Journal of the American Pharmacists Association最新文献

{"title":"Evaluation of pharmacist-led management of type 2 diabetes using personal continuous glucose monitors across a large tertiary academic health system.","authors":"Christina Mnatzaganian, Mark Bounthavong, Wendelle Abalos, Truc Chau, Oluchi Nwosu, Andrew Yi, Ila Saunders, Panteha Kelly","doi":"10.1016/j.japh.2025.102397","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102397","url":null,"abstract":"<p><strong>Background: </strong>There is limited but positive evidence of the impact of pharmacists in managing patients with type 2 diabetes (T2D) using a personal continuous glucose monitor (CGM). Previous studies have been limited to single clinic pilots or community pharmacies with small sample sizes.</p><p><strong>Objectives: </strong>To evaluate the impact on glycemic outcomes of an innovative pharmacist-led Diabetes Management and Education Clinic (DMEC) on patients with T2D using a personal CGM.</p><p><strong>Practice description: </strong>The DMEC operates in primary care settings in a large, tertiary academic health care system serving a large patient population. Pharmacists manage care for patients with T2D who are referred by primary care and specialty medical providers under a collaborative practice agreement.</p><p><strong>Practice innovation: </strong>To use CGM data to guide decision making for clinical pharmacists seeing patients with T2D in the DMEC.</p><p><strong>Evaluation methods: </strong>This was a retrospective study conducted at the DMEC over two years. Demographics and glycemic outcomes were collected from the electronic medical record for patients who had a personal CGM prior to the initial clinic visit, supplied during the visit, or ordered as a prescription. A descriptive analysis was completed for this study.</p><p><strong>Results: </strong>DMEC pharmacists used CGMs to guide treatment decisions for 165 patients. The average hemoglobin A1c decreased by 1.48% at three months (p<0.001) and 1.74% at six months (p<0.001) after initial visit. Time in range improved by 8.2% at three months (p<0.001) and 12.1% at six months (p <0.001). The glucose management indicator decreased by 0.27% at three months (p<0.001) and 0.53% at six months (p<0.001). The average glucose decreased by 13.5 mg/dL at three months (p<0.001) and 18.8 mg/dL at six months (p<0.001).</p><p><strong>Conclusion: </strong>Pharmacist-led management of T2D using personal CGMs can improve diabetes outcomes in a large academic health care system.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102397"},"PeriodicalIF":2.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796896","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":"Process standardization of encounter labeling to characterize ambulatory care pharmacist activity.","authors":"Carly Gabriel, Clinical Pharmacist, Trisha A Miller, Jack Janosik, Stephanie L Ballard, Clinical Pharmacist, Deanne Hall","doi":"10.1016/j.japh.2025.102396","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102396","url":null,"abstract":"<p><strong>Background: </strong>Structured documentation of pharmacist-provided patient care activities within the electronic medical record (EMR) is crucial for recording, continuity, billing, and collecting clinical outcome data. In chart notes, the encounter reason field allows multiple semi-structured or free-text entries to describe the purpose for a patient interaction. Without standardization, reason entries could not be pooled for analysis without additional chart review.</p><p><strong>Objective: </strong>The primary aim was to increase the utility of the encounter reason field by standardizing ambulatory care pharmacist encounter labeling and provide a template for adoption across a large academic health system. The resulting structured data is intended to better characterize pharmacist activity at individual, clinic and system levels.</p><p><strong>Methods: </strong>A report collected encounter reason entries for pharmacist encounters in 4 primary care settings April-June 2022. After review, an ambulatory care pharmacist workgroup created a procedure for entering encounter reason, requiring entry of both an indication and an action or pharmacist service. Pharmacists were trained on the new procedure in August. A post- implementation report was repeated for September-Nov 2022. Presence and description of encounter reason entries were analyzed with descriptive statistics and presented for comparison between pre- and post-implementation.</p><p><strong>Results: </strong>Pre-implementation, 18.6% (n=370) of total encounters had a generic entry that did not define the visit indication or the pharmacists' activity. Post-implementation, generic entries decreased to 3.9% (n=88). After exclusion of anticoagulation encounters, the number of encounters with no reason decreased from 26.8% (n=252) to 12.1% (n=123). The number of encounters, unique patients, and disease states labeled did not change significantly from pre- to post- implementation.</p><p><strong>Conclusion: </strong>Implementation of a procedure for labeling encounter reason allowed for more robust characterization of pharmacist services using congruent data across pharmacist practices. This approach may be useful for pharmacist practices with limited analytics resources for more sophisticated service metrics and dashboards.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102396"},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755487","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":"Statin Therapy Prescribing in Atherosclerotic Cardiovascular Disease Patients with Chronic Kidney Disease.","authors":"Armen K Fstkchian, Rachel N Lowe, Joseph J Saseen","doi":"10.1016/j.japh.2025.102395","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102395","url":null,"abstract":"<p><strong>Background: </strong>Evidence supporting high-intensity statin therapy in atherosclerotic cardiovascular disease (ASCVD) patients and advanced non-dialysis chronic kidney disease (CKD) is lacking. Moreover, FDA restricts the dosing of rosuvastatin to moderate-intensity in advanced CKD. It is unclear if these limitations impact the overall prescribing of high-intensity statin therapy in advanced CKD patients.</p><p><strong>Objective: </strong>This study evaluated real-world prescribing patterns of statin therapy among ASCVD patients with non-dialysis dependent Stage 3a/3b and Stage 4/5 CKD.</p><p><strong>Methods: </strong>This retrospective, cross-sectional study identified patients aged 18-89 years within the University of Colorado Health system between January 1, 2019 to September 30, 2020. Patients with a diagnosis of ASCVD and CKD with an active statin prescription were included and divided into two groups, eGFR <30 mL/min/1.73m² or eGFR 30-59 mL/min/1.73m². Patients on dialysis, history of organ transplant or HIV, or a contraindication to statin therapy were excluded.</p><p><strong>Results: </strong>A total of 350 patients were included, 175 patients in each group. A total of 65.7% patients in the eGFR <30 mL/min/1.73m² and 64% in the eGFR 30-59 mL/min/1.73m² were prescribed high-intensity statin therapy (p-value=0.74). Among patients with eGFR <30 mL/min/1.73m² prescribed rosuvastatin, 67.6% were prescribed doses higher than the FDA recommended dose adjustment for severe kidney dysfunction (P=0.02).</p><p><strong>Conclusion: </strong>There was no difference in the prescribing of high-intensity statin therapy in patients with eGFR <30 mL/min/1.73m² compared to eGFR 30-59 mL/min/1.73m². This aligns with current guideline recommendations. However, most prescriptions for rosuvastatin did not comply with the FDA dose restriction in patients with severe kidney dysfunction.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102395"},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755488","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' Perspectives on Providing Educational Intervention to Address E-Cigarette Use and Vaping among Adolescents and Their Parents.","authors":"Ellie Maday, Annika Brekke, Jenny Li, Olufunmilola Abraham","doi":"10.1016/j.japh.2025.102392","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102392","url":null,"abstract":"<p><strong>Background: </strong>The use of newer forms of nicotine, such as e-cigarettes, has become popular among youth, creating a growing concern about its health impact on adolescents. As the adolescent vaping epidemic persists, it is necessary to engage all public-facing healthcare professionals in prevention and reduction efforts against e-cigarette use. With pharmacists being the most accessible health care professional, they are well-suited to expand their tobacco services to include vaping.</p><p><strong>Objective: </strong>The objectives of this study are to examine pharmacists' opinions on the potential role they may have in addressing adolescent vaping and to determine pharmacists' view on a proposed educational tool (Ph-EVER) for adolescents and parents to learn more about vaping and e-cigarette use.</p><p><strong>Methods: </strong>Licensed and practicing pharmacists in Wisconsin were recruited via pharmacy organizations' email listservs to take part in a semi-structured interview. The interview questions covered knowledge on adolescent vaping, the role of pharmacists in addressing adolescent vaping, interactions with adolescents in their practice, and feedback on the Ph-EVER. Two study team members independently coded the interviews to generate prevalent themes and subthemes.</p><p><strong>Results: </strong>In this study, 30 pharmacist participants were interviewed. From their interviews, themes that emerged included how pharmacists interact with teens, what they already know about e-cigarettes, the potential roles pharmacists may have on adolescent vaping, and feedback on the Ph-EVER.</p><p><strong>Conclusion: </strong>Pharmacists can be key professionals in reducing adolescent vaping; however, they lack knowledge on the topic of e-cigarettes, indicating the need for continuing education. Many pharmacists noted that they rarely see adolescents in their practice setting, making adolescents a difficult population to reach. Pharmacists were open to the idea of implementing the Ph-EVER within their pharmacy stating it achieved its intended purpose. Recommendations were made to expand this resource to social media to target the adolescent population.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102392"},"PeriodicalIF":2.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732696","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":"Inside the Pharmacy: A qualitative Study Uncovering Community Pharmacists' Experiences with Paxlovid Prescribing.","authors":"Sura O AlMahasis, Bonyan Qudah, James H Ford, David Mott","doi":"10.1016/j.japh.2025.102390","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102390","url":null,"abstract":"<p><strong>Background: </strong>Community pharmacists were authorized to prescribe Paxlovid to eligible patients, yet little is known about their experiences in this role. Understanding these experiences is crucial for improving patient access.</p><p><strong>Objectives: </strong>This study aimed to 1) describe the Paxlovid prescribing process in community pharmacies and 2) explore associated barriers and facilitators.</p><p><strong>Methods: </strong>This exploratory qualitative study involved semi-structured virtual interviews with pharmacists in Wisconsin (June-September 2023). Pharmacists were identified using the Wisconsin Department of Health Services list of pharmacies offering Paxlovid and the Pharmacy Practice Enhancement and Action Research Link network. The interview guide, pre-tested with one pharmacist, was informed by the Consolidated Framework for Implementation Research (CFIR). Descriptive statistics and thematic analysis guided by the CFIR were used.</p><p><strong>Results: </strong>Five pharmacists were interviewed, including three in leadership roles. One represented a pharmacy partnering with two health systems, while another represented a healthcare system collaborating with 15 independent pharmacies. On average, pharmacists dispensed 130 (±142) Paxlovid doses, with eligibility screening taking 5 to 45 minutes, conducted in person, by phone, or via electronic health records (EHR). The prescribing process involved two steps: 1) assessing eligibility and 2) dispensing the appropriate prescription, with slight variations based on pharmacy's EHR access. Key themes describing facilitators and barriers to Paxlovid prescribing emerged within four CFIR domains (i.e., inner setting, outer setting, individual characteristics, and process). Major barriers included limited access to patient health information and inadequate reimbursement. Facilitators included access to decision-making support tools, compatibility, and the ability to screen and counsel patients remotely.</p><p><strong>Conclusions: </strong>Community pharmacists are vital to expanding access to Paxlovid but struggle with limited access to patient health information and inadequate reimbursement. Ensuring EHR access and advocating for provider status will enhance patient care. Involving pharmacists in public health program design can optimize resource allocation and effectiveness.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102390"},"PeriodicalIF":2.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701436","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 Interventions in Immigrant and Refugee Populations: A Scoping Review.","authors":"Ann M Philbrick, Omolayo Umaru, Sarah Jane Brown, Alec Helmke, Kathryn Momary, Jordan Peterson, Van Hellerslia","doi":"10.1016/j.japh.2025.102393","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102393","url":null,"abstract":"<p><strong>Background: </strong>Global movement has heightened concerns regarding the well-being of immigrant and refugee populations. In the United States, the influx of refugees underscores the pressing need to address their unique health challenges, alongside social determinants of health (SDOH). Pharmacists are well-positioned to mitigate these disparities.</p><p><strong>Objectives: </strong>This scoping review aims to identify pharmacist-led interventions targeting immigrants and refugees in the US.</p><p><strong>Methods: </strong>A health sciences librarian created a comprehensive search strategy in five electronic databases. After de-duplication and screening of 2,603 studies by four independent reviewers, ten were selected for inclusion by two independent reviewers. Selected articles were mapped to SDOH framework.</p><p><strong>Results: </strong>Among the ten manuscripts, two were randomized controlled trials, and eight observational studies. Four manuscripts focused on the SDOH framework of Education Access and Quality and six on Healthcare Access and Quality. Under the former, three interventions focused on understanding how to access a pharmacy or understand medication directions while the fourth assessed hepatitis B education. Regarding Healthcare Access and Quality, both randomized controlled trials examined the impact of lifestyle interventions with medication-therapy management (MTM). Four examined the pharmacists' role in providing healthcare access including chronic disease management, latent-tuberculosis infection (LTBI), diabetes, and health screenings for metabolic disorders.</p><p><strong>Conclusion: </strong>Ten pharmacist interventions proactively addressed barriers to healthcare in immigrant and refugee populations in the two SDOH domains that pharmacists are most in a position to aid; Education Access and Quality and Healthcare Access and Quality. The remaining SDOHs represent areas of opportunities for pharmacists.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102393"},"PeriodicalIF":2.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701500","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":"Challenges of Managing Pediatric Polypharmacy in a Pediatric Complex Care Program: A Qualitative Pilot Study.","authors":"Julia Reedy, Talia Thompson, Anowara Begum, Megan A Morris, Allison Kempe, Chris Feudtner, Mark Gritz, James A Feinstein","doi":"10.1016/j.japh.2025.102391","DOIUrl":"10.1016/j.japh.2025.102391","url":null,"abstract":"<p><strong>Background: </strong>Pediatric polypharmacy is often necessary for symptom and disease management in children with medical complexity (CMC) but can result in medication-related problems. Little is known about how pediatric care teams coordinate efforts to manage polypharmacy. This limits the pragmatic design of interventions to comprehensively manage pediatric polypharmacy.</p><p><strong>Objectives: </strong>In a large outpatient pediatric complex care program for CMC, we sought to understand 1) how pediatric polypharmacy is managed by a multidisciplinary team, 2) associated challenges, and 3) opportunities for improvement.</p><p><strong>Methods: </strong>We conducted a qualitative pilot study of pediatric clinicians with prescribing and non-prescribing roles. Thematic content analysis was used to synthesize findings across participants and identify key themes.</p><p><strong>Results: </strong>We interviewed 16 clinicians representing prescribing (n=9) and non-prescribing (n=7) clinicians. Three overarching themes emerged: 1) pediatric polypharmacy poses unique safety risks for CMC; 2) polypharmacy management requires careful collaboration between distinct clinical roles to accomplish numerous medication-related tasks; and 3) multiple prescribers across subspecialties complicates polypharmacy management, including challenges in identifying responsibility for certain medications. Clinicians described myriad challenges across different levels of the healthcare system (patient, clinic, hospital, and system) and endorsed the need for a pediatric pharmacist to help mitigate these challenges.</p><p><strong>Conclusion: </strong>Interventions to manage pediatric polypharmacy for CMC will require a multi-level approach including the 1) curation of accessible highly centralized medication documentation, 2) delegation of certain medication-related tasks based on clinical expertise, and 3) coordination of medication management activities across healthcare organizations and settings of care. Integrated pediatric pharmacist support could address many of these needs.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102391"},"PeriodicalIF":2.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702056","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":"Expanding Vaccination Access in Underserved Communities Across Maryland Through a Collaborative Approach.","authors":"Nicole J Brandt, F Mark Hindman, Cherokee Layson-Wolf, Sarah Brandt, Barbara J Zarowitz","doi":"10.1016/j.japh.2025.102389","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102389","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;From April 2023 through April 2024, Maryland Living Well Center of Excellence (LWCE) in collaboration with The Peter Lamy Center on Drug Therapy and Aging at the University of Maryland School of Pharmacy and community partners, Meals on Wheels of Central Maryland, and Maryland Primary Care Program (MDPCP) provided vaccination services and education for older persons including those with disabilities who have been historically underserved.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To expand equitable access to all applicable adult vaccines with a focus on influenza and COVID-19 in adults 60 years of age and older.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Practice description: &lt;/strong&gt;A collaborative team of pharmacists, pharmacy students, pharmacy technicians, community and public health workers, as well as primary care physician practices were assembled. Through a series of bi-weekly meetings, a model of outreach to low-income, urban, rural and remote underserved and senior housing communities was established to provide education and referral services directed toward improving vaccine access and administering vaccines. To bridge access barriers, vaccines were offered, in community centers, pharmacies, physician practices, low-income senior housing units, and individual patient homes in an effort to enable equitable access to influenza and COVID-19 vaccines principally, but other vaccines were available. Development of an age-friendly vaccine brochure and interest form was disseminated to Meals-on-Wheels recipients and through housing and pharmacy partners. Biweekly public health emails were distributed to over 1,100 primary care practices calling for providers to promote vaccines and engage in this initiative.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Practice innovation: &lt;/strong&gt;This community-based collaborative model of vaccination programs featured a multi-pronged innovative approach of: a) outreach through a school of pharmacy, community wellness hub, Meals-on-Wheels, community pharmacies, and primary care practices; b) referral services for vaccine scheduling assistance and transportation; c) vaccine services provided in the communities including in: low-income senior housing buildings, community centers, primary care practices, and in patient's homes; and d) widely disseminated services to urban, suburban, rural, and remote areas of the state with a concentration to individuals with socioeconomic challenges.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Evaluation methods: &lt;/strong&gt;Goal attainment was measured by the number of all vaccines administered with a focus on influenza and COVID-19 vaccines to adults 60 and older including those with disabilities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Community outreach to 115,785 people through Meals-on-Wheels, primary care offices, wellness and cultural events resulted in 23,521 administered vaccines (COVID-19 (48%), influenza (36%), hepatitis B (13%), and other (3%)). Over 11,400 individuals received scheduling assistance (63%), transportation (&lt;1%), and refe","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102389"},"PeriodicalIF":2.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694267","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":"Roles and Perceptions of Community Pharmacists in Suicide Prevention in Jordan: A Cross-Sectional Study.","authors":"Rana Abu-Farha, Karem H Alzoubi, Lobna Gharaibeh, Mariam Al-Ameri, Aya Nawasreh, Ammena Y Binsaleh, Sireen Abdul Rahim Shilbayeh","doi":"10.1016/j.japh.2025.102388","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102388","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate community pharmacists' awareness regarding suicide warning signs, identify perceived barriers to engaging in suicide prevention, and assess their attitudes and perceptions regarding their role in mental health support in Jordan.</p><p><strong>Study design: </strong>A cross-sectional survey was conducted from August to September 2024 among practicing community pharmacists registered with the Jordanian Pharmacy Association.</p><p><strong>Methods: </strong>The study survey was distributed electronically through social media and professional networks, included questions on demographics, knowledge of suicide warning signs, training, experiences with suicidal patients, and perceptions of their role in mental health support. Data were analyzed using SPSS version 26.</p><p><strong>Results: </strong>A total of 412 pharmacists participated in this study. Regarding familiarity with suicide warning signs, 150 (36.4%) reported being familiar, however confidence in identifying suicide warning signs was low, with only 73 (17.7%) feeling very confident. Among the 208 (50.5%) pharmacists who encountered patients with suicidal thoughts, common warning signs included withdrawal from activities (181, 87.0%) and feelings of hopelessness (179, 86.1%). In response to these situations, 187 (89.9%) pharmacists provided empathetic support, 172 (82.7%) encouraged seeking professional help, and 167 (80.3%) assessed the seriousness of the situation. Barriers to effective intervention included cultural barriers (329, 79.9%), lack of training (327, 79.4%), and fear of offending patients (323, 78.4%).</p><p><strong>Conclusion: </strong>Community pharmacists in Jordan recognize the importance of their role in suicide prevention but face barriers such as lack of training and cultural sensitivities. Enhancing training and providing clear guidelines can improve their effectiveness in supporting mental health and suicide prevention efforts.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102388"},"PeriodicalIF":2.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694268","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-led sulfonylurea deprescribing in older adults.","authors":"Katherine Busque, Emma R Blackmore, David Fox, Kristen Foli, Karina Wold, Joshua Fendelander","doi":"10.1016/j.japh.2025.102387","DOIUrl":"10.1016/j.japh.2025.102387","url":null,"abstract":"<p><strong>Background: </strong>Sulfonylureas are a high-risk medication in the elderly due to risk of hypoglycemia. Given the continued use of these low-cost medications in elderly patients over recent decades and guideline recommendations for individualized glycosylated hemoglobin (A1c) goals in the elderly, opportunities exist to reduce use in patients with well-controlled diabetes. Hypoglycemia is a costly and potentially deadly adverse effect of inappropriate treatment with sulfonylureas in older adults.</p><p><strong>Objectives: </strong>To decrease hypoglycemia risk with a clinical pharmacist-led intervention by systematically deprescribing sulfonylureas in a cohort of elderly patients.</p><p><strong>Methods: </strong>Patients in a managed care setting aged ≥ 80 years with a tightly controlled A1c (≤ 6.5%) and a sulfonylurea pharmacy claim in the previous 120 days were identified as candidates for deprescribing. Medical data were reviewed to determine the clinical appropriateness of sulfonylurea discontinuation for each patient. Physicians were contacted to consider deprescribing based on pertinent clinical characteristics of identified patients, current guideline recommendations, and rationale for deprescribing.</p><p><strong>Results: </strong>Eighty-nine patients were identified as candidates for discontinuation. Of these, sulfonylurea was discontinued in 41% (n = 37) of patients following pharmacist intervention. Average A1c following intervention remained within generalized guideline goals.</p><p><strong>Conclusion: </strong>Pharmacist-led interventions can facilitate successful deprescribing by providing systematic guidance, medication therapy expertise, and collaborative decision-making support for physicians.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102387"},"PeriodicalIF":2.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674774","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}