Journal of the American Pharmacists Association最新文献

{"title":"Personalized patient education to improve CGM health literacy","authors":"Nathan T. Vo BSPS, Michelle S. Gonsalves BSPS, Amy C. Donihi PharmD, Lucas A. Berenbrok PharmD, MS","doi":"10.1016/j.japh.2024.102189","DOIUrl":"10.1016/j.japh.2024.102189","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102189"},"PeriodicalIF":2.5,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735528","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":"Empowering and educating the next generation of pharmacists through children’s books: A quality assurance initiative","authors":"Shay Roth,&nbsp;Rhea Bowman,&nbsp;Randall Smith,&nbsp;Ashley Yarabinec","doi":"10.1016/j.japh.2024.102190","DOIUrl":"10.1016/j.japh.2024.102190","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of this quality assurance initiative was to internally measure children’s perceptions of the book, “All Aboard the Rx-Express!” and knowledge gained from its content.</p></div><div><h3>Methods</h3><p>This pharmacy-focused children’s book was read to elementary-age youth at a rural, Pennsylvania elementary school in the Spring of 2022. A brief, optional, anonymous prepost survey was administered to the youth before and after the reading to measure the book’s impact on third through fifth graders’ perceptions and knowledge of the pharmacy profession. Descriptive statistics, chi squared analysis, independent samples t-tests, and one sample proportions tests were used to analyze survey responses.</p></div><div><h3>Results</h3><p>One hundred ninety-one students participated in the presurvey to assess baseline knowledge about the pharmacy profession before the book was read. One hundred eighty-five students answered the postsurvey. Prepost respondent demographics were collected in aggregate and were not significantly different between the pre- and postcohorts. Survey results demonstrated an increase in all questions that asked about students’ perceptions of pharmacists and the profession, and students reported favorable perceptions of the book itself.</p></div><div><h3>Conclusion</h3><p>Early interventions such as this can increase elementary-age youth’s perceptions and knowledge of the roles of pharmacists. Future work in early intervention will be needed to increase interest in the profession and admissions to pharmacy schools.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102190"},"PeriodicalIF":2.5,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735527","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 initiated interventions using RxChange message communication with prescribers for electronic prescriptions: A retrospective descriptive study","authors":"Jun Gong,&nbsp;Yifan Zheng,&nbsp;Corey A. Lester","doi":"10.1016/j.japh.2024.102188","DOIUrl":"10.1016/j.japh.2024.102188","url":null,"abstract":"<div><h3>Background</h3><p>RxChange messages improve patient medication management by enhancing pharmacist-prescriber communication, but their usage patterns in the United States are not well-documented.</p></div><div><h3>Objective</h3><p>To determine intervention characteristics by pharmacists and prescribers using RxChange messages.</p></div><div><h3>Methods</h3><p>A retrospective analysis of electronic prescription and RxChange messages from 2022 to 2023, using data from Surescripts, LLC, was conducted. This included NewRx messages and RxChange Responses, categorized by 7 RxChange use cases and Anatomical Therapeutic Chemical level 4 medication classes. Descriptive statistics and nonparametric tests were used for statistical analysis.</p></div><div><h3>Results</h3><p>The study analyzed 1,361,528 RxChange messages. Therapeutic interchange was the predominant use case (76.14%). Direct approvals accounted for 10.44% of requests, approvals with changes for 42.55%, and denials for 47.01%. Script clarification had the highest approval rate (64.21%), while prior authorization faced the most frequent denials (73.38%). The top denial reason was \"Request addressed through alternate methods such as phone or fax (41.50%).” The most frequent drug classes observed in the data were selective beta-2 adrenoreceptor agonists, extended-spectrum penicillins, selective serotonin reuptake inhibitors, and glucagon-like peptide 1 analogues. Time from new e-prescription issuance to RxChange request submission was longer than from request to response, with a significant statistical difference (median 1.57 vs 0.27 days, <em>P</em>-value &lt; 0.05).</p></div><div><h3>Conclusion</h3><p>This study highlights interventions pharmacists make using RxChange with electronic prescriptions to improve patient care and medication safety. It underlined the need for improved RxChange message content and data on the effectiveness of RxChange messages in improving medication use.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102188"},"PeriodicalIF":2.5,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728053","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 roles in the medication use Process: Qualitative analysis of stakeholder perceptions","authors":"Eunhee Kim,&nbsp;Marcia M. Worley,&nbsp;Samantha Yum,&nbsp;Anandi V. Law","doi":"10.1016/j.japh.2024.102186","DOIUrl":"10.1016/j.japh.2024.102186","url":null,"abstract":"<div><h3>Background</h3><p>Pharmacist roles in the Medication Use Process (MUP) have advanced along with new healthcare delivery models and interprofessional collaborative practice. It is unclear whether stakeholder perceptions of pharmacist roles have evolved simultaneously.</p></div><div><h3>Objectives</h3><p>Examine patient, pharmacist, and physician perceptions of pharmacist roles in the MUP.</p></div><div><h3>Methods</h3><p>This institutional review board-approved study used a cross-sectional design with Qualtrics panels of patients, pharmacists, and physicians. Role Theory was used as a framework to develop 12-item surveys to study pharmacist role perceptions in the MUP: prescribing, transcribing, dispensing, administration, and monitoring. Content analysis was performed on the responses to open-ended questions.</p></div><div><h3>Results</h3><p>From 1004 patients, a total of 7217 comments were obtained on 9 questions (740-1004 comments), resulting in an average of 802 comments per question or 0.8 comments per question per respondent (CQR). Similarly, 1620 comments from 205 pharmacists on 11 questions (121-205 comments) averaged 0.72 CQR; and 1561 comments from 200 physicians on 11 questions (136-200 comments) equated to 0.74 CQR. Content analysis revealed recurring themes across the stakeholders: “pharmacists,” “physicians,” “insurance,” “technology,” “collaboration,” “time,” “communication,” and “patient’s responsibility.” Some role congruence was seen regarding pharmacist roles by all 3 stakeholders; noting pharmacist roles in improving all steps of the MUP, except <em>transcribing</em>. Pharmacists highlighted professional challenges such as staffing issues, burnout, and competing demands; which were not acknowledged by patients and physicians indicating the need to increase awareness.</p></div><div><h3>Conclusion</h3><p>This study showed increased visibility and awareness of pharmacist roles in the MUP by all stakeholders, compared to previous research showing pharmacist roles limited to dispensing. Known barriers to pharmacy practice such as lack of provider status and reimbursement were not reported by any of the stakeholders in this study. There is a need to continuously inform stakeholders about pharmacists’ expanding roles in the MUP through advocacy and marketing.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102186"},"PeriodicalIF":2.5,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1544319124002061/pdfft?md5=76605327120622d4e76ef7a316cca0b1&pid=1-s2.0-S1544319124002061-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trust in information sources during the COVID-19 pandemic and its association with vaccine trust among a sample of Hispanic adults","authors":"","doi":"10.1016/j.japh.2024.102184","DOIUrl":"10.1016/j.japh.2024.102184","url":null,"abstract":"<div><h3>Background</h3><p>Public response to the COVID-19 pandemic has underscored the importance of trust, particularly among minority populations. Several factors might affect vaccine safety trust, including source trustworthiness. Using data from the Puerto Rico Community Engagement Alliance, we assessed the association between trust in information sources and the COVID-19 vaccine in a sample of Hispanic adults.</p></div><div><h3>Methods</h3><p>A cross-sectional survey-based study was conducted from November 2021 to March 2022. Participants were telephone-interviewed to assess sociodemographic, clinical, and COVID-19-related variables. Vaccine trust was assessed by how confident respondents were regarding COVID-19 vaccine safety. Trust in COVID-19 information sources was assessed by asking respondents how much they trusted selected sources of information to provide accurate information about COVID-19, including the US and Puerto Rico governments, Centers for Disease Control and Prevention (CDC), health care professionals, and traditional media (television/radio/newspaper/internet). Logistic regression models estimated the odds ratio (OR, 95% CI) of COVID-19 vaccine trust based on trust in information sources.</p></div><div><h3>Results</h3><p>A total of 200 adults aged ≥21 years completed the telephone interview. While most of the study sample (97.5%) had been inoculated with at least 1 dose of the COVID-19 vaccine, 86% trusted in the COVID-19 vaccine’s safety. After adjusting for age and sex, participants who attested greater trust in their health care professionals (odds ratio [OR] = 1.99, 95% confidence interval [CI] = 0.71, 5.62), the US government (OR = 2.44, 95% CI = 0.69, 8.68), and the CDC (OR = 8.18, 95% CI = 2.97, 22.57) reported increased vaccine trust as compared to those not having great confidence in these entities.</p></div><div><h3>Conclusion</h3><p>These findings support that trust in information provided by the CDC is positively associated with COVID-19 vaccine trust. Acknowledging predictors of trust regarding COVID-19 vaccination could help address factors that affect vaccine confidence. In turn, it strengthens COVID-19 prevention efforts, benefiting common welfare, reducing health disparities, and aiding underserved populations.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102184"},"PeriodicalIF":2.5,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591871","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":"Suppressed thyroid stimulating hormone levels after initiation of a subcutaneous glucagon-like peptide-1 receptor agonist in a post-thyroidectomy patient managed with levothyroxine case report","authors":"","doi":"10.1016/j.japh.2024.102185","DOIUrl":"10.1016/j.japh.2024.102185","url":null,"abstract":"<div><h3>Objectives</h3><div>Glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy has demonstrated an increased risk of thyroid C-cell hyperplasia and C-cell tumors in rodents. Due to this risk, a boxed warning for this drug class exists for people with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2. There is a lack of data regarding any possible effect of GLP-1 RA therapy on serum thyroid levels. The objective of this case report is to describe a case of suppressed thyroid stimulating hormone levels after initiation of a subcutaneous semaglutide in a post-total thyroidectomy patient managed with levothyroxine in order to highlight the need for closer monitoring of these patients and further research in this area.</div></div><div><h3>Case Summary</h3><div>The patient described in the case underwent a total thyroidectomy in 2015 with stable thyroid hormone replacement requirements with levothyroxine for 5 years until the initiation and titration of subcutaneous semaglutide. The reduction in thyroid stimulating hormone (TSH) after starting GLP-1 RA therapy necessitated a 25 percent dose reduction of levothyroxine from her original dose.</div></div><div><h3>Practice implications</h3><div>This patient experienced suppressed TSH levels following initiation and titration of subcutaneous semaglutide. The etiology of these changes may be related to the direct effects of GLP-1 RA therapy on TSH levels, changes in absorption related to delayed gastric emptying rates, secondary to GLP-1 RA-associated weight loss, or a combination of these proposed mechanisms. It may be prudent to exercise more frequent monitoring of medications that require weight-based dosing and those with a narrow therapeutic index when initiating and titrating GLP-1 RA-based therapies and is an area of potential study.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102185"},"PeriodicalIF":2.5,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polypharmacy among adults with asthma in the United States, 2005-2020","authors":"","doi":"10.1016/j.japh.2024.102154","DOIUrl":"10.1016/j.japh.2024.102154","url":null,"abstract":"<div><h3>Background</h3><p>Asthma is a chronic disease that often requires medication for control. Polypharmacy remains a major issue to medication adherence; however, its evidence among patients with asthma is limited.</p></div><div><h3>Objectives</h3><p>To evaluate the prevalence and determinants of polypharmacy and its associations with asthma control among adults with asthma in the United States.</p></div><div><h3>Methods</h3><p>Data from the 2005-2020 National Health and Nutrition Examination Survey were used to estimate the weighted prevalence of polypharmacy. Selected variables, including demographics, comorbidities, prescription medications, and asthma-related adverse events, were extracted from the National Health and Nutrition Examination Survey. Multivariable logistic regression was conducted to identify factors associated with polypharmacy. Another two sets of multivariable logistic regression models were employed to further assess the association between polypharmacy and asthma-related adverse events: one for asthma attacks and the other for asthma-related emergency department visits.</p></div><div><h3>Results</h3><p>From 2005 to 2020, polypharmacy prevalence was 34.3% and 14.1% among adults with and without asthma, respectively. Characteristics, including older age (<em>P</em> &lt; 0.01), non-Hispanic blacks (<em>P</em> &lt; 0.01), health insurance coverage (<em>P</em> &lt; 0.01), number of health care visits (<em>P</em> &lt; 0.01), and multiple comorbidities (<em>P</em> &lt; 0.01), were associated with polypharmacy. Polypharmacy was associated with increased risks of having asthma attacks (odds ratio, 1.38; 95% CI, 1.08-1.76) and asthma-related emergency department visits (odds ratio, 1.46; 95% CI, 1.09-1.94) among adults with asthma. Among patients taking at least one asthma medication, risks of asthma attacks, and asthma-related emergency department visits did not differ between those with and without polypharmacy.</p></div><div><h3>Conclusion</h3><p>Approximately one in three adults with asthma experienced polypharmacy in the United States. Disparities existed in several characteristics, highlighting the necessity for appropriate care and policies among vulnerable populations. Further validation on the impact of polypharmacy on asthma control is required.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 5","pages":"Article 102154"},"PeriodicalIF":2.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a North Dakota opioid misuse and overdose prevention program in West Virginia","authors":"","doi":"10.1016/j.japh.2024.102152","DOIUrl":"10.1016/j.japh.2024.102152","url":null,"abstract":"<div><h3>Background</h3><p>Pharmacy has an important role in combating the opioid epidemic. However, there is a need for more consistency of programs and evidence-based practices across the country.</p></div><div><h3>Objectives</h3><p>To describe how an evidence-based opioid misuse and overdose prevention program that originated in North Dakota was implemented in West Virginia and to compare program results between the two states including pharmacist interventions and patient screening for opioid misuse and overdose.</p></div><div><h3>Practice description</h3><p>This advancement in practice took place in participating North Dakota and West Virginia community pharmacies.</p></div><div><h3>Practice innovation</h3><p>An evidence-based program that originated in North Dakota was implemented in West Virginia. The details of this collaboration are outlined in this manuscript.</p></div><div><h3>Evaluation methods</h3><p>Program screening and pharmacist intervention data were collected using DocStation, an online pharmacy patient management platform.</p></div><div><h3>Results</h3><p>Thirty-four pharmacies in West Virginia implemented the program. Between April 2022 and September 2023, a total of 34 West Virginia pharmacies conducted 449 documented screenings compared to 12,105 screenings by 81 pharmacies in North Dakota over the same time. There were differences between the states with regard to the proportion of individuals screened as high-risk for opioid use disorder and individuals at risk of accidental opioid overdose likely attributable to different demographics.</p></div><div><h3>Conclusion</h3><p>An opioid misuse and prevention program was successfully implemented in two states, which can serve as a model to implement similar programs in other pharmacies across the United States.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 5","pages":"Article 102152"},"PeriodicalIF":2.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535794","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":"Actions of the 2024 American Pharmacists Association House of Delegates, Orlando, FL, March 22 – 25, 2024","authors":"","doi":"10.1016/j.japh.2024.102117","DOIUrl":"10.1016/j.japh.2024.102117","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 4","pages":"Article 102117"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1544319124001377/pdfft?md5=88613e2669b4681b0ff64684171003f2&pid=1-s2.0-S1544319124001377-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142228583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost analysis of one-time intravenous antibiotic doses in the emergency department","authors":"","doi":"10.1016/j.japh.2024.102114","DOIUrl":"10.1016/j.japh.2024.102114","url":null,"abstract":"<div><h3>Background</h3><div>Research shows that one-time doses of intravenous (IV) antibiotics do not improve resolution of infection. However, providers continue to use them—especially in the emergency department (ED). Very few studies have aimed to quantify the cost of this practice.</div></div><div><h3>Objectives</h3><div>The primary objective was to evaluate the difference in average total cost of ED stay between patients who received a one-time dose of IV antibiotics in the ED before discharging on oral antibiotics and patients who were just discharged on oral antibiotics. Secondary objectives were to evaluate the differences in durations of stay between the 2 groups, as well as the differences in adverse drug effects and need for health care contact after discharge.</div></div><div><h3>Methods</h3><div>Chart review was conducted to identify patients who received and did not receive a one-time dose of IV antibiotics in the ED between April 30, 2020, and April 30, 2022. A microcosting approach was used to determine ED-associated costs per patient. Comparisons in primary and secondary outcomes were performed using statistical inferential tests.</div></div><div><h3>Results</h3><div>A total of 102 patients were analyzed in each group. Patients who received a one-time dose of IV antibiotics in the ED before being discharged on oral antibiotics had an average length of stay of 4.55 hours, as opposed to patients who did not receive a one-time dose of IV antibiotics before being discharged on oral antibiotics who had an average length of stay of 2.82 hours (absolute difference 1.73 hours, <em>P</em> &lt; 0.001). One-time dosing of IV antibiotics in the ED incurred an additional cost of approximately $556 per patient, totaling to more than $56,000 in our study cohort.</div></div><div><h3>Conclusion</h3><div>The use of one-time IV antibiotics in the ED did not confer any additional benefits to patients. The use of one-time doses resulted in statistically significant reduced throughput in the ED and statistically significant increased health care costs.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 4","pages":"Article 102114"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858720","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}