JAPhA Practice Innovations最新文献

{"title":"Evaluation of standardized pharmacist dosing approach of epoetin in acutely hospitalized patients with chronic kidney disease","authors":"Dennis Dubovetsky,&nbsp;Heeyun Choi,&nbsp;Maha Fansa","doi":"10.1016/j.japhpi.2026.100109","DOIUrl":"10.1016/j.japhpi.2026.100109","url":null,"abstract":"<div><h3>Background</h3><div>Practice guidelines recommend an individualized dosing strategy approach for erythropoiesis-stimulating agent (ESA) therapy because of the narrow therapeutic range of target hemoglobin (Hb). Data on optimal dosing of ESA in acutely hospitalized patients with chronic kidney disease (CKD) is not well established.</div></div><div><h3>Objectives</h3><div>The study aimed to evaluate the impact of pharmacist-driven dosing standardization of ESA on efficacy, safety, and associated costs in acutely hospitalized non-dialysis and dialysis-dependent patients with CKD anemia.</div></div><div><h3>Methods</h3><div>The study was a single-center, retrospective cohort evaluating the impact of pharmacist-driven initial ESA dose optimization intervention compared to standard of care. Outcomes evaluated included ESA dosing characterization, clinical safety, and efficacy.</div></div><div><h3>Results</h3><div>The study included a total of 254 patients. Baseline characteristics were equally balanced for the majority. The intervention group favored a reduction in the primary outcome of median ESA dose: 100 units/kg/dose compared to 137 units/kg/dose (<em>P</em> &lt; 0.001). The intervention group was associated with reduced ESA dosing characteristics: total dose of ESA per patient (30,000 units vs. 40,000 units, <em>P</em> = 0.047); total dose of ESA (5,659,000 units vs. 6,733,000 units, <em>P</em> = 0.047); and the total weekly dose of ESA used per patient (15,000 units vs. 20,000 units, <em>P</em> &lt; 0.001). The intervention group yielded a total estimated drug-related savings of $19,267.56. There were no differences in clinical outcomes: the last known Hb (<em>P</em> = 0.096), relative change of Hb (<em>P</em> = 0.768), absolute change of Hb (<em>P</em> = 0.809), packed red blood cell transfusion (<em>P</em> = 0.167), hospitalization within 90 days due to thrombotic events (<em>P</em> = 0.271), proportion of patients experiencing hypertensive crisis (<em>P</em> = 0.132), and inpatient survival (<em>P</em> = 0.725). The intervention group was associated with a longer length of stay (15 days vs. 11 days, <em>P</em> = 0.009), a finding likely associated with confounders.</div></div><div><h3>Conclusion</h3><div>Pharmacist-driven dosing standardization protocol limited to initial ESA dose adjustment was associated with reduced ESA use in acutely hospitalized patients with CKD.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 2","pages":"Article 100109"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147850797","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":"Characterization of clinical pharmacist services within an outpatient gastroenterology clinic","authors":"Bailey Perkins,&nbsp;Katherine A. Curtis,&nbsp;Megan Kline,&nbsp;Rachel S. Stein","doi":"10.1016/j.japhpi.2025.100087","DOIUrl":"10.1016/j.japhpi.2025.100087","url":null,"abstract":"<div><h3>Background</h3><div>Despite the continued health care burden of gastrointestinal (GI) diseases and recognition of pharmacists as integral members of the health care team, the clinical pharmacist role and appropriate billing for services within the gastroenterology setting have not been sufficiently defined.</div></div><div><h3>Objectives</h3><div>This project aimed to explore the characterization of pharmacist services in an outpatient gastroenterology clinic and the interventions performed.</div></div><div><h3>Methods</h3><div>This institutional review board–exempt quality improvement project was conducted in the outpatient gastroenterology clinic at Indiana University Health (IUH) over a 5-month period. Patients were included if they were 18 years of age or older, were seen by an IUH gastroenterology physician or advanced practice provider, and received pharmacist services. The primary outcome was the number of pharmacist interventions performed. Pharmacist interventions were captured, including the reason for referral; the method of referral and chronic conditions managed were also recorded.</div></div><div><h3>Results</h3><div>Over the project timeline, there were 83 interventions captured for 58 unique patients. Approximately 28% of referrals were in-person, another 28% were referred through chart review, and approximately 44% were referred through electronic medical record messaging. The most common conditions managed were Crohn’s disease and chronic constipation. There were 15 specialty medications sent to the internal specialty pharmacy but only 2 were approved to fill internally. A total of 57 pharmacist visits were conducted. The most common type was telephonic visits, with 49 visits for 20 unique patients.</div></div><div><h3>Conclusions</h3><div>The results of this project provide insight into future characterization of clinical pharmacist services within the outpatient GI setting, largely justified by internal capture of specialty medications and building patient relationships.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 1","pages":"Article 100087"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145749988","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":"Improving prescription capture rates through a standardized meds to beds program at Parkview Heart Institute","authors":"Haley M. Michaud,&nbsp;Tara K. Jellison,&nbsp;Katelyn A. Wees,&nbsp;Sarah E. Ferrell,&nbsp;Shery I. Grosjean,&nbsp;Inderjit S. Ajimal","doi":"10.1016/j.japhpi.2025.100084","DOIUrl":"10.1016/j.japhpi.2025.100084","url":null,"abstract":"<div><h3>Background</h3><div>Medication adherence is critical for patients with cardiac conditions discharged with new prescriptions. Barriers such as high costs, insurance challenges, and lack of transportation often prevent patients from accessing prescribed therapies, leading to readmissions, increased healthcare costs, and worse outcomes. Meds to beds programs offer patients a convenient, patient-centered solution by delivering discharge prescriptions directly to patients’ rooms, reducing readmission rates, and enhancing adherence. Despite success in other departments at Parkview Health, utilization of the program in the Parkview Heart Institute (PHI) remains limited.</div></div><div><h3>Objectives</h3><div>To implement and evaluate a standardized Meds to Beds (M2B) workflow aimed at improving prescription capture rates at Parkview Heart Institute. Secondary endpoints include margin, turnaround time, and readmission rates.</div><div><em>Practice Description:</em> This is a process improvement initiative conducted within a large health system, Parkview Health, at its Parkview Regional Medical Center campus. This project focused on the Parkview Heart Institute.</div></div><div><h3>Practice Innovation</h3><div>Prior to the study, there was no formal workflow in place for M2B in PHI. Within this study, a formal workflow and process were created to help aid technicians, nurses, and pharmacists with a standardized process.</div></div><div><h3>Evaluation Methods</h3><div>A retrospective analysis compared prescription capture rates, readmission rates, margin, and turnaround time before and after workflow implementation. Statistical analyses included two-tailed t-tests and chi-squared tests.</div></div><div><h3>Results</h3><div>Following implementation, PHI prescription capture rates significantly improved (<em>p</em>=0.0023), with most of the success coming from floor 3 of PHI (<em>P</em> = 0.0002). Margins improved, though not reaching statistical significance (projected $196,990 over 12 months, <em>P</em> = 0.078). Readmission rates for M2B patients were shown to be decreased compared to non-M2B patients (15.0% vs. 21.5%, <em>P</em> = 0.009).</div></div><div><h3>Conclusion</h3><div>The implementation of a standardized M2B process at PHI successfully enhanced prescription capture and provides a framework for expansion to additional service areas.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 1","pages":"Article 100084"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145749989","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":"Exploratory analysis of pharmacist involvement in motivational interviewing intervention for patients with prescription opioid misuse behaviors","authors":"Katie Kinsey,&nbsp;Grace Broussard,&nbsp;Yingjia Wei,&nbsp;Craig Field,&nbsp;Nicholas Cox,&nbsp;Ashley White,&nbsp;Kenneth C. Hohmeier,&nbsp;Gerald Cochran","doi":"10.1016/j.japhpi.2025.100044","DOIUrl":"10.1016/j.japhpi.2025.100044","url":null,"abstract":"<div><h3>Background</h3><div>Community pharmacists are an underutilized resource to address opioid medication misuse (OMM) among patients. It is unknown in the field if specific training in high-fidelity motivational interviewing (MI) targeting OMM can be integrated into pharmacist-led medication therapy management (MTM) sessions.</div></div><div><h3>Objective(s)</h3><div>Present and analyze displayed pharmacist MI skills during 47 pharmacist-led medication therapy management sessions, completed as part of the larger parent Healthy Opioid Prescription Engagement 2.0 study.</div></div><div><h3>Methods</h3><div>Design/participants: We conducted an exploratory analysis utilizing recordings from three pharmacist interventionists who received MI training and subsequent supervision sessions as part of a behavioral health randomized clinical trial targeting OMM using MTM. Procedure: 20-minute session segments (N = 47) employing MI skills were coded using the MI Treatment Integrity Coding Manual 4.2.1. Assessments/analyses: Frequencies/percentages and means described intervention recipient demographics and fidelity of pharmacist MI skills—global scores, reflections, and MI behavior counts.</div></div><div><h3>Results</h3><div>Intervention recipients were approximately 50 years old, had more than or equal to moderate severity depression (51.1%), and/or opioid use disorder (29.8%). Regarding pharmacist performance, relational/technical global scores averaged 3.6 and 3.8, respectively, reaching competency. Complex reflections averaged 60.2%, reaching proficiency. MI adherent counts averaged 11 times greater than non-adherent counts (4.4, 0.4) and zero confrontations were coded, meaning pharmacists avoided stigmatizing behaviors while delivering high fidelity MI skills during MTM sessions to address opioid medication misuse.</div></div><div><h3>Conclusion</h3><div>Pharmacists delivering MTM sessions have the potential to effectively address opioid-related risk during MTM sessions by integrating high-fidelity MI skills following structured training/supervision.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 1","pages":"Article 100044"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187491","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 telephone intervention to re-engage patients with positive hepatitis C antibody tests at an academic medical center","authors":"Denise Mendoza,&nbsp;Bernadette Jakeman,&nbsp;Paulina Deming,&nbsp;Heather Cabos,&nbsp;Kristin Bacon,&nbsp;Keenan L. Ryan","doi":"10.1016/j.japhpi.2025.100055","DOIUrl":"10.1016/j.japhpi.2025.100055","url":null,"abstract":"<div><h3>Background</h3><div>A hepatitis C virus (HCV) microelimination project at our institution identified a substanial number of patients who tested positive for HCV antibodies (Abs) without subsequent confirmatory HCV RNA testing.</div></div><div><h3>Objectives</h3><div>The objectives of this study were to (1) implement a telephone intervention to re-engage patients with positive HCV Ab results and (2) assess patients’ understanding of HCV disease progression, testing, and treatment.</div></div><div><h3>Methods</h3><div>Patients were eligible for study inclusion if they were aged 18 years and older and had a positive HCV Ab test without documented confirmatory HCV RNA testing between January 2019 and December 2020. Eligible patients were contacted by phone and offered study participation. Participants completed a survey that assessed their awareness of HCV status, knowledge of HCV infection, and understanding of current treatment options. After survey completion, investigators provided a short 5-minute educational intervention, which covered these same concepts. Participants were offered HCV confirmatory testing. Re-engagement was measured based on the completion of the HCV RNA.</div></div><div><h3>Results</h3><div>Study investigators attempted to contact 563 patients. Of those, only 45 patients could be reached; 20 agreed to complete the survey (44% response rate). There was a delay between the generation of the potential participant list and the implementation of the intervention. The median age of participants was 47 years; 55% were male and 55% were white. Most patients (82%) had an annual income of less than $35k. Age, gender, education, and annual income were not associated with obtaining confirmatory HCV RNA testing; however, being white was associated with higher rates of confirmatory testing (<em>P</em> = 0.046). Six patients still lacked confirmatory testing at the time of study participation; all agreed to confirmatory testing, but none had completed it at 6 months after the intervention.</div></div><div><h3>Conclusion</h3><div>A telephone intervention was not successful in re-engaging patients in care for HCV. This study highlights the complexity of reaching this patient population and the need for interventions that minimize barriers in the HCV continuum of care.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 1","pages":"Article 100055"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145797104","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":"Review of student pharmacist–led patient assistance program services at a student-run free medical clinic","authors":"Andrew A. Fritz,&nbsp;Sadie E. Pyle,&nbsp;Marilee D. Clemons,&nbsp;Jangus B. Whitner,&nbsp;Mitchell S. Howard","doi":"10.1016/j.japhpi.2025.100080","DOIUrl":"10.1016/j.japhpi.2025.100080","url":null,"abstract":"<div><h3>Background</h3><div>High medication costs in the United States can result in medication access challenges for underserved patients. These challenges may result in suboptimal outcomes (e.g., nonadherence and lower life expectancy). Patient assistance programs (PAPs) supply free or low-cost medications to underserved, low-income individuals who meet program eligibility criteria.</div></div><div><h3>Objectives</h3><div>This research seeks to quantify the annual patient medication savings attained through a student pharmacist–led PAP service within a free clinic and also illustrate this unique methodology for other clinics to replicate.</div></div><div><h3>Methods</h3><div>A team of pharmacists and student pharmacists initiated a student pharmacist–led PAP service at the CommunityCare Clinic (CCC), one of the largest student-run free clinics in the United States, to enable consistent and affordable access to medications. This implementation was executed through interdisciplinary medical team collaboration to drive optimal patient care. Estimated annual medication savings used the specific national dispensing code of the product, the wholesale acquisition cost, the maximum quantity received annually based on prescription directions, and pricing algorithms.</div></div><div><h3>Results</h3><div>Between July 1, 2023, and May 31, 2024, the CCC successfully fulfilled 31 PAP applications, accounting for $201,018.92 in estimated annual patient medication savings. These applications were related to endocrine, pulmonary, and thrombotic prophylaxis and neuropathic pain conditions. The PAP service consisted of 3 student pharmacists and 1 pharmacist knowledgeable of available programs. The PAP team provides an overview to all volunteers weekly to identify patients during the patient visits in addition to PAP team chart reviews. Once the PAP intervention is determined to be eligible and approved by health care providers, the team initiates the application process and all required follow-up with additional patient resources.</div></div><div><h3>Conclusion</h3><div>The CCC’s experience using student pharmacist–led PAP service demonstrates a pharmacy team’s ability to advocate for underserved patients by enabling affordable and optimal health management while offering practical strategies for other clinics to adopt similar services.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 1","pages":"Article 100080"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145442675","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":"Identifying expected barriers and facilitators to participation in “Choose My Pharmacy”: A community pharmacy quality rating system","authors":"Katelyn N. Hettinger-Riddell,&nbsp;Elizabeth G. Riley-Jensen,&nbsp;Allyson Strader,&nbsp;Kristen Kepley,&nbsp;Margie E. Snyder","doi":"10.1016/j.japhpi.2025.100079","DOIUrl":"10.1016/j.japhpi.2025.100079","url":null,"abstract":"<div><h3>Background</h3><div>The Centers for Medicare and Medicaid Services have used “star” ratings to quantify the quality of health care provided by health plans. Although tasks completed in routine community pharmacy workflow contribute to “star” ratings, these ratings are not designed to show quality of care in the community pharmacy setting. Seguridad’s “Choose My Pharmacy” (CMP) rating system is the first quality measurement system designed specifically for community pharmacies.</div></div><div><h3>Objectives</h3><div>This study aimed to identify barriers and facilitators to implementing CMP in community pharmacies to improve future implementation and enhance scalability.</div></div><div><h3>Methods</h3><div>Pharmacists and other pharmacy staff members at pharmacy sites that either have not used CMP or are actively using CMP participated in virtual semi-structured interviews. Interview guides were informed and developed using the Consolidated Framework for Implementation Research.</div></div><div><h3>Results</h3><div>Three barriers and 4 facilitators to scaling CMP use were identified. Barriers include a need for CMP measures to be further enhanced, CMP data collection that can be inefficient and disruptive to workflow, and unclear return on investment. Facilitators to CMP use include support of quality measures that are more appropriate for community pharmacies, CMP’s potential to support novel payment contracts, data collected through CMP helps pharmacies better address community needs, and a review of the CMP report card supports process improvement efforts.</div></div><div><h3>Conclusion</h3><div>Pharmacy teams find CMP to be useful for identifying areas to improve care and a facilitator for process improvement efforts. As CMP use expands, continued evaluation of CMP on potential novel payment mechanisms and the impact on patient pharmacy preferences should be studied.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 1","pages":"Article 100079"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145442674","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 direct stewardship intervention on prescribing practices for the management of uncomplicated gram-negative bloodstream infections","authors":"Jillian Walters,&nbsp;Mary Joyce B. Wingler,&nbsp;David A. Cretella,&nbsp;Amelia Bryant,&nbsp;Katie E. Barber,&nbsp;Kayla R. Stover","doi":"10.1016/j.japhpi.2025.100050","DOIUrl":"10.1016/j.japhpi.2025.100050","url":null,"abstract":"<div><h3>Background</h3><div>Gram-negative bloodstream infections (GN BSIs) are associated with high rates of mortality and increased health care costs. Literature suggests that shorter courses (7 days) with the option to transition to highly bioavailable oral antibiotics are safe and efficacious.</div></div><div><h3>Objective</h3><div>This project evaluated the impact of a direct stewardship intervention on prescribing practices for uncomplicated GN BSIs.</div></div><div><h3>Methods</h3><div>This single-center, pre- and postintervention study was conducted at a large academic medical center. The intervention consisted of an uncomplicated GN BSI guideline followed by provider education and targeted prospective audit and feedback. Adult patients with uncomplicated GN BSIs from October 2021 to September 2022 (preintervention) and November 2022 to June 2023 (postintervention) were included, with October 2022 serving as a washout period. The primary outcome was calendar days of effective antibiotic therapy.</div></div><div><h3>Results</h3><div>A total of 142 uncomplicated GN BSIs (92 preintervention; 50 postintervention) were evaluated. Patients were predominantly African American (63%) with bloodstream infections primarily caused by <em>Escherichia coli</em> (42%) from a urinary source (66%). The median total duration of antibiotic therapy was 10 days (interquartile range [IQR] 8-11.5 days) in the preintervention group and 9 days (IQR 8-13 days) in the postintervention group (<em>P</em> = 0.514). Oral transition occurred in 41% versus 50% of patients in the pre- and postintervention groups, respectively (<em>P</em> = 0.319). In the postintervention group, 30-day mortality was significantly lower (9% vs. 0%, <em>P</em> = 0.05). There were no statistically significant differences in 30-day readmission or recurrence.</div></div><div><h3>Conclusions</h3><div>Implementation of guidelines with a direct stewardship intervention was associated with a numerically lower duration of therapy that was not statistically significant for GN BSIs, despite a nearly 10% increase in IV to oral transitions. No difference was seen in readmissions or recurrence between groups. This evaluation highlights the importance of antimicrobial stewardship interventions targeting the management of GN BSI and reveals an opportunity for a more focused intervention related to oral transition.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 1","pages":"Article 100050"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187490","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":"Digital clinical decision support to improve pharmacotherapy in hospitalized obese patients: A prospective intervention study","authors":"Ala Keyany,&nbsp;Ilse Groenen,&nbsp;Sarb Saini,&nbsp;Barbara Maat","doi":"10.1016/j.japhpi.2025.100077","DOIUrl":"10.1016/j.japhpi.2025.100077","url":null,"abstract":"<div><h3>Background</h3><div>In obese patients, standard medication dosing is often suboptimal and requires dose adjustments to body mass index (BMI) or body weight (BW). Digital clinical decision support (eCDS) may help optimize this.</div></div><div><h3>Objective</h3><div>This study aimed to assess the effect of eCDS on adjustments to BMI or BW in pharmacotherapy in hospitalized obese patients.</div></div><div><h3>Methods</h3><div>This prospective intervention study included hospitalized patients aged ≥ 18 years with a BMI of ≥ 30 kg/m² and/or BW ≥ 90 kg from January 1, 2022, to September 30, 2022 (before eCDS), and from October 10, 2022, to November 25, 2022 (after eCDS). After eCDS, pharmacy recommended dose adjustments to physicians based on eCDS, a tool that selected patients whose medication orders needed adjustment to BMI or BW. Study outcomes were prevalence of medication orders adjusted to BMI or BW before eCDS versus after eCDS; prevalence of post-eCDS patients with ≥ 1 medication order with a recommendation for adjustment; physician acceptance rate, including reasons for rejection; and occurrence of treatment failure/adverse events.</div></div><div><h3>Results</h3><div>In post-eCDS patients (n = 804), pharmacotherapy was significantly more often adjusted to BMI or BW than in pre-eCDS patients (n = 4428): 77.7% (912 of 1173 medication orders) after eCDS versus 58.2% (3519 of 6049 medication orders) before eCDS (<em>P</em> &lt; 0.0001). After eCDS, 328 patients had ≥ 1 medication order, resulting in 349 pharmacotherapeutic recommendations. Physician acceptance rate was 53.3% (186 of 349 for 167 patients). Recommendations mainly concerned nadroparin (92.8% [324 of 349]) and antibiotics (6.9% [24 of 349]). The main reason for rejecting a recommendation was near discharge (90.8% [148 of 163]). No treatment failures and 4 possible adverse events occurred.</div></div><div><h3>Conclusions</h3><div>Implementation of eCDS significantly increased the prevalence of medication orders adjusted to BMI or BW in hospitalized obese patients and is useful in optimizing treatment for this growing population.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 1","pages":"Article 100077"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187492","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":"State of work-life balance and career aspirations among Japan’s pharmacists","authors":"Misa Nagata","doi":"10.1016/j.japhpi.2025.100048","DOIUrl":"10.1016/j.japhpi.2025.100048","url":null,"abstract":"<div><h3>Background</h3><div>Work-life balance (WLB) and career aspirations are critical determinants of job satisfaction and professional sustainability among pharmacists. Research on these elements concerning Japanese pharmacists remains limited.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate WLB, career aspirations, and professional contributions to the overall health care of pharmacists in Japan using a nationwide survey.</div></div><div><h3>Methods</h3><div>This cross-sectional Web-based survey was conducted in April 2024 with 481 randomly selected pharmacists across Japan. The survey included 29 items analyzed using exploratory factor analysis (EFA) and hierarchical cluster analysis.</div></div><div><h3>Results</h3><div>EFA identified 4 key factors that explained 62% of the variance: self-evaluation as a pharmacist, WLB and career satisfaction, evaluation of professional skills and expertise, and prospects and career orientation. Cluster analysis revealed 4 respondent groups: (1) ambitious and upwardly mobile professionals (33%), (2) career-oriented professionals with WLB challenges (12%), (3) balanced professionals with limited career prospects (38%), and (4) disengaged professionals (16%). Ambitious professionals exhibited strong aspirations, whereas disengaged professionals lacked interest and expertise in their profession. This illustrates the diversity within the pharmacist profession, highlighting subgroups with different challenges and needs. By identifying the characteristics of each group, this study aids in providing interventions and support measures suitable for each group. Leadership training and skill development programs are vital for ambitious and upwardly mobile professionals. In contrast, flexible working hours and revised work assignments are necessary for career-oriented professionals facing WLB challenges. However, it was unclear from this study whether disengaged professionals were motivated.</div></div><div><h3>Conclusions</h3><div>This study highlights the diverse challenges and aspirations of pharmacists in Japan. Targeted interventions, including leadership development, workload adjustments, and career growth opportunities, are essential for addressing subgroup-specific needs. These findings provide a framework for policy makers and administrators to enhance pharmacist satisfaction and health care workforce sustainability.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 1","pages":"Article 100048"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187493","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}