Journal of the American Pharmacists Association最新文献

{"title":"Cover","authors":"","doi":"10.1016/S1544-3191(25)00056-1","DOIUrl":"10.1016/S1544-3191(25)00056-1","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102377"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593392","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":"Marginal health care expenditures and health-related quality of life burden in patients with osteoporosis in the United States","authors":"Prajakta P. Masurkar,&nbsp;Sanika Rege","doi":"10.1016/j.japh.2024.102315","DOIUrl":"10.1016/j.japh.2024.102315","url":null,"abstract":"<div><h3>Background</h3><div>Osteoporosis, marked by reduced bone density, significantly impacts quality of life. Recent estimates on its economic and humanistic burden in the United States are scarce.</div></div><div><h3>Objective</h3><div>To evaluate the marginal burden of osteoporosis on total all-cause health care costs and health-related quality of life (HRQoL) in the United States.</div></div><div><h3>Methods</h3><div>This retrospective cross-sectional study utilized 2019–2021 Medical Expenditure Panel Survey data, including adults aged ≥50 years with or without osteoporosis. HRQoL was assessed using physical component summary (PCS) and mental component summary (MCS) scores. Descriptive analyses reported sociodemographic/clinical characteristics, healthcare expenditures, and PCS/MCS scores. A two-part model assessed the marginal effect of osteoporosis on total healthcare expenditures. Multivariable generalized linear model (GLM) estimated the marginal differences in MCS and PCS scores between the osteoporosis and nonosteoporosis groups, while multivariable linear regression assessed factors associated with HRQoL among patients with osteoporosis.</div></div><div><h3>Results</h3><div>There were approximately 2.89 million patients with osteoporosis and 25 million without osteoporosis. The marginal total health care expenditures were $8572.15 (95% CI: $6546.39–$14,597.92) higher for the osteoporosis Vs. nonosteoporosis group. Age, sex, marital status, year, and certain comorbidities were significant predictors of HRQoL among osteoporosis patients. Multivariable GLM indicated PCS scores were 6.29 units lower (95% CI: −7.08 to −4.15) and MCS scores were 4.22 units lower (95% CI: −8.34 to −3.31) among osteoporosis Vs. nonosteoporosis patients.</div></div><div><h3>Conclusion</h3><div>Patients with osteoporosis showed higher economic burden and lower HRQoL than those without, highlighting the need for policy changes and innovative approaches to improve HRQoL and reduce healthcare expenses for osteoporosis management.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102315"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873365","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":"Barriers to and facilitators of buprenorphine dispensing for opioid use disorder: Evidence from focus groups in Appalachian Kentucky","authors":"Douglas R. Oyler,&nbsp;Dustin K. Miracle,&nbsp;Hannah Hesener,&nbsp;Laura Stinson,&nbsp;Monica Roberts,&nbsp;Adrienne Matson,&nbsp;Patricia R. Freeman","doi":"10.1016/j.japh.2024.102308","DOIUrl":"10.1016/j.japh.2024.102308","url":null,"abstract":"<div><h3>Background</h3><div>As efforts to increase buprenorphine prescribing continue to intensify, pharmacy dispensing plays an important role in access to essential medications for opioid use disorder. Existing survey research suggests stigma and regulatory concerns are barriers to pharmacists dispensing buprenorphine, but facilitators are less clear, as are in-depth perceptions of pharmacists regarding buprenorphine.</div></div><div><h3>Objective</h3><div>To assess barriers and facilitators to buprenorphine dispensing in Appalachian Kentucky using a series of focus groups with pharmacy employees.</div></div><div><h3>Methods</h3><div>Between September and October 2023, 5 structured focus groups were conducted with a total of 19 pharmacists and pharmacy technicians across a mixture of high- and low-buprenorphine-dispensing counties. Investigators independently coded focus group transcriptions using a grounded theory approach to describe current dispensing practices as well as barriers to and facilitators of buprenorphine dispensing.</div></div><div><h3>Results</h3><div>Most participants described dispensing buprenorphine, but there was substantial variation in dispensing practices. Participants identified patient-, provider-, pharmacy-, regulatory-and medication-related barriers to and patient-, provider-, pharmacy-, and regulatory-related facilitators of pharmacy dispensing. Patient- and provider-related barriers accounted for over half of barriers identified. The most common facilitators were also patient- and provider-related.</div></div><div><h3>Conclusion</h3><div>In a series of 5 focus groups with pharmacy staff in Appalachian Kentucky, the most common barriers to buprenorphine dispensing were patient and provider behaviors. Patient stories were the most common facilitators. Interventions to increase pharmacy buprenorphine dispensing should focus on addressing misperceptions regarding behavior, preferably driven by positive patient testimony.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102308"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792703","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 United States and leveraging community pharmacies for expansion","authors":"Jacinda Tran,&nbsp;Anu Mishra,&nbsp;Marita Zimmermann,&nbsp;Ryan Hansen","doi":"10.1016/j.japh.2024.102274","DOIUrl":"10.1016/j.japh.2024.102274","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>We identified census tracts with limited or no access (“deserts”) to PrEP facilities and community pharmacies in 2022 using 2 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, 2 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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102274"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","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":"Assessment and categorization of medication errors in a veterinary teaching hospital.","authors":"Jessica A Barazowski, Lauren R Forsythe, Alexandria E Gochenauer","doi":"10.1016/j.japh.2025.102362","DOIUrl":"10.1016/j.japh.2025.102362","url":null,"abstract":"<p><strong>Background: </strong>Medication errors are one of the most common types of errors in health care; however, similar data are limited to veterinary institutions. Pharmacists are not always present in veterinary hospitals. Therefore, all staff members actively engaged in the dispensation of medications must be aware of the high incidence of medication errors.</p><p><strong>Objectives: </strong>This study aimed to quantify the amount of and assess the types of medication errors that occur frequently within a veterinary teaching hospital (including both large and small animal patients), identify the specific medications that are most often involved in these errors, and determine whether the inclusion of pharmacist chart review decreases the number of medication error incident reports.</p><p><strong>Methods: </strong>Incident reports between July 2019 and March 2023 and pharmacist chart review documents between September 2022 and March 2023 were collected and reviewed. The total number of incidents was quantified and the incidents were categorized according to the type of error and medication involved. The number of incidents was compared for the period before and after the implementation of pharmacist chart review.</p><p><strong>Results: </strong>Between July 2019 and March 2023, medication errors accounted for 66% (n = 685) of all incident reports (n = 1031), and of those medication errors, 51% (n = 351 of n = 685) were errors caused by an incorrect dose. Gabapentin, methadone, and butorphanol were the most common medications cited in medication error incident reports. Incident reports containing medication errors reduced after the implementation of pharmacist chart review from 62% (n = 352) to 48% (n = 240) (P = 0.0504).</p><p><strong>Conclusion: </strong>Although not statistically significant, the results of this study indicated that the inclusion of daily pharmacist chart reviews may lead to a decrease in submitted medication error incident reports, warranting further study.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102362"},"PeriodicalIF":2.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525189","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":"Bibliometric analysis of United States and global obstetrical pharmacy literature from 1994 to 2023.","authors":"Stephen M Small","doi":"10.1016/j.japh.2025.102345","DOIUrl":"10.1016/j.japh.2025.102345","url":null,"abstract":"<p><strong>Background: </strong>Federal research policy in the U.S. changed in the early 1990s to include more pregnant patients in clinical research. However, pregnancy outcomes in the United States have gradually declined over the past few decades. Little research has been conducted to characterize U.S. obstetrical pharmacy publications and compare them with global trends.</p><p><strong>Objectives: </strong>This study aimed to measure the volume and types of U.S. and non-U.S. obstetrical pharmacy literature over 30 years to characterize research in this specialty. The secondary objectives included measuring trends in authorship and citations and performing a text-mining analysis of obstetrical pharmacy publications.</p><p><strong>Methods: </strong>This bibliometric analysis used the Web of Science database to identify obstetrical pharmacy documents published between 1994 and 2023 in the United States and non-U.S. countries. Articles were included if they contained obstetrical or pregnancy topics and were within the pharmacy and pharmacology research areas. Data on document types, citations, authors, and common words were collected and analyzed using descriptive statistics.</p><p><strong>Results: </strong>A total of 12,190 obstetrical pharmacy documents met the inclusion criteria, representing only 2.8% of global obstetrical publications. The United States had the most documents (29.6%), followed by China (10.7%), Italy (5%), the United Kingdom (3.2%), and Canada (3.2%). U.S. and non-U.S. documents increased exponentially (R² = 0.9485 and 0.979, respectively) over the 30 years. Text-mining analysis showed that both groups had common research topics and interests.</p><p><strong>Conclusion: </strong>Pharmacy documents represent a small proportion of obstetrical publications amidst worsening maternal outcomes in the United States. Despite the exponential growth in obstetrical publication frequency, the overall contribution from the United States is at risk of being superseded by that of China. High international collaboration and citations of U.S. documents may provide opportunities to increase future scientific production in this area and improve patient outcomes.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102345"},"PeriodicalIF":2.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426497","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":"Ambulatory care pharmacy specialty training","authors":"Raechel T. White,&nbsp;Kevin Cowart,&nbsp;Nicholas W. Carris","doi":"10.1016/j.japh.2024.102137","DOIUrl":"10.1016/j.japh.2024.102137","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102137"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288830","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":"Evaluating a generative artificial intelligence accuracy in providing medication instructions from smartphone images","authors":"Yusef Yassin,&nbsp;Thien Nguyen,&nbsp;Krishna Panchal,&nbsp;Katharine Getchell,&nbsp;Timothy Aungst","doi":"10.1016/j.japh.2024.102284","DOIUrl":"10.1016/j.japh.2024.102284","url":null,"abstract":"<div><h3>Background</h3><div>The Food and Drug Administration mandates patient labeling materials like the Medication Guide (MG) and Instructions for Use (IFU) to support appropriate medication use. However, challenges such as low health literacy and difficulties navigating these materials may lead to incorrect medication usage, resulting in therapy failure or adverse outcomes. The rise of generative AI, presents an opportunity to provide scalable, personalized patient education through image recognition and text generation.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the accuracy and safety of medication instructions generated by ChatGPT based on user-provided drug images, compared to the manufacturer's standard instructions.</div></div><div><h3>Methods</h3><div>Images of 12 medications requiring multiple steps for administration were uploaded to ChatGPT's image recognition function. ChatGPT's responses were compared to the official IFU and MG using text classifiers, Count Vectorization (CountVec), and Term Frequency-Inverse Document Frequency (TF-IDF). The clinical accuracy was further evaluated by independent pharmacists to determine if ChatGPT responses were valid for patient instruction.</div></div><div><h3>Results</h3><div>ChatGPT correctly identified all medications and generated patient instructions. CountVec outperformed TF-IDF in text similarity analysis, with an average similarity score of 76%. However, clinical evaluation revealed significant gaps in the instructions, particularly for complex administration routes, where ChatGPT's guidance lacked essential details, leading to lower clinical accuracy scores.</div></div><div><h3>Conclusion</h3><div>While ChatGPT shows promise in generating patient-friendly medication instructions, its effectiveness varies based on the complexity of the medication. The findings underscore the need for further refinement and clinical oversight to ensure the safety and accuracy of AI-generated medical guidance, particularly for medications with complex administration processes.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102284"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607318","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":"Real-world treatment patterns in drug naïve type 2 diabetes population: Initial combination therapy vs. sequential step-therapy","authors":"Zahra Majd,&nbsp;Hua Chen,&nbsp;Michael L. Johnson,&nbsp;Kim K. Birtcher,&nbsp;Omar Serna,&nbsp;Susan Abughosh","doi":"10.1016/j.japh.2024.102295","DOIUrl":"10.1016/j.japh.2024.102295","url":null,"abstract":"<div><h3>Background</h3><div>Despite evidence-based guidelines and available therapies, many patients with type 2 diabetes (T2D) have suboptimal glycemic control. The current standard of care suggests initial monotherapy followed by add-on therapy to achieve and maintain target HbA1c. However, clinical trials revealed that intensive glycemic control, especially at the early stages of the disease, could result in earlier and better long-term glycemic control in addition to reducing diabetes-related complications and mortality risk.</div></div><div><h3>Objective</h3><div>This population-based study aimed to investigate treatment initiation patterns among newly diagnosed drug-naïve patients with T2D in real-world clinical settings, focusing on two recommended approaches: initial combination therapy and step-therapy.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted using claims data from the Merative MarketScan Research Databases between 2017 and 2019. The study included drug-naïve patients with T2D with continuous enrollment in medical and pharmacy plans. Patients were categorized into the initial combination therapy or step-therapy cohorts based on their initial treatment regimen. Baseline characteristics of the cohorts were recorded, and logistic regression analysis was performed to identify factors associated with receiving each approach.</div></div><div><h3>Results</h3><div>The study included a total of 117,419 patients in the Commercial/Medicare population and 18,574 patients in the Medicaid population. About 10% to 12% of patients received initial combination therapy as their initial pharmacotherapy regimen. Several patient demographic and clinical characteristics were significantly associated with the use of initial combination therapy vs. step-therapy. Results also showed a greater usage of loose-dose combination pills over fixed-dose combinations.</div></div><div><h3>Conclusion</h3><div>Given the lack of real-world studies on combination vs. step-therapy, the study findings provide insights into the current treatment initiation patterns and associated factors among drug-naïve patients with T2D. These findings contribute to understanding the real-world clinical practices in diabetes management and may help guide clinicians in making informed decisions regarding pharmacotherapy approaches.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102295"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631395","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":"Mental health in rural agricultural workers: The role of a community pharmacist","authors":"Grayson Murray,&nbsp;Melissa McKnight,&nbsp;Tyler C. Melton","doi":"10.1016/j.japh.2024.102316","DOIUrl":"10.1016/j.japh.2024.102316","url":null,"abstract":"<div><div>Agriculture is one of the United States’ oldest occupations, dating back to before the founding of the country, when indigenous farmers maintained the land. Agriculture has since grown into an enormous industry, and with that has come financial and emotional strain impacting the mental health of those who strive to feed the world. Climate, financial, and stress-inducing conditions related to agriculture are leading causes of mental health crises in agricultural workers, putting this population at risk for suicidal ideation. With most farms being family-owned and operated in rural areas of the country, there is limited access to health care to address the mental health concerns occurring within the occupation.</div><div>Community pharmacists are ideally positioned to bridge the mental health care gap in small-town America. By obtaining training in Mental Health First Aid and becoming equipped with mental health care knowledge, community pharmacists can aid in crisis situations, refer to proper care and support systems, and aid in early intervention with the at-risk agricultural population. By doing so, community pharmacists can strengthen their role as the most accessible health care professionals and gain recognition from a population that often finds it difficult to ask for help in situations related to their mental health. This commentary provides a review of signs and symptoms of psychiatric disorders, early mental health interventions and screening tools, and mental health resources available for pharmacist use. These considerations are necessary to support and inform community pharmacy practice when serving rural agricultural communities.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102316"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865983","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}