Journal of the American Pharmacists Association最新文献

{"title":"ADVANCE-ing patient care: Implementation of the academic detailing program Illinois ADVANCE","authors":"Nerissa Caballes,&nbsp;Costadina Aneziris,&nbsp;Steve Hiemenz,&nbsp;Chirag S. Rathod,&nbsp;Brianna McQuade Hudak","doi":"10.1016/j.japh.2025.102904","DOIUrl":"10.1016/j.japh.2025.102904","url":null,"abstract":"<div><h3>Background</h3><div>Academic detailing (AD) is a unique educational resource that provides evidence-based decision-making tools for health care clinicians and is commonly done by pharmacists. Implementation of an AD program requires intentional planning, evaluation, and adaptation.</div></div><div><h3>Objectives</h3><div>This brief report aimed to describe the creation of a pharmacist-led AD program, Illinois ADVANCE (Academic Detailing Visits and New Evidence Center, or ILA), and lessons learned from the process, framed through the 4 phases of the quality implementation framework (QIF), to inform future AD program development.</div></div><div><h3>Methods</h3><div>ILA program implementation is described using the 4 phases of QIF: initial considerations regarding the host setting, creating a structure for implementation, ongoing structure once implementation begins, and improving future applications.</div></div><div><h3>Results</h3><div>The clinical pharmacists of ILA had expertise in providing AD and clinician outreach, making it an ideal fit for an AD program. Additional staff were hired, and all were trained on AD knowledge and skills. An initial structure was created based on best practices in the AD space. Through staff experience and feedback, the structure was adapted and future applications improved with the development of teams and the clarity of roles.</div></div><div><h3>Conclusion</h3><div>This brief report describes the implementation and adaptation of a pharmacist-led AD program, ILA, through the QIF framework. ILA’s current structure resulted from several sources of feedback, primarily from staff input and experiences. Ultimately, this work serves as a guide for future AD program implementation.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102904"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608588","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 descriptive study of systemic factors that affect ambulatory care pharmacists","authors":"Emily Parry,&nbsp;Allison Hursman,&nbsp;Ellen Rubinstein,&nbsp;Taylor Thooft,&nbsp;Rylie Johnson,&nbsp;Jada Ford,&nbsp;Kimaria Stevenson,&nbsp;Lauren Lowe","doi":"10.1016/j.japh.2025.102931","DOIUrl":"10.1016/j.japh.2025.102931","url":null,"abstract":"<div><h3>Background</h3><div>Ambulatory care pharmacists (ACPs) support patients and the health care team through clinical services such as patient education and comprehensive disease state management. Although multiple studies show the impact of ACPs on others, little research has been done on their own experiences.</div></div><div><h3>Objectives</h3><div>This study aimed to learn from ACPs about their workplace experiences and identify systemic factors that affect their role as members of interprofessional health care teams.</div></div><div><h3>Methods</h3><div>This exploratory, qualitative study consisted of digitally recorded, semistructured interviews with ACPs. Interviews were transcribed and analyzed inductively and iteratively by a multidisciplinary research team to determine salient themes.</div></div><div><h3>Results</h3><div>Twenty-one pharmacists (10 in private health systems, 11 in public health systems) participated, 15 of whom described the effects of leadership, metrics, and reimbursement on their roles. Although many pharmacists felt supported by leadership, others noted consistent pressure to meet arbitrary quality metrics and frustration with limited reimbursement options. Public health system pharmacists seemed to be more affected by these systemic factors than their private health system counterparts.</div></div><div><h3>Conclusion</h3><div>Leadership, metrics, and reimbursement are all systemic factors that affect ACPs’ workplace experiences, as evinced by participant interviews. More research is necessary to determine how best to support ACPs across health systems to ensure that they can continue providing high-quality, accessible patient care.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102931"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to “The public health impact of the Rx-to-OTC switch of triptan in Germany: Systematic review and framework analysis” [JAPH 65/5 (2025) 102489]","authors":"","doi":"10.1016/j.japh.2025.102923","DOIUrl":"10.1016/j.japh.2025.102923","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102923"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254222","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":"The minivisit method: Adapting opioid-related educational outreach for community pharmacies","authors":"Monica F. Roberts,&nbsp;Patricia R. Freeman,&nbsp;Laura K. Stinson,&nbsp;Adrienne Matson,&nbsp;Sharon L. Walsh","doi":"10.1016/j.japh.2025.102933","DOIUrl":"10.1016/j.japh.2025.102933","url":null,"abstract":"<div><div>Community pharmacists are well-positioned to contribute to public health initiatives related to prescription opioid safety and naloxone access, but many barriers, including gaps in knowledge and confidence, prevent them from fully engaging with their patients and communities on these topics. The Kentucky site of the HEALing (Helping to End Addiction Long-term Initiative) Communities Study sought to involve community pharmacists in the effort to prevent opioid-related overdose deaths. Throughout the study, strategies to provide in-person educational outreach to community pharmacists were developed, implemented, and redesigned, resulting in a new format: the minivisit method. Minivisits are based on the principles of academic detailing but aim to more efficiently meet the needs of busy community pharmacists. Implemented by pharmacists for pharmacists, minivisits deliver key messages in brief, unscheduled visits to all community pharmacies in an identified geographic area. Paired with on-going support, high-quality printed materials, and in-depth continuing education activities, minivisits offer a promising alternative to traditional education formats. The minivisit method can be adapted to the goals, budget, and educational needs of a given program. This commentary details the trial-and-error process by which minivisits were developed and implemented and the key components of the minivisit method. The aim of this commentary is to inspire and inform future efforts to educate community pharmacists and expand practice to improve public health.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102933"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260506","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":"Multilevel factors associated with timeliness of care along the lung cancer care continuum: A systematic review","authors":"Sabina Nduaguba,&nbsp;Safalta Khadka,&nbsp;Nicole Stout,&nbsp;Mohammad Almubarak,&nbsp;Kimberly Kelly","doi":"10.1016/j.japh.2025.102965","DOIUrl":"10.1016/j.japh.2025.102965","url":null,"abstract":"<div><h3>Background</h3><div>Factors affecting time to lung cancer care may occur at multiple levels of influence.</div></div><div><h3>Objective</h3><div>The study aimed to identify multilevel factors associated with delays in lung cancer care.</div></div><div><h3>Methods</h3><div>Following Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines, Medline (PubMed), CINAHL, and SCOPUS were searched using validated search terms for lung cancer and factors, health disparities and time/delay. Eligible studies included original articles with quantitative, qualitative, or mixed-methods designs that investigated health disparities in, risk factors for, or barriers to timely screening, confirmatory diagnosis, or treatment among patients with lung cancer or those at risk for lung cancer. Title/abstract (TIAB), and full-text screening, study quality assessment (QA), and data extraction were conducted by 2 reviewers.</div></div><div><h3>Results</h3><div>13,068, 2608, and 424 TIAB were identified from PubMed, CINAHL, and SCOPUS, respectively. After deduplication, 14,405 articles were screened and 74 full-texts were assessed. Fifteen studies (all quantitative) were selected for QA and data extracted. Based on the National Institutes of Health QA tool, 5, 6, and 4 studies were rated good, fair, and poor, respectively. Multilevel factors associated with diagnosis to treatment interval were: Patient (demographic – age, sex, race/ethnicity, marital status, region, health insurance; disease – comorbidity, lung cancer type, stage, tumor size, brain metastasis, and treatment), clinic setting (facility type), environmental (income, poverty, hospital supply, and subspecialist supply). Other intervals assessed include: screening to diagnosis, symptom to initial primary care provider visit, suspicious image to diagnostics, suspicious image to diagnosis, suspicious image to surgical referral, and surgical referral to surgery.</div></div><div><h3>Conclusion</h3><div>We did not identify any qualitative or mixed-methods study. The quality of the included quantitative were fair-good. Qualitative and mixed-methods studies on the timeliness of lung cancer care are recommended to provide context on multilevel factors. The identified multilevel factors will help in intervention planning to select intervention components that address gaps in the timeliness of lung cancer care.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102965"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440539","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 the implementation of an analgesia sedation protocol for adult mechanically ventilated patients","authors":"Kristin Kaupp,&nbsp;Kaley McKinnon,&nbsp;Jenna Vardy,&nbsp;Sarah Koppernaes,&nbsp;Volker Eichhorn,&nbsp;Shanna Trenaman,&nbsp;Meghan MacKenzie","doi":"10.1016/j.japh.2025.103003","DOIUrl":"10.1016/j.japh.2025.103003","url":null,"abstract":"<div><h3>Background</h3><div>Protocol-based pain and sedation protocols reduce sedative requirements, duration of mechanical ventilation, intensive care unit (ICU) length of stay (LOS), and pain intensity in critically ill adults. An analgesia sedation protocol for mechanically ventilated adults was created and implemented in 2022.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the implementation and impact of an analgesia sedation protocol for mechanically ventilated adults on opioid and sedative medication administration, level of sedation, and duration of mechanical ventilation.</div></div><div><h3>Practice description</h3><div>The creation and implementation of the analgesia sedation protocol was a pharmacist-led, multidisciplinary effort. The protocol is an assessment-driven, stepwise, nurse-protocolized approach to pain and sedation management.</div></div><div><h3>Practice innovation</h3><div>The protocol emphasizes standardized, routine pain assessment and treatment using an analgosedation approach.</div></div><div><h3>Evaluation methods</h3><div>This was a single-center, retrospective, cohort study with a pre-post design.</div></div><div><h3>Results</h3><div>Preprotocol implementation patients received 13% more propofol (odds ratio [OR] 1.1354 [95% CI 1.1310–1.1399]) and 14% less opioid analgesic medications (OR 0.8597 [95% CI 0.8564–0.8630]) relative to the postimplementation cohort. The median Richmond Agitation Sedation Scale score was −2 in both cohorts, and the median Critical Care Pain Observation Tool was 0 in both cohorts. The median duration of mechanical ventilation decreased by 11 hours or 22% (<em>P</em> &lt; 0.001), and the median ICU LOS decreased by 17 hours or 3.9% (<em>P</em> &lt; 0.001) after protocol implementation.</div></div><div><h3>Conclusions</h3><div>This study confirms successful implementation of an analgosedation protocol through evaluation of opioid and sedative medication exposure. After the implementation, patients received 13% less propofol and 14% more opioid analgesic medications. After protocol implementation, there was a decrease in the duration of mechanical ventilation and ICU LOS.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 103003"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673363","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":"Effectiveness, challenges, and improvement strategies for active tuberculosis case-finding practices by community pharmacy personnel: A scoping review","authors":"Carla Florencia,&nbsp;Kevin Aprilio,&nbsp;Dian Ayu Eka Pitaloka,&nbsp;Rob E. Aarnoutse,&nbsp;Ivan Surya Pradipta","doi":"10.1016/j.japh.2025.102966","DOIUrl":"10.1016/j.japh.2025.102966","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB) remains a major health challenge, with delayed detection accelerating its spread. Pharmacies are often the first contact for individuals with TB symptoms, yet their role in active case finding is underutilized.</div></div><div><h3>Objective</h3><div>This scoping review aims to comprehensively map the current studies, challenges, and potential strategies for effective and sustainable implementation.</div></div><div><h3>Methods</h3><div>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines, we searched PubMed and Scopus for relevant studies up to October 26, 2023. We included studies on community pharmacy personnel (PP) engaged in active TB case-finding. Outcomes covered effectiveness, challenges, and potential strategies for active TB case finding involving PP. Two reviewers independently screened and extracted data, which were synthesized using the Consolidated Framework for Implementation Research.</div></div><div><h3>Results</h3><div>Twelve of 2003 articles met the inclusion criteria. All studies showed a contribution to TB case finding. However, key challenges identified include the complexity of integrating TB case-detection into routine workflows, patients' access barriers to clinics, and lack of resources. PP also faced issues such as their lack of confidence in TB screening and inadequate knowledge regarding TB referral. Improvement strategies are electronic referral, capacity building for PP, free diagnostic services, incentives for PP, and improved coordination between PP and TB program staff.</div></div><div><h3>Conclusion</h3><div>Enhancing active TB case detection by PP requires addressing challenges in workflow integration, patient access, and resource limitations. Capacity building, electronic referrals, free diagnostics, and incentives are key strategies to support PP involvement. Strengthening collaboration between the PP and TB program staff is essential for effective and sustainable referral processes.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102966"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433632","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":"Mapping the U.S. literature on pharmacists prescribing to initiate medications: A scoping review of terminology, responsibilities, and alignment with international models","authors":"Surur Ahmed,&nbsp;Janice Kung,&nbsp;Vincent Chiang,&nbsp;Arjun Poudel,&nbsp;Damilola Olufemi-Yusuf,&nbsp;Chowdhury Farhana Faruquee,&nbsp;Mark Makowsky,&nbsp;Lisa Nissen,&nbsp;Lisa Guirguis","doi":"10.1016/j.japh.2025.102952","DOIUrl":"10.1016/j.japh.2025.102952","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacists play a greater role in patient-centred care, particularly in prescribing to initiate medications. In the United States, pharmacist prescribing evolved to meet healthcare challenges, although states vary in prescribing models, pharmacists' responsibilities, and terminology.</div><div>A literature review is necessary to capture and compare pharmacist practices in prescribing to initiate medications across the United States.</div></div><div><h3>Objectives</h3><div>This review aims to 1) characterize US prescribing terminology and pharmacists' responsibilities when initiating medication under various U.S. prescribing models, and 2) map the U.S. literature on pharmacists' initiating medication to the international context.</div></div><div><h3>Methods</h3><div>The study employed Arksey and O'Malley's scoping review framework and adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews. Ovid MEDLINE, Ovid Embase, and CINAHL were searched from 2000 to 2024. Eligible studies were included if they examined pharmacists initiating medication across diverse practice settings and prescribing models. Two independent reviewers conducted screening and data charting. The terminology and pharmacists' responsibilities when initiating medication (i.e., recognizing symptoms/diagnosis, selecting, supplying, and monitoring medications) under U.S. prescribing models were examined and categorized using international pharmacist prescribing models.</div></div><div><h3>Results</h3><div>Out of 92 studies, terminology describing pharmacist-initiated medication models varies widely, from formal legislative language to informal and broadly used descriptions. Most studies (n = 58) reported 3 of 4 pharmacist responsibilities, with diagnosing symptoms (n = 85) and selecting medication (n = 88) the most commonly reported. When using the international pharmacist prescribing models, prescribing by protocol (n = 77) was dominant, followed by independent prescribing in the Veterans Health Administration (n = 9) and formulary prescribing in Idaho state (n = 2).</div></div><div><h3>Conclusion</h3><div>This review has uniquely mapped the U.S. literature on pharmacists initiating medication to the international context, highlighting variation in prescribing terminology and responsibilities. The findings underscore the need for a standardized reporting guide with clear terminology and definitions of pharmacist prescribing responsibilities to facilitate meaningful international comparisons.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102952"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338440","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":"Systematic review of interest-holder perceptions of pharmacist-prescribed ulipristal acetate emergency contraception","authors":"Alexis C. Delanoy,&nbsp;Timothy C. Hutcherson,&nbsp;Nicole E. Cieri-Hutcherson","doi":"10.1016/j.japh.2025.103001","DOIUrl":"10.1016/j.japh.2025.103001","url":null,"abstract":"<div><h3>Background</h3><div>Emergency contraception (EC) is important for the prevention of unintended pregnancy.</div></div><div><h3>Objectives</h3><div>This systematic review aimed to evaluate literature assessing interest-holder perceptions of pharmacist-prescribed ulipristal acetate (UPA) EC.</div></div><div><h3>Methods</h3><div>A search of Embase, MEDLINE, and PubMed was conducted from inception to March 3, 2025, using the following search terms and permutations: ulipristal, ella, emergency contraception, pharmacist, and pharmacy. Eligibility criteria included the following: primary literature pertaining to pharmacist-prescribed UPA EC, studies reporting on data collected in the United States, studies related to interest-holder (pharmacist, patient, and other interest-holder) perceptions, and full reports in English. Abstract-only records were excluded. Reviewers extracted and synthesized data including study characteristics and interest-holder perceptions of pharmacist-prescribed UPA. Qualitative data were coded for themes. Risk of bias (ROB) was assessed using the Appraisal tool for Cross-Sectional Studies and the Joanna Briggs Institute Narrative Critical Appraisal tool.</div></div><div><h3>Results</h3><div>The search yielded 1906 records; 1298 were screened after deduplication and limited to English and humans. Seven records met the inclusion criteria: 6 California-based cross-sectional studies and 1 Indiana-based pilot study. Eleven outcomes regarding pharmacist, patient, and other interest-holder perceptions were identified; 5 reports included outcomes regarding pharmacists’ perceptions, 3 included patient perceptions, and 2 included a small amount of other interest-holder perceptions. Pharmacists in 3 of 5 reports cited barriers to pharmacist-prescribed UPA; the most common included time, reimbursement for services, and support via staffing, workflow, and management. Pharmacists in 2 of 5 reports expressed desire for additional training. Patients reported benefits of pharmacist-prescribed UPA including reduced cost, time, and improved accessibility in 1 of 2 reports. Other interest holders supported pharmacist-prescribed UPA. All 7 reports had high ROB owing to the response rate.</div></div><div><h3>Conclusion</h3><div>Pharmacist-prescribed UPA can enhance access to EC. Education, reimbursement, and support barriers must be addressed, in addition to legislation expansion, to enhance implementation.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 103001"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575209","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":"Interventions to improve primary medication nonadherence: A scoping review","authors":"Nga-Weng (Ivy) Leong MS,&nbsp;Shishir Maharjan PhD,&nbsp;Saara Z. Nasruddin PhD,&nbsp;Chandler Gandy,&nbsp;Donna W. Strum PhD,&nbsp;Yi Yang MD, PhD","doi":"10.1016/j.japh.2025.102938","DOIUrl":"10.1016/j.japh.2025.102938","url":null,"abstract":"<div><h3>Background</h3><div>Primary medication nonadherence is a multifaceted problem that leads to poor health outcomes. Various interventions have been studied to improve primary nonadherence across different populations and/or disease areas. However, there is no comprehensive review to understand the scope and depth of available evidence on intervention effectiveness.</div></div><div><h3>Objective</h3><div>This study aims to examine recent literature on interventions designed to improve primary medication nonadherence.</div></div><div><h3>Methods</h3><div>An electronic search of CINAHL, Cochrane Central, Embase, ProQuest, PsycINFO, PubMed, and Scopus was conducted for relevant literature up to July 2025. Articles published in English since 2000 and focused on interventions to improve primary medication nonadherence were included. The Health Pyramid Framework and the Template for Intervention Description and Replication were used for data extraction.</div></div><div><h3>Results</h3><div>Forty articles published after 2000 were included in this review. Thirty-two studies were conducted in the US. Study settings included ambulatory care clinic, inpatient, outpatient, emergency department, and pharmacy. Eighteen studies focused on cardiovascular diseases/medications. Interventions were classified as clinical intervention (n = 6, 15%), patient counseling and education-related (n = 23, 57.5%), and socioeconomics-related (n = 11, 27.5%). Intervention types included national statutory amendments (n = 2, 5%), face-to-face education (n = 4, 10%), hybrid education (n = 3, 7.5%), e-prescribing (n = 6, 15%), patient assistance provided by manufacturers (n = 9, 22.5%), and virtual reminders or education (n = 16, 40%). Most counseling and education-related interventions (n = 13, 32.5%) were conducted by pharmacists. Primary nonadherence was measured using prescription abandonment, failure to initiate medications or reversed claims. Interventions (n = 9, 22.5%) involving face-to-face or hybrid counseling by pharmacists and interventions (n = 10, 25%) that lowered out-of-pocket costs were found to be effective in improving primary nonadherence.</div></div><div><h3>Conclusion</h3><div>Various strategies have been employed across different health care settings and patient populations to improve primary medication nonadherence; their effectiveness varied significantly. Face-to-face or hybrid counseling by pharmacists or nurses has been shown to be effective in improving primary nonadherence.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102938"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277027","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}