Journal of the American Pharmacists Association最新文献

{"title":"Implementation of a multi-dose ophthalmic medication policy change at a large health system.","authors":"Gregory Mak, Cecilia Cece Speck, Indrani Kar, Douglas Rhee","doi":"10.1016/j.japh.2025.102356","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102356","url":null,"abstract":"<p><strong>Background: </strong>In response to a multi-dose ophthalmic medication (topical eye drop) shortage, the health system had to evaluate the current policy for multi-dose medications and propose changes to the policy to provide patient care while managing the drug shortage. The use of multi-dose eye drops on multiple patients is accepted in ophthalmology care per the CMS updated guidance for ambulatory surgical centers. Prior to this, the use of multi-dose eye drops on multiple patients had not been in practice at our health system due to contamination risk from repeated use in the pre-operative setting. Given the ambiguity of the current policy with regards to multi-dose ophthalmic drop usage and the available literature, an updated policy was developed.</p><p><strong>Objectives: </strong>The objective of this report is to describe the evaluation, assessment, and implementation of a policy change supporting the use of multi-dose ophthalmic medications on multiple patients.</p><p><strong>Methods: </strong>Key stakeholders met and assessed the impact of the shortage and potential policy needs. After evaluation of available literature and regulatory guidance, the proposed change was brought through the necessary formulary, safety, and policy channels for review.</p><p><strong>Results: </strong>After review of the available literature, a determination was made that there is sufficient support of the practice to use multi-dose eye drops in multiple patients provided there are appropriate infection control guidelines. The policy edits were approved by the appropriate committees, and subsequently the organization's policy oversight committee.</p><p><strong>Conclusions: </strong>Our organization was able to make a substantial policy change through a collaborative, interdisciplinary review of literature and best practices to address a critical patient care need resulting from a medication shortage.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102356"},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434210","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 Pharmacist Collaborative Practice Agreement to Improve a Medicare Quality Measure: Statin Use in Persons with Diabetes.","authors":"Christina M Polomoff, Anna Sandalidis, Sean M Jeffery","doi":"10.1016/j.japh.2025.102347","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102347","url":null,"abstract":"<p><strong>Background: </strong>Statin Use in Persons with Diabetes (SUPD) is a Centers for Medicare and Medicaid Services (CMS) star quality measure used in Medicare Part D. This measure assesses the Part D plans' success in prescribing statins to individuals with diabetes between the age of 40 - 75 years. This paper illustrates how pharmacists can improve SUPD star ratings by using a collaborative drug therapy management (CDTM) agreement to initiate statin therapy.</p><p><strong>Methods: </strong>In 2023, pharmacists in a clinically integrated delivery network implemented a CDTM for closing SUPD gaps in care (GIC). Utilizing payer claims data, the pharmacists analyzed multiple years of SUPD results. Open GIC were categorized by practice location, provider, and measurement year. Results were stratified into providers with lower SUPD closure rates (less than 80%) and higher open GIC. Practice locations with the highest number of GIC were prioritized for the pharmacist intervention.</p><p><strong>Results: </strong>By close of member year 2022, 7,529 individuals were identified as SUPD eligible individuals from within the employed medical group. Of the 7,529 patients, 85.4% were prescribed a statin, leaving 1,098 individuals, cared for by 277 providers with open GICs. There were 76 practice locations showing a range of 5 to 48 open GICs. Provider open GIC ranged from 1 to 13 (mean 2.57). By the end of measurement year 2023, pharmacists increased SUPD star ratings from 2 to 4 stars with two payers and from 2 to 3 stars with one payer.</p><p><strong>Conclusion: </strong>Expanded CDTM law enables qualified pharmacists to play a pivotal role in influencing population health outcomes. With a CDTM agreement, pharmacists can overcome barriers to initiating statins for eligible individuals and thereby directly impact star ratings.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102347"},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434217","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 structural models to evaluate the association between adherence to direct oral anticoagulants and safety or efficacy outcomes among patients with Atrial Fibrillation.","authors":"Anjana Mohan, Hua Chen, Ashish A Deshmukh, Matthew Wanat, Ekere James Essien, Rutugandha Paranjpe, Bilqees Fatima, Susan Abughosh","doi":"10.1016/j.japh.2025.102355","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102355","url":null,"abstract":"<p><strong>Background: </strong>Although the management of AF has improved over the years, suboptimal adherence to direct oral anticoagulants (DOACs) is a major health concern. Adherence and long-term persistence to DOACs declines over time resulting in increased risks of stroke, major bleeding and death. The objective of this study was to evaluate the association between adherence to DOACs and composite or bleeding events using marginal structural models (MSM).</p><p><strong>Methods: </strong>A retrospective study was conducted using the Medicare Advantage Plan from January 2016-December 2020. Atrial fibrillation patients prescribed any DOACs were identified. Adherence was calculated using proportion of days covered (PDC). Patients with PDC ≥0.80 were considered adherent. Composite (stroke, systemic embolism, acute coronary syndrome) and bleeding (major and minor) events were calculated for each of the four time periods. A MSM was conducted to estimate the association between adherence and composite/bleeding events by controlling for time dependent covariates and time dependent exposure affected by the prior exposure.</p><p><strong>Results: </strong>A total of 1969 patients with AF were included in the study. Adherence was suboptimal during all the five time periods, and it was ranging from 39.8% to 53.12%. This study did not find any significant association between adherence to DOACs and composite/bleeding events. The safety and efficacy outcomes were comparable among apixaban, rivaroxaban, and dabigatran.</p><p><strong>Conclusion: </strong>This study revealed that adherence declined over time among elderly AF patients. Future studies should explore the association between adherence to DOACs and health outcomes for a longer duration of follow-up using MSM.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102355"},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434223","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":"Mixed methods systematic review of pharmacist-administered injectable contraception: Insights from patients, pharmacists, and other healthcare professionals.","authors":"Nicole E Cieri-Hutcherson, Timothy C Hutcherson, Elizabeth M Bradley, John Rizk, Nicholas D Steele","doi":"10.1016/j.japh.2025.102360","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102360","url":null,"abstract":"<p><strong>Background: </strong>The role of the pharmacist in reproductive health and contraception management continues to expand. Examination of the perspectives of patients, pharmacists, and other healthcare professionals can highlight both the benefits and challenges associated with pharmacist-administration of injectable contraception.</p><p><strong>Objectives: </strong>The objective of this systematic review was to assess the feasibility, applicability, and satisfaction of patients, pharmacists, and other healthcare professionals regarding pharmacist-administered injectable contraception.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search of Medline and Embase databases, from inception through June 3, 2024, was conducted using a predefined search strategy to capture relevant records. Initial records were screened based on pre-specified inclusion criteria focusing on patient, pharmacist, and other healthcare professional outcomes related to the pharmacist-administration of injectable contraceptives. After deduplication and screening, three independent reviewers extracted data, with any disagreements resolved through discussion by a fourth reviewer. Risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized studies and the Appraisal Tool for Cross-Sectional Studies. A convergent integrated mixed-methods approach was utilized to analyze both qualitative and quantitative data.</p><p><strong>Results: </strong>Five cross-sectional studies and one randomized controlled trial were included. Pharmacists were interested in administering injectable contraceptives and reported that implementation would positively impact patient access and convenience. Quantitative analysis demonstrated that pharmacists felt confident and capable in this role and expressed the need for further training and resources. Qualitative analysis highlighted patient satisfaction for the convenience and accessibility, specifically in rural areas. Barriers included insufficient training, lack of infrastructure, mixed acceptance among other healthcare professionals, reimbursement, and regulatory frameworks.</p><p><strong>Conclusion: </strong>Pharmacist-administered injectable contraception appears to be beneficial, accessible, and convenient for patients while aligning with pharmacists' capabilities and professional roles. Barriers should be addressed when considering implementation. Future research should aim to broaden the evidence-based research across different regions and explore long-term outcomes.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102360"},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434226","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":"Laying the foundation for success: A guide to pharmacy residency research projects.","authors":"Sarah E Vordenberg, Adriane N Irwin, Yvonne Mai, Jeffrey G Hamper, Michael R Gionfriddo, Kenneth C Hohmeier, Jordan R Covvey","doi":"10.1016/j.japh.2025.102358","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102358","url":null,"abstract":"<p><p>Thousands of pharmacy graduates in the United States enter postgraduate pharmacy residency programs each year in various practice settings. While these programs primarily focus on clinical training, residents must also complete longitudinal projects, often in the form of research. However, programs and residents face challenges in the execution of research, including time constraints, limited resources, and variable expertise, often contributing to project redundancy and low publication rates. This paper provides a guide to the early planning phases of structuring a successful residency research project. Using the analogy of building a house, we outline essential steps, including necessary resources from programs, as well as the value of rigorous research questions, literature reviews, and study design. We emphasize the importance of feasible project scope, institutional support, and effective mentorship.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102358"},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434220","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 Targeted Recruitment Approach for a Medication Adherence Packaging Program.","authors":"Alex William Middendorf, Christopher B Robbins, Deidra Van Gilder, Erin Miller, Nicholas Elgersma, Sharrel Pinto","doi":"10.1016/j.japh.2025.102359","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102359","url":null,"abstract":"<p><strong>Background: </strong>Medication synchronization and packaging services have been shown to positively impact patient adherence, however lack of robust mechanisms to recruit and enroll patients can present barriers to their utilization.</p><p><strong>Objectives: </strong>To assess the effectiveness of a systematically targeted approach to patient recruitment into a medication packaging program.</p><p><strong>Practice description: </strong>An upper Midwest pharmacy chain, Lewis Drug, provides these services through two programs called SmartSync and SmartPack. Historically, there has been no targeted method for recruiting patients, leading to variable success of the programs.</p><p><strong>Practice innovation: </strong>A targeted recruitment strategy was implemented identifying patients through pharmacy records including prescribed medications, adherence, and PioneerRx Risk Score, a composite score from 0-100 representing patient risk for hospitalization or medication therapy issues. Lead pharmacists from each of the eight intervention sites were provided patient lists for recruitment with recruitment instructions. Untargeted recruitment approaches continued to facilitate comparisons.</p><p><strong>Evaluation methods: </strong>Patient data was described using counts, percentages, measures of central tendency, and data dispersion. Analyses for enrollment growth were conducted using an interrupted time series analysis, and within-group comparisons with Wilcoxon signed-rank Test. Chi-square analysis was used to test associations between groups and categorical variables.</p><p><strong>Results: </strong>A total of 272 patients were identified. Of the patients with contact documented, 40% were enrolled. Of those enrolled, 81.4% were retained at 12 months. For risk scoring, statistically significant differences at 12 months compared to baseline were noted in recruited patients both for mean risk score reductions and shifts to lower risk categories. Adherence metrics remained high.</p><p><strong>Conclusion: </strong>Overall, the targeted approach was successful in enrolling and retaining patients. Additionally, enrollment from untargeted recruitment approaches increased during the intervention, indicating the positive indirect effects targeted approaches can have on cumulative enrollment. Other pharmacy organizations may benefit from developing systematically targeted recruitment strategies for medication packaging programs.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102359"},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434142","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":"Over-the-counter naloxone availability: Insights from rural community pharmacists in the Southern US.","authors":"Emily Gravlee, Carolanne Wartman, Meagen Rosenthal","doi":"10.1016/j.japh.2025.102357","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102357","url":null,"abstract":"<p><strong>Background: </strong>Previous work has found that naloxone availability without a prescription in the Southern United States is highly varied, with 37% of Mississippi pharmacies and 53% of North Carolina pharmacies having naloxone available without a prescription in 2022 and 2024, respectively.^1,2 The United States Food and Drug Administration approved Narcan® nasal spray for over-the-counter availability in 2023. However, limited information exists on the uptake of OTC naloxone across the United States, especially in rural spaces across the Southern United States.</p><p><strong>Methods: </strong>This study employed a cross-sectional survey study design of community pharmacists enrolled in the Rural Research Alliance of Community Pharmacies (RURAL-CP) practice-based research network (PBRN). Data were descriptively analyzed using IBM SPSS Statistics.</p><p><strong>Objectives: </strong>This study aimed to describe the availability and cost of OTC naloxone at rural community pharmacies across the Southern US. Secondary outcomes included pharmacists' perceived barriers to OTC naloxone for both pharmacists and patients.</p><p><strong>Results: </strong>There were N=47 responses to the survey, yielding a response rate of 34.8%. Of the responding community pharmacists, 40% indicated that their pharmacy carried OTC naloxone at the time of the survey (n=18/47, 38.3%). Among these pharmacies, the median cost of OTC naloxone was $50.00 (IQR $46.25-$64.25, range $43.00-$123.20).</p><p><strong>Conclusions: </strong>Despite OTC Narcan® nasal spray being available in pharmacies as of September 2023, availability of this life-saving medication remains less than ideal in rural and Southern pharmacies. These findings emphasize the need for further educational and policy interventions to improve naloxone availability.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102357"},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434191","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 Cavaretta, Rabya Mirza, Joseph T Finn, Timothy Trumbower, Josephine Luong","doi":"10.1016/j.japh.2025.102354","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102354","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102354"},"PeriodicalIF":2.5,"publicationDate":"2025-02-13","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":"Pharmacists as Gate Keepers in Suicide Prevention: Assessing Support Needs of Pharmacy Teams.","authors":"Pauline Stas, Elien Cornelis, Eva De Jaegere, Céline Claus, Kirsten Pauwels, Kees van Heeringen, Gwendolyn Portzky","doi":"10.1016/j.japh.2025.102353","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102353","url":null,"abstract":"<p><strong>Background: </strong>Gatekeeper training is an effective suicide prevention strategy. Pharmacy teams are amongst the most visible and accessible health care providers, making them important as possible gatekeepers. Given the pharmacists' role in dispensing medication, which is a common method of suicide and suicide attempts in Flanders and internationally, they are uniquely positioned to contribute to suicide prevention-not only by restriction or management of means, but also by engaging with individuals at risk and facilitating referrals to appropriate care.</p><p><strong>Objectives: </strong>This study aimed at assessing pharmacy teams' support needs regarding their role as gatekeepers in suicide prevention.</p><p><strong>Methods: </strong>Participants completed an online questionnaire examining their perceptions, attitudes, perceived barriers in suicide prevention, self-efficacy, and need for gatekeeper training. Furthermore, experience with suicide(prevention) and suicidal behaviour among pharmacists was investigated.</p><p><strong>Results: </strong>A total of 110 participants gave informed consent, of whom 69 (62.7%) completed the questionnaire. While nearly three-quarters (73.6%) had encountered suicidal individuals in their pharmacy, only 9.7% felt confident addressing potential suicide risk. Moreover, many indicated that they lacked training in screening mental health issues (81.8%), did not know which actions to undertake with suicidal individuals (64.8%) or how to ask about suicidal thoughts (63.6%). Most participants indicated the need for training (91.3%), and nearly all (97.1%) were willing to follow such a training. They preferred an online training, including topics such as recognizing signs, starting a conversation about suicide and referring to other caregivers.</p><p><strong>Conclusion: </strong>These findings contribute to the growing body of evidence on the important role of pharmacists as gatekeepers in suicide prevention and provide insight into their current perceptions, attitudes and barriers. The study identifies the topics of importance for inclusion in a gatekeeper training. Overall, this study shows a clear need and willingness to participate in such a training amongst pharmacists.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102353"},"PeriodicalIF":2.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426444","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":"Utilizing academic detailing to take a bite out of antibiotic prophylaxis prior to dental procedures.","authors":"David Brennan Portman","doi":"10.1016/j.japh.2025.102351","DOIUrl":"10.1016/j.japh.2025.102351","url":null,"abstract":"<p><strong>Background: </strong>Within the United States, dentists represent the top specialty prescriber of antibiotics in the ambulatory care setting. With the growth of antimicrobial stewardship programs an overall decrease in antibiotic prescribing has been observed. However, prescribing within the dental subset has remained steady.</p><p><strong>Objective: </strong>To describe implementation of an antibiotic stewardship initiative targeting proper utilization of antibiotic prophylaxis by dentists prior to dental procedures.</p><p><strong>Practice description: </strong>Academic detailing, a form of educational outreach, was utilized to facilitate prescribing behavior change. An academic detailer met with dental staff in a face-to-face one-on-one manner to align prescribing with current evidence-based practice. During the encounter, developed resources were utilized to deliver key messages focusing on specific prescribing improvements, while robust conversation allowed the detailer to identify and address any prescriber motivations and/or perceived barriers.</p><p><strong>Practice innovation: </strong>An antimicrobial stewardship initiative specific to the dental setting, utilizing academic detailing, has not been previously described in the literature.</p><p><strong>Evaluation methods: </strong>Comparisons of prescribing appropriateness before and after the intervention was performed using a one-way analysis of variance model. Additionally, a single-group generalized least-squares interrupted time series analysis was performed to estimate the impact of the intervention on the level and slope changes before and after implementation on the number of inappropriate prescriptions.</p><p><strong>Results: </strong>There were 257 prescriptions for dental prophylaxis included in the preimplementation period and 42 prescriptions for dental prophylaxis included in the postimplementation period. Dental prophylaxis prescribing appropriateness was greater in the postimplementation period (17.6% vs. 89.8%; P < 0.001). The incidence of inappropriate prescriptions decreased by 25.39 per 1000 population (P < 0.001) between the periods.</p><p><strong>Conclusion: </strong>Academic detailing improved the prescribing appropriateness of antibiotic prophylaxis prior to dental procedures at Veterans Affairs Butler Healthcare System.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102351"},"PeriodicalIF":2.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426464","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}