{"title":"Pharmacist provider status in Medicaid: A state health director’s perspective on policy and practice","authors":"Alex J. Adams","doi":"10.1016/j.japh.2025.102932","DOIUrl":"10.1016/j.japh.2025.102932","url":null,"abstract":"<div><div>Despite expanded clinical authority, pharmacists often face barriers to full provider status in Medicaid owing to outdated reimbursement policies and administrative restrictions. This paper describes Idaho’s comprehensive approach to pharmacist integration into its Medicaid program through a profession-neutral “what, not who” reimbursement framework coupled with its “standard of care” regulatory framework. Rather than defining eligibility by provider type, Idaho allows any licensed health professional to bill for Medicaid-covered services within their legal scope of practice. Key reforms included statutory changes, regulatory updates, provider enrollment optimization, and alignment of pharmacist reimbursement with midlevel providers. Pharmacists can now enroll as rendering providers and bill directly for services using their National Provider Identifier. Idaho’s model demonstrates that full pharmacist integration into Medicaid can be achieved in a framework that is scalable, bipartisan, and adaptable, offering a policy roadmap for other states seeking to enhance access to health care especially in rural settings.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102932"},"PeriodicalIF":2.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188271","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}
Emily Parry, Allison Hursman, Ellen Rubinstein, Taylor Thooft, Rylie Johnson, Jada Ford, Kimaria Stevenson, Lauren Lowe
{"title":"A descriptive study of systemic factors that affect ambulatory care pharmacists","authors":"Emily Parry, Allison Hursman, Ellen Rubinstein, Taylor Thooft, Rylie Johnson, Jada Ford, Kimaria Stevenson, Lauren Lowe","doi":"10.1016/j.japh.2025.102931","DOIUrl":"10.1016/j.japh.2025.102931","url":null,"abstract":"<div><h3>Background</h3><div>Ambulatory care pharmacists (ACPs) support patients and the health care team through clinical services such as patient education and comprehensive disease state management. Although multiple studies show the impact of ACPs on others, little research has been done on their own experiences.</div></div><div><h3>Objectives</h3><div>This study aimed to learn from ACPs about their workplace experiences and identify systemic factors that affect their role as members of interprofessional health care teams.</div></div><div><h3>Methods</h3><div>This exploratory, qualitative study consisted of digitally recorded, semistructured interviews with ACPs. Interviews were transcribed and analyzed inductively and iteratively by a multidisciplinary research team to determine salient themes.</div></div><div><h3>Results</h3><div>Twenty-one pharmacists (10 in private health systems, 11 in public health systems) participated, 15 of whom described the effects of leadership, metrics, and reimbursement on their roles. Although many pharmacists felt supported by leadership, others noted consistent pressure to meet arbitrary quality metrics and frustration with limited reimbursement options. Public health system pharmacists seemed to be more affected by these systemic factors than their private health system counterparts.</div></div><div><h3>Conclusion</h3><div>Leadership, metrics, and reimbursement are all systemic factors that affect ACPs’ workplace experiences, as evinced by participant interviews. More research is necessary to determine how best to support ACPs across health systems to ensure that they can continue providing high-quality, accessible patient care.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102931"},"PeriodicalIF":2.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188216","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}
Shaquib Al Hasan, Tsung-Hua Shen, Felix Cheuk Wun Ting, Joel F. Farley
{"title":"Health care utilization and spending following comprehensive medication review in Medicare part D","authors":"Shaquib Al Hasan, Tsung-Hua Shen, Felix Cheuk Wun Ting, Joel F. Farley","doi":"10.1016/j.japh.2025.102930","DOIUrl":"10.1016/j.japh.2025.102930","url":null,"abstract":"<div><h3>Background</h3><div>The Medicare Part D medication therapy management (MTM) program provides comprehensive medication reviews (CMRs) to eligible patients. Despite its introduction in 2006, benefits of the MTM program are still not well understood, lacking research in large generalizable Medicare populations.</div></div><div><h3>Objectives</h3><div>To examine the effectiveness of receiving a CMR on health care utilizations and associated spending.</div></div><div><h3>Methods</h3><div>A new user retrospective cohort study was used to compare changes in healthcare utilization and spending in CMR recipients to a matched cohort of Medicare beneficiaries who were eligible, but did not receive a CMR. Linking MTM files to inpatient, outpatient, and prescription claims for a 20% random sample of Medicare beneficiaries aged 65 and older, we obtained 533,550 CMR recipients and 1,413,860 non-recipients, and a propensity score matched sample of 531,314 CMR recipients and 531,314 nonrecipients. Difference-in-difference models were used to compare the 1-year probability and number of emergency department (ED) and hospital visits, and inpatient, outpatient, and prescription and total health spending between CMR recipients and nonrecipients.</div></div><div><h3>Results</h3><div>Relative to CMR nonrecipients and the year prior to CMR delivery, CMR recipients experienced a 0.49% (95% confidence interval [CI], 0.33% to 0.64%%) and 1.72% (95% CI, 1.57% to 1.88%) lower probability of an ED visit and hospitalization 1 year after CMR delivery, respectively. Similarly, CMR receipt resulted in a reduction of 80 hospital stays (95% CI, 45 to 115) and 337 ED visits (95% CI, 305 to 370) per 10,000 recipients, respectively. Per beneficiary, non-prescription medical spending declined by $378 (95% CI = 314 to $442) while prescription spending increased by $470 (95% CI = $436 to $503) resulting in an additional $91 in total spending (95% CI = $20 to $164) among recipients.</div></div><div><h3>Conclusion</h3><div>Health care utilization reduction associated with CMR, found in this study, suggests that CMR in older adults may help reduce nonprescription health care expenditure in the year following CMR.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102930"},"PeriodicalIF":2.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180701","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}
Suzanne Whitten, Sharmon P. Osae, Russ Palmer, Rebecca H. Stone, Beth Bryles Phillips, Chelsea A. Keedy, Blake R. Johnson, Henry N. Young, Devin L. Lavender
{"title":"Rural health system administrator perspectives on pharmacists' role in collaborative drug therapy management","authors":"Suzanne Whitten, Sharmon P. Osae, Russ Palmer, Rebecca H. Stone, Beth Bryles Phillips, Chelsea A. Keedy, Blake R. Johnson, Henry N. Young, Devin L. Lavender","doi":"10.1016/j.japh.2025.102929","DOIUrl":"10.1016/j.japh.2025.102929","url":null,"abstract":"<div><h3>Background</h3><div>Collaborative drug therapy modification (CDTM) authorizes adjustment of dosages, dosage schedules, and/or medications within a defined protocol under physician supervision within Georgia. Pharmacist-led collaborative drug therapy management positively impacts health outcomes leading to reduced health care expenditures. Less than 1% of Georgia pharmacists have a CDTM license.</div></div><div><h3>Objective</h3><div>The objective was to obtain feedback from rural primary health care system administrators to assist in increasing CDTM services and expand access to patient care services in Georgia.</div></div><div><h3>Methods</h3><div>An exploratory qualitative interview research design was utilized. Complete target population sampling was used to increase likelihood of data saturation. In January 2023, 7 health system administrators were interviewed regarding knowledge of pharmacists and pharmacist-led CDTM, as well as perceived benefits of and barriers to implementation of pharmacist-led CDTM. Interview responses were transcribed. A two-cycle inductive coding process utilizing constant comparison was employed to identify themes verified by analyst triangulation.</div></div><div><h3>Results</h3><div>Inconsistent understanding of pharmacist knowledge, skills, and abilities under CDTM by administrators was identified. Perceived benefits of pharmacist-led CDTM included (1) improved patient care, (2) increased value-based metrics, and (3) enhanced physician-pharmacist collaborations. Perceived barriers to the expansion of pharmacist services included concerns regarding (1) physician acceptance, (2) pharmacist knowledge and comfort, and (3) loss of revenue. Improving administrator and provider awareness of pharmacist abilities and providing evidence of benefit from similar services were identified by administrators as potential ways to encourage CDTM participation.</div></div><div><h3>Conclusion</h3><div>Health-system administrators are one of the key stakeholders in successful pharmacist-led CDTM implementation, but may have limited understanding of pharmacist knowledge, skills, and abilities under pharmacist-led CDTM. Improving their knowledge and understanding, as well as identifying and addressing their perceived benefits and barriers to implementing CDTM, may facilitate the expansion of pharmacist-led CDTM services, particularly in Georgia.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102929"},"PeriodicalIF":2.5,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145153282","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}
Laura Hellemans, Julie Hias, Leen Haegemans, Karolien Walgraeve, Astrid Liesenborghs, Astrid Lammens, Lorenz Van der Linden, Mieke Deschodt, Jos Tournoy
{"title":"Implementation evaluation of a pharmacist-led complex intervention: A mixed-methods analysis embedded within the ASPIRE randomized controlled trial","authors":"Laura Hellemans, Julie Hias, Leen Haegemans, Karolien Walgraeve, Astrid Liesenborghs, Astrid Lammens, Lorenz Van der Linden, Mieke Deschodt, Jos Tournoy","doi":"10.1016/j.japh.2025.102928","DOIUrl":"10.1016/j.japh.2025.102928","url":null,"abstract":"<div><h3>Background</h3><div>Geriatric patients with multimorbidity and polypharmacy are at high risk for medication-related harm. Complex interventions including medication reconciliation and medication review can improve outcomes, though their effectiveness in older patients remains unclear due to implementation failure in recent trials. The ASPIRE (The effect of a trAnSitional Pharmacist Intervention in geRiatric inpatients on hospital visits after dischargE) project evaluates a complex intervention aimed at reducing unplanned hospital revisits in geriatric patients while simultaneously maximizing intervention implementation.</div></div><div><h3>Objectives</h3><div>To perform an implementation evaluation by describing the implementation strategies, evaluating fidelity, feasibility, and acceptability and documenting process outcomes of the ASPIRE intervention.</div></div><div><h3>Methods</h3><div>A convergent parallel mixed-methods design was used with quantitative data from all intervention patients and qualitative data from semi-structured interviews and one focus group. The implementation strategies were designed based on the Expert Recommendations for Implementing Change guidelines. Fidelity to each intervention component was quantitatively measured for all intervention patients, using an 80% threshold to define successful implementation. Feasibility and acceptability were qualitatively assessed using Flottorp's contextual analysis framework. Intervention duration and process outcomes were reported descriptively.</div></div><div><h3>Results</h3><div>The ASPIRE trial enrolled 415 intervention participants aged 85.9 (±5.78) years. The complex intervention was successfully implemented with 87% of patients receiving all intervention components and considered feasible and acceptable by the majority of stakeholders. Key factors for successful implementation with the greatest impact on fidelity, feasibility, and acceptability included adequate time and workforce allocation, additional training, established working relationships, a shared information system and a detailed intervention guide. Median intervention duration was 77.3 (interquartile range (IQR) 65.8-93.5) minutes and 64.5 (IQR 54.2-78.8) minutes for patients discharged home or to a nursing home, respectively.</div></div><div><h3>Conclusion</h3><div>The ASPIRE intervention was successfully implemented and considered feasible and acceptable by the stakeholders, highlighting its potential to improve care for geriatric patients. The high level of implementation provide a strong basis for the further evaluation of its effectiveness.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102928"},"PeriodicalIF":2.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139993","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}
Abigail Leszczynski, Benjamin Bowen, Charlese P. Schultz, Alexandra Herman, Kelsea Gallegos Aragon, Amy Bachyrycz
{"title":"Utilizing pharmacists to bridge gaps in contraceptive care: New Mexico as a case study","authors":"Abigail Leszczynski, Benjamin Bowen, Charlese P. Schultz, Alexandra Herman, Kelsea Gallegos Aragon, Amy Bachyrycz","doi":"10.1016/j.japh.2025.102926","DOIUrl":"10.1016/j.japh.2025.102926","url":null,"abstract":"<div><div>Hormonal contraception, both daily and emergency use, has played a central role in reproductive care to prevent pregnancy, reduce the need for abortion, and manage medical conditions. Contraceptive access is a longstanding issue that carries personal, social, economic, and health-related consequences. Approximately 45% of all pregnancies each year in the United States are unplanned, with individuals of lower income experiencing rates 5 times more than those with higher incomes. Rural populations face additional challenges, including higher rates of adolescent pregnancy and limited access to care. New Mexico (NM) will serve as a central example in this commentary on pharmacy access to contraception, as 26 of its 33 counties are considered rural. NM has an adolescent pregnancy rate above national average and high uninsured and poverty rates. In 1993, NM became the first state in the United States to pass legislation authorizing specially trained pharmacists to prescribe under a collaborative agreement with a physician, an early and innovative step toward expanding care in underserved areas. Pharmacy access to contraception is aimed at increasing availability of contraceptives, though significant barriers remain. As these barriers grow across the nation, this commentary explores how pharmacist-led models, using NM as a case study, can be leveraged to improve access to contraception and broader health outcomes in all communities.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102926"},"PeriodicalIF":2.5,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077171","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}
Jordan R. Covvey, John Swegle, K. Ashley Garling-Nañez, Jeffrey G. Hamper, Sarah E. Vordenberg, Kimberly M. Kelly
{"title":"Demystifying responding to peer reviews: Turning feedback into success","authors":"Jordan R. Covvey, John Swegle, K. Ashley Garling-Nañez, Jeffrey G. Hamper, Sarah E. Vordenberg, Kimberly M. Kelly","doi":"10.1016/j.japh.2025.102925","DOIUrl":"10.1016/j.japh.2025.102925","url":null,"abstract":"<div><div>The process of responding to peer review comments can sometimes be confusing and emotional. This article aims to provide guidance to authors on how to navigate this aspect of the academic publishing process. It details the peer review process generally, formatting responses, negotiating timelines, leveraging co-authors for assistance, navigating conflicts and disagreements, dealing with unprofessional reviews, and handling manuscript rejections. The authors emphasize the importance of constructive engagement with reviewer feedback, even when challenging, and offer strategies for managing the submission process effectively.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102925"},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067378","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":"Achievement of time in range goals among patients with diabetes using continuous glucose monitoring","authors":"Faezeh Azizi, Katherine Diehl, Lauren Enser, Samantha Heacock","doi":"10.1016/j.japh.2025.102924","DOIUrl":"10.1016/j.japh.2025.102924","url":null,"abstract":"<div><h3>Background</h3><div>Despite robust evidence supporting continuous glucose monitoring (CGM) use, successful utilization remains relatively low.</div></div><div><h3>Objective(s)</h3><div>This study aimed to determine the percentage of patients with a baseline time in range (TIR) < 70% who achieved TIR ≥ 70% when using CGM and identify patient variables associated with either achievement or maintenance of the TIR goal within our institution.</div></div><div><h3>Methods</h3><div>This was a retrospective, observational review of adult patients with diabetes using CGM for at least 6 months consecutively. Key exclusion criteria were gestational diabetes, pregnancy, nonadherence, and controlled baseline TIR. The primary outcome was the percentage of patients achieving TIR ≥ 70% within 6 months of starting CGM. Secondary outcomes included identifying patient variables associated with either achievement or maintenance of TIR goals and describing the relationship between TIR and hemoglobin A1c.</div></div><div><h3>Results</h3><div>A total of 71 patients were included; 54% were male and the median age was 57 years (interquartile range [IQR] 39-75). Sixty-two percent of patients had type 2 diabetes (T2D). Fifty-four percent of patients achieved TIR ≥ 70% at any time during the study period, with a median time to achievement of 42 days (IQR 28-84). Among patients who achieved the TIR goal, 58% maintained this at 6 months and 67% also reached an A1c of < 7%. T2D, use of metformin, and glucagon-like peptide-1 receptor antagonists were positively associated with achievement of the TIR goal (<em>P</em> = 0.008, <em>P</em> = 0.026, and <em>P</em> = 0.004, respectively).</div></div><div><h3>Conclusion</h3><div>Among patients with diabetes using CGM consecutively for 6 months, most reached and maintained TIR goals. Larger studies are needed to confirm these findings.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102924"},"PeriodicalIF":2.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035051","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}
Noah S. Ball, Eric M. Kinney, Erin McMahan, Jon P. Wietholter
{"title":"Assessing inpatient formulary-driven inhaler use in presumed Group B chronic obstructive pulmonary disease","authors":"Noah S. Ball, Eric M. Kinney, Erin McMahan, Jon P. Wietholter","doi":"10.1016/j.japh.2025.102916","DOIUrl":"10.1016/j.japh.2025.102916","url":null,"abstract":"<div><h3>Background</h3><div>Long-acting muscarinic antagonist (LAMA) and long-acting beta-agonist (LABA) combination maintenance therapy is recommended for patients with Group B chronic obstructive pulmonary disease (COPD) in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Exposure to inhaled corticosteroids (ICS) in these patients may increase adverse effects without adding clinical benefit. Inpatient formulary limitations may facilitate unnecessary exposure to ICS and ICS-associated adverse events while hindering the use of optimal LAMA/LABA inhaler therapy in Group B COPD patients.</div></div><div><h3>Objectives</h3><div>The main objectives of this project were to evaluate the appropriateness of inpatient prescribing of ICS products in patients with presumed Group B COPD and to determine the incidence of ICS-associated adverse events when used in this patient population.</div></div><div><h3>Methods</h3><div>This single-center retrospective cohort study used EPIC electronic health record data to capture patients 18 years and older diagnosed with COPD, classified as presumed GOLD Group B, who had an admission medication reconciliation completed between July 26, 2022 and September 20, 2023. Patients were excluded if they were adherent to ICS prior to admission, currently or had been admitted for a COPD exacerbation, diagnosed with asthma, or had never received a pharmacist medication reconciliation. Descriptive statistics were utilized to assess all objectives.</div></div><div><h3>Results</h3><div>Our study included 100 patients with presumed Group B COPD. We showed that 14% of the patients assessed (n = 14) were given ICS therapy against GOLD criteria. Additionally, we identified that 14% of these patients (n = 2) experienced potential ICS-associated pneumonia during their inpatient stay.</div></div><div><h3>Conclusion</h3><div>Assessment of inappropriate ICS use at an institution without a lone LABA or LAMA/LABA inhaler on formulary showed that inhaler availability may contribute to the risk of presumed GOLD Group B patients receiving inappropriate ICS therapy.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102916"},"PeriodicalIF":2.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007032","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":"Stay strong, community pharmacists and fellow researchers","authors":"Kimberly M. Kelly","doi":"10.1016/j.japh.2025.102917","DOIUrl":"10.1016/j.japh.2025.102917","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102917"},"PeriodicalIF":2.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007052","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}