Journal of the American Pharmacists Association最新文献

{"title":"How new pharmacists handled COVID-19 misinformation: A qualitative study","authors":"Saara Z. Nasruddin,&nbsp;Shishir Maharjan,&nbsp;Joanne Canedo,&nbsp;Vibhuti Arya,&nbsp;Alicia Bouldin,&nbsp;Marie Barnard,&nbsp;Meagen Rosenthal","doi":"10.1016/j.japh.2024.102226","DOIUrl":"10.1016/j.japh.2024.102226","url":null,"abstract":"<div><h3>Background</h3><div>New pharmacists, PharmD graduates of 2020 and 2021, faced the unique challenge of entering the workforce during the volatile and divisive COVID-19 pandemic. They had to navigate patient-driven misinformation while adapting to evolving roles, including the distribution and administration of COVID-19 vaccines. Understanding the experiences of new pharmacists during this period is crucial for professional development and patient care.</div></div><div><h3>Objective</h3><div>The study aimed to describe new pharmacists’ experiences of handling COVID-19 vaccine misinformation presented by patients.</div></div><div><h3>Methods</h3><div>Semi-structured Zoom interviews were conducted with PharmD 2020 and 2021 graduates recruited from St. John’s University College of Pharmacy and Health Sciences and the University of Mississippi School of Pharmacy until saturation was achieved. Interview questions were based on constructs of the Hearing, Understanding, Interpreting, Evaluating, Remembering, and Responding model and World Health Organization (WHO) algorithm on how to respond to vocal vaccine deniers. Data analysis was performed through deductive thematic content analysis, and findings were reported using the Consolidated Criteria for Reporting Qualitative Research.</div></div><div><h3>Results</h3><div>A total of 13 interviews were conducted, with 61.5% of participants from St. John’s University and 38.5% from UM. They worked in various pharmacy settings, including independent (30.8%), chain (23.0%), long-term care (15.4%), and ambulatory care/hospital pharmacies (30.8%). The types of COVID-19 misinformation new pharmacists heard during the pandemic align with the techniques and topics of anti-vaccine arguments outlined by the WHO’s algorithm. New pharmacists utilized evaluation skills to identify credible sources and information, interpreted patients' language and sources, and assessed patients' willingness to be corrected. All new pharmacists responded to misinformation regardless of the technique or topic; however, the mechanism of response may have differed depending on whether a technique or topic was presented.</div></div><div><h3>Conclusions</h3><div>This baseline understanding of new pharmacists’ practices in managing health misinformation can inform the development of recommendations for health misinformation management and assist pharmacy schools in identifying areas for further training for student pharmacists.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102226"},"PeriodicalIF":2.5,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120997","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":"Because I see you: Pharmacist social determinants of health as predictor of structural awareness","authors":"Olihe Okoro PhD, MPH (Associate Professor),&nbsp;Nyika Friberg (Medical Student),&nbsp;Tobyn Chiu (Master of Public Health Student)","doi":"10.1016/j.japh.2024.102225","DOIUrl":"10.1016/j.japh.2024.102225","url":null,"abstract":"<div><h3>Background</h3><div>The contribution of Social Determinants of Health (SDOH) to health disparities and patient outcomes is widely acknowledged. Much less has been done to characterize provider SDOH, and in particular, their effect on delivery of structurally competent care. Differing lived experiences create blind spots to the critical upstream factors contributing to health.</div></div><div><h3>Objectives</h3><div>The primary objective of this study was to examine the association between Structural Awareness (SA) and SDOH when controlling for year of first licensure, primary setting of pharmacy practice, race, and gender. The secondary objective was to examine the difference in mean SA scores with 4 stand-alone predictor variables: reliance on public transportation, insurance coverage gaps, food insecurity, and housing insecurity.</div></div><div><h3>Methods</h3><div>This study is a cross-sectional web-based survey of 606 Minnesota pharmacists. SDOH risk and SA scores were assessed using modified versions of the <em>Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences</em> and <em>Cultural Competence Self-Assessment Questionnaire</em> tools, respectively. The association of these scores was assessed using a multiple linear regression model, and the association with stand-alone variables was done using t-tests.</div></div><div><h3>Results</h3><div>SDOH risk was significantly associated with SA at the 95% confidence level with a <em>P</em>-value of 0.0016. Food and housing insecurity were also significantly associated with SA score while reliance on public transportation and insurance coverage gaps were not.</div></div><div><h3>Conclusion</h3><div>Pharmacy and other healthcare professional training programs should create opportunities for exposure to the SDOH experienced by their patients through immersive learning and/or experiential education.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102225"},"PeriodicalIF":2.5,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114239","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":"Qualitative evaluation to Understand barriers and facilitators to prescribing angiotensin receptor-neprilysin inhibitors (ARNi) and sodium-glucose cotransporter inhibitors (SGLT2i) in patients with heart failure with reduced ejection fraction (HFrEF)","authors":"Apoorva M. Pradhan,&nbsp;Mia E. Lussier,&nbsp;My Nguyen,&nbsp;Stephen J. Voyce,&nbsp;Eric A. Wright","doi":"10.1016/j.japh.2024.102224","DOIUrl":"10.1016/j.japh.2024.102224","url":null,"abstract":"<div><h3>Background</h3><div>Despite sodium-glucose cotransporter-2 inhibitors (SGLT2i) and angiotensin receptor/neprilysin inhibitors (ARNi) being cost-effective evidenced-based therapies for the management of Heart Failure with Reduced Ejection Fraction (HFrEF), research shows that less than 30% of patients with HFrEF are prescribed these agents.</div></div><div><h3>Objective</h3><div>This study aimed to understand clinician-perceived barriers and facilitators to prescribing ARNi and SGLT2i in patients with HFrEF.</div></div><div><h3>Methods</h3><div>We conducted virtual and in-person semi-structured interviews in a large integrated healthcare delivery system in the United States. Twenty cardiology clinicians managing patients with HFrEF were recruited using purposeful sampling to target providers across professions and practice sites. The interview guide was developed based on a literature review and insights from a practicing cardiologist. It inquired about perceived prescribing behaviors, focusing on factors affecting the use of ARNi and SGLT2i. We identified key themes using rapid qualitative analysis.</div></div><div><h3>Results</h3><div>Twenty clinicians were interviewed: 13 physicians, 5 advanced practitioners, and 2 clinic-based pharmacists. Eighteen interviews were analyzed; we excluded 2 as the clinicians interviewed did not meet the inclusion criteria. Three major themes were identified: 1) clinician-reported prescribing patterns don't always align with the American College of Cardiology/American Heart Association guidelines for the use of SGLT2i and ARNi due to clinical inertia, lack of familiarity, knowledge, and comfort with use, and concerns over polypharmacy or adverse events, 2) clinician-perceived and actual out-of-pocket cost reduced prescribing of ARNi or SGLT2i to patients, exacerbated by a lack of visibility into patients' prescription coverage, denials of coverage by insurance, and navigating prior authorization related workflows, and 3) incorporation of a clinic-based pharmacist increased the prescribing of these medications.</div></div><div><h3>Conclusion</h3><div>Increasing cost transparency, implementing interventions to overcome clinical inertia and cost hurdles, and increasing clinic-based pharmacist support may improve evidenced-based prescribing in patients with HFrEF, especially for comparatively novel classes such as ARNi and SGLT2i.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102224"},"PeriodicalIF":2.5,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examination of differences between actual and potential revenue generation in a pharmacist-run ambulatory clinic","authors":"Emily Van Klompenburg,&nbsp;Amelia Koster,&nbsp;Jacob Ford,&nbsp;Shanna K. O’Connor","doi":"10.1016/j.japh.2024.102223","DOIUrl":"10.1016/j.japh.2024.102223","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacists are not billable health care providers under Medicare Part B or most insurance plans. Because of this, pharmacist services are relegated to incident-to-provider billing, despite pharmacists routinely providing services high in complexity. This discrepancy may negatively skew perceptions of pharmacists’ contributions to outpatient clinic care.</div></div><div><h3>Objective</h3><div>The objective of this study was to identify the potential revenue generation for pharmacist-delivered services at a single, rural South Dakota clinic if pharmacists were considered billable health care providers.</div></div><div><h3>Methods</h3><div>This retrospective, single center study utilized a chart review of first-quarter data from a single ambulatory clinic served by a 0.5 full time equivalent pharmacist serving Chronic Disease Management (CDM) and COVID-19 patients. For each appointment, the chart note was reviewed for elements that would satisfy requirements for Current Procedural Terminology billing codes. Medicare and Medicaid reimbursement was determined using official 2022 Physician Fee Schedules and private insurance reimbursement was set at a single rate of 60% of the fee schedule of the most common private payer.</div></div><div><h3>Results</h3><div>During the 3-month study period, 118 patients (206 appointments) were seen by the pharmacist. The amount paid to the clinic was estimated at $2174.91. The hypothetical amount paid to the clinic if pharmacists were considered billable health care providers is $10,415.31 for CDM clinic and $7953.48 for COVID-19 clinic, totaling $18,368.79. Excluding uninsured patients, the hypothetical total is $17,102.03, with total unrealized revenue of $16,193.88.</div></div><div><h3>Conclusion</h3><div>If pharmacists were considered billable health care providers and their services were billed accordingly, the potential revenue generation is significantly higher than actually generated revenue. This estimated data can be used to better quantify and qualify appointment-related data for nonpharmacist clinic managers.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102223"},"PeriodicalIF":2.5,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094113","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":"Career advancement insights from certified pharmacy technicians: Enhanced opportunities for the pharmacy technician workforce","authors":"Jeffrey A. Gray,&nbsp;Michelle E. Rapier,&nbsp;Jessica M. Robinson,&nbsp;James S. Wheeler","doi":"10.1016/j.japh.2024.102214","DOIUrl":"10.1016/j.japh.2024.102214","url":null,"abstract":"<div><h3>Background</h3><div>Sustainable career advancement opportunities for pharmacy technicians will be a critical part of patient-centered community pharmacy environments as the role of the pharmacist provider expands.</div></div><div><h3>Objective</h3><div>(1) To determine the impact of a Pharmacy Technician Certification Board (PTCB) pharmacy certification on career advancement and professional growth metrics; (2) To assess technicians’ role in advanced pharmacy services before and after certification; and (3) To identify changes in pharmacist services when a certified pharmacy technician (CPhT) was added to the provider team.</div></div><div><h3>Methods</h3><div>A 73-question web-based survey was distributed to all PTCB CPhT in the United States, Washing DC, Puerto Rico, Guam, and the US Virgin Islands. The survey was distributed by PTCB in April 2021 with a 28-day collection period. The survey included multiple choice, rating scale, and free text questions centered on 5 domains: practice experience, career aspirations, compensation, pharmacy practice motivations, and impact of COVID-19 pandemic.</div></div><div><h3>Results</h3><div>A total of 23,007 CPhTs completed the survey. Respondents were primarily females (85.5%), age 30-39 (32.8%), and ≥10 years CPhT experience (42.8%). The majority of respondents cited improvement of patient health (77.4%), career advancement opportunities (53.5%), the ability to expand their role during emergencies (e.g., COVID-19) (52.6%), and future career advancement opportunities (51.7%) as benefits of CPhT certification. Increases in job responsibility after certification included changes occurring in roles related to clinical pharmacy services, patient education, preventive health services, provider communication, and staff training. Respondents agreed that PTCB-certification allowed for the expansion of pharmacists’ services where they practiced, including clinical services (18.5%), patient education (18.3%), and preventive health services (18.1%).</div></div><div><h3>Conclusion</h3><div>CPhT’s value certification for its benefits on career advancement, personal growth, and salary enhancement. Affirmation of skill and training through certification is also recognized to positively influence patient care and the pharmacy's ability to provide advanced patient care and services.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102214"},"PeriodicalIF":2.5,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community pharmacy chlamydia and gonorrhea test-to-treat program: Development of an implementation toolkit","authors":"Joni C. Carroll,&nbsp;Thai Q. Nguyen,&nbsp;Jordan Ciraolo,&nbsp;Emily Drake,&nbsp;Alexandria Rothey,&nbsp;Barbara S. Nightingale","doi":"10.1016/j.japh.2024.102222","DOIUrl":"10.1016/j.japh.2024.102222","url":null,"abstract":"<div><h3>Background</h3><div>Sexually transmitted infection (STI) surveillance showed more than 2.5 million cases of chlamydia, gonorrhea, and syphilis nationally in the United States in 2022. Individuals often seek out nonemergency medical care at pharmacies. This makes community pharmacies well-positioned to address rising STI rates by offering services to screen and treat common STIs. A local health department, an independent pharmacy, and a school of pharmacy in Pennsylvania partnered to implement a test-to-treat service for chlamydia and gonorrhea within a pharmacy. This pilot program utilized the following: (1) patient self-collected test kits for chlamydia and gonorrhea screening and; (2) standing orders for treatment at the pharmacy. One goal of this pilot was to develop resources others can use to implement similar pharmacy-based chlamydia and gonorrhea testing and treatment services.</div></div><div><h3>Objective</h3><div>Develop an expert-informed implementation toolkit for a chlamydia and gonorrhea test-to-treat program at a community pharmacy.</div></div><div><h3>Methods</h3><div>The “How to Build an Implementation Toolkit from Start to Finish” framework from the University of California at Berkeley was used to design the initial toolkit outline. Toolkit content was triangulated from 3 sources: (1) comprehensive literature review; (2) pilot program implementation team meetings; and (3) feedback from public health and other experts. Pilot program partners met regularly to review and edit the toolkit. The draft toolkit was then reviewed by outside experts and potential end-users.</div></div><div><h3>Results</h3><div>An 11-item toolkit was developed. Toolkit contents were reviewed by 11 outside experts and potential end-users. Toolkit resources included STI training resources for pharmacy teams, testing and treatment standing orders, pharmacy treatment screening form, marketing strategies, patient education materials, sample workflow, essential supply list, and other key resources.</div></div><div><h3>Conclusion</h3><div>Pharmacies may need additional resources for STI testing and treatment program implementation. Toolkit resources developed from this pilot program may help pharmacies overcome implementation barriers for similar programs.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102222"},"PeriodicalIF":2.5,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential feasibility of tobacco-focused medication therapy management in pharmacies affiliated with Federally Qualified Health Centers: Perspectives of pharmacists","authors":"Kathleen J. Porter,&nbsp;Christopher M. Dunlap,&nbsp;Rebecca A. Krukowski,&nbsp;Abigail G. Wester,&nbsp;Melissa A. Little","doi":"10.1016/j.japh.2024.102210","DOIUrl":"10.1016/j.japh.2024.102210","url":null,"abstract":"<div><h3>Background</h3><div>Tobacco-focused medication therapy management (MTM) interventions executed in pharmacies located in Federally Qualified Health Centers (FQHC) may provide an innovative means to reach smokers with low incomes and reduce health disparities. However, greater understanding of the intervention’s potential feasibility in this setting is needed.</div></div><div><h3>Objective</h3><div>To inform the feasibility of implementing an MTM program to address tobacco and nicotine dependence in the FQHC setting by assessing the experience and perceptions of pharmacists working in pharmacies associated with FQHCs.</div></div><div><h3>Methods</h3><div>A convergent mixed methods approach was used to assess indicators associated with the domains of the Consolidated Framework for Implementation Research (CFIR). Pharmacists from FQHC-based pharmacies in the Southeast United States completed surveys (n = 24) and interviews (n = 15). Quantitative data were summarized descriptively. Qualitative data were content coded.</div></div><div><h3>Results</h3><div>Quantitative and qualitative data were mapped across all 5 CFIR domains. Pharmacists report high rates of tobacco and nicotine use among their patients and that addressing their use is important. A total of 62.5% of pharmacists had some or a great deal of experience with tobacco and nicotine dependence. Quantitative and qualitative data demonstrate that the pharmacists and their FQHCs would support MTM efforts focused on tobacco and nicotine dependence. Qualitative findings highlight that pharmacists view an MTM intervention as aligning with their current workflow. Quantitative and qualitative data highlight how factors related to pharmacists’ engagement in introducing tobacco and nicotine dependence treatment programs to patients, the electronic medical record, time, staffing, and patient-level barriers could impact the feasibility of an MTM intervention focused on tobacco and nicotine dependence.</div></div><div><h3>Conclusion</h3><div>Findings suggest an MTM intervention focused on tobacco and nicotine dependence has the potential to be feasible within FQHC-based pharmacies. Considerations related to training, staffing, time, identifying participants, and supporting participant engagement must be taken into account to support its implementation.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102210"},"PeriodicalIF":2.5,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057032","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 analgesic-related exposure and toxicity in pediatrics","authors":"Samantha Bentley,&nbsp;Lindsey Downs,&nbsp;Samuel Oliver,&nbsp;Shelby Pandy,&nbsp;Shantanu Rao,&nbsp;Laura Perry","doi":"10.1016/j.japh.2024.102218","DOIUrl":"10.1016/j.japh.2024.102218","url":null,"abstract":"<div><h3>Background</h3><p>Analgesics are one of the most commonly purchased and used over-the-counter (OTC) medication classes from pharmacies in the United States. Drug toxicity is a leading cause of injury death in the United States. Limited studies, if any, have examined the impact of specific OTC medication toxicities in the pediatric population.</p></div><div><h3>Objective</h3><p>To examine the toxicity arising from the use of OTC analgesic medications in pediatric patients in Ohio.</p></div><div><h3>Methods</h3><p>Data from National Poison Data System for Ohio were obtained for the past 5 years. This data were processed to focus on target populations; pediatrics defined as ages 0–17 years experiencing toxicities related to OTC analgesic medications. The data were categorized into 3 groups: 0–6 year old, 7–12 year old, and 13–17 year old, and reported toxicity was studied based on medications used/given, reasoning for toxicity, and medical outcomes.</p></div><div><h3>Results</h3><p>Patients aged 0–6 years mainly experienced toxicities from acetaminophen (35%) and ibuprofen (52.7%), due to unintentional exposure (general misuse and therapeutic error; 74.2% and 25.4%, respectively), causing primarily minimal clinical effect (48.4%). Ages 7–12 experienced toxicities from acetaminophen (38.5%) and ibuprofen (44.9%) due to unintentional exposure therapeutic error (44.8%) and intentional suspected suicides (30.1%), causing mainly minimal clinical effects (35.5%) and no effect (23.4%). Pediatric ages 13–17 experienced toxicities due to ibuprofen (36.3%) and acetaminophen (38.9%), with primary reasoning of intentional suspected suicide (81.3%), causing medical outcomes of minor effect and no effect (38.2% and 31.2%, respectively). A chi-square test was performed to analyze correlation between case intention (unintentional or intentional) and age group. Proportion of intentional exposures differed by age [<em>X</em>² (2, <em>N</em> = 18,766) = 14,672, <em>P</em> &lt; 0.0001].</p></div><div><h3>Conclusion</h3><p>Observations from this study underscore the importance of raising awareness about OTC analgesic toxicities which remain prominent in Ohio.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102218"},"PeriodicalIF":2.5,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1544319124002449/pdfft?md5=7dfc052e694a071b06cf572ed20f55aa&pid=1-s2.0-S1544319124002449-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping pharmacy deserts in North Carolina: a geospatial analysis and its implications for University of North Carolina Health’s catchment population","authors":"Nivedha Poondi,&nbsp;Andrew Douglas,&nbsp;Philip McDaniel,&nbsp;Kate Naper,&nbsp;Kamakshi Rao,&nbsp;Stephanie Kiser,&nbsp;Ina Liu","doi":"10.1016/j.japh.2024.102215","DOIUrl":"10.1016/j.japh.2024.102215","url":null,"abstract":"<div><h3>Background</h3><p>Pharmacy deserts represent areas where residents face notable challenges to accessing pharmacies. North Carolina (NC) presents an intriguing case study due to its diverse geographic landscape yet lacks extensive research regarding its pharmacy deserts.</p></div><div><h3>Objectives</h3><p>This study aims to map pharmacy deserts in NC using pharmacy location and social determinants of health (SDOH) data measured using the social vulnerability index (SVI) and descriptively characterize health care utilization statistics for University of North Carolina (UNC) Health’s catchment population.</p></div><div><h3>Methods</h3><p>Pharmacy location data was compiled from the NC Board of Pharmacy. Pharmacy deserts were defined based on SVI &gt; 0.75 and distance thresholds aligned to United States Department of Agriculture standards. Residential characteristics were retrieved from PolicyMap and Social Explorer databases. UNC Health patient utilization data were collected by UNC Pharmacy Data Analytics group for 3 NC counties.</p></div><div><h3>Results</h3><p>Two thousand and two NC pharmacies met inclusion criteria. 17.2% urban tracts (1.3M residents) and 4.25% rural tracts (0.14M residents) were identified as pharmacy deserts (adj. <em>P</em> &lt; 0.001). Those residing in deserts had significantly less internet access, annual medical cost per capita, and access to homeless relief services as well as significantly higher food insecurity rates and Medicare cost per capita (adj. <em>P</em> &lt; 0.001). UNC-specific health care utilization statistics for the 3 assessed counties were all poorer in deserts compared to nondeserts within the same counties (<em>P</em> &gt; 0.05).</p></div><div><h3>Conclusion</h3><p>A geospatial map with the location of pharmacy deserts in NC was created to highlight differences in patient health care utilization, affecting rural and urban areas. By incorporating SDOH predictors, this study provides a more nuanced map of NC pharmacy deserts compared to reviewing distance to pharmacies alone. Higher rates of emergency department and inpatient visits in counties with more residents in pharmacy deserts suggests potential health outcomes associated with limited pharmacy access.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102215"},"PeriodicalIF":2.5,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019379","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":"Borne of necessity: pharmacy-based harm reduction and express sexually transmitted infection services","authors":"Whitney Dickson,&nbsp;Jinny Meyer,&nbsp;Jessica Leston,&nbsp;Brigg Reilley","doi":"10.1016/j.japh.2024.102213","DOIUrl":"10.1016/j.japh.2024.102213","url":null,"abstract":"<div><h3>Background</h3><div>HIV, hepatitis C virus (HCV), Sexually Transmitted Infections (STIs), and substance use disorder are interrelated epidemics. Augmented services to respond to this “syndemic” are hampered by shortages of health care workers, especially in rural areas. In an Indian Health Service hospital in rural Minnesota, the pharmacy sought to integrate harm reduction and express STI services into its scope of practice.</div></div><div><h3>Objectives</h3><div>Provide pharmacy-based harm reduction and express STI services to increase access to care for community members, especially those without a primary care provider.</div></div><div><h3>Methods</h3><div>The program was designed with input from tribal counterparts and internal medical staff. The pharmacy window was made the intake point for services for patient education, harm reduction materials, and STI testing and treatment. Collaborative practice agreements and standing orders greatly expanded the pharmacy’s ability to deliver care. Later in the program, the pharmacy was able to introduce patient incentives.</div></div><div><h3>Results</h3><div>From October 2022 to November 2023, the program had 500 visits from 101 unique patients with a median age of 36. Among users of the service, 71% did not have a primary care provider. Once patient incentives were introduced, express STI testing increased over 10-fold. The laboratory panels had a 44% positivity rate for either an STI or HCV.</div></div><div><h3>Conclusions</h3><div>Pharmacy can be an accessible and effective means of delivering harm reduction, STI, and HCV services. Patient incentives may greatly increase testing and detection of infectious diseases among patients who may otherwise not seek care.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"64 6","pages":"Article 102213"},"PeriodicalIF":2.5,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019378","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}