Journal of the American Pharmacists Association最新文献

{"title":"Bringing Providers into the Community Pharmacy: Experiential Education.","authors":"Rebecca Lahrman","doi":"10.1016/j.japh.2024.102276","DOIUrl":"https://doi.org/10.1016/j.japh.2024.102276","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591412","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":"Feasibility of reaching populations at high risk for HIV in community pharmacies","authors":"","doi":"10.1016/j.japh.2024.102239","DOIUrl":"10.1016/j.japh.2024.102239","url":null,"abstract":"<div><h3>Background</h3><div>Growing evidence has shown feasibility for human immunodeficiency virus (HIV) prevention service integration in pharmacies, including HIV testing and screening for pre-exposure prophylaxis (PrEP). Yet, further work is needed to determine whether pharmacies can effectively reach those at increased risk of HIV transmission.</div></div><div><h3>Objective</h3><div>We aimed to describe the HIV risk profiles and willingness to obtain HIV prevention services from a sample of pharmacy clients.</div></div><div><h3>Methods</h3><div>This was a cross-sectional pilot study aimed to develop a culturally appropriate pharmacy-based PrEP delivery model among Black men who have sex with men. Two pharmacies were recruited from low-income, underserved communities and participants were recruited within pharmacies for screener and social and behavioral surveys. Individuals were grouped by PrEP eligibility due to sexual risk, injection drug use risk, or both, and demographic and willingness measures were compared.</div></div><div><h3>Results</h3><div>Among 460 pharmacy clients, 81 (17.6%) would have been eligible for PrEP due to sex or injection drug use risk. Most were eligible due to sexual risk (58.0%), while a substantial proportion were eligible due to injection drug use (27.2%) or a combination of sexual and injection drug use risk behaviors (42.0%). Of these eligible, the median age was 31 years (interquartile range = 28.32) and most had ≥1 female (75.3%) or male (96.3%) partner in the past 6 months. There was high willingness to receive a free HIV test in a pharmacy (90.1%). Most were willing to screen for PrEP in a pharmacy (95.1%) despite these services not being available in the state where this study was performed. There were no differences in willingness to obtain pharmacy-based HIV prevention services across risk groups.</div></div><div><h3>Conclusion</h3><div>This study shows that pharmacies in disadvantaged areas can serve a key role in preventing and decreasing the transmission of HIV by reaching populations with high HIV burden and providing HIV prevention services.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146711","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":"A shared passion for providing care","authors":"","doi":"10.1016/j.japh.2024.102269","DOIUrl":"10.1016/j.japh.2024.102269","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553175","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":"Pharmacists are the medication, and medication literacy, experts","authors":"","doi":"10.1016/j.japh.2024.102267","DOIUrl":"10.1016/j.japh.2024.102267","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553177","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":"Addressing health literacy and patient communication from the lens of science","authors":"","doi":"10.1016/j.japh.2024.102268","DOIUrl":"10.1016/j.japh.2024.102268","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553176","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":"Implementation of an Outpatient Clinical Pharmacy Service at an Adult Cystic Fibrosis Center.","authors":"Olga Marshall, Engy Dous, Kaitlyn Simpson, Cheng-Shiun Leu, Jiying Han, Claire Keating, Emily DiMango","doi":"10.1016/j.japh.2024.102270","DOIUrl":"https://doi.org/10.1016/j.japh.2024.102270","url":null,"abstract":"<p><strong>Background: </strong>High treatment burden can adversely impact health outcomes in people with cystic fibrosis (PwCF). There is a continued need for medication adherence education and further research to evaluate impact of CF pharmacist interventions in an ambulatory care setting.</p><p><strong>Objective(s): </strong>To evaluate whether pharmacist integration into an outpatient adult CF clinic can positively impact patient satisfaction and medication adherence through various pharmacist-based interventions.</p><p><strong>Methods: </strong>At a single urban medical center, a clinical pharmacist on an adult CF care team conducted comprehensive counseling sessions with PwCF. During these visits, types of pharmacist interventions were documented. Patients were provided a baseline and post-counseling survey to assess satisfaction with the pharmacist visit. Adherence to cystic fibrosis transmembrane regulator (CFTR) modulator and mucolytics were tracked 12 months before and 12 months after the counseling session.</p><p><strong>Results: </strong>A total of 723 pharmacist interventions were performed throughout 100 pharmacist visits in 100 PwCF. Most common interventions were inhaler technique education (17%), drug interaction identification (12%), provision of drug education material (12%), and medication refills (12%). Prior to any intervention, 97% of patients felt they could benefit from a pharmacist visit. Post-counseling survey results demonstrated that 98% of patients found pharmacist counseling to be beneficial. Medication adherence rate prior to pharmacy intervention was 81.9% for CFTR modulators and 62.5% for mucolytics, and 86.9% (p=0.143) and 63.6% (p=0.773), respectively, after pharmacist intervention.</p><p><strong>Conclusion: </strong>Integration of a clinical pharmacist within the CF clinic can help improve satisfaction and understanding of medication use among PwCF. Nearly all PwCF favorably perceived pharmacist counseling. We report that various pharmacist interventions including optimizing medication use knowledge, reinforcing adherence strategies, and streamlining timely access to treatment can contribute to enhanced care of PwCF.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548632","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":"A community pharmacist intervention for people living with epilepsy.","authors":"Jennifer L Bacci, Ifechukwu Benedict Nwogu, Sabra Zaraa, Michelle Guignet, H Steve White, Andy Stergachis, Derek Ems, Edward J Novotny","doi":"10.1016/j.japh.2024.102275","DOIUrl":"https://doi.org/10.1016/j.japh.2024.102275","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy is a complex spectrum of seizure disorders. Antiseizure medications (ASMs) are the first-line treatment for most patients. Community pharmacists are among the most accessible healthcare providers with extensive knowledge of pharmacotherapy yet are seldom engaged in epilepsy care.</p><p><strong>Objectives: </strong>The objective of this project was to pilot a community pharmacist-led intervention for people living with epilepsy (PWE).</p><p><strong>Methods: </strong>The Community Pharmacist Epilepsy Services Program was a 6-month disease state management intervention that included 4 components: patient-pharmacist consultation, care plan development, regular check-ins, and care coordination. A pilot was conducted in 4 independent community pharmacies (2 intervention and 2 comparator) in western Washington State. A prospective, two-arm, pre-post study was planned to evaluate the impact of the intervention on patient-reported quality of life (QoL), health, and satisfaction outcomes. The approach shifted to a one-arm, pre-post design due to low patient recruitment. The primary QoL outcome was the patient-weighted Quality of Life in Epilepsy Inventory-10 (QOLIE-10-P). Staff at intervention and comparator pharmacies were surveyed to evaluate perceived barriers to patient recruitment.</p><p><strong>Results: </strong>Ten patients, including 7 intervention and 3 usual care patients, enrolled in the study. Five intervention patients completed the pre- and post-surveys. The median pre-QOLIE-10-P score was 1.09 and the median post-score was 1.73, indicating a slight non-significant decrease in QoL. Eleven pharmacy staff completed the survey evaluating perceived patient recruitment barriers. Limited number of eligible PWE at each pharmacy was perceived as significant barriers.</p><p><strong>Conclusion: </strong>While low patient enrollment limited the ability to observe trends and draw conclusions about the potential impact of the intervention, enrollment barriers and lessons learned highlight opportunities to refine the intervention with the goal of improving the outcomes and well-being of PWE.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569823","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":"Chain community pharmacists' requests for patient information during routine care.","authors":"Elizabeth G Riley-Jensen, Katelyn N Hettinger-Riddell, Jonathan E Sarky, Margie E Snyder","doi":"10.1016/j.japh.2024.102273","DOIUrl":"https://doi.org/10.1016/j.japh.2024.102273","url":null,"abstract":"<p><strong>Background: </strong>To optimize service provision, community pharmacists need information (e.g., laboratory values and updated medication lists), which can be difficult to obtain. Contacting prescriber offices is a common approach to obtain information but is often ineffective. Health information exchange (HIE) is one potential solution to this problem, and recent survey research has identified the information needs of independent pharmacists that could be addressed through HIE. However, the information needs of chain community pharmacists are unknown.</p><p><strong>Objectives: </strong>The objective of this study was to characterize the patient information requests made by chain community pharmacists during routine practice.</p><p><strong>Methods: </strong>This electronic card study captured cross-sectional observational data on patient information requests made by chain pharmacists in central Indiana during routine practice. Only one pharmacist meeting eligibility criteria per pharmacy could submit data. Pharmacists were randomized to a two-week data collection period. In real-time, pharmacists recorded the following: type of information requested, reason for request, information source, whether initial or follow up request, modality of communication, and the time required to make the request. Data analysis occurred via descriptive statistics. The Indiana University Institutional Review Board approved all study procedures.</p><p><strong>Results: </strong>Nineteen of the 33 eligible pharmacists (57.6%) consented to the study. Most participants held a PharmD degree (78.9%) and were the pharmacy manager (89.5%) at their location. Updated medication orders/lists (41.3%) and insurance (33.3%) were the most common type of requested information and was primarily used for prescription clarification/filling (93.4%). The prescriber office (53.6%), as well as the patient/caregiver (39.8%), were the most frequent source of this information. Requests were largely completed by telephone (61.2%) and averaged 6.0 minutes (SD: 4.8).</p><p><strong>Conclusion: </strong>Community pharmacists require key patient data during routine practice. There is a need to develop mechanisms, like HIE, to address gaps in needed information in the community pharmacy setting, regardless of the offered services.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512052","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":"Bridging PrEP Access Gaps: Mapping Geospatial Accessibility Across the US and Leveraging Community Pharmacies for Expansion.","authors":"Jacinda Tran, Anu Mishra, Marita Zimmermann, Ryan Hansen","doi":"10.1016/j.japh.2024.102274","DOIUrl":"https://doi.org/10.1016/j.japh.2024.102274","url":null,"abstract":"<p><strong>Background: </strong>Pre-exposure prophylaxis (PrEP) is key to ending the US HIV epidemic, but uptake remains low. Federal legislation permitting community pharmacists to initiate PrEP nationwide could expand access to PrEP services.</p><p><strong>Objectives: </strong>This study aimed to evaluate census tract-level geospatial access to PrEP facilities and community pharmacies across the US and characterize geographic areas and populations where community pharmacies could help bridge the gap in care.</p><p><strong>Methods: </strong>We identified census tracts with limited or no access (\"deserts\") to PrEP facilities and community pharmacies in 2022 using two primary definitions: 1) a tract with no PrEP facilities or pharmacies within a 30-minute drive of the tract centroid; and 2) a tract with low income and low access (no PrEP facilities or pharmacies within one mile of the centroid for low vehicle access tracts, two miles in urban tracts, 10 miles in suburban tracts, 20 miles in rural tracts). Tracts with access were \"oases,\" and \"PrEP desert, pharmacy oasis\" tracts represented areas without PrEP facilities where community pharmacies could expand access. We characterized the social determinants of health associated with desert status and conducted sensitivity analyses exploring additional access definitions.</p><p><strong>Results: </strong>Of the 82,729 census tracts in our analysis, most were classified as dual PrEP and pharmacy oases. We categorized 13.3% as PrEP deserts under the 30-minute definition, and 94.3% of these tracts were pharmacy oases. Under the low income and low access definition, 17.0% of all tracts were PrEP deserts, 78.2% of which were pharmacy oases. PrEP deserts were predominantly located in the Midwest and South and associated with higher poverty, social vulnerability, and uninsurance.</p><p><strong>Conclusion: </strong>Our analysis confirmed inequitable access to PrEP facilities across the US. Federal recognition of pharmacists as health care providers empowered to initiate PrEP nationwide has the potential to substantially bridge access gaps for underserved communities.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512051","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":"Impact of a Clinical Pharmacist-Led, Artificial Intelligence-Supported Medication Adherence Program on Medication Adherence Performance, Chronic Disease Control Measures, and Cost Savings.","authors":"Charles Worrall, David Shirley, Jeff Bullard, Ashley Dao, Taylor Morrisette","doi":"10.1016/j.japh.2024.102271","DOIUrl":"https://doi.org/10.1016/j.japh.2024.102271","url":null,"abstract":"<p><strong>Background: </strong>Chronic diseases are the leading cause of disability and death in the United States. Clinical pharmacists have been shown to optimize health outcomes and reduce healthcare expenditures in patients with chronic diseases through improving medication adherence.</p><p><strong>Objective: </strong>The primary objective of this study was to evaluate a pharmacist-led, artificial intelligence-supported medication adherence program on medication adherence, select disease control measures, and healthcare expenditures.</p><p><strong>Methods: </strong>This was a multicenter, retrospective, quasi-experimental evaluation from January 2019 to December 2019 (pre-implementation) and January 2021 to December 2021 (post-implementation). This pharmacy-driven service focuses on improving medication adherence and patient outcomes through artificial intelligence-supported analytics, individual patient case review, and pharmacist-led individual patient outreach. The primary endpoint was to determine if implementation improved medication adherence in three medication-related measures: medication adherence for hypertension (MAH), medication adherence for cholesterol (MAC), and medication adherence for diabetes (MAD). Secondary outcomes were to evaluate reductions in select chronic diseases control measures and cost savings of this service following implementation of this service.</p><p><strong>Results: </strong>This medication adherence service was deployed across 10,477 patients: 60.6% of patients were in at least one medication-related measure, generating 2,762 actionable medication adherence gaps. Following the implementation of this pharmacist-led program, medication adherence improved in all three disease state measures (MAH: 5.9% improvement; MAC: 7.9% improvement; MAD: 6.4% improvement), and Medicare Star ratings also improved. The percentage of patients with diabetes who reached their A1c goal also increased (75.5% to 81.7%). Furthermore, reductions in overall healthcare expenditures were seen per member per month in patients that were adherent in comparison to those who were non-adherent (hypertension: 31% cost savings; hyperlipidemia 25% cost savings; diabetes: 32% cost savings).</p><p><strong>Conclusion: </strong>This clinical pharmacist driven service leveraged technology and patient connection to increase medication adherence in patients with chronic disease states and led to improvement in select disease control measures and substantial healthcare cost savings.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479217","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}