Journal of the American Pharmacists Association最新文献

{"title":"An analysis of the impact of a multimodal therapy order set on postoperative opioid prescribing after orthopedic shoulder procedures.","authors":"Dan Arendt, Marisa Brizzi, Ryan Ruehl, Jacob Cryer, Christopher J Utz, Brian Grawe","doi":"10.1016/j.japh.2025.102322","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102322","url":null,"abstract":"<p><strong>Background: </strong>Opioids are effective for postoperative pain control but are no longer considered appropriate as the sole method for managing pain after surgery. Newer, multimodal approaches to pain control are increasingly being employed to decrease reliance on opioids, but patient-related outcomes are not consistently reported with these interventions.</p><p><strong>Objective: </strong>This study evaluated the effect of implementing a new multimodal therapy order set, coupled with new patient education materials, on postoperative outcomes after complex shoulder surgery.</p><p><strong>Methods: </strong>This retrospective cohort study compared outcomes from patients who received medications via the new multimodal therapy order set (order set cohort) and patients who did not (nonorder set cohort). All patients were contacted on postoperative days 1,7, and 14 to answer questions about postoperative pain and general measures of function. Data on opioid prescribing and use were collected. There were 2 primary endpoints: median morphine equivalent daily dose (MEDD) prescribed at 14 days postsurgery and median satisfaction with pain control at 14 days postsurgery.</p><p><strong>Results: </strong>There were 16 patients included in the nonorder set cohort and 19 in the order set cohort. At 14 days postsurgery, the median MEDD prescribed was significantly less in the order set cohort than in the nonorder set cohort (P = 0.003), and there was no significant difference in patient satisfaction scores between groups.</p><p><strong>Conclusion: </strong>The implementation of a multimodal order set, coupled with new patient education materials, resulted in a significant reduction in the median MEDD of prescribed opioids without negatively influencing patient satisfaction after complex shoulder interventions.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102322"},"PeriodicalIF":2.5,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"American Pharmacists Association Foundation Incentive Grants: A 30-year descriptive review.","authors":"Cristian Rodriquez, Shanna K O'Connor, Emily Albers","doi":"10.1016/j.japh.2025.102323","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102323","url":null,"abstract":"<p><strong>Background: </strong>The American Pharmacists Association Foundation Incentive Grant program provides funding for pharmacy learners to conduct community pharmacy-based research projects. Over the 30-year period since its inception, the number of grants awarded has grown through support from the Community Pharmacy Foundation.</p><p><strong>Objective: </strong>The objective of this project was to describe the breakdown of project topics and geographic reach of Incentive Grant-funded projects from 1994 to 2024 and summarize the number of patients or survey respondents reached.</p><p><strong>Methods: </strong>All available reports and supporting documents for the Incentive Grant program were reviewed using the American Pharmacists Association Foundation internal database. Projects were assigned a geographical region using US Census Bureau Divisions and categorized using focus areas from grant calls-for-proposals. Project impact was evaluated by summing the number of interventions reported in final reports.</p><p><strong>Results: </strong>A total of 784 projects were conducted and 551 had final reports available. Thirteen project focus areas were identified, with a majority of projects related to cardiovascular disease management (21.1%), pharmacy workflow/processes (14%), and immunizations (13.3%). Projects were conducted most frequently in the U.S. regions of South Atlantic (27.4%), East North Central (24.2%), and West North Central (14.9%). Of 398 projects with intervention-level data reported (2004-2024), 100,547 interventions were made (86,616 patients impacted and 13,931 survey respondents reached).</p><p><strong>Conclusion: </strong>The findings of this study serve as a summary of community pharmacy-based research over time, indicating the American Pharmacists Association Foundation Incentive Grant program has likely had a positive influence on community pharmacy-based research as evidenced by number of funded projects, geographic scope, participant impact, and breadth of project focus.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102323"},"PeriodicalIF":2.5,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication therapy management lifestyle and wellness program for patients in rural Arizona.","authors":"David R Axon, Becka Eckert, Terra Leon, Sonia Morales, John Ehiri, Aminata Kilungo, Thelma Okotie, Tenneh Turner-Warren","doi":"10.1016/j.japh.2025.102324","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102324","url":null,"abstract":"<p><strong>Background: </strong>Pharmacist-provided medication therapy management (MTM) services have demonstrated improved clinical outcomes for patients. MTM services could incorporate additional lifestyle and wellness counseling to potentially enhance health care for underserved patients.</p><p><strong>Objective: </strong>To report the outcomes of a new pharmacist-provided MTM lifestyle and wellness counseling program for underserved rural Arizonans with diabetes and/or hypertension.</p><p><strong>Methods: </strong>A community health center referred rural Arizonans with type 2 diabetes and/or hypertension to the MTM pharmacist for telephonic MTM lifestyle and wellness counseling between July 2020 and June 2023. Data were collected on clinical characteristics, adherence issues, and pharmacist recommendations. A nurse reviewed the patients' electronic health record to determine which recommendations had been accepted by the primary care provider after 90 days. Summary statistics were computed.</p><p><strong>Results: </strong>For 93 patients in the program, pharmacists identified many drug-drug interactions, adverse drug reactions, utilization/cost concerns, and recommended preventative vaccines. Pharmacists provided counseling for exercise, nutrition, laboratory values, and disease state education. Twenty-nine patients reported missing any doses of their medications in the past 2 weeks. Patients used a variety of methods to remind them to take their medications. A total of 309 recommendations were made by the pharmacist averaging 3.3 ± 1.4 per patient. Of these, 113 (36.6%) were accepted within 90 days. The most common recommendations made were screening needed (n = 77) and vaccination due (n = 70). The most frequently accepted recommendations by the patients' provider were reinforcing lifestyle/disease self-management strategies (61.7%) and decreasing medication dose (60.0%).</p><p><strong>Conclusion: </strong>This novel MTM lifestyle and wellness counseling program demonstrated some success for underserved Arizonans with diabetes and/or hypertension. Over one-third of recommendations made by the pharmacist to the patients' primary care provider were accepted, which is encouraging in showing the value of this program but suggests further work is needed to act upon them or understand why they are not implemented.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102324"},"PeriodicalIF":2.5,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of out-of-pocket costs on medications for opioid use disorder and overdose: A scoping review","authors":"Ronald Watema-Lord,&nbsp;Feng Xie,&nbsp;Chiranjeev Sanyal","doi":"10.1016/j.japh.2024.102299","DOIUrl":"10.1016/j.japh.2024.102299","url":null,"abstract":"<div><h3>Background</h3><div>The opioid epidemic is a major public health crisis in Canada and elsewhere. The increase in opioid prescriptions is a major contributor to this crisis. Medications for opioid use disorder (OUD) and overdose are effective and lifesaving treatments. Often, patients do not have adequate insurance coverage (or uninsured) for medications for OUD and have to pay out of pocket (OOP). OOP costs (OOPCs) result in financial burdens among patients, limiting their access to medications for OUD, and overdose.</div></div><div><h3>Objectives</h3><div>To identify the evidence on (1) the OOPCs of medications for OUD and overdose, and (2) the effect of insurance coverage (or being uninsured) and corresponding OOPCs on medications for OUD initiation, retention, and discontinuation.</div></div><div><h3>Methods</h3><div>This scoping review was conducted in accordance with methodological guidance from the Joanna Briggs Institute. The literature search aimed to identify peer-reviewed publications in English in MEDLINE, Embase, and CINAHL, which were searched from inception to March 22, 2024. Two reviewers independently completed title, abstract, and full-text screening against inclusion criteria. Data extracted were used to describe the body of literature using descriptive and qualitative approaches.</div></div><div><h3>Results</h3><div>Out of the 2003 search results, a total of ten studies met the inclusion criteria and were included in the review. Uninsured patients have paid higher OOPCs compared to private or publicly insured patients. Among privately insured patients with OUD, greater OOPC may result in poor retention of buprenorphine. The risk of discontinuation was higher with the buprenorphine/naloxone tablet compared with the sublingual buprenorphine/naloxone film. Generic substitution or providing coverage for these medications being dispensed from community pharmacies can potentially minimize the burden of OOPCs and improve access.</div></div><div><h3>Conclusion</h3><div>The literature highlights beneficiaries of private/commercial health plans experience a substantial burden of OOPCs, creating barriers to treatment initiation, retention, and adherence to medications for OUD.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102299"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Take care of the patient: Pharmacists should advocate for overdose prevention centers as harm reduction","authors":"Nicole Famiglietti,&nbsp;Jeffrey Bratberg","doi":"10.1016/j.japh.2024.102289","DOIUrl":"10.1016/j.japh.2024.102289","url":null,"abstract":"<div><div>Overdose prevention centers (OPCs) are places where people can bring previously obtained substances to use under the supervision of trained health care professionals who are prepared to intervene in the event of an overdose. Health care professionals, counselors, and peer support provide services including naloxone distribution, provision of sterile injection equipment, counseling services, referrals to necessary providers, and above all a safe and compassionate space for people to get the care they need. This is a method of harm reduction that has been used worldwide for decades and is now gaining traction in the United States. Pharmacists play a vital role in harm reduction for patients, and they should support the legalization and establishment of OPCs across the country to extend this essential service. A compelling body of evidence shows that OPCs reduce overdose deaths, emergency department visits for overdoses and wounds relating to injection drug use, and emergency medical service utilization in the area surrounding the centers. They also reduce drug use and discarded hazardous drug paraphernalia in public areas. OPCs also provide wrap-around services that aid in the holistic care of the person, including referrals to inpatient substance use treatment, detoxification, primary care, transportation, and housing. It is the responsibility of pharmacists to advocate for the needs of patients, and OPCs will provide an effective avenue for pharmacists to deliver counseling and medication management services as part of care of the individual.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102289"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacy in 2050: To succeed, we must adapt","authors":"Spencer E. Harpe PharmD, PhD, MPH, FAPhA","doi":"10.1016/j.japh.2024.102287","DOIUrl":"10.1016/j.japh.2024.102287","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102287"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the pharmacist role in insomnia management and care provision: A scoping review","authors":"Mariam M. Basheti,&nbsp;Christopher Gordon,&nbsp;Ronald Grunstein,&nbsp;Bandana Saini","doi":"10.1016/j.japh.2024.102312","DOIUrl":"10.1016/j.japh.2024.102312","url":null,"abstract":"<div><h3>Background</h3><div>Insomnia is a highly burdensome sleep disorder, with a global prevalence of approximately 30% in adults. Insomnia has negative effects on daily functioning and can play a pivotal role in the development and progression of comorbid mental and physical disease. Therefore, appropriate and timely management is essential. Pharmacists are at the forefront of the primary care workforce and given their expanding roles in care provision, would be able to alleviate the burden of insomnia in the community by delivering evidence-based management.</div></div><div><h3>Objective</h3><div>To describe the current practice and potential roles of pharmacists in insomnia management.</div></div><div><h3>Methods</h3><div>The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines were followed in this scoping exercise. An extensive search of 5 databases (MEDLINE, Embase, Scopus, IPA, and CINAHL) was conducted, generating 1057 initial results. Titles, abstracts, and full-text articles were screened in a two-step process to identify relevant studies for review inclusion. Studies reporting on insomnia management by pharmacists in primary care settings were included in the review. Articles were reviewed and data extracted, analyzed, and grouped categorically based on study design.</div></div><div><h3>Results</h3><div>Twenty-eight studies met inclusion criteria with 5 qualitative, 8 observational and 15 interventional studies. Over a third of the studies were conducted in Australia (n = 11). Insomnia management across these studies ranged from 1) screening/assessment services (n = 5), 2) pharmacological and nonpharmacological care provision (n = 16), and 3) sedative-hypnotic deprescribing services (n = 7). It was evident that pharmacological approaches remain the most common treatment modality adopted despite guidelines recommending cognitive behavioral therapy as first-line. The results show that with adequate training and education, pharmacists have the potential to provide insomnia screening, behavioral therapy, and pharmacological deprescribing services, improving overall insomnia management in primary care.</div></div><div><h3>Conclusion</h3><div>The outcomes of this review highlight a current gap in insomnia management practices carried out by pharmacists and provide evidence for expanded roles and improved care provision when pharmacists are upskilled with specialized training/education.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102312"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing SGLT-2 inhibitor prescribing through an integrated case-finding algorithm guided interdisciplinary intervention.","authors":"Cindy Leslie A Roberson, Abby F Hoffman, Pamela Cohen, Victoria Lee Jackson, Susan E Spratt","doi":"10.1016/j.japh.2024.102320","DOIUrl":"10.1016/j.japh.2024.102320","url":null,"abstract":"<p><strong>Background: </strong>Use of sodium-glucose cotransporter 2 inhibitors (SGLT-2 inhibitors) falls short of their cardiorenal protective benefits. Patient and provider-level barriers hinder the adoption of these life-saving medications. Innovative practices to provide primary care providers (PCPs) with added clinical-decision support via a dedicated remote interdisciplinary diabetes rounds (IDRs) team could promote SGLT-2 inhibitor selection.</p><p><strong>Objective: </strong>To evaluate the impact of the IDR's proactive provider outreach on the prescribing rate of SGLT-2 inhibitors and assess the application of an SGLT-2 inhibitor case-finding algorithm to allow targeted intervention in a population-health-based setting.</p><p><strong>Methods: </strong>This is a quality improvement prospective cohort observational study from October 2021 to May 2022. Patients who met the prespecified criteria for SGLT-2 eligibility were reviewed via IDR with recommendations sent to the PCP via the electronic health record. The primary analysis employed a multivariate logistic regression to assess the difference in SGLT-2 inhibitor prescription rates between reviewed and not reviewed patients, adjusting for variables affecting SGLT-2 inhibitor prescribing. The secondary analysis measured the algorithm's accuracy in identifying patients with compelling indications.</p><p><strong>Results: </strong>The IDR team reviewed a total of 206 patients (mean age, 63 years; 53.9% women; 42.7% Black; mean A1c 8.3%) with a successful PCP appointment. Patients reviewed by the IDR team had an increased prescribing rate within 90 days of the visit (adjusted odds ratio 5.1, 95% CI 3.06-8.47). The algorithm identified 1084 SGLT-2 inhibitor-eligible patients with a sensitivity of 90.4% (95% CI, 86.4%, 94.4%) and specificity of 85.1% (95% CI, 79.9%, 90.4%).</p><p><strong>Conclusion: </strong>IDR team's review of eligible patients with recommendations to PCPs was associated with significantly increased SGLT-2 inhibitor prescription rates. Development of an algorithm with high sensitivity and specificity for targeted intervention may provide a pathway for channeling therapy and decreasing clinical inertia in population health management efforts.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102320"},"PeriodicalIF":2.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacist perceptions of motivation and well-being using Self-Determination Theory: A qualitative study.","authors":"Kayla Walker, Alexcia S Carr, Andrew Wash, Leticia R Moczygemba","doi":"10.1016/j.japh.2024.102321","DOIUrl":"10.1016/j.japh.2024.102321","url":null,"abstract":"<p><strong>Background: </strong>Many US hospitals and health systems have implemented well-being programs to address the clinician well-being and burnout crisis. Most community pharmacists experience at least one symptom of burnout, yet they have been overlooked for inclusion in well-being initiatives.</p><p><strong>Objective: </strong>To explore community pharmacists' perceptions of how motivation and burnout impact patient care and how fulfillment of basic psychological needs (autonomy, competence, and relatedness) impacts motivation and well-being.</p><p><strong>Methods: </strong>Focus groups were conducted with 20 community pharmacists. A semistructured focus group guide was developed using Self-Determination Theory (SDT). Transcriptions from the focus groups were analyzed using deductive qualitative analysis with SDT as a framework and inductive analysis to code subthemes.</p><p><strong>Results: </strong>Our findings revealed that pharmacists who feel burnout experience depersonalization toward patients which lowers the quality of patient-pharmacist interactions. Pharmacists who did not feel burnout expressed a sense of professional fulfillment, which motivated them to provide patient-centered care. Pharmacists indicated that unrealistic expectations from patients and corporate management, such as pressure from patients to fill prescriptions quickly and management expectations to meet prescription fill quotas, negatively impacted autonomy. Conversely, having access to clinical information, workflow optimization, and realistic job expectations supported autonomy. Poor relationships with patients and coworkers negatively impacted relatedness and contributed to communication barriers, workplace negativity, and emotional detachment from work. Relatedness was facilitated by building relationships and mutual respect with patients and coworkers and cultivating a positive work culture. Expectations for perfection and the need for multitasking when understaffed diminished competency. Adequate staffing and allocation of time to complete job duties served to support competency.</p><p><strong>Conclusion: </strong>Community pharmacists are faced with situations that undermine autonomy, relatedness, and competency, which according to SDT need to be fulfilled to facilitate well-being.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102321"},"PeriodicalIF":2.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of buprenorphine adherence with telemedicine Vs. in-person for rural and urban patients.","authors":"Thomas J Reese, Nana Addo Padi-Adjirackor, Kevin N Griffith, Bryan Steitz, Stephen W Patrick, Ashley A Leech, Andrew D Wiese, Adam Wright, Mauli V Shah, Jessica S Ancker","doi":"10.1016/j.japh.2024.102318","DOIUrl":"10.1016/j.japh.2024.102318","url":null,"abstract":"<p><strong>Background: </strong>Policy changes during the COVID-19 pandemic allowed buprenorphine to be prescribed for opioid use disorder via telemedicine without an in-person visit. A recently proposed change will limit buprenorphine access to 30 days without an in-person visit. Given that people living in rural areas may be disproportionally impacted by this change, we sought to better understand how buprenorphine adherence may be impacted by requiring in-person visits.</p><p><strong>Objective: </strong>Compare buprenorphine adherence after telemedicine to adherence after in-person visits for patients who live in rural and urban areas.</p><p><strong>Methods: </strong>In this retrospective cohort study, we used electronic health record data from a large medical center. The cohort included all adult patients prescribed buprenorphine for opioid use disorder during 2017-2022. The primary outcome was adherence, characterized by the Medication Possession Ratio (MPR) and gaps in buprenorphine treatment at 30 and 180 days. We conducted a longitudinal analysis at visit level, stratified by patient urbanicity, and controlled for patient, prescriber, prescription, and setting characteristics.</p><p><strong>Results: </strong>From 511 patients, we followed 3302 in-person and 519 telemedicine visits. Compared to in-person visits we observed no difference in the adherence following telemedicine visits overall. However, telemedicine was associated with higher MPR for rural patients (30 days: adjusted marginal effects [AME], 3.7%; 95% CI, 2.0-5.5; P < 0.001 and 180 days: AME, 8.5%; 95% CI 5.7-11.3; P < 0.001) and fewer gaps (30 days: AME, -6.7%; 95% CI, -9.9 to -0.1; P < 0.001 and 180 days: AME, -9.4%; -14.0 to -4.5; P < 0.001) compared to in-person visits.</p><p><strong>Conclusion: </strong>These findings suggest that telemedicine is a viable alternative to in-person visits, especially for patients living in rural areas, which should help guide future policies that preserve or increase access to buprenorphine in a manner that can reduce barriers for patients.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102318"},"PeriodicalIF":2.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}