Journal of the American Pharmacists Association最新文献

{"title":"Pharmacists' perspectives on providing an educational intervention to address E-cigarette use and vaping among adolescents and their parents","authors":"Ellie Maday,&nbsp;Annika Brekke,&nbsp;Jenny S. Li,&nbsp;Olufunmilola Abraham","doi":"10.1016/j.japh.2025.102392","DOIUrl":"10.1016/j.japh.2025.102392","url":null,"abstract":"<div><h3>Background</h3><div>The use of newer forms of nicotine, such as e-cigarettes, has become popular among youth, creating a growing concern about its health impact on adolescents. As the adolescent vaping epidemic persists, it is necessary to engage all public-facing health care professionals in prevention and reduction efforts against e-cigarette use. With pharmacists being the most accessible health care professional, they are well-suited to expand their tobacco services to include vaping.</div></div><div><h3>Objective</h3><div>The objectives of this study are to examine pharmacists' opinions on the potential role they may have in addressing adolescent vaping and to determine pharmacists' view on a proposed educational tool (Pharmacist-Led E-cigarette and Vaping Educational Resource [Ph-EVER]) for adolescents and parents to learn more about vaping and e-cigarette use.</div></div><div><h3>Methods</h3><div>Licensed and practicing pharmacists in Wisconsin were recruited via pharmacy organizations' email listservs to take part in a semi-structured interview. The interview questions covered knowledge on adolescent vaping, the role of pharmacists in addressing adolescent vaping, interactions with adolescents in their practice, and feedback on the Ph-EVER. Two study team members independently coded the interviews to generate prevalent themes and subthemes.</div></div><div><h3>Results</h3><div>In this study, 30 pharmacist participants were interviewed. From their interviews, themes that emerged included how pharmacists interact with teens, what they already know about e-cigarettes, the potential roles pharmacists may have on adolescent vaping, and feedback on the Ph-EVER.</div></div><div><h3>Conclusion</h3><div>Pharmacists can be key professionals in reducing adolescent vaping; however, they lack knowledge on the topic of e-cigarettes, indicating the need for continuing education. Many pharmacists noted that they rarely see adolescents in their practice setting, making adolescents a difficult population to reach. Pharmacists were open to the idea of implementing the Ph-EVER within their pharmacy, stating it achieved its intended purpose. Recommendations were made to expand this resource to social media to target the adolescent population.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 4","pages":"Article 102392"},"PeriodicalIF":2.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732696","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":"Inside the pharmacy: A qualitative study uncovering community pharmacists' experiences with Paxlovid prescribing","authors":"Sura O. AlMahasis,&nbsp;Bonyan Qudah,&nbsp;James H. Ford II,&nbsp;David Mott","doi":"10.1016/j.japh.2025.102390","DOIUrl":"10.1016/j.japh.2025.102390","url":null,"abstract":"<div><h3>Background</h3><div>Community pharmacists were authorized to prescribe Paxlovid to eligible patients, yet little is known about their experiences in this role. Understanding these experiences is crucial for improving patient access.</div></div><div><h3>Objectives</h3><div>This study aimed to 1) describe the Paxlovid prescribing process in community pharmacies and 2) explore associated barriers and facilitators.</div></div><div><h3>Methods</h3><div>This exploratory qualitative study involved semi-structured virtual interviews with pharmacists in Wisconsin (June-September 2023). Pharmacists were identified using the Wisconsin Department of Health Services list of pharmacies offering Paxlovid and the Pharmacy Practice Enhancement and Action Research Link network. The interview guide, pretested with one pharmacist, was informed by the Consolidated Framework for Implementation Research (CFIR). Descriptive statistics and thematic analysis guided by the CFIR were used.</div></div><div><h3>Results</h3><div>Five pharmacists were interviewed, including 3 in leadership roles. One represented a pharmacy partnering with 2 health systems, while another represented a health care system collaborating with 15 independent pharmacies. On average, pharmacists dispensed 130 (±142) Paxlovid doses, with eligibility screening taking 5 to 45 minutes, conducted in person, by phone, or via electronic health records (EHRs). The prescribing process involved 2 steps: 1) assessing eligibility and 2) dispensing the appropriate prescription, with slight variations based on pharmacy's EHR access. Key themes describing facilitators and barriers to Paxlovid prescribing emerged within 4 CFIR domains (i.e., inner setting, outer setting, individual characteristics, and process). Major barriers included limited access to patient health information and inadequate reimbursement. Facilitators included access to decision-making support tools, compatibility, and the ability to screen and counsel patients remotely.</div></div><div><h3>Conclusion</h3><div>Community pharmacists are vital to expanding access to Paxlovid but struggle with limited access to patient health information and inadequate reimbursement. Ensuring EHR access and advocating for provider status will enhance patient care. Involving pharmacists in public health program design can optimize resource allocation and effectiveness.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 4","pages":"Article 102390"},"PeriodicalIF":2.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701436","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":"Pharmacist interventions in immigrant and refugee populations: A scoping review","authors":"Ann M. Philbrick,&nbsp;Omolayo Umaru,&nbsp;Sarah Jane Brown,&nbsp;Alec Helmke,&nbsp;Kathryn Momary,&nbsp;Jordan Peterson,&nbsp;Van Hellerslia","doi":"10.1016/j.japh.2025.102393","DOIUrl":"10.1016/j.japh.2025.102393","url":null,"abstract":"<div><h3>Background</h3><div>Global movement has heightened concerns regarding the well-being of immigrant and refugee populations. In the United States, the influx of refugees underscores the pressing need to address their unique health challenges, alongside social determinants of health (SDOH). Pharmacists are well-positioned to mitigate these disparities.</div></div><div><h3>Objectives</h3><div>This scoping review aims to identify pharmacist-led interventions targeting immigrants and refugees in the US.</div></div><div><h3>Methods</h3><div>A health sciences librarian created a comprehensive search strategy in 5 electronic databases. After deduplication and screening of 2603 studies by 4 independent reviewers, 10 were selected for inclusion by 2 independent reviewers. Selected articles were mapped to SDOH framework.</div></div><div><h3>Results</h3><div>Among the 10 manuscripts, 2 were randomized controlled trials, and 8 observational studies. Four manuscripts focused on the SDOH framework of Education Access and Quality and 6 on Healthcare Access and Quality. Under the former, 3 interventions focused on understanding how to access a pharmacy or understand medication directions while the fourth assessed hepatitis B education. Regarding Healthcare Access and Quality, both randomized controlled trials examined the impact of lifestyle interventions with medication therapy management. Four examined the pharmacists' role in providing health care access including chronic disease management, latent-tuberculosis infection, diabetes, and health screenings for metabolic disorders.</div></div><div><h3>Conclusion</h3><div>Ten pharmacist interventions proactively addressed barriers to health care in immigrant and refugee populations in the 2 SDOH domains that pharmacists are most in a position to aid; Education Access and Quality and Healthcare Access and Quality. The remaining SDOHs represent areas of opportunities for pharmacists.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 4","pages":"Article 102393"},"PeriodicalIF":2.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701500","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":"Challenges of managing pediatric polypharmacy in a pediatric complex care program: A qualitative pilot study","authors":"Julia Reedy,&nbsp;Talia Thompson,&nbsp;Anowara Begum,&nbsp;Megan A. Morris,&nbsp;Allison Kempe,&nbsp;Chris Feudtner,&nbsp;Mark Gritz,&nbsp;James A. Feinstein","doi":"10.1016/j.japh.2025.102391","DOIUrl":"10.1016/j.japh.2025.102391","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric polypharmacy is often necessary for symptom and disease management in children with medical complexity (CMC) but can result in medication-related problems. Little is known about how pediatric care teams coordinate efforts to manage polypharmacy. This limits the pragmatic design of interventions to comprehensively manage pediatric polypharmacy.</div></div><div><h3>Objectives</h3><div>In a large outpatient pediatric complex care program for CMC, we sought to understand 1) how pediatric polypharmacy is managed by a multidisciplinary team, 2) associated challenges, and 3) opportunities for improvement.</div></div><div><h3>Methods</h3><div>We conducted a qualitative pilot study of pediatric clinicians with prescribing and nonprescribing roles. Thematic content analysis was used to synthesize findings across participants and identify key themes.</div></div><div><h3>Results</h3><div>We interviewed 16 clinicians representing prescribing (n = 9) and nonprescribing (n = 7) clinicians. Three of the following overarching themes emerged: 1) pediatric polypharmacy poses unique safety risks for CMC; 2) polypharmacy management requires careful collaboration between distinct clinical roles to accomplish numerous medication-related tasks; and 3) multiple prescribers across subspecialties complicates polypharmacy management, including challenges in identifying responsibility for certain medications. Clinicians described myriad challenges across different levels of the healthcare system (patient, clinic, hospital, and system) and endorsed the need for a pediatric pharmacist to help mitigate these challenges.</div></div><div><h3>Conclusion</h3><div>Interventions to manage pediatric polypharmacy for CMC will require a multilevel approach including the 1) curation of accessible highly centralized medication documentation, 2) delegation of certain medication-related tasks based on clinical expertise, and 3) coordination of medication management activities across health care organizations and settings of care. Integrated pediatric pharmacist support could address many of these needs.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 4","pages":"Article 102391"},"PeriodicalIF":2.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702056","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":"Expanding vaccination access in underserved communities across Maryland through a collaborative approach.","authors":"Nicole J Brandt, F Mark Hindman, Cherokee Layson-Wolf, Sarah Brandt, Barbara J Zarowitz","doi":"10.1016/j.japh.2025.102389","DOIUrl":"10.1016/j.japh.2025.102389","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;From April 2023 through April 2024, Maryland Living Well Center of Excellence, in collaboration with The Peter Lamy Center on Drug Therapy and Aging at the University of Maryland School of Pharmacy and community partners, Meals-on-Wheels of Central Maryland, and Maryland Primary Care Program provided vaccination services and education for older persons including those with disabilities who have been historically underserved.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To expand equitable access to all applicable adult vaccines with a focus on influenza and coronavirus disease-2019 (COVID-19) in adults 60 years of age and older.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Practice description: &lt;/strong&gt;A collaborative team of pharmacists, pharmacy students, pharmacy technicians, community and public health workers, and primary care physician practices were assembled. Through a series of biweekly meetings, a model of outreach to low-income, urban, rural, and remote underserved and senior housing communities was established to provide education and referral services directed toward improving vaccine access and administering vaccines. To bridge access barriers, vaccines were offered in community centers, pharmacies, physician practices, low-income senior housing units, and individual patient homes in an effort to enable equitable access to influenza and COVID-19 vaccines principally, but other vaccines were available. Development of an age-friendly vaccine brochure and interest form was disseminated to Meals-on-Wheels recipients and through housing and pharmacy partners. Biweekly public health emails were distributed to over 1100 primary care practices, calling for providers to promote vaccines and engage in this initiative.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Practice innovation: &lt;/strong&gt;This community-based collaborative model of vaccination programs featured a multipronged innovative approach of: (a) outreach through a School of Pharmacy, community wellness hub, Meals-on-Wheels, community pharmacies, and primary care practices; (b) referral services for vaccine scheduling assistance and transportation; (c) vaccine services provided in the communities including in: low-income senior housing buildings, community centers, primary care practices, and in patient's homes; and (d) widely disseminated services to urban, suburban, rural, and remote areas of the state with a concentration to individuals with socioeconomic challenges.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Evaluation methods: &lt;/strong&gt;Goal attainment was measured by the number of all vaccines administered with a focus on influenza and COVID-19 vaccines to adults 60 and older including, those with disabilities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Community outreach to 115,785 people through Meals-on-Wheels, primary care offices, wellness, and cultural events resulted in 23,521 administered vaccines COVID-19 (48%), influenza (36%), hepatitis B (13%), and other (3%)). Over 11,400 individuals received scheduling assistance (63%), transportation (&lt;1%),","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102389"},"PeriodicalIF":2.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694267","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":"Roles and perceptions of community pharmacists in suicide prevention in Jordan: A cross-sectional study.","authors":"Rana Abu-Farha, Karem H Alzoubi, Lobna Gharaibeh, Mariam Al-Ameri, Aya Nawasreh, Ammena Y Binsaleh, Sireen Abdul Rahim Shilbayeh","doi":"10.1016/j.japh.2025.102388","DOIUrl":"10.1016/j.japh.2025.102388","url":null,"abstract":"<p><strong>Background: </strong>Suicide is a major global public health issue, with mental health disorders closely linked to suicidal behaviors. Community pharmacists, as accessible health care providers, can play a key role in prevention but face challenges like limited training and societal stigma.</p><p><strong>Objectives: </strong>This study aimed to evaluate community pharmacists' awareness regarding suicide warning signs, identify perceived barriers to engaging in suicide prevention, and assess their attitudes and perceptions regarding their role in mental health support in Jordan.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted from August to September 2024 among practicing community pharmacists registered with the Jordanian Pharmacy Association. The study survey was distributed electronically through social media and professional networks, included questions on demographics, knowledge of suicide warning signs, training, experiences with suicidal patients, and perceptions of their role in mental health support. Data were analyzed using SPSS version 26 (IBM Corp.).</p><p><strong>Results: </strong>A total of 412 pharmacists participated in this study. Regarding familiarity with suicide warning signs, 150 (36.4%) reported being familiar; however, confidence in identifying suicide warning signs was low, with only 73 (17.7%) feeling very confident. Among the 208 (50.5%) pharmacists who encountered patients with suicidal thoughts, common warning signs included withdrawal from activities (181, 87.0%) and feelings of hopelessness (179, 86.1%). In response to these situations, 187 (89.9%) pharmacists provided empathetic support, 172 (82.7%) encouraged seeking professional help, and 167 (80.3%) assessed the seriousness of the situation. Barriers to effective intervention included cultural barriers (329, 79.9%), lack of training (327, 79.4%), and fear of offending patients (323, 78.4%).</p><p><strong>Conclusion: </strong>Community pharmacists in Jordan recognize the importance of their role in suicide prevention but face barriers such as lack of training and cultural sensitivities. Enhancing training and providing clear guidelines can improve their effectiveness in supporting mental health and suicide prevention efforts.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":" ","pages":"102388"},"PeriodicalIF":2.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694268","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":"TikTok’s Take on Adverse Effects for Glucagon-Like Peptide-1 and Gastric Inhibitory Polypeptide Receptor Agonists","authors":"Gwendolyn A. Wantuch,&nbsp;Jerica Singleton","doi":"10.1016/j.japh.2025.102384","DOIUrl":"10.1016/j.japh.2025.102384","url":null,"abstract":"<div><h3>Background</h3><div>TikTok’s MedTok is an interconnected network of patients, providers, and producers sharing knowledge and experiences of health-related topics. Awareness of popular content on weight loss medications can benefit health care professionals, especially regarding adverse effects and management.</div></div><div><h3>Objectives</h3><div>Describe content in popular TikTok videos using adverse effect hashtags for gastric inhibitory peptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonists. Compare content between health care and non-health care creators and reported adverse effects versus medication package inserts.</div></div><div><h3>Methods</h3><div>This observational study evaluated videos for popular GLP-1 and GIP receptor agonist side-effect hashtags on TikTok, in June 2023. Video metadata collected included content creator demographics and content of video, including adverse effects discussed and recommendations to address these. Adverse effects were compared to package insert data. Qualitative data was evaluated through descriptive coding, quantitative data through descriptive statistics, and Pearson chi-square for comparisons.</div></div><div><h3>Results</h3><div>A total of 165 videos were analyzed. Content creators were mostly medication users (89%) and non-health care professionals (90%). Medication indications included weight loss (82%), polycystic ovarian syndrome (20%), and diabetes (6%). Diet, exercise, or weight loss were discussed in 34%, 16%, and 38% of videos, respectively. Non-health care professionals mentioned specific products to address adverse effects more frequently than health care professionals, 24% versus 13% (<em>P</em> = 0.292). All adverse effects mentioned in at least 5 videos aligned with medication package inserts, most commonly gastrointestinal disturbances, except for insomnia.</div></div><div><h3>Conclusion</h3><div>Most content creators were non-health care professionals and medication users. Despite Ozempic and Mounjaro lacking Food and Drug Administration approval for weight loss at the time, it was the most identified indication. The alignment of most reported adverse effects with medication package inserts underscores the reliability of user-shared experiences, though discrepancies like insomnia were noted. Given TikTok's remarkable reach and influence, awareness of patient-reported experiences and recommendations is essential for health care providers to enhance care and dispel misconceptions.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 4","pages":"Article 102384"},"PeriodicalIF":2.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574588","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":"Australian community pharmacists’ experiences of prescription drug monitoring programs: Comparisons between mandated and nonmandated states","authors":"Rose Laing ,&nbsp;Pei Ying ,&nbsp;Ting Xia,&nbsp;Suzanne Nielsen,&nbsp;Louisa Picco","doi":"10.1016/j.japh.2024.102313","DOIUrl":"10.1016/j.japh.2024.102313","url":null,"abstract":"<div><h3>Background</h3><div>Prescription drug monitoring programs (PDMPs) track patients’ prescription records for high-risk medications and prompt real-time alerts to pharmacists when specific criteria are met. PDMPs are increasingly implemented by health care systems to attempt to mitigate harms associated with prescription opioids.</div></div><div><h3>Objective</h3><div>This study aims to explore and compare PDMP experiences among Australian community pharmacists from states where PDMP use is mandated and nonmandated.</div></div><div><h3>Methods</h3><div>A representative sample of community pharmacists from New South Wales, Queensland, Victoria, and Western Australia were invited to complete an anonymous online survey. The survey collected pharmacy and pharmacist-related information and asked pharmacists to rank PDMP’s usefulness and barriers on a 5-point scale. Mann-Whitney <em>U</em> tests were conducted to determine if there were statistically significant differences in scores between mandated and nonmandated states.</div></div><div><h3>Results</h3><div>In total, 690 pharmacists were included. Pharmacists in mandated states had statistically higher mean ‘usefulness’ scores for 5 out of 17 items, such as informing clinical decision-making (<em>P</em> &lt; 0.001) and increasing confidence to refuse medication supply (<em>P</em> = 0.002). PDMP-related barriers were rarely reported by pharmacists, although there were statistically significant differences for specific barriers between mandated and nonmandated states. Nonmandated states had significantly higher mean scores for 5 barriers, including ‘unsure what to do with the PDMP information’ (<em>P</em> &lt; 0.001) and ‘PDMP is not integrated into dispensing software’ (<em>P</em> = 0.005). Mandated states had statistically higher mean scores for 9 barriers, including ‘not all scripts appear in PDMP’ (<em>P</em> &lt; 0.001) and ‘inaccurate information in the PDMP’ (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>There were significant differences in pharmacists’ PDMP experiences between mandated and nonmandated states, which may have policy implications given Australia’s recent investment into national prescription monitoring.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102313"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855826","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":"Increasing SGLT-2 inhibitor prescribing through an integrated case-finding algorithm-guided interdisciplinary intervention","authors":"Cindy Leslie A. Roberson,&nbsp;Abby F. Hoffman,&nbsp;Pamela Cohen,&nbsp;Victoria Lee Jackson,&nbsp;Susan E. Spratt","doi":"10.1016/j.japh.2024.102320","DOIUrl":"10.1016/j.japh.2024.102320","url":null,"abstract":"<div><h3>Background</h3><div>Use of sodium-glucose cotransporter 2 inhibitors (SGLT-2 inhibitors) falls short of their cardiorenal protective benefits. Patient and provider-level barriers hinder the adoption of these life-saving medications. Innovative practices to provide primary care providers (PCPs) with added clinical-decision support via a dedicated remote interdisciplinary diabetes rounds (IDRs) team could promote SGLT-2 inhibitor selection.</div></div><div><h3>Objective</h3><div>To evaluate the impact of the IDR's proactive provider outreach on the prescribing rate of SGLT-2 inhibitors and assess the application of an SGLT-2 inhibitor case-finding algorithm to allow targeted intervention in a population-health-based setting.</div></div><div><h3>Methods</h3><div>This is a quality improvement prospective cohort observational study from October 2021 to May 2022. Patients who met the prespecified criteria for SGLT-2 eligibility were reviewed via IDR with recommendations sent to the PCP via the electronic health record. The primary analysis employed a multivariate logistic regression to assess the difference in SGLT-2 inhibitor prescription rates between reviewed and not reviewed patients, adjusting for variables affecting SGLT-2 inhibitor prescribing. The secondary analysis measured the algorithm's accuracy in identifying patients with compelling indications.</div></div><div><h3>Results</h3><div>The IDR team reviewed a total of 206 patients (mean age, 63 years; 53.9% women; 42.7% Black; mean A1c 8.3%) with a successful PCP appointment. Patients reviewed by the IDR team had an increased prescribing rate within 90 days of the visit (adjusted odds ratio 5.1, 95% CI 3.06–8.47). The algorithm identified 1084 SGLT-2 inhibitor-eligible patients with a sensitivity of 90.4% (95% CI, 86.4%, 94.4%) and specificity of 85.1% (95% CI, 79.9%, 90.4%).</div></div><div><h3>Conclusion</h3><div>IDR team's review of eligible patients with recommendations to PCPs was associated with significantly increased SGLT-2 inhibitor prescription rates. Development of an algorithm with high sensitivity and specificity for targeted intervention may provide a pathway for channeling therapy and decreasing clinical inertia in population health management efforts.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102320"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902869","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":"Pharmacist perceptions of motivation and well-being using self-determination theory: A qualitative study","authors":"Kayla Walker,&nbsp;Alexcia S. Carr,&nbsp;Andrew Wash,&nbsp;Leticia R. Moczygemba","doi":"10.1016/j.japh.2024.102321","DOIUrl":"10.1016/j.japh.2024.102321","url":null,"abstract":"<div><h3>Background</h3><div>Many US hospitals and health systems have implemented well-being programs to address the clinician well-being and burnout crisis. Most community pharmacists experience at least one symptom of burnout, yet they have been overlooked for inclusion in well-being initiatives.</div></div><div><h3>Objective</h3><div>To explore community pharmacists' perceptions of how motivation and burnout impact patient care and how fulfillment of basic psychological needs (autonomy, competence, and relatedness) impacts motivation and well-being.</div></div><div><h3>Methods</h3><div>Focus groups were conducted with 20 community pharmacists. A semistructured focus group guide was developed using Self-Determination Theory (SDT). Transcriptions from the focus groups were analyzed using deductive qualitative analysis with SDT as a framework and inductive analysis to code subthemes.</div></div><div><h3>Results</h3><div>Our findings revealed that pharmacists who feel burnout experience depersonalization toward patients which lowers the quality of patient-pharmacist interactions. Pharmacists who did not feel burnout expressed a sense of professional fulfillment, which motivated them to provide patient-centered care. Pharmacists indicated that unrealistic expectations from patients and corporate management, such as pressure from patients to fill prescriptions quickly and management expectations to meet prescription fill quotas, negatively impacted autonomy. Conversely, having access to clinical information, workflow optimization, and realistic job expectations supported autonomy. Poor relationships with patients and coworkers negatively impacted relatedness and contributed to communication barriers, workplace negativity, and emotional detachment from work. Relatedness was facilitated by building relationships and mutual respect with patients and coworkers and cultivating a positive work culture. Expectations for perfection and the need for multitasking when understaffed diminished competency. Adequate staffing and allocation of time to complete job duties served to support competency.</div></div><div><h3>Conclusion</h3><div>Community pharmacists are faced with situations that undermine autonomy, relatedness, and competency, which according to SDT need to be fulfilled to facilitate well-being.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102321"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903070","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}