Journal of the American Pharmacists Association最新文献

{"title":"Use of glucagon-like peptide 1 receptor agonist to sustain patients off basal-bolus insulin regimens","authors":"Lauren Blumenfeld,&nbsp;Jillian Morgan,&nbsp;Timothy C. Morgan,&nbsp;Ashley M. Thomas","doi":"10.1016/j.japh.2024.102288","DOIUrl":"10.1016/j.japh.2024.102288","url":null,"abstract":"<div><h3>Background</h3><div>The 2024 Standards of Care in Diabetes recommend initiation of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) prior to starting basal insulin and to reconsider initiating a GLP-1 RA before starting bolus insulin if not already initiated. GLP-1 RA addition leads to improved glycemic benefits as well as risk reduction of cardiovascular and renal outcomes in patients with a history of these events. While there is evidence demonstrating the trends of insulin reduction or discontinuation following GLP-1 RA initiation, data regarding longer-term durability of GLP-1 RA use to sustain patients off bolus insulin are lacking.</div></div><div><h3>Objective</h3><div>This retrospective study aimed to assess the percentage of patients remaining off bolus insulin after transitioning from a basal-bolus regimen to GLP-1 RA therapy with basal insulin over a period of 3 years.</div></div><div><h3>Methods</h3><div>We conducted a single centered, retrospective study analyzing patient data from July 2018 through July 2023. Patients were included if they had a diagnosis of type 2 diabetes, were on a basal-bolus insulin regimen, had a GLP-1 RA initiated followed by bolus insulin discontinuation within 90 days, and remained on a GLP-1 RA for at least 6 months. The primary outcome was the percentage of patients who were sustained off bolus insulin after 3 years following GLP-1 RA initiation.</div></div><div><h3>Results</h3><div>There were 252 patients included. At 3 years, 82.6% of patients were sustained off bolus insulin. The mean change in weight at 3 years was −8.5 kg. The mean A1c initially decreased from 8.6% to 7.8%, but then increased slightly to 8.1% at the end of the study timeframe.</div></div><div><h3>Conclusion</h3><div>This trial demonstrated the majority of patients on basal-bolus regimens where bolus insulin was replaced with a GLP-1 RA were sustained off bolus insulin for a 3 year period of time. These results highlight the promising durability of converting bolus insulin to GLP-1 RAs.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102288"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631458","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":"Alabama community pharmacists’ knowledge and perceptions regarding fentanyl test strips: A cross-sectional survey","authors":"Shannon Woods,&nbsp;Erin Blythe,&nbsp;Giovanna Valle-Ramos,&nbsp;Jessica Richardson,&nbsp;Karen Pham,&nbsp;Kavon Diggs,&nbsp;Klaudia Harris,&nbsp;Yi Zhao,&nbsp;Lindsey Hohmann","doi":"10.1016/j.japh.2024.102148","DOIUrl":"10.1016/j.japh.2024.102148","url":null,"abstract":"<div><h3>Background</h3><div>Fentanyl test strips (FTS) are used to detect the presence of fentanyl in other substances, but Alabama pharmacists’ opinions regarding FTS provision are unknown.</div></div><div><h3>Objective</h3><div>The purpose of this study was to assess the knowledge and perceptions of Alabama pharmacists regarding FTS and factors influencing pharmacists’ FTS provision intentions across community pharmacy locations and types.</div></div><div><h3>Methods</h3><div>An anonymous cross-sectional survey was distributed via email to Alabama pharmacists employed in community (retail) pharmacies. The survey consisted of multiple-choice questions and 5-point Likert-type scales (1 = strongly disagree, 5 = strongly agree) informed by the Theory of Planned Behavior. Primary outcome measures included: knowledge; general attitudes; perceived benefits; perceived barriers; self-efficacy; subjective norms; perceived behavioral control (PBC); and intention regarding FTS provision. Outcomes were characterized using descriptive statistics and differences in scales scores across pharmacy locations (rural vs. urban) and types (corporately-vs. independently-owned) were assessed using Mann-Whitney U tests. Predictors of FTS provision intentions were evaluated using multiple linear regression (alpha=0.05).</div></div><div><h3>Results</h3><div>Respondents (N = 131; 3.82% response rate) were mostly female (64%) and Caucasian (92%). No respondents stocked FTS at their pharmacy and knowledge about FTS was low (mean[SD] knowledge score: 58.7% [15.1]). Despite the existence of perceived barriers (mean [SD] scale score: 3.2 [0.6]), pharmacists’ general attitudes (3.4 [0.5]), perceived benefits (3.7 [0.6]), self-efficacy (3.1 [0.8]), and intentions (3.2[0.7]) were positive. While subjective norms were positive (3.5[0.6]), PBC over FTS decision-making was negative (2.7[0.8]). Subjective norms were higher (<em>P</em> = 0.040) and PBC was lower (<em>P</em> &lt; 0.001) amongst corporately-versus independently-owned pharmacies, but no differences existed between rural and urban locations for any measures. Additionally, perceived benefits (β=0.342, <em>P</em> = 0.002), PBC (β = 0.133, <em>P</em> = 0.045), and self-efficacy (β = 0.142, <em>P</em> = 0.034) were positive predictors and perceived barriers (β = −0.211, <em>P</em> = 0.029) was a negative predictor of intention.</div></div><div><h3>Conclusion</h3><div>Alabama community pharmacists have positive attitudes regarding FTS, but future research should focus on strategies to increase PBC and overcome perceived barriers.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102148"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447481","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":"Implementing a telemedicine-led heart failure medication regimen optimization clinic in medically underserved heart failure populations","authors":"Kazuhiko Kido,&nbsp;Wei Fang,&nbsp;Kimberly Becher,&nbsp;Brittany Carey,&nbsp;George Sokos","doi":"10.1016/j.japh.2024.102309","DOIUrl":"10.1016/j.japh.2024.102309","url":null,"abstract":"<div><h3>Background</h3><div>Suboptimal guideline-directed medical therapy (GDMT) management for heart failure (HF) is a critical issue in rural communities. Most patients with HF in rural communities are treated in primary care settings. Multidisciplinary telemedicine-led HF medication optimization clinics were implemented to improve access to specialty care and address health disparities in HF care in rural Appalachian areas.</div></div><div><h3>Objectives</h3><div>The project aimed to evaluate the effect of a multidisciplinary telemedicine HF medication optimization clinic on the use of GDMT in cardiology and primary care services.</div></div><div><h3>Methods</h3><div>This pilot study was a multicenter prospective cohort study over a 6-month follow-up period. Patients aged &gt; 18 years with HF with reduced ejection fraction or HF with mildly reduced ejection fraction were included. Telemedicine visits were conducted every 2 to 4 weeks. The primary outcome was the use of all 4 GDMT classes.</div></div><div><h3>Results</h3><div>The use of all 4 GDMT agents was numerically higher in HF cardiology service (n = 70) than the general cardiology cohort (n = 11) at baseline (46% vs. 9%), 1 month (55% vs. 18%), 3 months (58% vs. 18%), and 6 months (52% vs. 18%). The individual use of angiotensin receptor neprilysin inhibitor (ARNI), mineralocorticoid receptor antagonist (MRA), or sodium-glucose cotransporter 2 inhibitor (SGLT2I) was also numerically higher in HF cardiology service over 6 months. In the primary care service (n = 25), the use of all 4 GDMT agents was not significantly changed over 6 months. ARNI and beta-blocker use was numerically increased from the baseline to follow-up periods. MRA use was numerically decreased from baseline to follow-up periods. SGLT2I use was not significantly changed.</div></div><div><h3>Conclusion</h3><div>The multidisciplinary telemedicine approach was effective in the HF service group for GDMT optimization. However, further academic detailing for primary care and general cardiology services is needed, focusing on the initiation and persistence of MRA and SGLT2I and dose titration of GDMT agents.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102309"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839739","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":"Accuracy and applicability of a tool designed to address pharmacy personnel stress","authors":"Jon C. Schommer,&nbsp;Paul D. Tieger,&nbsp;Anthony W. Olson,&nbsp;SuHak Lee,&nbsp;Gavin Wilson","doi":"10.1016/j.japh.2024.102296","DOIUrl":"10.1016/j.japh.2024.102296","url":null,"abstract":"<div><h3>Background</h3><div>Many pharmacy workplaces are so stressful that pharmacy personnel are unable to meet both clinical and nonclinical duties. Adjustments to training, roles, and responsibilities are not able to be made quickly enough to adapt to change and meet expanding responsibilities.</div></div><div><h3>Objectives</h3><div>Misalignment between a person’s unique personality type and their work dynamics can be associated with a stress reaction, what that reaction looks like, and what strategies would be most effective for reducing stress. The objectives for this study were to: (1) assess variability in the personality types of pharmacy personnel, (2) explore variation in most satisfying job activities and perceptions of stress by personality type, and (3) receive feedback regarding the accuracy, applicability, and recommendations for improving a tool for addressing stress.</div></div><div><h3>Methods</h3><div>A self-administered online questionnaire was used for collecting data from 1098 pharmacy personnel licensed in Minnesota. After answering four Preferred Communication Style Questionnaire items, a personalized De-Stress Rx report was generated for each respondent’s feedback by answering questions about the tool’s accuracy, applicability to them for helping reduce or manage stress, and recommendations for improving its usefulness. Data were analyzed using content analysis and descriptive statistics.</div></div><div><h3>Results</h3><div>The findings showed variability in the personality types of pharmacy personnel and that both the most satisfying job activities and stress perceptions vary by personality type. A tool that was designed to address pharmacy personnel stress was found to be both accurate and applicable. Study participants encouraged the expansion of the tool to include resources for follow-up and implementation. Also, they recommended expansion to teach groups and leaders about how to apply this tool to whole organizations, group dynamics, and evolving practice settings.</div></div><div><h3>Conclusion</h3><div>We propose that the De-Stress Rx Tool can help reduce the stress that is inherent in current pharmacy work settings.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102296"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacy 2050: A new clinical and patient experience","authors":"George Bernard Van Antwerp Jr.","doi":"10.1016/j.japh.2024.102290","DOIUrl":"10.1016/j.japh.2024.102290","url":null,"abstract":"<div><div>With the changing demographics of the U.S. population and evolving shift in urban design, the physical experience at the community level will change how health care is delivered. This will allow for more personalized and localized care complemented by digital technologies and smart devices over the next 25 years. At the same time, the evolution of clinical research with prevention, vaccinations, 3-dimensional printing, drone delivery, clustered interspaced short palindromic repeats, and implantables, will change the pharmaceutical landscape.</div><div>Pharmacists and pharmacies have an opportunity to evolve with these changes making their role an integral part of the care team, but it is important that regulations and reimbursement also change. By 2050, pharmacists may play very different roles from clinical specialists to digital coaches and use data, artificial intelligence, and technology to help drive outcomes whereas robots and technology automate many of their current repetitive tasks.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102290"},"PeriodicalIF":2.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631356","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":"Bringing providers into the community pharmacy: Experiential education","authors":"Rebecca M. Lahrman","doi":"10.1016/j.japh.2024.102276","DOIUrl":"10.1016/j.japh.2024.102276","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102276"},"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":"Natalie D. Crawford,&nbsp;Kristin R.V. Harrington,&nbsp;Christina Chandra,&nbsp;Daniel I. Alohan,&nbsp;Alvan Quamina,&nbsp;Omarri Beck,&nbsp;Henry N. Young","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":"64 6","pages":"Article 102239"},"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":"Diana D. Martínez-Nava BA, BS","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":"64 6","pages":"Article 102269"},"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":"Heather A. Johnson PharmD, BCACP","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":"64 6","pages":"Article 102267"},"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":"Aleda M.H. Chen PharmD, PhD, MS, FAPhA","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":"64 6","pages":"Article 102268"},"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}