><div><h3>Results</h3><div>The most frequent types of eConsults included suspected adverse drug reaction (26.9%), medication optimization (24.7%), and diabetes-specific medication optimization (14.0%). Of the 93 eConsults placed, 88 pharmacists’ recommendations (94.6%) were accepted. A total of 84 primary recommendations (90.3%) were accepted, 4 contingency recommendations (4.3%) were accepted, 4 outcomes (4.3%) were missing, and 1 recommendation (1.1%) was not accepted. Approximately 25% of the patients were affected by one or more social determinants of health, the most common of which were financial resource strain, food insecurity, and housing stability.</div></div><div><h3>Conclusion</h3><div>This study found that most of the pharmacist recommendations from eConsults were accepted, which highlights the importance and value of continuing a pharmacy eConsult service.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"2 3","pages":"Article 100032"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a pharmacist-led asthma clinic in a high-risk pediatric population at a federally qualified health center within a medically underserved area","authors":"Kaitlyn L. North,&nbsp;Reagan K. Barfield,&nbsp;David Turell,&nbsp;Carrington S. Royals,&nbsp;Ismaeel Yunusa,&nbsp;P. Brandon Bookstaver","doi":"10.1016/j.japhpi.2025.100030","DOIUrl":"10.1016/j.japhpi.2025.100030","url":null,"abstract":"<div><h3>Background</h3><div>There are few publications regarding pediatric asthma treatment at federally qualified health centers (FQHCs). FQHC patients are considered high risk with complex social determinants of health. This FQHC, located in a medically underserved area, has an established collaborative practice agreement for pharmacist-led management of pediatric asthma.</div></div><div><h3>Objective</h3><div>This study aimed to assess the asthma control of pediatric FQHC patients before and after pharmacist intervention.</div></div><div><h3>Methods</h3><div>This was a single-center, retrospective, observational cohort study. Patients were included if they had a current asthma diagnosis, were aged 4-21 years, and were an active patient of the FQHC. Patients were referred to the pharmacist-led asthma clinic to receive disease state, medication, and device education with guideline-directed asthma pharmacotherapy changes when needed. Patients and caregivers were surveyed using the age-appropriate Asthma Control Test (ACT) before the first asthma clinic appointment and at each follow-up visit. The primary end point was the change in ACT score from baseline to the most recent follow-up. Secondary end points included proportions of patients who achieved a clinically meaningful increase in ACT (a change of 2-3 points has been validated as a clinically meaningful difference), usage of systemic corticosteroids and emergent care, and patients converted to using the FQHC’s on-site pharmacy. Continuous end points were evaluated using paired <em>t</em> tests and categorical variables with Fisher’s exact tests.</div></div><div><h3>Results</h3><div>Thirteen patients were enrolled with an average age of 11.8 years and 4.4 years since asthma diagnosis. Pharmacist intervention showed a statistically significant improvement in the primary end point (mean ± SD ACT score increase 6.1 ± 3.1; <em>P</em> &lt; 0.001). All patients had a clinically meaningful improvement in their asthma control. One patient (7.7%) sought emergent care with systemic corticosteroid usage. Among eligible patients, 4 of 5 (80%) were converted to using the FQHC’s on-site pharmacy.</div></div><div><h3>Conclusion</h3><div>Pharmacist intervention improved asthma control in high-risk pediatric patients within an FQHC.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"2 3","pages":"Article 100030"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Pennsylvania advanced pharmacy practice experience student perceptions of pharmacist burnout in various areas of pharmacy practice","authors":"Ghada Ayad,&nbsp;Jason Zupec,&nbsp;Jeffrey Hamper,&nbsp;Patricia Melissen,&nbsp;Kathleen Dempsey,&nbsp;Linh Huynh","doi":"10.1016/j.japhpi.2025.100049","DOIUrl":"10.1016/j.japhpi.2025.100049","url":null,"abstract":"<div><h3>Background</h3><div>With burnout continuing to impact the pharmacy profession, this research aims to explore how it may influence pharmacy student perceptions of different practice settings. Through final-year rotations, pharmacy student gain exposure to a range of practice settings and working conditions, offering valuable insight into this issue.</div></div><div><h3>Objective</h3><div>This research aimed to assess Pennsylvania-based advanced pharmacy practice experience (APPE) student perceptions of pharmacist burnout and how that may affect student career trajectory.</div></div><div><h3>Methods</h3><div>A survey-based design was conducted to assess APPE student perceptions of pharmacist burnout across various areas of pharmacy practice, specifically looking at coping mechanisms, work environment, pharmacist advice to students, and their influence on student career paths. The electronic survey was distributed to 6 pharmacy schools in Pennsylvania, with recruitment occurring in 4 of the 6 colleges of pharmacy. Data collection occurred from March 2024 to May 2024 through Qualtrics and used a variety of question types, including binary, multiple-choice, and Likert-scale questions. The survey results were analyzed using descriptive statistics in Microsoft Excel.</div></div><div><h3>Results</h3><div>Through this research survey, it was found that students observed signs of burnout among pharmacists to some extent in each area of pharmacy practice, with the numerically highest among community chain (90%), community independent (69%), and hospital and health system (65%). More than 50% of respondents changed their career interests after starting APPE rotations, mainly owing to perceived work-life balance, work environment, and preceptor or pharmacist influence.</div></div><div><h3>Conclusion</h3><div>Continuous preceptor development and company adaptability are important to retaining and recruiting student pharmacists and minimizing burnout during a time of declining pharmacy enrollment and pharmacist retention.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"2 3","pages":"Article 100049"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}