JAPhA Practice Innovations最新文献

{"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":"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":"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":"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}

{"title":"Retrospective analysis of direct oral anticoagulation hold recommendation adherence for gastrointestinal procedures by an outpatient anticoagulation clinic","authors":"Allison L. Thurman,&nbsp;Aaron W. Brown,&nbsp;Christopher A. Knefelkamp,&nbsp;Sarah L. Hutfilz,&nbsp;Deanna S. Kania PharmD,&nbsp;Kristin S. Gaby","doi":"10.1016/j.japhpi.2025.100034","DOIUrl":"10.1016/j.japhpi.2025.100034","url":null,"abstract":"<div><h3>Background</h3><div>Anticoagulant medications can cause harm to patients in the periprocedural setting if managed inappropriately. Recent guidelines have attempted to standardize recommendations for anticoagulation management, but patients may still experience harm if these recommendations are not followed.</div></div><div><h3>Objectives</h3><div>This study aimed to compare the hold recommendations given by an outpatient anticoagulation clinic with the actual duration that patients held their anticoagulants periprocedurally. Additional outcomes included time between hold duration communication and procedure, significant bleeding events, thromboembolic events, and death within 30 days of the procedure.</div></div><div><h3>Methods</h3><div>This was a retrospective chart review of patients taking a direct oral anticoagulant (DOAC) who underwent an elective gastrointestinal procedure between April 30, 2021, and April 30, 2023. Data collection included adherence to periprocedural hold recommendations, length of time between communication of instructions and procedure, number of procedure cancellations or reschedules, and rates of 30-day bleeding events, thromboembolic events, and death.</div></div><div><h3>Results</h3><div>Two hundred charts were reviewed and 118 patients (59%) followed the preprocedure hold recommendations given by the anticoagulation clinic. The mean time between communicating recommendations to a patient and the date of the procedure was 56.6 days. No procedures were cancelled or rescheduled owing to DOAC mismanagement. There were 5 bleeding events and no clotting events or deaths within 30 days of the procedure. Of the patients who experienced a bleeding event, none held their anticoagulant for a shorter duration than recommended.</div></div><div><h3>Conclusion</h3><div>This study revealed nonideal patient adherence to guideline-based periprocedural hold recommendations for DOACs. Despite this, no procedures were delayed or cancelled, and limited safety events occurred. The length of time between communication of the recommendation and the date of the procedure was long and may explain low patient adherence. Additional studies are necessary to determine periprocedural adherence and potential adverse outcomes for other surgical procedures.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"2 3","pages":"Article 100034"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631582","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":"Implementation of pharmacist-initiated proton pump inhibitor deprescribing for ambulatory care patients","authors":"Sehara Hill,&nbsp;Marissa Egipciaco,&nbsp;Tina Tidwell","doi":"10.1016/j.japhpi.2025.100037","DOIUrl":"10.1016/j.japhpi.2025.100037","url":null,"abstract":"<div><h3>Background</h3><div>The 2022 American Gastroenterological Association Proton Pump Inhibitor (PPI) Deprescribing Clinical Guidelines recommend regular review of patients prescribed PPI therapy; however, this may be limited due to insufficient provider time and resources. This evaluation aimed to assess the impact of pharmacist-initiated PPI deprescribing interventions for ambulatory care patients.</div></div><div><h3>Objectives</h3><div>The objectives of this evaluation were to describe (a) PPI deprescribing interventions defined as PPI discontinuation or de-escalation of dose by Veterans Affairs clinical pharmacists in the outpatient setting; (b) the percentage of appropriate indications documented within the electronic medical record for high-dose PPI therapy; (c) the percentage of PPI deprescribing success at 3-week follow-up and 1-year follow-up; and (d) estimated total cost savings annually.</div></div><div><h3>Methods</h3><div>This was a single-centered, quality improvement, evaluation that utilized a patient monitoring tool dashboard to identify ambulatory patients with an active outpatient prescription for high-dose PPI therapy. Inclusion criteria included adult patients without an indication for long-term PPI therapy. Pharmacists contacted eligible patients to assess interest in PPI deprescribing via implementation of a shared decision-making intervention(s) based on an approved institution-specific algorithm.</div></div><div><h3>Results</h3><div>Of the 50 patients eligible for PPI deprescribing, 33 (66%) were agreeable to PPI deprescribing interventions. In patients without an indication, pharmacist intervention led to 25 indications being added to the electronic health record. PPI deprescribing success at the 3-week follow-up occurred in 27 patients (82%) of patients. A 1-year follow-up was conducted with 91% deprescribing interventions sustained and an estimated total cost savings of $58,919.90 annually.</div></div><div><h3>Conclusion</h3><div>A pharmacist-initiated shared decision model demonstrated sustained outcomes in PPI deprescribing. Overall, this evaluation provided data to support pharmacist deprescribing interventions as an effective way to minimize inappropriate continuation of high-dose PPI therapy. Further research is warranted to determine the long-term feasibility, sustainability, and safety benefits.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"2 3","pages":"Article 100037"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631769","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 pharmacist-led continuous glucose monitoring program on reduction in A1c in an FQHC","authors":"Makenzie Evers,&nbsp;Juanita Draime,&nbsp;Rachel Barhorst","doi":"10.1016/j.japhpi.2025.100039","DOIUrl":"10.1016/j.japhpi.2025.100039","url":null,"abstract":"<div><h3>Background</h3><div>Type 2 diabetes mellitus (T2DM) is a common disease affecting 37.3 million people in the United States. The use of continuous glucose monitors (CGMs) has been proven to improve patient glycemic outcomes and lower A1c. There is limited data available regarding the evaluation of personal CGMs in a pharmacist-led CGM management program.</div></div><div><h3>Objectives</h3><div>The primary objective of the study was to evaluate the effects of a pharmacist-led CGM management program in a Federally Qualified Health Center (FQHC). The secondary objective of the study was to assess the A1c reduction over time in a pharmacist-led CGM management program compared to the use of a CGM alone.</div></div><div><h3>Methods</h3><div>Family Health Services of Darke County is an FQHC in rural Ohio. Clinical pharmacists provide disease state management services for chronic disease states using a collaborative practice agreement (CPA). The CGM management program consists of uploading patient’s personal CGMs, interpreting the data, providing education, and utilizing a CPA to make therapeutic adjustments based on CGM data. A retrospective cohort analysis was performed. Patients with T2DM were included if they had a baseline A1c within 2 months of initiating a CGM, continued use of the CGM for at least 6 months, A1c measured at 3- or 4-month intervals, and at least one pharmacist-led appointment. Data collected included the date of CGM initiation, date of baseline A1c, baseline, and follow-up A1c readings, number of appointments, and number of medication interventions made by the clinical pharmacist.</div></div><div><h3>Results</h3><div>A significant reduction in A1c was observed in patients who participated in a pharmacist-led CGM management program.</div></div><div><h3>Conclusion</h3><div>This study demonstrated the impact that pharmacists can have on health outcomes when utilizing a CPA to provide individualized care.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"2 3","pages":"Article 100039"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631486","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":"Deprescribing sulfonylureas in patients over the age of 65 within the Boise VA Medical Center","authors":"Natalie Everett,&nbsp;Robyn Cruz,&nbsp;Leanne Ertle,&nbsp;Elaine Nguyen","doi":"10.1016/j.japhpi.2025.100051","DOIUrl":"10.1016/j.japhpi.2025.100051","url":null,"abstract":"<div><h3>Background</h3><div>There are hypoglycemia-related safety concerns with sulfonylureas, especially in older adults with type 2 diabetes mellitus (T2DM). Clinical pharmacist practitioners working in primary care clinics have the opportunity to address these concerns and potentially optimize patients’ diabetes medication regimens through deprescribing of potentially unsafe sulfonylureas.</div></div><div><h3>Objective</h3><div>This study aimed to assess the impact of a pharmacist-led sulfonylurea deprescribing campaign in older adults with T2DM in the primary care setting of a Veterans Affairs medical center.</div></div><div><h3>Methods</h3><div>This was a prospective sulfonylurea deprescribing campaign conducted over a period of approximately 5 months at a single institution. Patients were enrolled if they were older than 65 years with an active sulfonylurea prescription, had an A1c of less than 8%, and were on select primary care teams. The primary project evaluator telephoned eligible patients to invite them to participate in a sulfonylurea deprescribing initiative, with those accepting then receiving a scheduled call to deprescribe their therapy and at least 1 subsequent follow-up call to assess changes in blood glucose. The primary end point was the percentage of patients successfully deprescribed from sulfonylurea therapy. Secondary end points were the number of patients requiring diabetes therapy adjustment and the number of follow-up visits required to optimize antidiabetic medications after sulfonylurea discontinuation.</div></div><div><h3>Results</h3><div>Nineteen patients received the sulfonylurea deprescribing intervention. Of these patients, 11 were able to successfully discontinue therapy with 3 of these patients requiring additional antidiabetic medication adjustments. Nine patients who received the intervention needed only 1 follow-up visit. At the time of data collection, 4 patients were still undergoing therapy adjustments after their initial sulfonylurea discontinuation.</div></div><div><h3>Conclusion</h3><div>This pharmacist-led sulfonylurea deprescribing campaign was successful. However, it did require substantial pharmacist involvement with some patients needing extended follow-up.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"2 3","pages":"Article 100051"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631586","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}