Journal of the American Pharmacists Association最新文献

{"title":"Community pharmacy-based buprenorphine programs and pharmacists' roles, knowledge, attitudes, and barriers to providing buprenorphine-related services: A systematic review.","authors":"Smita Rawal, Justine W Welsh, Courtney R Yarbrough, Amanda J Abraham, Natalie D Crawford, Jordan W Khail, Ashley Chinchilla, Joshua Caballero, Lorenzo Villa Zapata, Henry N Young","doi":"10.1016/j.japh.2024.102319","DOIUrl":"10.1016/j.japh.2024.102319","url":null,"abstract":"<p><strong>Background: </strong>Buprenorphine is an effective medication for treating opioid use disorder (OUD) and reducing opioid-related overdose deaths. Community pharmacies are key access points for buprenorphine, with pharmacists well-positioned to dispense and counsel patients on appropriate use. Recent evidence has identified pharmacists' growing engagement in buprenorphine services; yet, access to buprenorphine and related services in community pharmacies remains limited.</p><p><strong>Objectives: </strong>This systematic review aimed to investigate and synthesize evidence from existing literature on pharmacy-based buprenorphine programs for OUD, including stocking/dispensing patterns, and pharmacists' knowledge, attitudes, and barriers (KAB) to providing buprenorphine services.</p><p><strong>Methods: </strong>Searches were performed across 4 databases: PubMed, Web of Science, CINAHL, and Google Scholar. Eligible articles included U.S.-based, peer-reviewed original research conducted between 2002 and 2024, focusing on pharmacy-based buprenorphine programs for OUD and community pharmacists' KAB related to buprenorphine. PRISMA guidelines were followed.</p><p><strong>Results: </strong>Search retrieved a total of 488 articles with 38 meeting the criteria for inclusion. Community pharmacy-based buprenorphine programs for OUD included physician-pharmacist collaborative care models, established dispensing agreements, and reinforced counseling. Buprenorphine stocking/availability varied across pharmacy types, with independent pharmacies less likely to stock and dispense the medication than chain pharmacies. Pharmacists appeared to exhibit limited knowledge and a cautious willingness to dispense buprenorphine. Barriers included concerns about perceived Drug Enforcement Administration (DEA) \"caps\"/investigations, wholesaler flags, diversion risks, inadequate knowledge, and insufficient communication with clinicians.</p><p><strong>Conclusion: </strong>This study found that community pharmacist involvement in buprenorphine programs has the potential to improve access to OUD treatment. However, wider adoption of these initiatives requires rigorous evaluation through randomized controlled trials and longitudinal studies to demonstrate their effectiveness. Barriers, including perceived DEA investigations and wholesaler restrictions, may limit pharmacist engagement in providing buprenorphine. Policy reforms addressing these concerns are needed, alongside efforts to increase pharmacists' knowledge and foster better communication/collaboration between clinicians and pharmacists to enhance buprenorphine access and utilization.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102319"},"PeriodicalIF":2.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903999","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":"Navigating transition with hope and resilience.","authors":"Pamela C Heaton","doi":"10.1016/j.japh.2024.102317","DOIUrl":"https://doi.org/10.1016/j.japh.2024.102317","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102317"},"PeriodicalIF":2.5,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899992","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":"Marginal health care expenditures and health-related quality of life burden in patients with osteoporosis in the United States.","authors":"Prajakta P Masurkar, Sanika Rege","doi":"10.1016/j.japh.2024.102315","DOIUrl":"10.1016/j.japh.2024.102315","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis, marked by reduced bone density, significantly impacts quality of life. Recent estimates on its economic and humanistic burden in the United States are scarce.</p><p><strong>Objective: </strong>To evaluate the marginal burden of osteoporosis on total all-cause health care costs and health-related quality of life (HRQoL) in the United States.</p><p><strong>Methods: </strong>This retrospective cross-sectional study utilized 2019-2021 Medical Expenditure Panel Survey data, including adults aged ≥50 years with or without osteoporosis. HRQoL was assessed using physical component summary (PCS) and mental component summary (MCS) scores. Descriptive analyses reported sociodemographic/clinical characteristics, healthcare expenditures, and PCS/MCS scores. A two-part model assessed the marginal effect of osteoporosis on total healthcare expenditures. Multivariable generalized linear model (GLM) estimated the marginal differences in MCS and PCS scores between the osteoporosis and nonosteoporosis groups, while multivariable linear regression assessed factors associated with HRQoL among patients with osteoporosis.</p><p><strong>Results: </strong>There were approximately 2.89 million patients with osteoporosis and 25 million without osteoporosis. The marginal total health care expenditures were $8572.15 (95% CI: $6546.39-$14,597.92) higher for the osteoporosis Vs. nonosteoporosis group. Age, sex, marital status, year, and certain comorbidities were significant predictors of HRQoL among osteoporosis patients. Multivariable GLM indicated PCS scores were 6.29 units lower (95% CI: -7.08 to -4.15) and MCS scores were 4.22 units lower (95% CI: -8.34 to -3.31) among osteoporosis Vs. nonosteoporosis patients.</p><p><strong>Conclusion: </strong>Patients with osteoporosis showed higher economic burden and lower HRQoL than those without, highlighting the need for policy changes and innovative approaches to improve HRQoL and reduce healthcare expenses for osteoporosis management.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102315"},"PeriodicalIF":2.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873365","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":"Mental health in rural agricultural workers: The role of a community pharmacist.","authors":"Grayson Murray, Melissa McKnight, Tyler C Melton","doi":"10.1016/j.japh.2024.102316","DOIUrl":"10.1016/j.japh.2024.102316","url":null,"abstract":"<p><p>Agriculture is one of the United States' oldest occupations, dating back to before the founding of the country, when indigenous farmers maintained the land. Agriculture has since grown into an enormous industry, and with that has come financial and emotional strain impacting the mental health of those who strive to feed the world. Climate, financial, and stress-inducing conditions related to agriculture are leading causes of mental health crises in agricultural workers, putting this population at risk for suicidal ideation. With most farms being family-owned and operated in rural areas of the country, there is limited access to health care to address the mental health concerns occurring within the occupation. Community pharmacists are ideally positioned to bridge the mental health care gap in small-town America. By obtaining training in Mental Health First Aid and becoming equipped with mental health care knowledge, community pharmacists can aid in crisis situations, refer to proper care and support systems, and aid in early intervention with the at-risk agricultural population. By doing so, community pharmacists can strengthen their role as the most accessible health care professionals and gain recognition from a population that often finds it difficult to ask for help in situations related to their mental health. This commentary provides a review of signs and symptoms of psychiatric disorders, early mental health interventions and screening tools, and mental health resources available for pharmacist use. These considerations are necessary to support and inform community pharmacy practice when serving rural agricultural communities.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102316"},"PeriodicalIF":2.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865983","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":"Australian community pharmacists' experiences of prescription drug monitoring programs: Comparisons between mandated and nonmandated states.","authors":"Rose Laing, Pei Ying, Ting Xia, Suzanne Nielsen, Louisa Picco","doi":"10.1016/j.japh.2024.102313","DOIUrl":"10.1016/j.japh.2024.102313","url":null,"abstract":"<p><strong>Background: </strong>Prescription drug monitoring programs (PDMPs) track patients' prescription records for high-risk medications and prompt real-time alerts to pharmacists when specific criteria are met. PDMPs are increasingly implemented by health care systems to attempt to mitigate harms associated with prescription opioids.</p><p><strong>Objective: </strong>This study aims to explore and compare PDMP experiences among Australian community pharmacists from states where PDMP use is mandated and nonmandated.</p><p><strong>Methods: </strong>A representative sample of community pharmacists from New South Wales, Queensland, Victoria, and Western Australia were invited to complete an anonymous online survey. The survey collected pharmacy and pharmacist-related information and asked pharmacists to rank PDMP's usefulness and barriers on a 5-point scale. Mann-Whitney U tests were conducted to determine if there were statistically significant differences in scores between mandated and nonmandated states.</p><p><strong>Results: </strong>In total, 690 pharmacists were included. Pharmacists in mandated states had statistically higher mean 'usefulness' scores for 5 out of 17 items, such as informing clinical decision-making (P < 0.001) and increasing confidence to refuse medication supply (P = 0.002). PDMP-related barriers were rarely reported by pharmacists, although there were statistically significant differences for specific barriers between mandated and nonmandated states. Nonmandated states had significantly higher mean scores for 5 barriers, including 'unsure what to do with the PDMP information' (P < 0.001) and 'PDMP is not integrated into dispensing software' (P = 0.005). Mandated states had statistically higher mean scores for 9 barriers, including 'not all scripts appear in PDMP' (P < 0.001) and 'inaccurate information in the PDMP' (P < 0.001).</p><p><strong>Conclusion: </strong>There were significant differences in pharmacists' PDMP experiences between mandated and nonmandated states, which may have policy implications given Australia's recent investment into national prescription monitoring.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102313"},"PeriodicalIF":2.5,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855826","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 2023 Washington State pharmacist workforce survey: Employment and patient care roles.","authors":"Jennifer L Bacci, Clayton English, Peggy S Odegard, Andy Stergachis, Cyndy R Snyder, Jennifer Hookstra Danielson","doi":"10.1016/j.japh.2024.102314","DOIUrl":"10.1016/j.japh.2024.102314","url":null,"abstract":"<p><strong>Background: </strong>The pharmacy workforce is evolving rapidly, and while national data reveal broad trends, they often overlook the impact of state-level policies on local pharmacy practice and education.</p><p><strong>Objective: </strong>To describe employment status and patient care roles of pharmacists in Washington State.</p><p><strong>Methods: </strong>A cross-sectional survey of pharmacists licensed in Washington State was conducted in June-July 2023. The survey assessed participants' personal and professional demographics; employment status, including changes in employment status since 2020 and consideration of a change in the next 12 months; and patient care roles, including time spent in patient care roles and services provided. Data were analyzed using descriptive statistics.</p><p><strong>Results: </strong>We received 856 responses (10.6% response rate) and 810 responses were included in the final analysis. Participants' median age was 43 years. Most participants were female (64%) and White (73%). Over 3-quarters of participants reported practicing in community (37%), hospital (27%), and/or ambulatory care/clinic (21%) settings. Over one-third of participants (39%) reported a job or employment change since 2020 and 17% reported they were considering a job or employment change in the next 12 months. The 5 most frequently reported patient care services were medication education or counseling (83%), medication dispensing (70%), prescribing via a collaborative drug therapy agreement or protocol (59%), medication therapy management (53%), and medication reconciliation (52%).</p><p><strong>Conclusion: </strong>This study offers important insights into pharmacist employment and practice in Washington State. Certain trends in Washington State, particularly in pharmacist employment shifts within clinic settings and patient care roles such as prescribing and medication education, stand out when compared to national patterns. These findings highlight the importance of ongoing state-level workforce assessments to guide educational strategies and the supply of pharmacists with local needs.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102314"},"PeriodicalIF":2.5,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing a telemedicine-led heart failure medication regimen optimization clinic in medically underserved heart failure populations.","authors":"Kazuhiko Kido, Wei Fang, Kimberly Becher, Brittany Carey, George Sokos","doi":"10.1016/j.japh.2024.102309","DOIUrl":"10.1016/j.japh.2024.102309","url":null,"abstract":"<p><strong>Background: </strong>Suboptimal guideline-directed medical therapy (GDMT) management for heart failure (HF) is a critical issue in rural communities. Most patients with HF in rural communities are treated in primary care settings. Multidisciplinary telemedicine-led HF medication optimization clinics were implemented to improve access to specialty care and address health disparities in HF care in rural Appalachian areas.</p><p><strong>Objectives: </strong>The project aimed to evaluate the effect of a multidisciplinary telemedicine HF medication optimization clinic on the use of GDMT in cardiology and primary care services.</p><p><strong>Methods: </strong>This pilot study was a multicenter prospective cohort study over a 6-month follow-up period. Patients aged > 18 years with HF with reduced ejection fraction or HF with mildly reduced ejection fraction were included. Telemedicine visits were conducted every 2 to 4 weeks. The primary outcome was the use of all 4 GDMT classes.</p><p><strong>Results: </strong>The use of all 4 GDMT agents was numerically higher in HF cardiology service (n = 70) than the general cardiology cohort (n = 11) at baseline (46% vs. 9%), 1 month (55% vs. 18%), 3 months (58% vs. 18%), and 6 months (52% vs. 18%). The individual use of angiotensin receptor neprilysin inhibitor (ARNI), mineralocorticoid receptor antagonist (MRA), or sodium-glucose cotransporter 2 inhibitor (SGLT2I) was also numerically higher in HF cardiology service over 6 months. In the primary care service (n = 25), the use of all 4 GDMT agents was not significantly changed over 6 months. ARNI and beta-blocker use was numerically increased from the baseline to follow-up periods. MRA use was numerically decreased from baseline to follow-up periods. SGLT2I use was not significantly changed.</p><p><strong>Conclusion: </strong>The multidisciplinary telemedicine approach was effective in the HF service group for GDMT optimization. However, further academic detailing for primary care and general cardiology services is needed, focusing on the initiation and persistence of MRA and SGLT2I and dose titration of GDMT agents.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102309"},"PeriodicalIF":2.5,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term opioid therapy in older adults: Incidence and risk factors related to patient characteristics and initial opioid dispensed.","authors":"Iftekhar Ahmed, Alan J Zillich, Noll L Campbell, Kevin M Sowinski, David R Foster","doi":"10.1016/j.japh.2024.102311","DOIUrl":"10.1016/j.japh.2024.102311","url":null,"abstract":"<p><strong>Background: </strong>The clinical benefits of long-term opioid therapy (LTOT) are not clearly known; however, LTOT is associated with various adverse outcomes.</p><p><strong>Objective: </strong>This study aimed to estimate the incidence and risk factors associated with LTOT in adults aged ≥ 65 years.</p><p><strong>Methods: </strong>This was a retrospective cohort study using Medicare claims data. Opioid-naïve older adults filling an opioid prescription between 2014 and 2016 were included. The outcome variable was LTOT, defined as an opioid use episode longer than 90 days and having > 60 cumulative days of supply. Predictor variables included patient characteristics, characteristics of initial opioid dispensed, and pain conditions. Multivariable logistic regression was performed to assess the association between predictors and LTOT.</p><p><strong>Results: </strong>Among 162,287 participants, 10,296 (6.3%) met the definition of LTOT. Key patient characteristics associated with LTOT were age > 85 years (adjusted odds ratio 1.13 [95% confidence interval 1.05-1.21]); > 5 comorbidities (1.55 [1.45-1.65]); and history of drug use disorder (1.53 [1.35-1.74]), alcohol use disorder (1.38 [1.23-1.54]), tobacco use disorder (1.31 [1.23-1.40]), and opioid use disorder (2.00 [1.69-2.37]). Characteristics of initial opioid associated with LTOT were dispensing long-acting opioids (1.72 [1.21-2.44]) and concomitant use of benzodiazepines (1.16 [1.08-1.25]), gabapentinoids (1.57 [1.47-1.67]), and prescription nonsteroidal anti-inflammatory drugs (1.24 [1.17-1.31]). Anxiety disorders were associated with 1.4-1.5 times increased odds of LTOT. Moreover, initial opioid supply of ≥ 30 days led to 11-16 times higher odds of LTOT than days' supply of 1-3 days.</p><p><strong>Conclusions: </strong>Factors related to patient characteristics (age, number of comorbidities, substance use disorders, anxiety disorders) and initial opioid dispensation (duration of action, certain concomitant medications, days' supply) are associated with LTOT in older adults. Prescribers should consider these factors when prescribing opioids to senior patients.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102311"},"PeriodicalIF":2.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacists enhance national security through medical countermeasure program leadership.","authors":"Alexandria VanBuren, Dakota McMurray, Alexander Eastman","doi":"10.1016/j.japh.2024.102310","DOIUrl":"10.1016/j.japh.2024.102310","url":null,"abstract":"<p><strong>Background: </strong>Chemical, biological, radiological, or nuclear threats and emerging infectious diseases are significant threats to public health and national security. U.S. Customs and Border Protection plays a vital role in safeguarding the nation's borders and protecting against all threats. Pharmacists, with their expertise in medication and public health, can play a crucial role in medical countermeasure (MCM) programs.</p><p><strong>Objectives: </strong>The study aims to identify pharmacist-led quality improvements and explain expanded pharmacist roles through advancing a federal MCM program.</p><p><strong>Practice description: </strong>U.S. Customs and Border Protection is the nation's largest law enforcement agency charged with protecting the American people and safeguarding the nation's borders.</p><p><strong>Practice innovation: </strong>Program management for MCM transitioned to the Office of the Chief Medical Officer under pharmacist leadership, better aligning the program with the agency's health security mission.</p><p><strong>Evaluation methods: </strong>Pharmacists conducted a baseline program analysis then spearheaded 5 improvements over 1 year to fill identified gaps. Pharmacist-led improvements include development of a Standard Operating Procedure for accountability, SharePoint site development for inventory tracking/reporting, inventory analysis through SharePoint utilization, creation of a MCM channel in Microsoft Teams for information sharing, and establishment of a Point of Dispensing exercise schedule for readiness.</p><p><strong>Results: </strong>Pharmacist-led improvements resulted in Standard Operating Procedure recognition as best practice guidance by the Department of Homeland Security, improved inventory completion rates from 0% to 99%, initiation of 29 new MCM sites protecting 3,000 additional U.S. Customs and Border Protection workforce and persons in custody, inventory distribution to 55 sites protecting 35,000 additional personnel and persons in custody, enrollment of 247 members to the MCM channel in Microsoft Teams, improved Point of Dispensing exercise completion from 5% to 66%, and scheduled 90 Point of Dispensing exercises.</p><p><strong>Conclusion: </strong>Pharmacists play a vital role in MCM program advancement and contribute to national security efforts against chemical, biological, radiological, or nuclear threats and emerging infectious diseases.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102310"},"PeriodicalIF":2.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814765","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":"Specialty pharmacy services compared with community-based pharmacy services on HIV viral load.","authors":"Laura L Pedersen, Patricia Fulco, Rachel Pryor, Gonzalo Bearman","doi":"10.1016/j.japh.2024.102307","DOIUrl":"10.1016/j.japh.2024.102307","url":null,"abstract":"<p><strong>Objectives: </strong>People with human immunodeficiency virus (HIV) (PWH) on antiretroviral therapy (ART) with viral load (VL) suppression eliminate the risk of sexual transmission. Many factors including decreased ART adherence and medication access barriers decrease the success of treatment as an HIV prevention strategy. ART access may be enhanced with specialty pharmacy services (SPS), but the impact compared with community-based practices is variably reported. This study aimed to compare the impact of specialty vs community pharmacies on medication adherence via VL assessment.</p><p><strong>Design: </strong>This retrospective cohort medical record study investigated whether the use of specialty pharmacies compared with community-based practices improves VL suppression. A record review was performed to collect the most recent HIV VL Demographic data collected included age range, race, ethnicity, and patient-reported gender identity. Pharmacy type was determined via review of prescription refill history linked to the medical record.</p><p><strong>Setting and participants: </strong>Patients included were enrolled in the Ryan White HIV/AIDS Program (RWHAP) (May 31, 2022, to May 30, 2023) at an HIV/infectious diseases academic medical center clinic.</p><p><strong>Outcome measures: </strong>An undetectable VL was defined as the most recent HIV VL being < 50 copies/mL or suppressed as < 200 copies/mL.</p><p><strong>Results: </strong>A total of 1631 PWH were eligible, 179 were excluded, and 1452 were included in the analysis; 91.3% were virologically suppressed (n = 1326) with an undetectable VL in 83.3% (n = 1210). When adjusting for age, self-reported gender identity, race, and ethnicity, PWH using SPS were more likely to have a suppressed (adjusted odds ratio [AOR] 1.469 [95% CI 1.007-2.142]) and undetectable VL (AOR 1.396 [95% CI 1.051-1.854]), respectively, than the use of community-based practices.</p><p><strong>Conclusions: </strong>The use of specialty compared with community-based pharmacies had a statistically significant, yet modest association with VL suppression in PWH enrolled in RWHAP services in this single academic medical center retrospective analysis. Further studies are needed to determine whether mail-order services, specifically those without specialty service support, are sufficient for high rates of virologic control.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102307"},"PeriodicalIF":2.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792710","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}