Journal of the American Pharmacists Association最新文献

{"title":"A community pharmacist intervention for people living with epilepsy","authors":"Jennifer L. Bacci,&nbsp;Ifechukwu Benedict Nwogu,&nbsp;Sabra Zaraa,&nbsp;Michelle Guignet,&nbsp;H. Steve White,&nbsp;Andy Stergachis,&nbsp;Derek Ems,&nbsp;Edward J. Novotny","doi":"10.1016/j.japh.2024.102275","DOIUrl":"10.1016/j.japh.2024.102275","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy is a complex spectrum of seizure disorders. Antiseizure medications are the first-line treatment for most patients. Community pharmacists are among the most accessible health care providers with extensive knowledge of pharmacotherapy yet are seldom engaged in epilepsy care.</div></div><div><h3>Objective</h3><div>The objective of this project was to pilot a community pharmacist-led intervention for people living with epilepsy (PWE).</div></div><div><h3>Methods</h3><div>The Community Pharmacist Epilepsy Services Program was a 6-month disease state management intervention that included 4 components: patient-pharmacist consultation, care plan development, regular check-ins, and care coordination. A pilot was conducted in 4 independent community pharmacies (2 intervention and 2 comparator) in western Washington State. A prospective, 2-arm, pre-post study was planned to evaluate the impact of the intervention on patient-reported quality of life (QoL), health, and satisfaction outcomes. The approach shifted to a 1-arm pre-post design due to low patient recruitment. The primary QoL outcome was the patient-weighted Quality of Life in Epilepsy Inventory-10 (QOLIE-10-P). Staff at intervention and comparator pharmacies were surveyed to evaluate perceived barriers to patient recruitment.</div></div><div><h3>Results</h3><div>Ten patients, including 7 intervention and 3 usual care patients, enrolled in the study. Five intervention patients completed the pre- and postsurveys. The median pre-QOLIE-10-P score was 1.09 and the median postscore was 1.73, indicating a slight nonsignificant decrease in QoL. Eleven pharmacy staff completed the survey evaluating perceived patient recruitment barriers. Limited number of eligible PWE at each pharmacy was perceived as significant barriers.</div></div><div><h3>Conclusion</h3><div>While low patient enrollment limited the ability to observe trends and draw conclusions about the potential impact of the intervention, enrollment barriers and lessons learned highlight opportunities to refine the intervention with the goal of improving the outcomes and well-being of PWE.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102275"},"PeriodicalIF":2.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569823","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":"Chain community pharmacists’ requests for patient information during routine care","authors":"Elizabeth G. Riley-Jensen,&nbsp;Katelyn N. Hettinger-Riddell,&nbsp;Jonathan E. Sarky,&nbsp;Margie E. Snyder","doi":"10.1016/j.japh.2024.102273","DOIUrl":"10.1016/j.japh.2024.102273","url":null,"abstract":"<div><h3>Background</h3><div>To optimize service provision, community pharmacists need information (e.g., laboratory values and updated medication lists), which can be difficult to obtain. Contacting prescriber offices is a common approach to obtain information but is often ineffective. Health information exchange (HIE) is one potential solution to this problem, and recent survey research has identified the information needs of independent pharmacists that could be addressed through HIE. However, the information needs of chain community pharmacists are unknown.</div></div><div><h3>Objective</h3><div>The objective of this study was to characterize the patient information requests made by chain community pharmacists during routine practice.</div></div><div><h3>Methods</h3><div>This electronic card study captured cross-sectional observational data on patient information requests made by chain pharmacists in central Indiana during routine practice. Only one pharmacist meeting eligibility criteria per pharmacy could submit data. Pharmacists were randomized to a 2-week data collection period. In real-time, pharmacists recorded the following: type of information requested, reason for request, information source, whether initial or follow up request, modality of communication, and the time required to make the request. Data analysis occurred via descriptive statistics. The Indiana University Institutional Review Board approved all study procedures.</div></div><div><h3>Results</h3><div>Nineteen of the 33 eligible pharmacists (57.6%) consented to the study. Most participants held a Doctor of Pharmacy degree (78.9%) and were the pharmacy manager (89.5%) at their location. Updated medication orders/lists (41.3%) and insurance (33.7%) were the most common type of requested information and were primarily used for prescription clarification/filling (93.4%). The prescriber office (53.6%), as well as the patient/caregiver (39.8%), was the most frequent source of this information. Requests were largely completed by telephone (61.2%) and averaged 6.0 minutes (standard deviation: 4.8).</div></div><div><h3>Conclusion</h3><div>Community pharmacists require key patient data during routine practice. There is a need to develop mechanisms, like HIE, to address gaps in needed information in the community pharmacy setting, regardless of the offered services.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102273"},"PeriodicalIF":2.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512052","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":"Bridging PrEP access gaps: Mapping geospatial accessibility across the US and leveraging community pharmacies for expansion.","authors":"Jacinda Tran, Anu Mishra, Marita Zimmermann, Ryan Hansen","doi":"10.1016/j.japh.2024.102274","DOIUrl":"10.1016/j.japh.2024.102274","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102274"},"PeriodicalIF":2.5,"publicationDate":"2024-10-24","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":"Impact of a clinical pharmacist-led, artificial intelligence–supported medication adherence program on medication adherence performance, chronic disease control measures, and cost savings","authors":"Charles Worrall,&nbsp;David Shirley,&nbsp;Jeff Bullard,&nbsp;Ashley Dao,&nbsp;Taylor Morrisette","doi":"10.1016/j.japh.2024.102271","DOIUrl":"10.1016/j.japh.2024.102271","url":null,"abstract":"<div><h3>Background</h3><div>Chronic diseases are the leading cause of disability and death in the United States. Clinical pharmacists have been shown to optimize health outcomes and reduce health care expenditures in patients with chronic diseases through improving medication adherence.</div></div><div><h3>Objective</h3><div>The primary objective of this study was to evaluate a pharmacist-led, artificial intelligence (AI)–supported medication adherence program on medication adherence, select disease control measures, and health care expenditures.</div></div><div><h3>Methods</h3><div>This was a multicenter, retrospective, quasi-experimental evaluation from January 2019 to December 2019 (preimplementation) and January 2021 to December 2021 (postimplementation). This pharmacy-driven service focuses on improving medication adherence and patient outcomes through AI-supported analytics, individual patient case review, and pharmacist-led individual patient outreach. The primary end point was to determine whether implementation improved medication adherence in 3 medication-related measures: medication adherence for hypertension (MAH), medication adherence for cholesterol (MAC), and medication adherence for diabetes (MAD). Secondary outcomes were to evaluate reductions in select chronic diseases control measures and cost savings of this service after implementation of this service.</div></div><div><h3>Results</h3><div>This medication adherence service was deployed across 10,477 patients: 60.6% of patients were in at least 1 medication-related measure, generating 2762 actionable medication adherence gaps. After the implementation of this pharmacist-led program, medication adherence improved in all 3 disease state measures (MAH 5.9% improvement, MAC 7.9% improvement, MAD, 6.4% improvement), and Medicare Star ratings also improved. The percentage of patients with diabetes who reached their A1c goal also increased (75.5%-81.7%). Furthermore, reductions in overall health care expenditures were seen per member per month in patients who were adherent in comparison with those who were nonadherent (hypertension 31% cost savings, hyperlipidemia 25% cost savings, diabetes 32% cost savings).</div></div><div><h3>Conclusion</h3><div>This clinical pharmacist–driven service leveraged technology and patient connection to increase medication adherence in patients with chronic disease states and led to improvement in select disease control measures and substantial health care cost savings.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102271"},"PeriodicalIF":2.5,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479217","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":"Pharmacists’ mental health support behaviours with simulated patients: a mixed-methods pilot study","authors":"Tina X. Ung,&nbsp;Sarira El-Den,&nbsp;Rebekah J. Moles,&nbsp;Jack C. Collins,&nbsp;Kevin Ou,&nbsp;Jenny Chen,&nbsp;Claire L. O’Reilly","doi":"10.1016/j.japh.2024.102263","DOIUrl":"10.1016/j.japh.2024.102263","url":null,"abstract":"<div><h3>Background</h3><div>Simulated mental health role-plays provide a safe and relevant learning experience for pharmacy students, improving confidence in and attitudes toward providing mental health support. Little research explores the use of mental health role-plays, enacted by trained actors, with pharmacists.</div></div><div><h3>Objectives</h3><div>This study aimed to pilot the adaptation of simulated patient (SP) role-plays, from the university classroom with students, to a workshop with pharmacists, and explore pharmacists’ experiences.</div></div><div><h3>Methods</h3><div>Pharmacists attended a two-hour workshop. Trained actors enacted simulated scenarios (previously developed for pharmacy education) with pharmacist volunteers while being observed by peers, a workshop facilitator, and mental health consumer educator (MHCE). Pharmacists engaged in self-assessment immediately post-roleplay, followed by performance feedback and debrief discussions with MHCEs, workshop facilitators, and peers. Pharmacists completed pre- and post-workshop surveys exploring intended mental health support behaviours, then invited to participate in an interview exploring their workshop experiences and opinions about using mental health role-plays in clinical practice (via mystery shopping). Non-parametric tests were conducted to analyse role-play and survey scores, and thematic analyses were undertaken on interview transcripts.</div></div><div><h3>Results</h3><div>Thirty-five pharmacists attended the workshop. Fourteen role-plays were analysed. Pharmacist self-assessment scores were significantly lower than MHCE scores (<em>P</em> = 0.028). Overall, the role-plays significantly increased pharmacists’ intentions in supporting a person experiencing mental health crises such as suicide and psychosis, as well as encouraging other supports (<em>P</em> &lt; 0.05). Four themes emerged from interviews (n = 4): realistic context for skills application and practice, benefits of observing, self-assessment and feedback, and integrating into clinical practice (via mystery shopping).</div></div><div><h3>Conclusion</h3><div>SP role-plays of mental health symptoms and crises, enacted by trained actors, may effectively assess and enhance pharmacists’ intended mental health support behaviours. It is recommended that the SP method is adapted into clinical practice, via repeated mystery shopping visits with immediate performance feedback, to shape pharmacists’ mental health support behaviours.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102263"},"PeriodicalIF":2.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479218","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":"Single-center retrospective review of standard versus minimal monitoring for hepatitis C direct-acting antiviral therapy","authors":"Anita Yang,&nbsp;Neel Swamy,&nbsp;Jane Giang","doi":"10.1016/j.japh.2024.102265","DOIUrl":"10.1016/j.japh.2024.102265","url":null,"abstract":"<div><h3>Background</h3><div>Highly effective direct-acting antiviral (DAA) therapies have transformed the landscape of hepatitis C virus (HCV) treatment. However, there continues to be limited data regarding the efficacy and safety of required in-person clinic visits (standard monitoring) versus completely telehealth clinic visits (minimal monitoring) during HCV therapy, which could delay practice adoption.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the rates of undetectable HCV ribonucleic acid (RNA) in sustained viral load 12 weeks after therapy (SVR12) in standard versus minimal monitoring approaches during DAA.</div></div><div><h3>Methods</h3><div>A 12-month, single-center retrospective cohort study was conducted in treatment-naïve HCV-infected adults who received DAA therapy between May 1, 2020, and April 30, 2021. The standard monitoring group had ≥1 in-person clinic visit with HCV RNA laboratory monitoring during DAA treatment. The minimal monitoring group had entirely telehealth visits without HCV RNA laboratory monitoring during treatment. Both groups received telephonic touchpoints throughout DAA treatment from a clinical pharmacist practitioner and a nurse care coordinator. The primary outcome was SVR12.</div></div><div><h3>Results</h3><div>From May 2020 to April 2021, 133 patients with HCV met inclusion criteria and were treated with DAA (standard, n = 56; minimal, n = 77), with no differences in baseline demographics. Overall, total encounters during DAA treatment remained statistically significant in the standard than minimal monitoring group (standard, 2.1 ± 0.8, vs. minimal, 1.7 ± 0.9; <em>P</em> &lt; .01). Although minimal monitoring had higher loss to follow-up rates (standard, 7.1%, vs. minimal, 18.2%; <em>P</em> = 0.06), the modified intention-to-treat analysis showed no differences in sustained virologic response (SVR) between standard and minimal monitoring approaches (standard, 98.1%, n = 51, vs. minimal, 95.3%, n = 60; <em>P</em> = 0.41).</div></div><div><h3>Conclusions</h3><div>This single-center retrospective cohort study demonstrated that minimal monitoring during HCV treatment was as effective in achieving SVR cure rates as standard monitoring. Eliminating required in-person clinic visits during DAA therapy alongside a collaborative approach may play a major role in overcoming barriers to HCV care in select patients.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102265"},"PeriodicalIF":2.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479219","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":"Complexity of patient encounters within a clinically integrated community pharmacy network Medicaid payer program","authors":"Joni C. Carroll,&nbsp;Katie Doong ,&nbsp;Sneha Mitra ,&nbsp;Melissa Somma McGivney,&nbsp;Stephanie Harriman McGrath,&nbsp;Kim C. Coley","doi":"10.1016/j.japh.2024.102264","DOIUrl":"10.1016/j.japh.2024.102264","url":null,"abstract":"<div><h3>Background</h3><div>Community pharmacists frequently care for patients with complex medical and social needs; however, specific evidence on pharmacist perceptions of what makes a patient encounter complex has not been clearly characterized. There is a need to better understand specific factors that contribute to patient encounter complexity and demonstrate how pharmacists in community settings care for these individuals.</div></div><div><h3>Objectives</h3><div>The objectives of this programmatic case study were to: (1) elucidate factors that contributed to patient encounter complexity as a part of a Medicaid Managed Care Organization comprehensive medication management payer program in community pharmacies and (2) curate a series of patient case vignettes that provide evidence of pharmacists care for patients with complex medical and social needs within community pharmacies.</div></div><div><h3>Methods</h3><div>This qualitative programmatic case study utilized data from semi-structured interviews with community pharmacists who provided comprehensive medication management services to Medicaid patients in Pennsylvania. Pharmacists described their most complex patient encounter. Interviews were transcribed and independently coded by 2 investigators. The coded texts were grouped into categories, and a cross-case inductive thematic analysis was performed to identify complexity factors.</div></div><div><h3>Results</h3><div>Thirty pharmacists provided 48 patient case vignettes and 3 complexity factors emerged: (1) care coordination; (2) behavioral health support; and (3) social determinants of health. Representative patient case vignettes were selected to illustrate these factors.</div></div><div><h3>Conclusion</h3><div>Pharmacists, who participated in a community pharmacy Medicaid Managed Care Organization payer program, provided care to patients with complex health needs. In addition to medication-related problems, specific factors that increased pharmacist perception of encounter complexity were care coordination with other health care providers, behavioral health support, and addressing social determinants of health.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102264"},"PeriodicalIF":2.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479306","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":"A positive change in student positivity about pharmacy","authors":"David Nau PhD,&nbsp;Karen L. Kier,&nbsp;Diego C. Avello","doi":"10.1016/j.japh.2024.102261","DOIUrl":"10.1016/j.japh.2024.102261","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102261"},"PeriodicalIF":2.5,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401786","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":"Predisposing, enabling, and need factors influencing health-related quality of life among people with metabolic syndrome","authors":"Olajide A. Adekunle,&nbsp;Yun S. Wang,&nbsp;Ismaeel Yunusa,&nbsp;Marc L. Fleming,&nbsp;Enrique Seoane-Vazquez,&nbsp;Lawrence M. Brown","doi":"10.1016/j.japh.2024.102255","DOIUrl":"10.1016/j.japh.2024.102255","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic syndrome (MetS) continues to impact the health-related quality of life (HRQoL) of patients despite various available therapeutic interventions. There is a dearth of information on how patient-centered factors holistically predict HRQoL to provide more insights on addressing MetS.</div></div><div><h3>Objective</h3><div>To predict the HRQoL of patients with MetS in the Southern states, using the predisposing, enabling, and need factors.</div></div><div><h3>Methods</h3><div>The study adopted a cross-sectional approach in collecting 706 complete surveys on HRQoL assessment using the EQ-5D-5L survey and demographic characteristics based on the predisposing, enabling, and need factors of Andersen’s Behavioral model. The study focused on people with MetS in the southern states of the United States. Multinomial logistic regression was conducted to investigate the relationship between the number of comorbidities and each HRQoL dimension. Ordinal regression was used to explore factors predicting HRQoL. Sensitivity analysis was conducted using bootstrapping analysis to evaluate the regression’s robustness.</div></div><div><h3>Results</h3><div>Over 70% were females and 30% had at least a bachelor's degree, while 47% were married. Most respondents (71.1%) had no problem with self-care. However, 20.0% had severe problems with pain, while the highest proportion (8.6%) was observed for extreme problems with anxiety or depression. A unit increase in comorbidities resulted in higher odds of having extreme problems with mobility (odds ratio [OR] = 1.95), usual activities (OR = 1.73), and pain (OR = 1.70). Only 40.8% of the respondents had good HRQoL, compared to 26.2% with poor HRQoL. Age, race, geographical area, marital status, household income, number of prescription drugs, comorbidities, and body mass index were predictors of HRQoL.</div></div><div><h3>Conclusion</h3><div>An increase in comorbidities significantly increased the odds of having challenges with the HRQoL dimensions. Demographic, socioeconomic, and health-related factors significantly predicted HRQoL. Therefore, health care providers must consider these factors as a component of patient-centered care to address health disparities and promote optimal health outcomes among people with MetS.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102255"},"PeriodicalIF":2.5,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394820","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":"Implementing a letter template to expedite specialty medication appeal letter submission","authors":"Jessica Fann,&nbsp;Miranda Kozlicki,&nbsp;Kristen Whelchel","doi":"10.1016/j.japh.2024.102262","DOIUrl":"10.1016/j.japh.2024.102262","url":null,"abstract":"<div><h3>Background</h3><div>Prior authorizations (PAs) for biologic medications, used to treat inflammatory bowel disease (IBD), are often denied by pharmacy benefits managers and can require a complex appeal process for patients to gain access to medication.</div></div><div><h3>Objective</h3><div>This quality improvement project evaluated the impact of implementing a standardized appeal letter template and customizable clinical rationale letter content on specialty pharmacist workflow and workload in an integrated hospital health system specialty pharmacy (HSSP) IBD clinic.</div></div><div><h3>Practice description</h3><div>This initiative was conducted in an IBD outpatient clinic at a tertiary academic medical center with an integrated HSSP whose specialty pharmacists work collaboratively with providers to manage specialty medications.</div></div><div><h3>Practice innovation</h3><div>A letter template was created in the electronic health record (EHR) for pharmacists to use when submitting appeal letters. The template automatically populates patient results from recent labs, imaging, and clinic visit notes as part of the appeal documentation. Clinical rationale letter content was developed for the most common appeal reasons using EHR functionality that allows the creation of standardized notes that can be shared among team members and customized at time of use.</div></div><div><h3>Evaluation method</h3><div>An analysis of 2 months of data preimplementation/postimplementation was conducted using descriptive statistics to report the number of appeals submitted, time from PA denial to appeal submission, and appeal approval rate. A pharmacist postimplementation satisfaction score was also collected.</div></div><div><h3>Results</h3><div>The number of appeals submitted preimplementation (n = 73) and postimplementation (n = 73) was the same. Postimplementation, 89% of appeals were submitted within 3 days of PA denial compared to 29% preimplementation. PA approval rate was high (93%) preimplementation and postimplementation. Overall pharmacist satisfaction was 9.7 out of 10.</div></div><div><h3>Conclusion</h3><div>Implementation of an appeal letter template and standardized clinical rationale letter content in the EHR led to decreased time to appeal submission and high specialty pharmacist satisfaction.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102262"},"PeriodicalIF":2.5,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394819","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}