Journal of the American Pharmacists Association最新文献

{"title":"Evaluating a generative artificial intelligence accuracy in providing medication instructions from smartphone images.","authors":"Yusef Yassin, Thien Nguyen, Krishna Panchal, Katharine Getchell, Timothy Aungst","doi":"10.1016/j.japh.2024.102284","DOIUrl":"10.1016/j.japh.2024.102284","url":null,"abstract":"<p><strong>Background: </strong>The Food and Drug Administration mandates patient labeling materials like the Medication Guide (MG) and Instructions for Use (IFU) to support appropriate medication use. However, challenges such as low health literacy and difficulties navigating these materials may lead to incorrect medication usage, resulting in therapy failure or adverse outcomes. The rise of generative AI, presents an opportunity to provide scalable, personalized patient education through image recognition and text generation.</p><p><strong>Objective: </strong>This study aimed to evaluate the accuracy and safety of medication instructions generated by ChatGPT based on user-provided drug images, compared to the manufacturer's standard instructions.</p><p><strong>Methods: </strong>Images of 12 medications requiring multiple steps for administration were uploaded to ChatGPT's image recognition function. ChatGPT's responses were compared to the official IFU and MG using text classifiers, Count Vectorization (CountVec), and Term Frequency-Inverse Document Frequency (TF-IDF). The clinical accuracy was further evaluated by independent pharmacists to determine if ChatGPT responses were valid for patient instruction.</p><p><strong>Results: </strong>ChatGPT correctly identified all medications and generated patient instructions. CountVec outperformed TF-IDF in text similarity analysis, with an average similarity score of 76%. However, clinical evaluation revealed significant gaps in the instructions, particularly for complex administration routes, where ChatGPT's guidance lacked essential details, leading to lower clinical accuracy scores.</p><p><strong>Conclusion: </strong>While ChatGPT shows promise in generating patient-friendly medication instructions, its effectiveness varies based on the complexity of the medication. The findings underscore the need for further refinement and clinical oversight to ensure the safety and accuracy of AI-generated medical guidance, particularly for medications with complex administration processes.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102284"},"PeriodicalIF":2.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607318","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":"Beyond the fill: Navigating pharmacy's technological future in 2050.","authors":"Timothy Dy Aungst","doi":"10.1016/j.japh.2024.102285","DOIUrl":"10.1016/j.japh.2024.102285","url":null,"abstract":"<p><p>The pharmacy profession stands at a pivotal juncture as it faces unprecedented technological advancements that will rapidly reshape the healthcare landscape by 2050. This commentary explores the implications of technological advancements for pharmacy practice and how it may impact the workforce in the coming decades. The advent of digital health technologies (DHTs), artificial intelligence (AI), and automation is poised to transform patient engagement and care delivery. The Covid-19 pandemic has accelerated this shift, and traditional pharmacy roles have evolved to meet these expectations. As AI and DHT adoption increase, it will push the profession beyond its historical focus on logistics and medication dispensing. Several potential scenarios may unfold by 2050, ranging from a diminished workforce overshadowed by technology to an evolved profession that leverages novel technologies to enhance clinical services and patient care. To prepare for these changes, the profession must address key challenges, including advancing education and training to incorporate new competencies, establishing sustainable financial models for emerging roles, embracing advocacy and navigating regulatory constraints to expand scopes of practice, and overcoming societal resistance to change. By embracing continuous learning and adaptability, pharmacists can seize the opportunity to redefine their roles, ensuring they remain indispensable in an evolving healthcare environment.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102285"},"PeriodicalIF":2.5,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607300","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":"Bringing providers into the community pharmacy: Experiential education","authors":"Rebecca M. Lahrman","doi":"10.1016/j.japh.2024.102276","DOIUrl":"10.1016/j.japh.2024.102276","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102276"},"PeriodicalIF":2.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591412","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":"Feasibility of reaching populations at high risk for HIV in community pharmacies","authors":"Natalie D. Crawford,&nbsp;Kristin R.V. Harrington,&nbsp;Christina Chandra,&nbsp;Daniel I. Alohan,&nbsp;Alvan Quamina,&nbsp;Omarri Beck,&nbsp;Henry N. Young","doi":"10.1016/j.japh.2024.102239","DOIUrl":"10.1016/j.japh.2024.102239","url":null,"abstract":"<div><h3>Background</h3><div>Growing evidence has shown feasibility for human immunodeficiency virus (HIV) prevention service integration in pharmacies, including HIV testing and screening for pre-exposure prophylaxis (PrEP). Yet, further work is needed to determine whether pharmacies can effectively reach those at increased risk of HIV transmission.</div></div><div><h3>Objective</h3><div>We aimed to describe the HIV risk profiles and willingness to obtain HIV prevention services from a sample of pharmacy clients.</div></div><div><h3>Methods</h3><div>This was a cross-sectional pilot study aimed to develop a culturally appropriate pharmacy-based PrEP delivery model among Black men who have sex with men. Two pharmacies were recruited from low-income, underserved communities and participants were recruited within pharmacies for screener and social and behavioral surveys. Individuals were grouped by PrEP eligibility due to sexual risk, injection drug use risk, or both, and demographic and willingness measures were compared.</div></div><div><h3>Results</h3><div>Among 460 pharmacy clients, 81 (17.6%) would have been eligible for PrEP due to sex or injection drug use risk. Most were eligible due to sexual risk (58.0%), while a substantial proportion were eligible due to injection drug use (27.2%) or a combination of sexual and injection drug use risk behaviors (42.0%). Of these eligible, the median age was 31 years (interquartile range = 28.32) and most had ≥1 female (75.3%) or male (96.3%) partner in the past 6 months. There was high willingness to receive a free HIV test in a pharmacy (90.1%). Most were willing to screen for PrEP in a pharmacy (95.1%) despite these services not being available in the state where this study was performed. There were no differences in willingness to obtain pharmacy-based HIV prevention services across risk groups.</div></div><div><h3>Conclusion</h3><div>This study shows that pharmacies in disadvantaged areas can serve a key role in preventing and decreasing the transmission of HIV by reaching populations with high HIV burden and providing HIV prevention services.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102239"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146711","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 shared passion for providing care","authors":"Diana D. Martínez-Nava BA, BS","doi":"10.1016/j.japh.2024.102269","DOIUrl":"10.1016/j.japh.2024.102269","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102269"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553175","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 are the medication, and medication literacy, experts","authors":"Heather A. Johnson PharmD, BCACP","doi":"10.1016/j.japh.2024.102267","DOIUrl":"10.1016/j.japh.2024.102267","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102267"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553177","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":"Addressing health literacy and patient communication from the lens of science","authors":"Aleda M.H. Chen PharmD, PhD, MS, FAPhA","doi":"10.1016/j.japh.2024.102268","DOIUrl":"10.1016/j.japh.2024.102268","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102268"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553176","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(24)00308-X","DOIUrl":"10.1016/S1544-3191(24)00308-X","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102277"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745848","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 an outpatient clinical pharmacy service at an adult cystic fibrosis center","authors":"Olga Marshall,&nbsp;Engy Dous,&nbsp;Kaitlyn Simpson,&nbsp;Cheng-Shiun Leu,&nbsp;Jiying Han,&nbsp;Claire Keating,&nbsp;Emily DiMango","doi":"10.1016/j.japh.2024.102270","DOIUrl":"10.1016/j.japh.2024.102270","url":null,"abstract":"<div><h3>Background</h3><div>High treatment burden can adversely impact health outcomes in people with cystic fibrosis (PwCF). There is a continued need for medication adherence education and further research to evaluate impact of cystic fibrosis (CF) pharmacist interventions in an ambulatory care setting.</div></div><div><h3>Objectives</h3><div>To evaluate whether pharmacist integration into an outpatient adult CF clinic can positively impact patient satisfaction and medication adherence through various pharmacist-based interventions.</div></div><div><h3>Methods</h3><div>At a single urban medical center, a clinical pharmacist on an adult CF care team conducted comprehensive counseling sessions with PwCF. During these visits, types of pharmacist interventions were documented. Patients were provided a baseline and postcounseling survey to assess satisfaction with the pharmacist visit. Adherence to cystic fibrosis transmembrane regulator (CFTR) modulator and mucolytics were tracked 12 months before and 12 months after the counseling session.</div></div><div><h3>Results</h3><div>A total of 723 pharmacist interventions were performed throughout 100 pharmacist visits in 100 PwCF. Most common interventions were inhaler technique education (17%), drug interaction identification (12%), provision of drug education material (12%), and medication refills (12%). Prior to any intervention, 97% of patients felt they could benefit from a pharmacist visit. Postcounseling survey results demonstrated that 98% of patients found pharmacist counseling to be beneficial. Medication adherence rate prior to pharmacy intervention was 81.9% for CFTR modulators and 62.5% for mucolytics, and 86.9% (<em>P</em> = 0.143) and 63.6% (<em>P</em> = 0.773), respectively, after pharmacist intervention.</div></div><div><h3>Conclusion</h3><div>Integration of a clinical pharmacist within the CF clinic can help improve satisfaction and understanding of medication use among PwCF. Nearly all PwCF favorably perceived pharmacist counseling. We report that various pharmacist interventions including optimizing medication use knowledge, reinforcing adherence strategies, and streamlining timely access to treatment can contribute to enhanced care of PwCF.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102270"},"PeriodicalIF":2.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548632","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 community pharmacist intervention for people living with epilepsy","authors":"Jennifer L. Bacci,&nbsp;Ifechukwu Benedict Nwogu,&nbsp;Sabra Zaraa,&nbsp;Michelle Guignet,&nbsp;H. Steve White,&nbsp;Andy Stergachis,&nbsp;Derek Ems,&nbsp;Edward J. Novotny","doi":"10.1016/j.japh.2024.102275","DOIUrl":"10.1016/j.japh.2024.102275","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy is a complex spectrum of seizure disorders. Antiseizure medications are the first-line treatment for most patients. Community pharmacists are among the most accessible health care providers with extensive knowledge of pharmacotherapy yet are seldom engaged in epilepsy care.</div></div><div><h3>Objective</h3><div>The objective of this project was to pilot a community pharmacist-led intervention for people living with epilepsy (PWE).</div></div><div><h3>Methods</h3><div>The Community Pharmacist Epilepsy Services Program was a 6-month disease state management intervention that included 4 components: patient-pharmacist consultation, care plan development, regular check-ins, and care coordination. A pilot was conducted in 4 independent community pharmacies (2 intervention and 2 comparator) in western Washington State. A prospective, 2-arm, pre-post study was planned to evaluate the impact of the intervention on patient-reported quality of life (QoL), health, and satisfaction outcomes. The approach shifted to a 1-arm pre-post design due to low patient recruitment. The primary QoL outcome was the patient-weighted Quality of Life in Epilepsy Inventory-10 (QOLIE-10-P). Staff at intervention and comparator pharmacies were surveyed to evaluate perceived barriers to patient recruitment.</div></div><div><h3>Results</h3><div>Ten patients, including 7 intervention and 3 usual care patients, enrolled in the study. Five intervention patients completed the pre- and postsurveys. The median pre-QOLIE-10-P score was 1.09 and the median postscore was 1.73, indicating a slight nonsignificant decrease in QoL. Eleven pharmacy staff completed the survey evaluating perceived patient recruitment barriers. Limited number of eligible PWE at each pharmacy was perceived as significant barriers.</div></div><div><h3>Conclusion</h3><div>While low patient enrollment limited the ability to observe trends and draw conclusions about the potential impact of the intervention, enrollment barriers and lessons learned highlight opportunities to refine the intervention with the goal of improving the outcomes and well-being of PWE.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102275"},"PeriodicalIF":2.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}