Journal of the American Pharmacists Association最新文献

{"title":"Implementing a letter template to expedite specialty medication appeal letter submission","authors":"Jessica Fann,&nbsp;Miranda Kozlicki,&nbsp;Kristen Whelchel","doi":"10.1016/j.japh.2024.102262","DOIUrl":"10.1016/j.japh.2024.102262","url":null,"abstract":"<div><h3>Background</h3><div>Prior authorizations (PAs) for biologic medications, used to treat inflammatory bowel disease (IBD), are often denied by pharmacy benefits managers and can require a complex appeal process for patients to gain access to medication.</div></div><div><h3>Objective</h3><div>This quality improvement project evaluated the impact of implementing a standardized appeal letter template and customizable clinical rationale letter content on specialty pharmacist workflow and workload in an integrated hospital health system specialty pharmacy (HSSP) IBD clinic.</div></div><div><h3>Practice description</h3><div>This initiative was conducted in an IBD outpatient clinic at a tertiary academic medical center with an integrated HSSP whose specialty pharmacists work collaboratively with providers to manage specialty medications.</div></div><div><h3>Practice innovation</h3><div>A letter template was created in the electronic health record (EHR) for pharmacists to use when submitting appeal letters. The template automatically populates patient results from recent labs, imaging, and clinic visit notes as part of the appeal documentation. Clinical rationale letter content was developed for the most common appeal reasons using EHR functionality that allows the creation of standardized notes that can be shared among team members and customized at time of use.</div></div><div><h3>Evaluation method</h3><div>An analysis of 2 months of data preimplementation/postimplementation was conducted using descriptive statistics to report the number of appeals submitted, time from PA denial to appeal submission, and appeal approval rate. A pharmacist postimplementation satisfaction score was also collected.</div></div><div><h3>Results</h3><div>The number of appeals submitted preimplementation (n = 73) and postimplementation (n = 73) was the same. Postimplementation, 89% of appeals were submitted within 3 days of PA denial compared to 29% preimplementation. PA approval rate was high (93%) preimplementation and postimplementation. Overall pharmacist satisfaction was 9.7 out of 10.</div></div><div><h3>Conclusion</h3><div>Implementation of an appeal letter template and standardized clinical rationale letter content in the EHR led to decreased time to appeal submission and high specialty pharmacist satisfaction.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102262"},"PeriodicalIF":2.5,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394819","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":"Assessing student and patient perspectives on pharmacist-prescribed hormonal contraceptives","authors":"Virginia Lemay PharmD,&nbsp;Audrey Whalen PharmD,&nbsp;Lisa Cohen PharmD,&nbsp;Jeffrey Bratberg PharmD","doi":"10.1016/j.japh.2024.102259","DOIUrl":"10.1016/j.japh.2024.102259","url":null,"abstract":"<div><h3>Background</h3><div>Increasing convenient, accessible, and cost effective contraceptive access is critically important. Two-thirds of U.S. states permit pharmacists to prescribe hormonal contraceptives. Community pharmacies are ideal settings for patients to be offered contraceptive therapeutic options, including hormonal contraceptives, emergency contraception (EC), and over-the-counter (OTC) oral contraception.</div></div><div><h3>Objective</h3><div>The objective of this study was to assess college student and community pharmacy patients’ perspectives on pharmacist-prescribed hormonal contraceptives, likelihood of accessing contraceptives from a pharmacist, and perspectives regarding EC and OTC oral contraception.</div></div><div><h3>Methods</h3><div>The researchers conducted an observational study distributed to college students and patients accessing care at community-based pharmacies from October 2022 to February 2023. The survey population included those who were 18 years or older, English speaking, and recruited both in person and online. Survey questions assessed barriers to contraception access, perspectives toward pharmacist-prescribed hormonal contraception, likelihood of receiving pharmacist-prescribed hormonal contraception, as well as EC and OTC oral contraception at the community pharmacy. Results from the pharmacist and clinician surveys were previously published, therefore this report will focus on the student and patient data.</div></div><div><h3>Results</h3><div>Ninety-one percent of all respondents strongly agreed or agreed with pharmacist-prescribed hormonal contraception. Students and patients reported convenience, time-saving, and money saving as reasons for obtaining from their pharmacist. In regard to EC, 36% reported having ever purchased from a pharmacy and 58% were extremely or somewhat likely to purchase OTC oral contraception.</div></div><div><h3>Conclusions</h3><div>The majority of students and community pharmacy patients surveyed in Rhode Island support pharmacist-prescribed hormonal contraceptives. State-level policy advancements with reimbursement for services provide pharmacists an opportunity to provide contraceptive care for all people.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102259"},"PeriodicalIF":2.5,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378528","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":"Knowledge and perceptions of health literacy among pharmacists in Ohio in 2013 and 2021","authors":"Karissa Kim,&nbsp;Anne M. Metzger,&nbsp;Megan Than Win,&nbsp;Madison Luck,&nbsp;Marwan Alrasheed","doi":"10.1016/j.japh.2024.102260","DOIUrl":"10.1016/j.japh.2024.102260","url":null,"abstract":"<div><h3>Background</h3><div>There is limited existing literature on pharmacists' knowledge of health literacy and the interventions pharmacists use to address limited health literacy.</div></div><div><h3>Objectives</h3><div>The primary objectives of this study were to evaluate pharmacists' knowledge and perceptions of the impact of limited health literacy on patients and their practice, and to review the techniques used to care for patients.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional, web-based survey of registered Ohio pharmacists in 2013 and repeated the survey in 2021. The Nursing Professional Health Literacy Survey was adapted and employed to assess 1) general knowledge; 2) health literacy in the workplace; and 3) demographics. Changes in pharmacists' knowledge and perceptions of health literacy, self-reported use of communication techniques, and methods for assessing a patient’s health literacy were evaluated.</div></div><div><h3>Results</h3><div>Response rates were 12.4% (N = 62) in 2013 and 3.5% (N = 174) in 2021. Awareness of the term health literacy increased, rising from 82.3% to 89.7% (<em>P</em> = 0.127). Less than 41% of pharmacists in both cohorts had received formal health literacy training; a regression model indicated that pharmacists with more years of practice were less likely to have had such training (<em>P</em> &lt; 0.05). Most pharmacists admitted they never formally assess health literacy (79.0% in 2013 and 81.6% in 2021; <em>P</em> = 0.875) but reported often relying on their gut feeling to gauge a patient's health literacy (37.1% in 2013 and 41.4% in 2021; <em>P</em> = 0.658). The percentage of pharmacists who orally reviewed written instructions with patients, used layman’s terms, and had patients demonstrate instructions significantly increased (<em>P</em> &lt; 0.05) between 2013 and 2021.</div></div><div><h3>Conclusion</h3><div>Gaps remain in pharmacists' knowledge and practices related to health literacy. From 2013 to 2021, there were improvements in how pharmacists communicate with patients who have limited health literacy, but no significant change in the methods used to assess health literacy.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102260"},"PeriodicalIF":2.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373395","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":"Differences in prescribing patterns of opioid dependence drugs among patients with primary alcohol use problems and opioid use disorders within New York State by social determinant factors, 2005-2018","authors":"Chi-Hua Lu,&nbsp;Hsuan-Yun Su,&nbsp;Zackary Falls,&nbsp;David M. Jacobs,&nbsp;Qiuyi Zhang,&nbsp;Walter Gibson,&nbsp;Gail Jette,&nbsp;Debanjan Paul,&nbsp;Peter L. Elkin,&nbsp;Kenneth E. Leonard,&nbsp;Edward M. Bednarczyk","doi":"10.1016/j.japh.2024.102258","DOIUrl":"10.1016/j.japh.2024.102258","url":null,"abstract":"<div><h3>Background</h3><div>The increase in alcohol use problems and opioid use disorder (OUD) highlights the need for research on effective medication treatments for patients with dual diagnoses.</div></div><div><h3>Objectives</h3><div>This study analyzed trends and social disparities in prescribing OUD medications for patients who initially had alcohol use problems and later received their first OUD diagnosis.</div></div><div><h3>Methods</h3><div>This study used merged data from the New York State Office of Addiction Services and Supports and the Medicaid to analyze individuals aged 18 years and older who initially had primary alcohol use problems and later had OUD for the first time between 2005 and 2018. It examined the rates of new buprenorphine and naltrexone prescriptions across various demographic and socioeconomic groups.</div></div><div><h3>Results</h3><div>Among 27,029 clients, the average rate of new buprenorphine was 64.23 per 1000 clients (95% CI 61.30–67.15), with upward trends. The 18-35 age group had the highest buprenorphine utilization (111.48 per 1000 clients) and highest increase rates compared with other age groups. The white non-Hispanic group had the highest rates of buprenorphine (119.23 per 1000 clients) and showed larger increase over time compared with other race or ethnicity groups. Disabled patients showed slower increasing rates of buprenorphine than other groups. Upward trends were observed in naltrexone. All observed differences were statistically significant (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Trends showed increased use of OUD medications, with varying rates of buprenorphine utilization across different ages, races, and employment statuses. Despite this, the rates of receiving new buprenorphine remained low, suggesting a need for innovative methods to expand access to treatments.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102258"},"PeriodicalIF":2.5,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331354","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":"Act for the future of community pharmacy","authors":"Jennifer L. Bacci,&nbsp;Joni C. Carroll,&nbsp;Kim C. Coley,&nbsp;Christopher Daly,&nbsp;William R. Doucette,&nbsp;Stefanie P. Ferreri,&nbsp;Sophia M.C. Herbert,&nbsp;Shelby A. Jensen,&nbsp;Melissa Somma McGivney,&nbsp;Megan Smith,&nbsp;Troy Trygstad,&nbsp;Randy McDonough","doi":"10.1016/j.japh.2024.102256","DOIUrl":"10.1016/j.japh.2024.102256","url":null,"abstract":"<div><div>Community pharmacies serve as a vital gateway to primary care and public health, offering face-to-face pharmacist expert care to assure safe and effective medication use. However, they are disappearing at an alarming rate, with 20%-30% of all community pharmacy locations projected to close within the next year. The objective of this commentary is to highlight the critical need for systemic reforms and collective action within our profession to address the unique challenges faced by community pharmacies, ensuring their sustainability and continued role in providing essential health care services for patients. Key issues and evidence are provided to help pharmacy professionals better articulate why pharmacy closures are happening now and how we can work toward a transformed future. Pharmacy closures stem from an unsustainable business model characterized by declining reimbursement for prescription medications, opaque and anticompetitive pricing practices of pharmacy benefit managers, and limited reimbursement for clinical services. Among these challenges, our profession has the opportunity to create a future for community pharmacy where every person has local access to pharmacist expert care and medications through sustainable, integrated community pharmacy practice. Our profession must embrace community pharmacy teams’ role in patient care, champion opportunities to integrate community pharmacists and their support staff as members of the health care team, and advocate for payment transparency and transformation. Creating this future will take all pharmacists and all pharmacy professionals.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102256"},"PeriodicalIF":2.5,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331351","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":"Cost-effectiveness of a pharmacist-led medication therapy management clinic for management of type 2 diabetes","authors":"Mrinmayee Joshi,&nbsp;Christine Pham,&nbsp;Huiwen Deng,&nbsp;Sheryl Mathew,&nbsp;Rachel M. Norton,&nbsp;Kibum Kim,&nbsp;Daniel R. Touchette,&nbsp;Jessica J. Tilton","doi":"10.1016/j.japh.2024.102253","DOIUrl":"10.1016/j.japh.2024.102253","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes imposes a substantial public health burden. Involvement of clinical pharmacists in diabetes disease management can improve health outcomes while managing expenditure.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the lifetime cost-effectiveness of a pharmacist-led medication therapy management clinic (MTMC) compared to usual care for individuals with type 2 diabetes mellitus, from a U.S. payer perspective.</div></div><div><h3>Methods</h3><div>A cohort simulation Markov model was developed to simulate the occurrence of major complications of diabetes. Transition probabilities, MTMC treatment effects, health state costs, and utilities were based on data from electronic health records and published literature. Outcomes evaluated were lifetime costs, quality-adjusted life years (QALYs), and incremental cost-effective ratio (ICER). Sensitivity analyses were conducted on all model inputs; scenario analyses assessed the impact of preventing additional diabetes complications on economic outcomes, and of reduced MTMC visit frequency.</div></div><div><h3>Results</h3><div>Over a lifetime, MTMC resulted in $160,145 total costs and 6.73 QALYs; usual care resulted in $152,806 total costs and 6.65 QALYs. The ICER for MTMC compared to usual care was $93,375 per QALY gained, indicating cost-effectiveness at a willingness-to-pay threshold of $100,000 per QALY gained. Scenario analyses showed that modeling additional complications or reduced visit frequency lowered the ICER. The results were most sensitive to MTMC costs, and hazard ratios for occurrence of stroke, myocardial infarction, and renal failure.</div></div><div><h3>Conclusion</h3><div>The study demonstrates the potential cost-effectiveness of integrating clinical pharmacy services into comprehensive care strategies. Findings support the broader coverage and reimbursement of such services to optimize clinical outcomes and reduce long-term health care costs.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102253"},"PeriodicalIF":2.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331352","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":"Delivery of enhanced asthma care in pharmacies: Perceptions and experiences of Australian service providers","authors":"Sarah Serhal,&nbsp;Ines Krass,&nbsp;Bandana Saini,&nbsp;Sinthia Bosnic-Anticevich,&nbsp;Lynne Emmerton,&nbsp;Bonnie Bereznicki,&nbsp;Luke Bereznicki,&nbsp;Bronwen Wright,&nbsp;Kiara Wilson,&nbsp;Bernadette Mitchell,&nbsp;Carol Armour","doi":"10.1016/j.japh.2024.102252","DOIUrl":"10.1016/j.japh.2024.102252","url":null,"abstract":"<div><h3>Background</h3><div>Evidence-based asthma management services have been tested in Australian community pharmacies for over 2 decades and have been well received by patients but are not retained in practice. The positive clinical outcomes of these tested services suggest the potential for wider implementation, for which the providers’ perspective is critical.</div></div><div><h3>Objective</h3><div>This investigation evaluates the implementability of the Pharmacy Asthma Service (PAS) through the experiences and perceptions of the community pharmacists delivering the service.</div></div><div><h3>Methods</h3><div>Forty-eight pharmacists took part in a posttrial semi-structured qualitative telephone interview, representing 42 of 51 (82%) eligible PAS intervention arm pharmacies. Qualitative data were deductively analyzed in accordance with the Implementation Outcomes Framework.</div></div><div><h3>Results</h3><div>Pharmacists recognized the positive impact of the service on patients’ health outcomes, the pharmacist’s practice, and in fostering stronger and more beneficial pharmacist-patient relationships. However, whilst acknowledging the importance of such a service, the pharmacists faced challenges in recruitment and patient follow-up. Pharmacists stated that further work is required to address pharmacist and patient time constraints, patient health beliefs and to increase the acceptance of pharmaceutical care provision in community pharmacy practice by patients and other health care professionals.</div></div><div><h3>Conclusion</h3><div>Pharmacists can deliver enhanced clinical care for asthma patients with positive perceived professional and patient outcomes. However, it remains evident that time, remuneration, and recognition of the pharmacist’s role in chronic care management form barriers to the implementation of asthma services in community pharmacies. Broader policy and systemic changes are required to successfully balance medication supply and quality patient management roles at the same time as a required shift in research processes.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102252"},"PeriodicalIF":2.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331353","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 barriers for transgender and gender diverse young adults","authors":"Hannah E. Johnson,&nbsp;TK Logan,&nbsp;Kelly K. Hill","doi":"10.1016/j.japh.2024.102251","DOIUrl":"10.1016/j.japh.2024.102251","url":null,"abstract":"<div><h3>Background</h3><div>Transgender and gender diverse (TGD) individuals face substantial physical and mental health care barriers. Community pharmacies are one of the most accessible health care settings; however, concern for discrimination at the pharmacy has been reported. It is important to gain a better understanding of TGD individual’s perspectives and experiences at the pharmacy to ensure optimal and inclusive care.</div></div><div><h3>Objective</h3><div>To identify TGD individual experiences and barriers at the pharmacy.</div></div><div><h3>Methods</h3><div>This institutional review board−approved qualitative study recruited TGD young adults in the United States between ages 18 and 29 years for semi-structured focus group discussions. Questions focused on barriers to obtaining medications at the pharmacy and negative or positive experiences with pharmacists. Interviews were recorded, transcribed, and transcripts were analyzed for common themes amongst participants.</div></div><div><h3>Results</h3><div>Nine 1.5- to 2-hour focus groups were conducted and included 30 participants (2–6 participants in each group). All participants reported having been prescribed medications by a physician or mental health provider. Participants self-reported issues at pharmacies and with pharmacy personnel. Major themes included issues accessing medications and supplies (needles, syringes), questioning of prescription validity and patient identity, and lack of education or understanding of TGD individuals by pharmacy staff.</div></div><div><h3>Conclusion</h3><div>TGD individuals experience barriers at the pharmacy and concerning issues with pharmacy staff. Education, structural competency, and improvements in gender-related data management are necessary for pharmacists and pharmacy staff to provide equitable and inclusive care for TGD individuals.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102251"},"PeriodicalIF":2.5,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331356","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":"Empowering pharmacy technicians as vaccine champions: A pilot study in independent community pharmacies","authors":"Allison Hursman,&nbsp;Hailey Wanner,&nbsp;Ellen Rubinstein","doi":"10.1016/j.japh.2024.102257","DOIUrl":"10.1016/j.japh.2024.102257","url":null,"abstract":"<div><h3>Background</h3><div>Increasing vaccine uptake in communities has been essential, even before coronavirus disease 2019. The use of \"vaccine champions\" or \"VaxChamps\" has shown promise. VaxChamps, who are often community members with specialized training but no special credentials, advocate for vaccination by sharing their experiences and knowledge. Pharmacy technicians’ scope of practice, coupled with their frequent interactions with pharmacy patients, make them ideal vaccine champions and a natural fit for the VaxChamp program. This study assessed the implementation and impact of the VaxChamp program in North Dakota community pharmacies.</div></div><div><h3>Objectives</h3><div>To describe the development and implementation of the VaxChamp program in community pharmacies and evaluate its effect on vaccination rates and vaccine-related tasks within each pharmacy’s organizational context.</div></div><div><h3>Methods</h3><div>The VaxChamp program involved training one technician per participating pharmacy to spend 5 hours per week on vaccine-related tasks. Data collection included pre-post surveys, monthly reports, and semi-structured interviews with VaxChamps and pharmacists-in-charge from 6 pharmacies. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed using inductive methods to identify key themes.</div></div><div><h3>Results</h3><div>The 6 participating pharmacies varied in location and staffing. Most had prior vaccine administration experience. VaxChamps’ roles ranged from administrative tasks to direct vaccine administration, depending on the pharmacy’s staffing and workflow. Vaccination rates for pneumococcal and hepatitis B vaccines increased in several pharmacies, while shingles vaccination rates declined. The presence of advanced pharmacy practice experience students often influenced VaxChamps’ responsibilities, underscoring the need for clear role delineation.</div></div><div><h3>Conclusion</h3><div>Integrating pharmacy technicians as VaxChamps in community pharmacies is a promising strategy to increase vaccination rates and enhance public health. Future research should explore ways to better integrate technicians into comprehensive immunization strategies and address the contextual factors that influence program implementation.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102257"},"PeriodicalIF":2.5,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331355","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 diabetic retinal exam screening program on quality measure gaps at a family medicine practice","authors":"Michael Hair,&nbsp;Alexandra Tardugno,&nbsp;Alyssa Greenaway,&nbsp;Chelse Wisenor,&nbsp;Autumn Stewart-Lynch","doi":"10.1016/j.japh.2024.102254","DOIUrl":"10.1016/j.japh.2024.102254","url":null,"abstract":"<div><h3>Background</h3><div>Diabetic retinopathy is a common complication in people with diabetes, and annual screening is recommended by the American Diabetes Association. This annual exam is also a Health Effectiveness Data and Information Set quality measure. Barriers such as lack of access to healthcare or cost of specialist visits may impact the number of patients who receive these exams.</div></div><div><h3>Objective</h3><div>The objective of this study is to describe the impact of a diabetic retinal exam screening program at a rural family medicine center on the number of quality measure gaps resolved.</div></div><div><h3>Practice description</h3><div>This study occurred at a rural family medicine center in southwestern Pennsylvania with a medically underserved patient population. A pharmacist at the site holds board certifications in Advanced Diabetes Management and as a Diabetes Care and Education Specialist. This pharmacist manages diabetes through a collaborative practice agreement.</div></div><div><h3>Practice innovation</h3><div>A regional Medical Assistance plan provided a list of patients with a quality measure gap for an annual diabetic retinal exam and loaned a RetinaVue 700 Imager to take retinal photos. After screening eligible patients via phone, retinal exams were administered by student pharmacists and medical assistants to consenting patients over the course of 9 days. Images were then sent to an ophthalmologist to be interpreted.</div></div><div><h3>Evaluation methods</h3><div>The rate of quality measure gaps closed and satisfaction survey results are reported using descriptive statistics.</div></div><div><h3>Results</h3><div>A total of 61 patients were included in the analysis. This program closed quality measure gaps for 11 (18.0%) patients who were able to receive an in-office eye exam.</div></div><div><h3>Conclusion</h3><div>This pilot project shows that offering in-office diabetic retinal exams may be an effective strategy to close quality measure gaps and provide access to screening among a medically underserved population.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102254"},"PeriodicalIF":2.5,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308964","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}