JAPhA Practice Innovations最新文献

{"title":"Evaluating provider satisfaction with the role of clinical pharmacists delivering chronic care management services within an accountable care organization","authors":"Courtney Whitfield,&nbsp;Anna Baird,&nbsp;Ashley Abode,&nbsp;Macary Weck Marciniak,&nbsp;Laura A. Rhodes","doi":"10.1016/j.japhpi.2026.100100","DOIUrl":"10.1016/j.japhpi.2026.100100","url":null,"abstract":"<div><h3>Background</h3><div>Chronic care management (CCM) involves coordinating comprehensive care for patients with multiple chronic conditions and focuses on addressing medical, functional, and psychosocial needs. This project describes an independent pharmacy that has delivered clinical services with a local accountable care organization (ACO). This collaboration has enabled clinical pharmacists to enhance patient care through medication expertise and patient relationships. Pharmacists facilitate communication with patients and care managers by remotely accessing electronic health records while providing the service. CCM services include reviewing medications and potential interactions, overseeing patient self-management of medications, and managing transitions of care.</div></div><div><h3>Objective</h3><div>This project aimed to assess provider perspectives on the role of the clinical pharmacist within the CCM model, access to a clinical pharmacist, and satisfaction with disease state impact and changes of care recommended by clinical pharmacists within an ACO.</div></div><div><h3>Methods</h3><div>A prospective, cross-sectional electronic survey was distributed to 32 ACO providers with pharmacists on their CCM teams. A 19-item survey captured provider perspectives on pharmacist contributions to CCM components. The survey was open for 30 days, with anonymized responses analyzed using descriptive statistics. Ranked responses were analyzed by generating a mean rank for each answer option, then ordered from low to high.</div></div><div><h3>Results</h3><div>Ten surveys were returned (response rate 31%). Most respondents were 46-65 years of age (n = 7, 70%) and physicians (n = 10, 100%), with 15+ years of practice experience (n = 8, 80%). The most impactful clinical pharmacy services were comprehensive medication reviews (mean, 2.7) and medication reconciliations (mean, 3.0). The top 5 disease states that clinical pharmacists affected were diabetes (mean, 2.7), atherosclerotic cardiovascular disease (mean, 3.9), chronic kidney disease (mean, 4.5), chronic obstructive pulmonary disease (mean, 5.4), and hypertension (mean, 6.0).</div></div><div><h3>Conclusion</h3><div>Providers expressed support for pharmacist-led services in CCM, highlighting pharmacists’ ability to enhance medication management, patient safety, and chronic disease outcomes.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100100"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"College student attitudes and perceptions toward opioid overdose and harm reduction at a large, public university","authors":"Kaileigh D. Yen,&nbsp;Alexis Shook,&nbsp;Macary Weck Marciniak,&nbsp;Laura A. Rhodes","doi":"10.1016/j.japhpi.2025.100090","DOIUrl":"10.1016/j.japhpi.2025.100090","url":null,"abstract":"<div><h3>Background</h3><div>The number of college-aged students using illicit drugs has increased, alongside cases of polysubstance use and the addition of illegally manufactured fentanyl into other substances. Harm reduction strategies have been implemented to reduce overdose encounters. Literature has focused on college students’ knowledge of these topics; however, evidence is lacking regarding student attitudes toward opioid overdose risk and harm reduction tools and their perceptions and knowledge regarding access to those tools.</div></div><div><h3>Objective</h3><div>This study aimed to assess (1) student attitudes regarding opioid overdose and harm reduction and (2) perception and knowledge of access to these services at a public university.</div></div><div><h3>Methods</h3><div>This survey was conducted by an on-campus pharmacy at a large university in the southern United States. A 32-item survey was developed in Qualtrics and distributed using Listservs and e-mail groups and by posting flyers around campus. Those 18+ years and students enrolled at the university were included. The survey included 3 sections: (1) perceptions and attitudes, (2) supplemental questions, and (3) demographics. The survey remained open for 30 days. Results were analyzed using descriptive statistics.</div></div><div><h3>Results</h3><div>A total of 196 surveys were included. Most respondents were unlikely or very unlikely to obtain naloxone for themselves (n = 113, 58%); however, almost three-quarters (n = 136, 70%) indicated that they were very likely or likely to recommend obtaining naloxone to a friend. Of 174 comments provided, 64 (38%) mentioned a lack of knowledge of resources and 26 (18%) cited stigma as a barrier. Most respondents (n = 141, 72%) were unaware that naloxone is available free of charge from on-campus pharmacies.</div></div><div><h3>Conclusion</h3><div>Many college-aged students agreed that there is a risk of overdose on campus, a lack of knowledge about harm reduction tools, and a need to increase access to these tools. Students’ attitudes toward the need for harm reduction tools highlight a need for expanded education in this population.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100090"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing timely access to medication changes: The role of ambulatory care pharmacists in overcoming transitions of care challenges","authors":"Alison N. Van Dyke,&nbsp;Karen S. Williams,&nbsp;Jessica Carswell,&nbsp;Keith M. Hughes Jr","doi":"10.1016/j.japhpi.2026.100110","DOIUrl":"10.1016/j.japhpi.2026.100110","url":null,"abstract":"<div><h3>Background</h3><div>Transitions of care are high-risk periods marked by frequent medication-related problems. Up to 80% of patients discharged from hospitals and 98% of older adults experience medication discrepancies. These lapses, often because of delayed refills or fragmented coordination, contribute to unplanned healthcare encounters, increased costs, and provider strain. Pharmacists in ambulatory care settings can mitigate these by improving medication access continuity.</div></div><div><h3>Objective</h3><div>To evaluate the impact of medication access gaps on time for the first unplanned healthcare encounter among patients discharged with chronic maintenance prescription medication changes.</div></div><div><h3>Methods</h3><div>A retrospective cohort study of patients discharged from two hospital sites between June 1, 2023 and May 31, 2024, with changes to chronic maintenance prescription medication. Eligible patients were ≥18 years of age, discharged to home, and followed up with a system-affiliated primary care provider. Patients were categorized as having a “medication gap” if they experienced any lapse in medication coverage because of delayed refills or required intervention. Patients with “no medication gap” maintained continuous medication access, with timely refills coordinated at follow-up.</div></div><div><h3>Results</h3><div>Among 104 patients, those with a medication gap had a significantly shorter time to first unplanned healthcare encounter (adjusted HR, 1.61; 95% CI, 1.09–2.39; <em>P</em> = 0.017) and were nearly four times more likely to experience a medication-related encounter (IPTW-adjusted HR, 3.76; 95% CI, 2.00–7.06; <em>P</em> &lt; 0.001). Patients with a medication gap were associated with more days without medication, lower refill rates at follow-up (26.9% vs. 61.5%, <em>P</em> &lt; 0.001), and more frequent barriers, such as inadequate discharge education.</div></div><div><h3>Conclusions</h3><div>Medication access gaps following discharge were associated with earlier and more frequent unplanned healthcare encounters. These findings highlight the need for pharmacist involvement in post-discharge medication management to reduce preventable healthcare use and improve care transitions.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100110"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing COPD outcomes: RPM, pulse oximetry, and direct billable clinical services","authors":"Rachel Carter,&nbsp;Blair Lykins,&nbsp;Ryan Cooper,&nbsp;Abigail Leonhard,&nbsp;Clark Kebodeaux","doi":"10.1016/j.japhpi.2026.100104","DOIUrl":"10.1016/j.japhpi.2026.100104","url":null,"abstract":"<div><h3>Background</h3><div>Chronic obstructive pulmonary disease (COPD) is currently 1 of the top 3 causes of death worldwide. A decrease in peripheral oxygen saturation (SpO₂) can be a strong indicator of a COPD exacerbation. Pharmacists are well positioned to monitor SpO₂ trends and changes in baseline symptoms and provide counseling on proper inhaler technique to prevent exacerbations, especially in the outpatient setting.</div></div><div><h3>Objectives</h3><div>This pilot study aimed to (1) determine the exacerbation rate of COPD after enrollment in a pharmacist-led remote patient monitoring (RPM) program that used a Bluetooth pulse oximeter to measure SpO₂ and (2) assess the impact of pharmacist-led RPM for COPD on adherence with maintenance inhaler therapy, smoking cessation, immunization uptake, and patient satisfaction.</div></div><div><h3>Methods</h3><div>Patients completed a pre- and postintervention survey at the beginning and end of the 90-day study period. While enrolled, patients were contacted on a weekly basis to discuss SpO₂ readings, changes in baseline COPD symptoms, inhaler adherence and technique, upcoming appointments, vaccine eligibility, and smoking cessation when applicable. If SpO₂ was less than or equal to 92%, an effort was made to reach the patient immediately.</div></div><div><h3>Results</h3><div>A total of 14 patients were enrolled, and 13 completed the pre- and postintervention survey. The median difference in average SpO₂ change over 90 days was an increase of 0.10%. Overall, 7 patients demonstrated promising trends in average SpO₂. Uptake of the influenza; tetanus, diphtheria, and pertussis; respiratory syncytial virus; and pneumococcal vaccines increased during the study period. There was also an increase in patient-reported satisfaction with COPD education and treatment.</div></div><div><h3>Conclusion</h3><div>Enrollment in a pharmacist-led RPM program for COPD suggests an improvement in average SpO₂, adherence with guideline-recommended therapy, immunization uptake, and patient satisfaction.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100104"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing food-is-medicine: A pilot of pharmacist-facilitated dietitian scheduling","authors":"Jackie Tan,&nbsp;Kimberly Johnson,&nbsp;Amy Bailey,&nbsp;Kellie J. Goodlet","doi":"10.1016/j.japhpi.2026.100096","DOIUrl":"10.1016/j.japhpi.2026.100096","url":null,"abstract":"<div><h3>Background</h3><div>“Food-is-medicine” (FIM) is an emerging health care model that integrates nutrition into chronic disease management. The accessibility of community pharmacists makes them well positioned to identify and refer eligible patients to dietitian services, yet these collaborations and associated patient perceptions remain underexplored in current practice.</div></div><div><h3>Objective</h3><div>This study aimed to explore the feasibility of community pharmacist-facilitated dietitian appointments.</div></div><div><h3>Methods</h3><div>A large pharmacy chain piloted an initiative allowing pharmacists in 1 regional division to directly schedule patients for virtual appointments with their nutrition team. A pharmacist contacted English-speaking adult patients with diabetes or hypertension by telephone between December 2024 and April 2025 and offered to schedule them with a dietitian. Patients who accepted direct scheduling were invited to complete a voluntary survey on their experience.</div></div><div><h3>Results</h3><div>The pharmacist reached 172 of 336 eligible patients (51.2%) across 110 pharmacy sites. After speaking with the pharmacist, 26 patients (15.1%) expressed interest in dietitian services and 8 (4.7%) were directly scheduled. Reasons for declining an appointment included not having insurance information readily available, requesting contact at a later time, or scheduling conflicts. Among patients who were directly scheduled, 50% attended their appointment. The most common reason for nonattendance was scheduling conflicts. Survey responses indicated overall favorable impressions of both the scheduling process and the dietitian service, including observed minor health improvements such as weight loss. Respondents recognized both pharmacists and dietitians as playing an important role in supporting the management of their chronic conditions.</div></div><div><h3>Conclusion</h3><div>The results of this pilot study support the hypothesis that community pharmacists can facilitate access to nutrition-focused care and highlight an actionable opportunity to integrate community pharmacists into FIM initiatives. Future research should focus on optimizing referral workflows and addressing patient barriers to increase engagement with dietitian services and develop sustainable and scalable models for broader implementation.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100096"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness and perceptions of community pharmacist–provided clinical services among Illinois health professional students","authors":"Joseph Shen,&nbsp;Chandni Clough,&nbsp;Christina J. Cross,&nbsp;Rachel Russell,&nbsp;Jeffrey Hamper,&nbsp;Beatrice Drambarean","doi":"10.1016/j.japhpi.2026.100116","DOIUrl":"10.1016/j.japhpi.2026.100116","url":null,"abstract":"<div><h3>Background</h3><div>The scope of practice and clinical responsibilities of community pharmacists have expanded over time but are not widely used. This cross-sectional study provides a quantitative assessment of how widely known clinical services provided at community pharmacies are to students of health care professions with prescriptive authority.</div></div><div><h3>Objective</h3><div>To determine health professional students’ awareness of and support for the clinical services that community pharmacists are permitted to perform under the Illinois Pharmacy Practice Act.</div></div><div><h3>Methods</h3><div>An online survey was conducted with students at accredited Illinois programs for physicians, nurse practitioners, and physician assistants. Participants answered questions regarding their awareness of available community pharmacist–provided clinical services and their support for patients using these services.</div></div><div><h3>Results</h3><div>Less than 40% of respondents reported having some awareness of services beyond vaccinations. Mean and median scores for support for services were above the positive response level, with maximum median scores in most subgroups. Except for the administration of long-acting medications, more than 80% of respondents reported that they support or strongly support patients using services from a community pharmacist. Most comparisons of differences between subgroups were not statistically significant.</div></div><div><h3>Conclusion</h3><div>Health care professional students are largely unaware of community pharmacist–provided clinical services but strongly support patients using them, suggesting trust and a willingness to delegate responsibilities to them. There are opportunities for educating students on the evolving capabilities of community pharmacists and potentially shifting how community pharmacists provide patient care. Future improvements to interprofessional education and experiental learning should address potential concerns about patient safety and outcomes.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100116"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness and perceptions of community pharmacist–provided clinical services among Illinois health professional students","authors":"Joseph Shen,&nbsp;Chandni Clough,&nbsp;Christina J. Cross,&nbsp;Rachel Russell,&nbsp;Jeffrey Hamper,&nbsp;Beatrice Drambarean","doi":"10.1016/j.japhpi.2026.100116","DOIUrl":"10.1016/j.japhpi.2026.100116","url":null,"abstract":"<div><h3>Background</h3><div>The scope of practice and clinical responsibilities of community pharmacists have expanded over time but are not widely used. This cross-sectional study provides a quantitative assessment of how widely known clinical services provided at community pharmacies are to students of health care professions with prescriptive authority.</div></div><div><h3>Objective</h3><div>To determine health professional students’ awareness of and support for the clinical services that community pharmacists are permitted to perform under the Illinois Pharmacy Practice Act.</div></div><div><h3>Methods</h3><div>An online survey was conducted with students at accredited Illinois programs for physicians, nurse practitioners, and physician assistants. Participants answered questions regarding their awareness of available community pharmacist–provided clinical services and their support for patients using these services.</div></div><div><h3>Results</h3><div>Less than 40% of respondents reported having some awareness of services beyond vaccinations. Mean and median scores for support for services were above the positive response level, with maximum median scores in most subgroups. Except for the administration of long-acting medications, more than 80% of respondents reported that they support or strongly support patients using services from a community pharmacist. Most comparisons of differences between subgroups were not statistically significant.</div></div><div><h3>Conclusion</h3><div>Health care professional students are largely unaware of community pharmacist–provided clinical services but strongly support patients using them, suggesting trust and a willingness to delegate responsibilities to them. There are opportunities for educating students on the evolving capabilities of community pharmacists and potentially shifting how community pharmacists provide patient care. Future improvements to interprofessional education and experiental learning should address potential concerns about patient safety and outcomes.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100116"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a pharmacist-led weight management service in patients with metabolic dysfunction–associated steatotic liver disease at outpatient clinics on the United States–Mexico border","authors":"Royce Li,&nbsp;Liliana Lunares,&nbsp;Karem E. Lambeth,&nbsp;Valerie M. Alvarado,&nbsp;Jacquelyn P. Navarrete,&nbsp;Bruno Hernandez Bizouarn,&nbsp;Alaa K. Abdelhakiem","doi":"10.1016/j.japhpi.2025.100082","DOIUrl":"10.1016/j.japhpi.2025.100082","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic dysfunction–associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease, affects up to 30% of adults in the United States and is associated with an increased risk of cardiovascular disease, cancer, and end-stage liver disease. The University Medical Center (UMC) of El Paso consists of 6 community health clinics along the United States–Mexico border in El Paso, TX, serving a unique population addressing multiple conditions including MASLD.</div></div><div><h3>Objective</h3><div>This study aimed to investigate the efficacy of a pharmacist-led weight management service in patients with MASLD at an outpatient clinic on the United States–Mexico border.</div></div><div><h3>Methods</h3><div>Clinical pharmacists at UMC conducted a cohort study to assess the impact of pharmacist-led weight management on patients with MASLD. The primary outcomes were the improvement of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and FibroScan controlled attenuation parameter (CAP) scores. The secondary outcomes of this study were the decrease in weight, body mass index, and hemoglobin A1C.</div></div><div><h3>Results</h3><div>Of 669 chart reviews, 86 participants met the inclusion criteria. There was a statistically significant overall decrease in AST levels over a 7-month study period (<em>P</em> &lt; 0.001). However, both primary care providers (PCPs) and clinical pharmacist health care teams experienced similar reductions in AST, with a mean decrease of 13 units/liter and 8 units/liter, respectively (PCP vs. clinical pharmacist, <em>P</em> = 0.382). ALT levels also decreased significantly over the 7-month period (<em>P</em> &lt; 0.001), with a significant reduction observed in the clinical pharmacists compared with PCPs (13 vs. 6 units/liter, <em>P</em> = 0.023). Owing to incomplete data, analysis of FibroScan CAP scores was not performed. The results demonstrate that pharmacist involvement in MASLD care is associated with potential improvements in metabolic and hepatic parameters.</div></div><div><h3>Conclusion</h3><div>Both AST and ALT levels showed statistically significant reductions over a 7-month period. The significant decline in AST (<em>P</em> &lt; 0.001) across both groups suggests general hepatic improvement.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100082"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the effectiveness of patient-pharmacist communication during medication counseling in Texas community pharmacies","authors":"Kendall McKenzie,&nbsp;Amanda R. Stallings,&nbsp;Elizabeth Unni","doi":"10.1016/j.japhpi.2026.100106","DOIUrl":"10.1016/j.japhpi.2026.100106","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacists, especially those in community settings, are well-positioned to reinforce medication understanding at the point of counseling, yet it remains unclear whether patients truly retain this information. There is a lack of understanding regarding the concordance between what pharmacists communicate and what patients perceive or recall.</div></div><div><h3>Objective</h3><div>To evaluate communication concordance between pharmacists and patients during counseling in community pharmacy settings.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted with 87 pharmacist–patient dyads across three Texas grocery store pharmacies. Both parties completed a five-item survey, including four closed-ended and one open-ended item. Concordance rates and demographic correlations were analyzed.</div></div><div><h3>Results</h3><div>Closed-ended item concordance was high (97.7%–100%), indicating strong agreement on structured counseling topics. Open-ended responses showed only 37.93% concordance, suggesting variability in perceived key takeaways. Patient age had a mild positive correlation with concordance (r = 0.324), while gender, ethnicity, insurance, and health literacy had no meaningful associations.</div></div><div><h3>Conclusion</h3><div>While pharmacists reliably deliver key medication information, discrepancies in open-ended recall point to a need for enhancing patient engagement and confirming understanding.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100106"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a pharmacist transitions of care team on medication reconciliation accuracy and readmission rates","authors":"Sonika Tahiliani,&nbsp;Emma Hevia,&nbsp;Leslie Wooten","doi":"10.1016/j.japhpi.2025.100089","DOIUrl":"10.1016/j.japhpi.2025.100089","url":null,"abstract":"<div><h3>Background</h3><div>Transitions of care (TOC) pharmacists play crucial roles in ensuring medication safety and preventing adverse events when patients move from one health care setting to another. By thoroughly reviewing discharge medication reconciliations (DMRs), pharmacists can identify and resolve discrepancies such as incorrect doses, duplicate therapies, or omissions. In January 2024, AdventHealth Orlando began a hospital-wide interdisciplinary initiative to reduce readmission rates including the implementation of a TOC pharmacist team.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the impact of the newly implemented TOC team on the accuracy of DMRs and the subsequent rate of readmissions.</div></div><div><h3>Methods</h3><div>In this retrospective, single-center cohort study, we assessed the accuracy of DMRs before and after TOC pharmacist team implementation. The study was divided into 2 cohorts: pre-TOC team from April to July 2023 and post-TOC team from April to July 2024. Patients were included if they were 65 years of age or older and had Medicare as primary or secondary insurance coverage, with a discharge disposition of home or home with home-health services. The primary outcome assessed the impact of the TOC team on the accuracy of DMRs. Secondary outcomes included medication histories collected, pharmacist review of admission medication reconciliation (AMR), and the subsequent rate of readmissions.</div></div><div><h3>Results</h3><div>A total of 1500 patients were assessed with 750 patients in each cohort. In the post-TOC team cohort, 94.7% of patients had accurate and complete DMRs compared with 49.2% in the pre-TOC team cohort (<em>P</em> &lt; 0.001). Medication histories were collected by the pharmacy team in 98.4% of admissions post-TOC team vs 91.7% pre-TOC team (<em>P</em> &lt; 0.001). In addition, 63.1% of AMRs were reviewed by pharmacists post-TOC team vs 36.9% pre-TOC team (<em>P</em> &lt; 0.001). Post-TOC team 30-day readmissions were 17.9% vs 18.1% pre-TOC team (<em>P</em> = 0.893).</div></div><div><h3>Conclusion</h3><div>Implementation of a pharmacist-led TOC team led to statistically significant improvement in accurate and complete DMRs but there were no differences in 30-day readmission rates.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100089"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}