Journal of the American Pharmacists Association最新文献

{"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":"10.1016/j.japh.2025.102355","url":null,"abstract":"<p><strong>Background: </strong>Although the management of atrial fibrillation (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 decline over time resulting in increased risks of stroke, major bleeding, and death.</p><p><strong>Objective: </strong>This study aimed to evaluate the association between adherence to DOACs and composite or bleeding events using marginal structural models (MSMs).</p><p><strong>Methods: </strong>A retrospective study was conducted using the Medicare Advantage Plan from January 2016 to December 2020. Patients with AF prescribed any DOACs were identified. Adherence was calculated using the 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 4 time periods. An MSM was conducted to estimate the association between adherence and composite efficacy or bleeding events by controlling for time-dependent covariates and time-dependent exposure affected by the previous exposure.</p><p><strong>Results: </strong>A total of 1969 patients with AF were included in the study. Adherence was suboptimal during all the 5 time periods, and it ranged from 39.8% to 53.12%. This study did not find any significant association between adherence to DOACs and composite efficacy or 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 old patients with AF. 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":"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":"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 2 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 to 100 representing patient risk for hospitalization or medication therapy issues. Lead pharmacists from each of the 8 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 were 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 United States.","authors":"Emily Gravlee, Carolanne Wartman, Meagen Rosenthal","doi":"10.1016/j.japh.2025.102357","DOIUrl":"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. The United States Food and Drug Administration approved Narcan nasal spray for over-the-counter (OTC) 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>Objectives: </strong>This study aimed to describe the availability and cost of OTC naloxone at rural community pharmacies across the Southern U.S. Secondary outcomes included pharmacists' perceived barriers to OTC naloxone for both pharmacists and patients.</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 practice-based research network. Data were descriptively analyzed using IBM SPSS Statistics.</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 (interquartile range $46.25-$64.25, range $43.00-$123.20).</p><p><strong>Conclusion: </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}

{"title":"Ensuring Safety in Cytotoxic Drug Preparation: A Systematic Review of Guidelines Addressing Education for Pharmacy Professionals.","authors":"Fernando Moreira, Ângelo Jesus, Cláudia Pinho, Marlene Santos, Mélanie Serdoura, Agostinho Cruz","doi":"10.1016/j.japh.2025.102352","DOIUrl":"https://doi.org/10.1016/j.japh.2025.102352","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy preparation involves the use of specific techniques and equipment, given the need to maintain preparation sterility and its strict prescribed composition, and avoid occupational exposure to cytotoxic agents.</p><p><strong>Objective: </strong>This study aims to identify the most relevant contents for pharmacy professionals' education and training programs and to elucidate the evaluation procedure these professionals should follow when handling cytotoxics.</p><p><strong>Methods: </strong>We adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in conducting and reporting this systematic review. We conducted a literature search in PubMed, Cochrane, and LILACS to identify guidelines on cytotoxic drug preparation published between 2004 and 2024. Inclusion criteria included guidelines written in English, Spanish, or Portuguese that addressed the education, training, and/or evaluation of pharmacy professionals involved in handling cytotoxic drugs. We excluded guidelines developed for other health professionals (e.g. nurses) and guidelines exclusively addressing the manipulation of oral dosage forms. Citation searching was also performed to avoid search biases. Three researchers independently selected 20 guidelines that met the inclusion criteria, out of 3781 unique references identified. Four appraisers assessed the guidelines using the AGREE-II tool.</p><p><strong>Results: </strong>Recommendations for training in cytotoxic drug handling generally included pre-initiation and periodic assessment. Personal protective equipment and engineering controls use, spill management, and aseptic technique were the most frequently mentioned specific training contents. We have developed a training proposal based on the guidelines, with four training levels that address the specific identified content. Each level presents potential competency assessment strategies.</p><p><strong>Conclusion: </strong>Included publications frequently recognized that conducting educational programs before and during the preparation of cytotoxic drugs was important and the combination of theoretical and practical learning seems of the utmost relevance. The development or update of guidelines in this area should prioritize their effective applicability to facilitate their implementation.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102352"},"PeriodicalIF":2.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426507","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":"Bibliometric analysis of United States and global obstetrical pharmacy literature from 1994 to 2023.","authors":"Stephen M Small","doi":"10.1016/j.japh.2025.102345","DOIUrl":"10.1016/j.japh.2025.102345","url":null,"abstract":"<p><strong>Background: </strong>Federal research policy in the U.S. changed in the early 1990s to include more pregnant patients in clinical research. However, pregnancy outcomes in the United States have gradually declined over the past few decades. Little research has been conducted to characterize U.S. obstetrical pharmacy publications and compare them with global trends.</p><p><strong>Objectives: </strong>This study aimed to measure the volume and types of U.S. and non-U.S. obstetrical pharmacy literature over 30 years to characterize research in this specialty. The secondary objectives included measuring trends in authorship and citations and performing a text-mining analysis of obstetrical pharmacy publications.</p><p><strong>Methods: </strong>This bibliometric analysis used the Web of Science database to identify obstetrical pharmacy documents published between 1994 and 2023 in the United States and non-U.S. countries. Articles were included if they contained obstetrical or pregnancy topics and were within the pharmacy and pharmacology research areas. Data on document types, citations, authors, and common words were collected and analyzed using descriptive statistics.</p><p><strong>Results: </strong>A total of 12,190 obstetrical pharmacy documents met the inclusion criteria, representing only 2.8% of global obstetrical publications. The United States had the most documents (29.6%), followed by China (10.7%), Italy (5%), the United Kingdom (3.2%), and Canada (3.2%). U.S. and non-U.S. documents increased exponentially (R² = 0.9485 and 0.979, respectively) over the 30 years. Text-mining analysis showed that both groups had common research topics and interests.</p><p><strong>Conclusion: </strong>Pharmacy documents represent a small proportion of obstetrical publications amidst worsening maternal outcomes in the United States. Despite the exponential growth in obstetrical publication frequency, the overall contribution from the United States is at risk of being superseded by that of China. High international collaboration and citations of U.S. documents may provide opportunities to increase future scientific production in this area and improve patient outcomes.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102345"},"PeriodicalIF":2.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426497","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":"Pharmacy harm reduction practices to help reduce opioid overdoses, Arizona 2023.","authors":"Beth E Meyerson, Sara Richter, Rosalie Gordon, Ethan P Y Chang, Nina Vadiei, Lori A Eldridge, Elias O Higbie, Ava A Pal, Addison Seckar-Martinez, Kylee Newgass, Heather M Lorenz, Irene Garnett","doi":"10.1016/j.japh.2025.102348","DOIUrl":"10.1016/j.japh.2025.102348","url":null,"abstract":"<p><strong>Background: </strong>Characterizing pharmacies based on their practices, community need for such practices and pharmacy type could advance pharmacy-based intervention precision to reinforce or increase pharmacy practices related to reducing opioid overdose deaths.</p><p><strong>Objective: </strong>To measure a combination of 3 pharmacy practices focused on opioid overdose death reduction and explore whether there are discernable groupings related to practices, pharmacy characteristics, and community characteristics.</p><p><strong>Methods: </strong>A telephone survey was conducted between August 1, 2023 and October 8, 2023 with the pharmacist on duty at 921 Arizona community pharmacies. The survey measured pharmacy characteristics, buprenorphine stocking, buprenorphine and naltrexone dispensing, likelihood of methadone dispensing for opioid use disorder (OUD) when legally permitted, and interest in state-subsidized naloxone dispensing.</p><p><strong>Results: </strong>A response rate of 22.6% was achieved (N = 208). The vast majority (93.8%) of pharmacies stocked buprenorphine and dispensed buprenorphine or naltrexone. About half (47.6%) were very likely or somewhat likely to dispense methadone for OUD when permitted. Metropolitan pharmacies were less likely to dispense methadone compared to rural pharmacies (45.1% Vs. 75.0%). Among pharmacies not likely to dispense methadone, 85.3% were located in counties with opioid overdose death rates above the national average. About half of pharmacies indicated interest in enrolling as a distributor of state-subsidized naloxone. When considered together as pharmacy practices, 26% of pharmacies reported frequent buprenorphine or naltrexone dispensing, expressed interest in subsidized naloxone dispensing and a likelihood of methadone dispensing. Latent class analysis yielded 4 distinct groups of pharmacies ranging from those only dispensing buprenorphine or naltrexone frequently to adopters of the 3 pharmacy practices related to opioid overdose reduction in the community. The 'adopters' who frequently dispensed buprenorphine or naltrexone, who had interest in subsidized naloxone, and would likely dispense methadone for OUD tended to be in metropolitan or small/rural areas but tended not to be mass merchandizers.</p><p><strong>Conclusion: </strong>An emerging group of pharmacies shows potential for greater adoption of pharmacy practices to reduce opioid overdose. Larger, multistate studies will help verify pharmacy latent class groups for greater precision of pharmacy practice interventions to reduce opioid overdose in communities. It is crucial to explore why pharmacies in higher need counties are not likely to adopt practices related to opioid overdose reduction.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102348"},"PeriodicalIF":2.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426447","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}