Journal of the American Pharmacists Association最新文献

{"title":"Financial threats and opportunities experienced by rural community pharmacies","authors":"Meagen Rosenthal,&nbsp;Delesha Carpenter,&nbsp;Tyler C. Melton,&nbsp;Megan Smith,&nbsp;Jordan Marie Ballou,&nbsp;Stephanie Kiser,&nbsp;Abigail Gamble","doi":"10.1016/j.japh.2025.102417","DOIUrl":"10.1016/j.japh.2025.102417","url":null,"abstract":"<div><h3>Background</h3><div>The cost of prescription medications is a significant health expenditure in the United States. Recent efforts to curtail these costs may have unintended consequences for patients in rural communities and the rural community pharmacies that serve them.</div></div><div><h3>Objective</h3><div>The objective of this project was to understand the financial threats and opportunities facing practicing rural community pharmacists.</div></div><div><h3>Methods</h3><div>This was a cross-sectional online survey comprising two key measures, financial threats and practice opportunity. Each of these measures were captured using both quantitative and qualitative data. The sampling frame included current members of a rural community pharmacy practice–based research network. Quantitative data were analyzed using descriptive statistics. Subgroup analyses examined differences by pharmacy rurality (highly rural and less rural) and pharmacy type (independent vs. other). Qualitative data were analyzed using qualitative content analysis.</div></div><div><h3>Results</h3><div>Fifty-four rural community pharmacies responded. The most concerning financial threats included: predatory health insurance, lower point of sale reimbursements for Medicare PartD medications, prescription discount cards, inadequate reimbursement for prescription fills, and direct and indirect remuneration fees. More highly rural pharmacies were also less likely to provide asthma and heart failure management, annual wellness visits, and travel medicine services. Independent pharmacies were less likely to provide travel medicine services than other pharmacy types. The top practice opportunities for expansion included point-of-care testing and diabetes self-management education and support programing. Qualitative data analyses yielded two themes: financial threats and the impact of efforts to reduce effects on patients and patient outcomes.</div></div><div><h3>Conclusion</h3><div>Prescription drugs are a costly but necessary feature of health care. While efforts to minimize these costs are needed, it is important that these efforts do not negatively impact patient outcomes. Rural community pharmacists identified several key financial threats and connected those threats to negative impacts on patients' ability to access quality care.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 5","pages":"Article 102417"},"PeriodicalIF":2.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006136","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":"Identifying the educational needs of pharmacists engaging in professional development: A global systematic review","authors":"Yalin Ozucelik BA/LLB, BPharm (Hons),&nbsp;Jack C. Collins BPharm (Hons), PhD,&nbsp;Jessica Pace BPharm (Hons), PhD","doi":"10.1016/j.japh.2025.102418","DOIUrl":"10.1016/j.japh.2025.102418","url":null,"abstract":"<div><h3>Background</h3><div>The pharmacy profession has encountered significant change to its scope of practice over the last 2 decades. Globally, this has precipitated a need for pharmacy governing bodies to update professional development frameworks and support structures to meet the challenge of future-proofing the pharmacy workforce. It is essential to determine the educational needs of pharmacists to ensure this challenge is met.</div></div><div><h3>Objectives</h3><div>To review the literature identifying the educational needs of pharmacists engaging in professional development.</div></div><div><h3>Methods</h3><div>A comprehensive search was undertaken in MEDLINE, Embase, IPA, and ERIC using a search strategy constructed from the concepts “pharmacists,” “continuing education/continuing professional development,” and “priorities, interests and preferences” to identify relevant literature published between January 2004 and March 2025. Results were screened against eligibility criteria and data from the retrieved records were extracted into a table, appraised for quality, and synthesized narratively. This review is reported in accordance with PRISMA guidelines.</div></div><div><h3>Results</h3><div>Thirty-four studies were identified for inclusion that utilized either quantitative (n = 18), qualitative (n = 9) or mixed method (n = 7) study designs. The majority of all the studies (n = 21) included pharmacists from more than one practice setting. Three key domains of need were identified: priority topics for education, which included disease management, pharmacotherapy and clinical/interpersonal skills; the need for reinforcement of learning, such as through assessments, feedback, and peer-sharing; and the need for support across all levels of governance to achieve successful engagement.</div></div><div><h3>Conclusion</h3><div>The needs-based education necessary to accommodate rapidly changing practice is lacking. The identification of needs is, therefore, essential. This review identified commonalities of need across jurisdictions, and essential areas of focus for regulators included the promotion of skill learning over simple knowledge acquisition, strategies to reinforce this learning, and the implementation of adequate and targeted support.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 5","pages":"Article 102418"},"PeriodicalIF":2.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036714","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 narrative literature review: Community pharmacy technician well-being and its implications","authors":"Grace Fick,&nbsp;Johnson Osei,&nbsp;Sodam Kim,&nbsp;Tara Hensle,&nbsp;Taylor L. Watterson","doi":"10.1016/j.japh.2025.102419","DOIUrl":"10.1016/j.japh.2025.102419","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacy technicians are integral to the day-to-day operations of community pharmacies, and their well-being directly influences workplace efficiency, safety, and overall patient outcomes. However, the expanding scope of their roles, without adequate support and increasing workplace pressures, impose significant psychological and physical demands.</div></div><div><h3>Objectives</h3><div>This literature review aims to investigate the well-being of community pharmacy technicians and identify organizational strategies that foster supportive work environments.</div></div><div><h3>Methods</h3><div>The Surgeon General's Framework for Workplace Mental Health and Well-Being was used as the conceptual and organizational framework supporting this review. Article inclusion criteria focused on community pharmacy technician well-being, job satisfaction, and work environment; as well as implemented or hypothetical interventions for improving job satisfaction.</div></div><div><h3>Results</h3><div>Findings were structured around the framework's 5 interconnected themes: Protection from Harm, Connection &amp; Community, Opportunity for Growth, Mattering at Work, and Work-Life Harmony. Highlighted solutions include enhancing leadership support, fostering more collaborative work environments, clear role definitions, expanded career advancement opportunities, and increased professional recognition.</div></div><div><h3>Conclusion</h3><div>It is imperative that community pharmacy organizations and leadership move beyond recognition of well-being issues and take proactive steps to create supportive, inclusive, and resilient work environments. Future research must address the significant gap between the theoretical models of well-being interventions and their practical application in community pharmacies, especially for technicians.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 5","pages":"Article 102419"},"PeriodicalIF":2.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055064","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":"State policies on pharmacist-initiated PrEP and PREP usage","authors":"Taylor Le,&nbsp;Thomas Kelly","doi":"10.1016/j.japh.2025.102415","DOIUrl":"10.1016/j.japh.2025.102415","url":null,"abstract":"<div><h3>Background</h3><div>To increase access and use of pre-exposure prophylaxis (PrEP), medications which serve as an effective prophylaxis for HIV, several U.S. states have permitted pharmacists to provide PrEP to patients independent from other providers. States have implemented this policy either by allowing pharmacists to serve as stop-gap providers by prescribing PrEP to patients for a limited duration, or by allowing pharmacists to fully provide these medications to patients without a time limitation.</div></div><div><h3>Objectives</h3><div>This study tested whether the introduction of these policies is associated with increased PrEP usage and whether any such effects on PrEP usage differed by whether pharmacists were authorized to prescribe PrEP for a limited or unlimited duration. This study tested whether both policy types were effective, neither, or a single policy type was effective.</div></div><div><h3>Methods</h3><div>The introduction of these policies is analyzed using a time-series cross-sectional regression model across all 50 U.S. states and the District of Columbia. The dependent variable was PrEP use per 100,000 state residents and the independent variables were the presence of specific pharmacist PrEP policies. State-level fixed effects were controlled for as were state-specific and national time trends.</div></div><div><h3>Results</h3><div>Allowing pharmacists to provide PrEP without time limitation is associated with an increase of PrEP of 25 users per 100,000 population, equivalent to 14% of the mean PrEP usage rate in 2023. Allowing pharmacists to serve as temporary providers of PREP is not associated with any increase in PrEP usage.</div></div><div><h3>Conclusion</h3><div>Allowing pharmacists to initiate the use of PrEP may be an effective way to promote the use of PrEP and achieve public health goals.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 5","pages":"Article 102415"},"PeriodicalIF":2.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993896","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":"Patient perceptions of pharmacist-provided tobacco treatment at a federally qualified health center","authors":"Jacob Zanolla,&nbsp;Nervana Elkhadragy,&nbsp;Katy Ellis Hilts,&nbsp;Robin L. Corelli,&nbsp;Karen Suchanek Hudmon","doi":"10.1016/j.japh.2025.102414","DOIUrl":"10.1016/j.japh.2025.102414","url":null,"abstract":"<div><h3>Background</h3><div>Tobacco use remains a leading cause of preventable death and disease in the United States. Pharmacists, due to their accessibility and expertise, are well-positioned to provide tobacco treatment, particularly in Federally Qualified Health Centers (FQHCs).</div></div><div><h3>Objective</h3><div>This study aimed to characterize patient perceptions of pharmacist-delivered tobacco treatment services, with medication prescribing, within an FQHC setting in Indiana.</div></div><div><h3>Methods</h3><div>Applying a qualitative approach, guided by the SERVQUAL and 5 Rights of Clinical Decision Support models, semi-structured interviews were conducted with patients who had recently completed follow-up appointments after receiving pharmacist-provided tobacco treatment services. The interviews assessed service quality, appropriateness, and patient satisfaction. Participants were connected to the pharmacist-delivered tobacco treatment services either through self-identification of interest at intake or through a referral from their primary care provider. Pharmacists utilized the 5 A's approach (Ask, Advise, Assess, Assist, Arrange) to guide the intervention, which included the provision of behavioral counseling and prescribing tobacco treatment medications, when appropriate. Follow-up appointments were scheduled within 14 days of the initial counseling to assess progress and adjust treatment plans. Qualitative data were analyzed using inductive and deductive thematic analysis.</div></div><div><h3>Results</h3><div>Interviews were conducted with 15 patients. Identified themes included satisfaction with the service, the inclusion of patients in treatment decisions, pharmacists' commitment to patient success, and the appropriateness of medication counseling and follow-up care. Results indicated high levels of patient satisfaction and perceived value in the pharmacist-provided services. Participants appreciated the personalized care and accessibility of pharmacists.</div></div><div><h3>Conclusion</h3><div>The study highlights patient perceptions of the effectiveness of pharmacist-led tobacco treatment services and provides insights for refinement of services to better meet patient needs.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 5","pages":"Article 102414"},"PeriodicalIF":2.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029433","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":"Facilitation influence on community pharmacy practice transformation in the Flip the Pharmacy program.","authors":"Arwa A Al-Khatib, William R Doucette","doi":"10.1016/j.japh.2025.102416","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102416","url":null,"abstract":"<p><strong>Background: </strong>The Flip the Pharmacy (FtP) program utilized hands-on facilitation to help CPESN®-participating community pharmacies transform their practices. There are limited data on the characteristics of successful facilitation as well as the factors that influence transformation. The objectives of this research were to: (1) evaluate practice transformation in a sample of FtP program participating pharmacies, (2) analyze the association between facilitation activities and practice transformation components, and (3) identify factors for successful facilitation.</p><p><strong>Methods: </strong>A cross-sectional mixed-mode survey was administered to FtP program Cohorts 1 and 2 participating pharmacies (n=809). The survey consisted of five main sections: (1) practice transformation using five work components of the Systems Engineering Initiative for Patient Safety (SEIPS) model; (2) questions on the facilitator's strategy, activities, and tools (3) overall practice transformation (4) demographics (5) pharmacy characteristics. Data analysis included descriptive statistics and linear regressions on: (1) perceived overall practice transformation regressed on facilitation strategy, tools, and activities, and (2) within SEIPS components, practice transformation regressed on its correspondent facilitation activity.</p><p><strong>Results: </strong>Perceived overall practice transformation was positively associated with coaching facilitation strategy (β =0.365, p<0.01), facilitation tools (β =0.37, p<0.01), and staffing (β =0.193, p<0.01). Cohort 1 had a higher perceived overall practice transformation vs. cohort 2. The facilitator's activities and facilitation tools were significant predictors for practice transformation in different work system components: Building capacity activity, Human Resources facilitation activity, Workflow design facilitation activity, Workspace facilitation activity, and IT use facilitation activity, with a standardized betas of (β =0.33, 0.25, 0.32, 0.31 ,0.22, P<0.01 ) respectively.</p><p><strong>Conclusion: </strong>The facilitator's coaching strategy and activities positively impacted practice transformation. It was also found that facilitation tools are key components to better engage pharmacists in practice transformation. Finally, the utilization of SEIPS work system components presented a holistic evaluation tool of practice transformation.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102416"},"PeriodicalIF":2.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052136","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":"Time to goal hemoglobin A1c with pharmacist management compared with nonpharmacist management","authors":"Olutuminiun Osunsanmi,&nbsp;Nolan Schmitz,&nbsp;Belinda Darkwah,&nbsp;Mallory Freeman,&nbsp;Jennifer Loucks,&nbsp;Dennis Grauer","doi":"10.1016/j.japh.2025.102413","DOIUrl":"10.1016/j.japh.2025.102413","url":null,"abstract":"<div><h3>Background</h3><div>Although there is robust literature showing pharmacist success reducing hemoglobin A1c% (A1c), studies evaluating the impact of pharmacists on time to goal A1c are lacking. This study aimed to assess the difference in time to achieve diabetes control with pharmacist management compared with nonpharmacist management.</div></div><div><h3>Objectives</h3><div>The primary objective was average time to achieve goal A1c with pharmacist management compared with nonpharmacist management. Secondary objectives included the rate of achieving goal A1c, mean A1c reduction, rate of hospitalization and emergency department visits, and the use of guideline-directed therapy in eligible patients (appropriateness of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and statin or proprotein convertase subtilisin/kexin type 9 inhibitor use).</div></div><div><h3>Methods</h3><div>This was a retrospective, single-center chart review of adult patients followed by primary care providers at a large academic health system. Patients with a referral to a pharmacist for diabetes management (pharmacist group) were compared with patients managed without pharmacist involvement (nonpharmacist group). Those in the nonpharmacist group received support from the chronic care management team, which included a primary care provider, a diabetes educator, a dietitian, and a nurse who assists with medication adherence.</div></div><div><h3>Results</h3><div>Of the 355 patients evaluated, 238 were included with 189 patients in the pharmacist group and 49 patients in the nonpharmacist group. Time to achieve goal A1c occurred sooner in patients managed by the pharmacist than the nonpharmacist group (8.8 ± 5.3 months vs. 22.5 ± 13.0 months, respectively, <em>P</em> = 0.001).</div></div><div><h3>Conclusion</h3><div>Pharmacist management of diabetes resulted in patients achieving their goal A1c approximately 14 months faster than those who did not receive pharmacist support. However, the results of the study do not take into consideration different comorbidities, length of disease, and specific medication classes used, which may have potentially affected the results.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 4","pages":"Article 102413"},"PeriodicalIF":2.5,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055821","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":"Discharge order verification process to reduce prescription errors and optimize diabetes management","authors":"Marissa J. Cavaretta,&nbsp;Rabya Mirza ,&nbsp;Joseph T. Finn,&nbsp;Timothy Trumbower,&nbsp;Josephine Luong","doi":"10.1016/j.japh.2025.102354","DOIUrl":"10.1016/j.japh.2025.102354","url":null,"abstract":"<div><h3>Background</h3><div>Prescription errors at discharge have a detrimental impact on patients, especially in high-risk populations like those with diabetes mellitus (DM). A team-based, patient-centered approach has been shown to reduce medication errors and improve patient outcomes. To address this, an inpatient pharmacist-driven initiative was implemented, focusing on a discharge order verification process to review and intervene on antidiabetic prescriptions before they are e-prescribed.</div></div><div><h3>Objective</h3><div>The objective was to evaluate the effectiveness of a discharge order verification process in improving the prescribing of antidiabetic medications and supplies for DM patients before e-prescriptions are transmitted to community pharmacies.</div></div><div><h3>Methods</h3><div>This proof of concept study ran over 4 weeks and included adult patients with a diagnosis of DM and who had at least one discharge order for the management of DM. Orders populated into a discharge verification queue built into the electronic health record (EHR) system. When an order was received, an investigator pharmacist reviewed the chart to determine appropriateness, evaluating medication safety, effectiveness, and accessibility. Interventions to address drug-related problems were made in real-time. Once verified, e-prescriptions were transmitted to community pharmacies. Pharmacist interventions were quantified and categorized. Data was collected on the intervention type, proportion of patients discharged on an optimized regimen, length of time an order remained in the queue, interventions unlikely to be detected without EHR access, and intervention acceptance and execution.</div></div><div><h3>Results</h3><div>Overall, 152 orders were verified on 63 patients. Thirty-eight patients (60.3%) had at least one order requiring intervention, totaling 56 interventions made overall. The most common interventions were additional drug necessary (17.9%), counseling required (16.1%), incorrect instructions (16.1%), and dosing adjustment (14.3%). Twenty-eight patients (73.7%) left on a newly optimized medication regimen.</div></div><div><h3>Conclusion</h3><div>This service model introduced a discharge order verification process for pharmacists to review and intervene on antidiabetic prescriptions before transmission to a community pharmacy. Pharmacist interventions effectively corrected errors, with a high rate of provider acceptance and execution of recommendations.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 3","pages":"Article 102354"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426506","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":"Development and implementation of a best practice alerting process for naloxone prescribing at rural community pharmacies in Wisconsin: A pilot study","authors":"Sura O. AlMahasis,&nbsp;Martha A. Maurer","doi":"10.1016/j.japh.2025.102382","DOIUrl":"10.1016/j.japh.2025.102382","url":null,"abstract":"<div><h3>Background</h3><div>The opioid overdose epidemic continues to worsen in the United States, with opioid-related deaths increasing by 13 folds from 2000 to 2022 in Wisconsin. Naloxone, an opioid antagonist, can save lives by reversing opioid overdose in a matter of minutes. However, naloxone access and utilization remain suboptimal.</div></div><div><h3>Objective</h3><div>This study examined the development and implementation of best practice alerting (BPA) processes within community pharmacies. This study assessed to what extent the BPA processes (1a) prompted pharmacists to discuss naloxone with high-risk patients; (1b) increased the number of naloxone prescriptions dispensed; and (2) evaluated the facilitators and barriers to implementing the BPA processes.</div></div><div><h3>Methods</h3><div>A pilot study was conducted to develop and implement a BPA process in 3 rural community pharmacies in Wisconsin. The process involved staff identifying high-risk patients, initiating naloxone discussions, and offering naloxone prescriptions. Quantitative monthly data were recorded by pharmacies. Semi-structured interviews were conducted with one pharmacist from each pharmacy to assess the implementation process and outcomes. Descriptive statistics were used to analyze quantitative data. Interview transcripts were analyzed for key themes describing facilitators and barriers to the implementation process.</div></div><div><h3>Results</h3><div>The naloxone alerting process resulted in a notable increase in naloxone discussions and naloxone prescriptions dispensed. Pharmacists reported that pharmacy staff buy-in and engagement, adequate staffing, developing meaningful partnerships, and using depersonalizing, destigmatizing, and normalizing approaches in discussing naloxone with patients were key facilitators. Key barriers included naloxone cost or co-payment and time constraints.</div></div><div><h3>Conclusion</h3><div>Implementing a BPA process in community pharmacies can notably increase naloxone prescribing for high-risk patients. Positive message framing, staffing, meaningful partnerships, and staff buy-in were key facilitators of implementation. Identified barriers were cost or co-payment and time constraints.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 3","pages":"Article 102382"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537960","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 pharmacist-led outpatient penicillin allergy testing clinic","authors":"Eric Linn,&nbsp;Michael Sanchez,&nbsp;Brekk DelHomme,&nbsp;Meera Baldeosingh,&nbsp;Theodore Heierman,&nbsp;John Perry,&nbsp;Adam Fier","doi":"10.1016/j.japh.2025.102346","DOIUrl":"10.1016/j.japh.2025.102346","url":null,"abstract":"<div><h3>Background</h3><div>Penicillin allergies affect approximately 10% of the population, leading to increased health care costs, treatment failures, and multidrug resistant organisms.</div></div><div><h3>Objective</h3><div>To determine the feasibility of implementing a pharmacist-led outpatient penicillin allergy testing program.</div></div><div><h3>Methods</h3><div>This single-site, retrospective cohort study was conducted from July 2022 through December 2023. The study site consisted of an outpatient clinic within a nonacademic community hospital. The primary outcome was the percentage of patients who had their penicillin allergy delabeled. Secondary outcomes included percentage of patients who received appropriate antibiotics following allergy delabeling, incidence and type of immunoglobulin E mediated penicillin reactions, number of patients who were relabeled with a penicillin allergy, number of orthopedic patients with a postoperative surgical site infection, average reimbursement per patient, and average appointment time.</div></div><div><h3>Results</h3><div>A total of 457 outpatients received penicillin allergy testing during the study period. Physician specialties who referred patients were orthopedics, obstetrician-gynecologists, infectious disease, urology, urogynecology, cardiothoracic surgeons, and primary care providers. For the primary outcome, 439 patients (96%) were successfully delabeled. All delabeled patients received appropriate antibiotics following testing. There were 17 patients who developed minor itching with or without a localized rash following the amoxicillin challenge, and one patient had a delayed reaction of rash 12 hours after the amoxicillin that resolved with an antihistamine. One patient had their penicillin allergy relabeled. Of the 192 orthopedic patients, 0 patients had a postoperative surgical site infection. The average reimbursement was $423 per patient with the average appointment lasting 96 minutes.</div></div><div><h3>Conclusion</h3><div>Pharmacists, in collaboration with multiple physician specialties, successfully implemented an outpatient penicillin allergy testing service to safely delabel patients and support antimicrobial stewardship.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 3","pages":"Article 102346"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416019","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}