Journal of the American Pharmacists Association最新文献

{"title":"Long-term opioid therapy in older adults: Incidence and risk factors related to patient characteristics and initial opioid dispensed","authors":"Iftekhar Ahmed,&nbsp;Alan J. Zillich,&nbsp;Noll L. Campbell,&nbsp;Kevin M. Sowinski,&nbsp;David R. Foster","doi":"10.1016/j.japh.2024.102311","DOIUrl":"10.1016/j.japh.2024.102311","url":null,"abstract":"<div><h3>Background</h3><div>The clinical benefits of long-term opioid therapy (LTOT) are not clearly known; however, LTOT is associated with various adverse outcomes.</div></div><div><h3>Objective</h3><div>This study aimed to estimate the incidence and risk factors associated with LTOT in adults aged ≥ 65 years.</div></div><div><h3>Methods</h3><div>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 &gt; 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.</div></div><div><h3>Results</h3><div>Among 162,287 participants, 10,296 (6.3%) met the definition of LTOT. Key patient characteristics associated with LTOT were age &gt; 85 years (adjusted odds ratio 1.13 [95% confidence interval 1.05–1.21]); &gt; 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102311"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","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":"An analysis of the impact of a multimodal therapy order set on postoperative opioid prescribing after orthopedic shoulder procedures","authors":"Dan Arendt,&nbsp;Marisa Brizzi,&nbsp;Ryan Ruehl,&nbsp;Jacob Cryer,&nbsp;Christopher J. Utz,&nbsp;Brian Grawe","doi":"10.1016/j.japh.2025.102322","DOIUrl":"10.1016/j.japh.2025.102322","url":null,"abstract":"<div><h3>Background</h3><div>Opioids are effective for postoperative pain control but are no longer considered appropriate as the sole method for managing pain after surgery. Newer, multimodal approaches to pain control are increasingly being employed to decrease reliance on opioids, but patient-related outcomes are not consistently reported with these interventions.</div></div><div><h3>Objective</h3><div>This study evaluated the effect of implementing a new multimodal therapy order set, coupled with new patient education materials, on postoperative outcomes after complex shoulder surgery.</div></div><div><h3>Methods</h3><div>This retrospective cohort study compared outcomes from patients who received medications via the new multimodal therapy order set (order set cohort) and patients who did not (nonorder set cohort). All patients were contacted on postoperative days 1,7, and 14 to answer questions about postoperative pain and general measures of function. Data on opioid prescribing and use were collected. There were 2 primary endpoints: median morphine equivalent daily dose (MEDD) prescribed at 14 days postsurgery and median satisfaction with pain control at 14 days postsurgery.</div></div><div><h3>Results</h3><div>There were 16 patients included in the nonorder set cohort and 19 in the order set cohort. At 14 days postsurgery, the median MEDD prescribed was significantly less in the order set cohort than in the nonorder set cohort (<em>P</em> = 0.003), and there was no significant difference in patient satisfaction scores between groups.</div></div><div><h3>Conclusion</h3><div>The implementation of a multimodal order set, coupled with new patient education materials, resulted in a significant reduction in the median MEDD of prescribed opioids without negatively influencing patient satisfaction after complex shoulder interventions.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102322"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081785","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":"Perceptions of PGY1 residency program directors toward online pharmacy students","authors":"Mohammad Sajjad,&nbsp;Michael R. Gionfriddo,&nbsp;Branden D. Nemecek","doi":"10.1016/j.japh.2024.102300","DOIUrl":"10.1016/j.japh.2024.102300","url":null,"abstract":"<div><h3>Background</h3><div>While research has identified characteristics that improve students’ chances of matching into a postgraduate year 1 (PGY1) residency, it is unclear how graduating from an online pharmacy program affects these chances.</div></div><div><h3>Objectives</h3><div>Our qualitative descriptive study aimed to explore perceptions of residency program directors (RPDs) toward online pharmacy students and how these perceptions may affect match rankings.</div></div><div><h3>Methods</h3><div>PGY1 RPDs were identified using the American Society of Health-System Pharmacists Residency Directory, recruited via email, and interviewed with a set of prespecified open-ended questions. Interviews were digitally recorded and transcribed, with transcripts being used to develop consensus codes and consequent themes and subthemes.</div></div><div><h3>Results</h3><div>Fourteen RPDs from a variety of residency program types were interviewed. Most RPDs had positive or neutral perceptions towards online pharmacy programs. Their perceptions of the students in these programs were mixed, with some extolling drive and motivation, while others assuming laziness as motivation for pursuing an online program. RPDs mentioned that being in an online pharmacy program could negatively affect students’ skills, such as patient care and communication skills, while others felt it could positively affect self-advocacy and time management skills. Despite these concerns, RPDs reiterated they use the same criteria and advice as they would for traditional students and that it would not affect their ranking.</div></div><div><h3>Conclusion</h3><div>RPDs’ perceptions toward online pharmacy programs and the students in them were mixed, with some being concerned the nature of these programs would negatively impact skills needed for residency. Despite these concerns, RPDs reiterated these students will be assessed no differently from traditional students.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102300"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741174","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":"Comparative effectiveness of buprenorphine adherence with telemedicine vs. in-person for rural and urban patients","authors":"Thomas J. Reese,&nbsp;Nana Addo Padi-Adjirackor,&nbsp;Kevin N. Griffith,&nbsp;Bryan Steitz,&nbsp;Stephen W. Patrick,&nbsp;Ashley A. Leech,&nbsp;Andrew D. Wiese,&nbsp;Adam Wright,&nbsp;Mauli V. Shah,&nbsp;Jessica S. Ancker","doi":"10.1016/j.japh.2024.102318","DOIUrl":"10.1016/j.japh.2024.102318","url":null,"abstract":"<div><h3>Background</h3><div>Policy changes during the COVID-19 pandemic allowed buprenorphine to be prescribed for opioid use disorder via telemedicine without an in-person visit. A recently proposed change will limit buprenorphine access to 30 days without an in-person visit. Given that people living in rural areas may be disproportionally impacted by this change, we sought to better understand how buprenorphine adherence may be impacted by requiring in-person visits.</div></div><div><h3>Objective</h3><div>Compare buprenorphine adherence after telemedicine to adherence after in-person visits for patients who live in rural and urban areas.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, we used electronic health record data from a large medical center. The cohort included all adult patients prescribed buprenorphine for opioid use disorder during 2017–2022. The primary outcome was adherence, characterized by the Medication Possession Ratio (MPR) and gaps in buprenorphine treatment at 30 and 180 days. We conducted a longitudinal analysis at visit level, stratified by patient urbanicity, and controlled for patient, prescriber, prescription, and setting characteristics.</div></div><div><h3>Results</h3><div>From 511 patients, we followed 3302 in-person and 519 telemedicine visits. Compared to in-person visits we observed no difference in the adherence following telemedicine visits overall. However, telemedicine was associated with higher MPR for rural patients (30 days: adjusted marginal effects [AME], 3.7%; 95% CI, 2.0–5.5; <em>P</em> &lt; 0.001 and 180 days: AME, 8.5%; 95% CI 5.7–11.3; <em>P</em> &lt; 0.001) and fewer gaps (30 days: AME, −6.7%; 95% CI, −9.9 to −0.1; <em>P</em> &lt; 0.001 and 180 days: AME, −9.4%; −14.0 to −4.5; <em>P</em> &lt; 0.001) compared to in-person visits.</div></div><div><h3>Conclusion</h3><div>These findings suggest that telemedicine is a viable alternative to in-person visits, especially for patients living in rural areas, which should help guide future policies that preserve or increase access to buprenorphine in a manner that can reduce barriers for patients.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102318"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904002","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":"Medication therapy management lifestyle and wellness program for patients in rural Arizona","authors":"David R. Axon,&nbsp;Becka Eckert,&nbsp;Terra Leon,&nbsp;Sonia Morales,&nbsp;John Ehiri,&nbsp;Aminata Kilungo,&nbsp;Thelma Okotie,&nbsp;Tenneh Turner-Warren","doi":"10.1016/j.japh.2025.102324","DOIUrl":"10.1016/j.japh.2025.102324","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacist-provided medication therapy management (MTM) services have demonstrated improved clinical outcomes for patients. MTM services could incorporate additional lifestyle and wellness counseling to potentially enhance health care for underserved patients.</div></div><div><h3>Objective</h3><div>To report the outcomes of a new pharmacist-provided MTM lifestyle and wellness counseling program for underserved rural Arizonans with diabetes and/or hypertension.</div></div><div><h3>Methods</h3><div>A community health center referred rural Arizonans with type 2 diabetes and/or hypertension to the MTM pharmacist for telephonic MTM lifestyle and wellness counseling between July 2020 and June 2023. Data were collected on clinical characteristics, adherence issues, and pharmacist recommendations. A nurse reviewed the patients' electronic health record to determine which recommendations had been accepted by the primary care provider after 90 days. Summary statistics were computed.</div></div><div><h3>Results</h3><div>For 93 patients in the program, pharmacists identified many drug-drug interactions, adverse drug reactions, utilization/cost concerns, and recommended preventative vaccines. Pharmacists provided counseling for exercise, nutrition, laboratory values, and disease state education. Twenty-nine patients reported missing any doses of their medications in the past 2 weeks. Patients used a variety of methods to remind them to take their medications. A total of 309 recommendations were made by the pharmacist averaging 3.3 ± 1.4 per patient. Of these, 113 (36.6%) were accepted within 90 days. The most common recommendations made were screening needed (n = 77) and vaccination due (n = 70). The most frequently accepted recommendations by the patients' provider were reinforcing lifestyle/disease self-management strategies (61.7%) and decreasing medication dose (60.0%).</div></div><div><h3>Conclusion</h3><div>This novel MTM lifestyle and wellness counseling program demonstrated some success for underserved Arizonans with diabetes and/or hypertension. Over one-third of recommendations made by the pharmacist to the patients' primary care provider were accepted, which is encouraging in showing the value of this program but suggests further work is needed to act upon them or understand why they are not implemented.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102324"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025490","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":"American Pharmacists Association Foundation Incentive Grants: A 30-year descriptive review","authors":"Cristian Rodriquez,&nbsp;Shanna K. O'Connor,&nbsp;Emily Albers","doi":"10.1016/j.japh.2025.102323","DOIUrl":"10.1016/j.japh.2025.102323","url":null,"abstract":"<div><h3>Background</h3><div>The American Pharmacists Association Foundation Incentive Grant program provides funding for pharmacy learners to conduct community pharmacy-based research projects. Over the 30-year period since its inception, the number of grants awarded has grown through support from the Community Pharmacy Foundation.</div></div><div><h3>Objective</h3><div>The objective of this project was to describe the breakdown of project topics and geographic reach of Incentive Grant–funded projects from 1994 to 2024 and summarize the number of patients or survey respondents reached.</div></div><div><h3>Methods</h3><div>All available reports and supporting documents for the Incentive Grant program were reviewed using the American Pharmacists Association Foundation internal database. Projects were assigned a geographical region using US Census Bureau Divisions and categorized using focus areas from grant calls-for-proposals. Project impact was evaluated by summing the number of interventions reported in final reports.</div></div><div><h3>Results</h3><div>A total of 784 projects were conducted and 551 had final reports available. Thirteen project focus areas were identified, with a majority of projects related to cardiovascular disease management (21.1%), pharmacy workflow/processes (14%), and immunizations (13.3%). Projects were conducted most frequently in the U.S. regions of South Atlantic (27.4%), East North Central (24.2%), and West North Central (14.9%). Of 398 projects with intervention-level data reported (2004–2024), 100,547 interventions were made (86,616 patients impacted and 13,931 survey respondents reached).</div></div><div><h3>Conclusion</h3><div>The findings of this study serve as a summary of community pharmacy-based research over time, indicating the American Pharmacists Association Foundation Incentive Grant program has likely had a positive influence on community pharmacy-based research as evidenced by number of funded projects, geographic scope, participant impact, and breadth of project focus.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102323"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043098","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":"Community pharmacy-based buprenorphine programs and pharmacists' roles, knowledge, attitudes, and barriers to providing buprenorphine-related services: A systematic review","authors":"Smita Rawal,&nbsp;Justine W. Welsh,&nbsp;Courtney R. Yarbrough,&nbsp;Amanda J. Abraham,&nbsp;Natalie D. Crawford,&nbsp;Jordan W. Khail,&nbsp;Ashley Chinchilla,&nbsp;Joshua Caballero,&nbsp;Lorenzo Villa Zapata,&nbsp;Henry N. Young","doi":"10.1016/j.japh.2024.102319","DOIUrl":"10.1016/j.japh.2024.102319","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102319"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","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":"Cover","authors":"","doi":"10.1016/S1544-3191(25)00056-1","DOIUrl":"10.1016/S1544-3191(25)00056-1","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102377"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593392","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,&nbsp;Sanika Rege","doi":"10.1016/j.japh.2024.102315","DOIUrl":"10.1016/j.japh.2024.102315","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102315"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","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":"Barriers to and facilitators of buprenorphine dispensing for opioid use disorder: Evidence from focus groups in Appalachian Kentucky","authors":"Douglas R. Oyler,&nbsp;Dustin K. Miracle,&nbsp;Hannah Hesener,&nbsp;Laura Stinson,&nbsp;Monica Roberts,&nbsp;Adrienne Matson,&nbsp;Patricia R. Freeman","doi":"10.1016/j.japh.2024.102308","DOIUrl":"10.1016/j.japh.2024.102308","url":null,"abstract":"<div><h3>Background</h3><div>As efforts to increase buprenorphine prescribing continue to intensify, pharmacy dispensing plays an important role in access to essential medications for opioid use disorder. Existing survey research suggests stigma and regulatory concerns are barriers to pharmacists dispensing buprenorphine, but facilitators are less clear, as are in-depth perceptions of pharmacists regarding buprenorphine.</div></div><div><h3>Objective</h3><div>To assess barriers and facilitators to buprenorphine dispensing in Appalachian Kentucky using a series of focus groups with pharmacy employees.</div></div><div><h3>Methods</h3><div>Between September and October 2023, 5 structured focus groups were conducted with a total of 19 pharmacists and pharmacy technicians across a mixture of high- and low-buprenorphine-dispensing counties. Investigators independently coded focus group transcriptions using a grounded theory approach to describe current dispensing practices as well as barriers to and facilitators of buprenorphine dispensing.</div></div><div><h3>Results</h3><div>Most participants described dispensing buprenorphine, but there was substantial variation in dispensing practices. Participants identified patient-, provider-, pharmacy-, regulatory-and medication-related barriers to and patient-, provider-, pharmacy-, and regulatory-related facilitators of pharmacy dispensing. Patient- and provider-related barriers accounted for over half of barriers identified. The most common facilitators were also patient- and provider-related.</div></div><div><h3>Conclusion</h3><div>In a series of 5 focus groups with pharmacy staff in Appalachian Kentucky, the most common barriers to buprenorphine dispensing were patient and provider behaviors. Patient stories were the most common facilitators. Interventions to increase pharmacy buprenorphine dispensing should focus on addressing misperceptions regarding behavior, preferably driven by positive patient testimony.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102308"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792703","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}