Journal of the American Pharmacists Association最新文献

{"title":"Reimagining the ambulatory care training pathway","authors":"Jean Y. Moon PharmD, BCACP, Sarah M. Westberg PharmD, BCPS, Todd D. Sorensen PharmD","doi":"10.1016/j.japh.2024.102135","DOIUrl":"10.1016/j.japh.2024.102135","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102135"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288843","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":"Exploring worldwide training pathways that enable clinical pharmacy career development","authors":"Laura Moura,&nbsp;A. Costa,&nbsp;Stephane Steurbaut,&nbsp;Helder Mota Filipe,&nbsp;Silvana Leite,&nbsp;Filipa Alves da Costa","doi":"10.1016/j.japh.2024.102266","DOIUrl":"10.1016/j.japh.2024.102266","url":null,"abstract":"<div><h3>Background</h3><div>Pharmaceutical education is crucial for preparing pharmacists for evolving professional practice. The clinical component of pharmaceutical education and practice has grown and improved globally, though its implementation varies. Training pathways for clinical pharmacy careers vary worldwide.</div></div><div><h3>Objective</h3><div>This study aimed to explore training pathways enabling career development in clinical pharmacy.</div></div><div><h3>Methods</h3><div>In-depth interviews on clinical pharmacy career development were conducted with a purposive sample of academic and practice experts from thirteen countries, selected based on a prior literature review. Interviews were recorded following participants’ consent, transcribed verbatim, thematically analyzed by one researcher, and verified by a second. Disagreements were resolved through discussion with a third researcher.</div></div><div><h3>Results</h3><div>In ten of the analyzed countries, the competencies required to perform clinical activities were considered the foundation of the pharmacy profession, suggesting that undergraduate education is sufficient to perform clinical pharmacy activities.</div><div>Reported training-related success factors associated with the development of a career in clinical pharmacy included: interprofessional education, focus on the health context of each country, ensuring students’ readiness, practice site partnerships, patient-centricity and patient contact, good mentorship and preceptorship, time and work flexibility of the candidates, effective training evaluation and, financial support for training. Conversely, shortage of mentors and teachers with clinical practice experience, slow responsiveness of the regulatory environment, insufficient funding, resistance to change, and education-practice mismatch were identified as training-related constraints.</div></div><div><h3>Conclusion</h3><div>Clinical activities form the foundation of the pharmacy profession in most countries, and undergraduate education directly provides the skills to undertake these, even though optional postgraduate education may be pursued. Understanding existing training pathways, including success factors and implementation challenges, can inform the creation, development, and optimization of education for clinical pharmacy careers.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102266"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479307","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":"Systematic review and meta-analysis on effectiveness of strategies for enhancing adverse drug reaction reporting","authors":"Niphonh Mongkhonmath,&nbsp;Phayom Sookaneknun Olson,&nbsp;Panupong Puttarak,&nbsp;Nathorn Chaiyakunapruk,&nbsp;Ratree Sawangjit","doi":"10.1016/j.japh.2024.102293","DOIUrl":"10.1016/j.japh.2024.102293","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacovigilance is essential for patient safety, but underreporting adverse drug reactions (ADRs) is a global challenge.</div></div><div><h3>Objectives</h3><div>This review evaluated the effectiveness of strategies for enhancing ADR reporting by healthcare professionals (HCPs).</div></div><div><h3>Methods</h3><div>This systematic review was conducted following the Cochrane and the PRISMA guidelines. Five international databases were searched from inception to December 2023 and updated search to September 2024. Randomized clinical controlled trials (RCTs) and non-RCTs on enhancing ADR reporting were included. The primary outcomes were the number of overall ADR and high-quality ADR reports. Study quality was assessed using the Effective Practice and Organization of Care risk of bias (ROB), and ROBIN-I for RCT, and non-RCT. All data were evaluated using a random-effects model, and heterogeneity was assessed using <em>I</em>^<em>2</em> statistic and chi-squared tests.</div></div><div><h3>Results</h3><div>From 1672 studies, 13 studies (10 RCTs, and 3 non-RCTs) with 28,116 participants were included. Two of 10 RCTs had low ROB while the remaining were judged as unclear and moderate ROB. Most studies were in high-income countries, and the main strategy was educating HCPs through workshops. Meta-analysis showed significant increases in overall ADR reporting through educating HCPs with a rate ratio (RR) of 5.09 (95% CI: 3.36-7.71, <em>I</em>^<em>2</em> = 84.5%, low certainty), and in high-quality reporting with 1.31 (95% CI: 1.09–1.58, <em>I</em>^<em>2</em> = 0.0%, moderate certainty). Subgroup analysis indicated that educating HCPs through face-to-face workshops combined with the Tawai app (RR:10.5, 95% CI: 8.74–12.61), a face-to-face workshop alone (RR:6.69, 95% CI: 5.43–8.25, <em>I</em>^<em>2</em> = 0.0%), and repeated telephone (RR:2.59, 95% CI: 1.75–3.84, <em>I</em>^<em>2</em> = 8.8%) significantly increased the overall number of ADR reports with moderate certainty. Email or letter communications showed no significant effect.</div></div><div><h3>Conclusion</h3><div>Educating HCPs via interactive strategies like face-to-face workshops with or without a mobile app and repeated phone calls improved ADR reporting. However, long-term, high-quality studies are needed to confirm these findings before recommending widespread implementation in clinical practice, especially in low-and middle-income countries.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102293"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 2023 Washington State pharmacist workforce survey: Employment and patient care roles","authors":"Jennifer L. Bacci,&nbsp;Clayton English,&nbsp;Peggy S. Odegard,&nbsp;Andy Stergachis,&nbsp;Cyndy R. Snyder,&nbsp;Jennifer Hookstra Danielson","doi":"10.1016/j.japh.2024.102314","DOIUrl":"10.1016/j.japh.2024.102314","url":null,"abstract":"<div><h3>Background</h3><div>The pharmacy workforce is evolving rapidly, and while national data reveal broad trends, they often overlook the impact of state-level policies on local pharmacy practice and education.</div></div><div><h3>Objective</h3><div>To describe employment status and patient care roles of pharmacists in Washington State.</div></div><div><h3>Methods</h3><div>A cross-sectional survey of pharmacists licensed in Washington State was conducted in June–July 2023. The survey assessed participants’ personal and professional demographics; employment status, including changes in employment status since 2020 and consideration of a change in the next 12 months; and patient care roles, including time spent in patient care roles and services provided. Data were analyzed using descriptive statistics.</div></div><div><h3>Results</h3><div>We received 856 responses (10.6% response rate) and 810 responses were included in the final analysis. Participants’ median age was 43 years. Most participants were female (64%) and White (73%). Over 3-quarters of participants reported practicing in community (37%), hospital (27%), and/or ambulatory care/clinic (21%) settings. Over one-third of participants (39%) reported a job or employment change since 2020 and 17% reported they were considering a job or employment change in the next 12 months. The 5 most frequently reported patient care services were medication education or counseling (83%), medication dispensing (70%), prescribing via a collaborative drug therapy agreement or protocol (59%), medication therapy management (53%), and medication reconciliation (52%).</div></div><div><h3>Conclusion</h3><div>This study offers important insights into pharmacist employment and practice in Washington State. Certain trends in Washington State, particularly in pharmacist employment shifts within clinic settings and patient care roles such as prescribing and medication education, stand out when compared to national patterns. These findings highlight the importance of ongoing state-level workforce assessments to guide educational strategies and the supply of pharmacists with local needs.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102314"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Specialty pharmacy services compared with community-based pharmacy services on HIV viral load","authors":"Laura L. Pedersen,&nbsp;Patricia Fulco,&nbsp;Rachel Pryor,&nbsp;Gonzalo Bearman","doi":"10.1016/j.japh.2024.102307","DOIUrl":"10.1016/j.japh.2024.102307","url":null,"abstract":"<div><h3>Objectives</h3><div>People with human immunodeficiency virus (HIV) (PWH) on antiretroviral therapy (ART) with viral load (VL) suppression eliminate the risk of sexual transmission. Many factors including decreased ART adherence and medication access barriers decrease the success of treatment as an HIV prevention strategy. ART access may be enhanced with specialty pharmacy services (SPS), but the impact compared with community-based practices is variably reported. This study aimed to compare the impact of specialty vs community pharmacies on medication adherence via VL assessment.</div></div><div><h3>Design</h3><div>This retrospective cohort medical record study investigated whether the use of specialty pharmacies compared with community-based practices improves VL suppression. A record review was performed to collect the most recent HIV VL Demographic data collected included age range, race, ethnicity, and patient-reported gender identity. Pharmacy type was determined via review of prescription refill history linked to the medical record.</div></div><div><h3>Setting and participants</h3><div>Patients included were enrolled in the Ryan White HIV/AIDS Program (RWHAP) (May 31, 2022, to May 30, 2023) at an HIV/infectious diseases academic medical center clinic.</div></div><div><h3>Outcome measures</h3><div>An undetectable VL was defined as the most recent HIV VL being &lt; 50 copies/mL or suppressed as &lt; 200 copies/mL.</div></div><div><h3>Results</h3><div>A total of 1631 PWH were eligible, 179 were excluded, and 1452 were included in the analysis; 91.3% were virologically suppressed (n = 1326) with an undetectable VL in 83.3% (n = 1210). When adjusting for age, self-reported gender identity, race, and ethnicity, PWH using SPS were more likely to have a suppressed (adjusted odds ratio [AOR] 1.469 [95% CI 1.007–2.142]) and undetectable VL (AOR 1.396 [95% CI 1.051–1.854]), respectively, than the use of community-based practices.</div></div><div><h3>Conclusions</h3><div>The use of specialty compared with community-based pharmacies had a statistically significant, yet modest association with VL suppression in PWH enrolled in RWHAP services in this single academic medical center retrospective analysis. Further studies are needed to determine whether mail-order services, specifically those without specialty service support, are sufficient for high rates of virologic control.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102307"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacists enhance national security through medical countermeasure program leadership","authors":"Alexandria VanBuren,&nbsp;Dakota McMurray,&nbsp;Alexander Eastman","doi":"10.1016/j.japh.2024.102310","DOIUrl":"10.1016/j.japh.2024.102310","url":null,"abstract":"<div><h3>Background</h3><div>Chemical, biological, radiological, or nuclear threats and emerging infectious diseases are significant threats to public health and national security. U.S. Customs and Border Protection plays a vital role in safeguarding the nation's borders and protecting against all threats. Pharmacists, with their expertise in medication and public health, can play a crucial role in medical countermeasure (MCM) programs.</div></div><div><h3>Objectives</h3><div>The study aims to identify pharmacist-led quality improvements and explain expanded pharmacist roles through advancing a federal MCM program.</div></div><div><h3>Practice description</h3><div>U.S. Customs and Border Protection is the nation’s largest law enforcement agency charged with protecting the American people and safeguarding the nation’s borders.</div></div><div><h3>Practice innovation</h3><div>Program management for MCM transitioned to the Office of the Chief Medical Officer under pharmacist leadership, better aligning the program with the agency’s health security mission.</div></div><div><h3>Evaluation methods</h3><div>Pharmacists conducted a baseline program analysis then spearheaded 5 improvements over 1 year to fill identified gaps. Pharmacist-led improvements include development of a Standard Operating Procedure for accountability, SharePoint site development for inventory tracking/reporting, inventory analysis through SharePoint utilization, creation of a MCM channel in Microsoft Teams for information sharing, and establishment of a Point of Dispensing exercise schedule for readiness.</div></div><div><h3>Results</h3><div>Pharmacist-led improvements resulted in Standard Operating Procedure recognition as best practice guidance by the Department of Homeland Security, improved inventory completion rates from 0% to 99%, initiation of 29 new MCM sites protecting 3,000 additional U.S. Customs and Border Protection workforce and persons in custody, inventory distribution to 55 sites protecting 35,000 additional personnel and persons in custody, enrollment of 247 members to the MCM channel in Microsoft Teams, improved Point of Dispensing exercise completion from 5% to 66%, and scheduled 90 Point of Dispensing exercises.</div></div><div><h3>Conclusion</h3><div>Pharmacists play a vital role in MCM program advancement and contribute to national security efforts against chemical, biological, radiological, or nuclear threats and emerging infectious diseases.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102310"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updates to a pharmacy-technician driven centralized medication refill service in a large community health system","authors":"Elizabeth G. Schlosser,&nbsp;Leandro Llambi,&nbsp;Thomas J. Hoffman,&nbsp;Ana L. Hincapie","doi":"10.1016/j.japh.2024.102142","DOIUrl":"10.1016/j.japh.2024.102142","url":null,"abstract":"<div><div>In 2020, we published a description of the newly implemented centralized refill service (CRS) led by pharmacy technicians in our large community health system. Since that time, the CRS has been refined, updated, and expanded. We have also received many inquiries with common questions about the process from those who seek to implement a similar process. The purpose of this commentary is to 1) provide updates to the process in the 5 years since its implementation, and 2) provide additional insights on specific topics from inquiries to the organization.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102142"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288844","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":"The Public Health Informatics Fellowship Program: Training pharmacists as data detectives","authors":"Sena Seged,&nbsp;Kevin Lan,&nbsp;Sonya Zhan,&nbsp;Jessica Eloso,&nbsp;Bradley Biggers,&nbsp;Roua El Kalach","doi":"10.1016/j.japh.2024.102216","DOIUrl":"10.1016/j.japh.2024.102216","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102216"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564917","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":"<div><div>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.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102285"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","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":"Provision of maternal health services among Ohio community pharmacists practicing in maternity care deserts","authors":"Maria Duodu,&nbsp;Natalie DiPietro Mager","doi":"10.1016/j.japh.2024.102292","DOIUrl":"10.1016/j.japh.2024.102292","url":null,"abstract":"<div><h3>Background</h3><div>Over 2.3 million reproductive-age women in the United States live in a maternity care desert, a county without obstetric services or providers; over 3 million more reside in a county with low access to maternity care. The National Alliance of State Pharmacy Associations (NASPA) issued a toolkit outlining maternal health services community pharmacists are positioned to provide within their scope of practice.</div></div><div><h3>Objectives</h3><div>The primary objective of this study was to determine whether community pharmacists practicing in maternity care deserts/low access areas in Ohio provide NASPA-recommended maternal health services. Secondary objectives were to assess knowledge and attitudes related to maternal health; interest and barriers for developing new services; and screening and referrals for key social determinants of health.</div></div><div><h3>Methods</h3><div>An anonymous cross-sectional survey was electronically distributed to Ohio community pharmacists working in maternity care deserts/low access areas (n = 216) in fall/winter 2023 to evaluate their awareness, practices, and attitudes.</div></div><div><h3>Results</h3><div>Thirty-one pharmacists responded (14%). Almost half knew that maternal mortality had increased in recent years. Although 61% reported familiarity with the term “maternity care desert,” only 35% recognized they are currently practicing in one. Provision of NASPA-recommended services to reproductive-age women ranged from 90% (immunizations) to 11% (alcohol use screening/counseling). About 96% believed that community pharmacists can help optimize women’s health before and during pregnancy. The majority of respondents reported “never” screening for social determinants of health, but 48% were interested in learning more. While 67% of respondents are interested in providing more services for women at their pharmacy, they also reported obstacles like lack of time and staff.</div></div><div><h3>Conclusion</h3><div>There is a need to raise awareness about maternal mortality and maternity care deserts among Ohio community pharmacists. Given the interest expressed in providing additional services, pharmacists should receive more support to provide needed care for medically-underserved populations.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102292"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631388","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}