Journal of the American Pharmacists Association最新文献

{"title":"Community pharmacists' public health role in addressing the appropriate use of over-the-counter oral contraception","authors":"Hailey M. Wanner,&nbsp;Brooke A. Suttles","doi":"10.1016/j.japh.2025.102900","DOIUrl":"10.1016/j.japh.2025.102900","url":null,"abstract":"<div><div>According to the U.S. Food and Drug Administration (FDA), half of the 6.1 million pregnancies per year in the United States are unintended. Minority and low socioeconomic status (SES) women are at increased risk of unintended pregnancy and face disparities in accessing contraception. On July 13, 2023, the U.S. FDA approved Opill (norgestrel) tablets as the first daily oral contraceptive (OC) approved for nonprescription use in the United States for the prevention of pregnancy. As a progestin-only pill (POP), norgestrel provides a method of oral contraception with minimal side effects and fewer contraindications than prescription-only combination oral contraceptives (COCs). A review of current literature on patient and pharmacist perceptions of prescription COC and over-the-counter (OTC) POP use indicates POPs are regarded as an accessible, affordable, and safe OTC option. In countries allowing nonprescription POPs, multiple benefits have been noted, including improved continuation rates of therapy and increased utilization by at-risk populations such as adolescents and low-SES or uninsured people. Pharmacists are known as the most accessible health care professionals, placing them in an ideal position to serve as a resource for OC information. As nonprescription norgestrel becomes widely available in the United States, pharmacists need to be prepared to educate patients about the similarities and differences among available contraceptive methods. Pharmacists can empower patients, promote autonomy in reproductive health, and ensure safe and appropriate medication use. The approval of nonprescription norgestrel provides pharmacists with new opportunities to expand their public health role in pregnancy prevention efforts across the population.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102900"},"PeriodicalIF":2.5,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850351","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":"Zada M. Cooper: Inspiring leadership, service, collaboration, and innovation to advance pharmacy","authors":"Melissa M. Corrigan,&nbsp;Nancy A. Alvarez,&nbsp;Brianne K. Bakken,&nbsp;Kelly A. Brock,&nbsp;Connie J. Connolly,&nbsp;Jill M. Kolesar,&nbsp;Donald E. Letendre,&nbsp;Lucinda L. Maine,&nbsp;Susan S. Vos,&nbsp;Logan T. Murry","doi":"10.1016/j.japh.2025.102902","DOIUrl":"10.1016/j.japh.2025.102902","url":null,"abstract":"<div><div>Zada Mary Cooper (1875–1961), known as the \"Grand and Glorious Lady of Pharmacy,\" was a pioneering educator, advocate, and leader who helped shape modern pharmacy practice. As the first known female pharmacy faculty member in the United States, Cooper’s career at The University of Iowa spanned 45 years, during which she championed innovation in education, promoted leadership in pharmacy, and influenced national professional organizations. Through prolific writing and visionary service, she addressed challenges still relevant today—engaging students in lifelong learning and preparing students for fulfilling careers in practice, aligning practice settings with pharmacist value, and educating the public on the role of pharmacists. This article describes Cooper’s enduring impact, with some of her scholarship referenced and related to pharmacy practice today. We conclude by introducing the forthcoming national Zada Cooper Leadership Medal, which beginning at the American Pharmacists Association’s annual meeting in 2026, will be awarded to individuals inspiring ongoing leadership, advocacy, and mentorship in pharmacy. Her legacy offers a blueprint for addressing today’s challenges with curiosity, collaboration, and courage.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102902"},"PeriodicalIF":2.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144819055","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":"Increasing statin prescribing through a pharmacogenomics-guided initiative","authors":"Claire Rennie,&nbsp;Mary Roads,&nbsp;Bridger Bright,&nbsp;Sally Armstrong,&nbsp;Jennifer Meyer Reid","doi":"10.1016/j.japh.2025.102898","DOIUrl":"10.1016/j.japh.2025.102898","url":null,"abstract":"<div><h3>Background</h3><div>Despite clear benefits of statin therapy, utilization remains suboptimal. Concern for adverse effects are a top reason for declining or discontinuing a statin. Certain genetic variations can predispose a patient to statin intolerance.</div></div><div><h3>Objective</h3><div>To offer Veterans pharmacogenomics testing to help guide statin therapy decision-making and increase appropriate statin prescribing within a single Veterans Affairs Health Care System (VAHCS).</div></div><div><h3>Practive innovation &amp; evaluation methods</h3><div>A team of pharmacists designed a quality improvement initiative that included personalized phone calls offering pharmacogenomics testing and/or statin initiation. Patients initiated on a statin were assessed for adherence and tolerability at least four weeks after initiation.</div></div><div><h3>Results</h3><div>A total of 107 patients were contacted for the statin initiative. About half (n = 50 [47%]) initiated a statin, and of those, 45 (90%) completed pharmacogenomics testing for a genomics-guided statin prescription. Most patients initiated on a statin (72%) reported adherence and tolerance at least 4 weeks after starting statin therapy.</div></div><div><h3>Conclusion</h3><div>Pharmacogenomics testing can potentially be used as a tool in the statin initiation process to facilitate a patient-centered discussion and increase shared clinical decision making.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102898"},"PeriodicalIF":2.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144819044","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":"Effects of passive information dissemination on human papillomavirus vaccination attitudes and knowledge among pharmacy visitors: A cluster randomized controlled trial","authors":"Nobuyuki Wakui ,&nbsp;Shoko Kawakubo ,&nbsp;Mariko Harayama,&nbsp;Itsuki Kageyama,&nbsp;Yoshiyuki Kobayashi,&nbsp;Kota Kodama,&nbsp;Masayuki Asakawa,&nbsp;Tetsuya Ogino,&nbsp;Mayumi Kikuchi,&nbsp;Hajime Kato","doi":"10.1016/j.japh.2025.102901","DOIUrl":"10.1016/j.japh.2025.102901","url":null,"abstract":"<div><h3>Background</h3><div>In Japan, human papillomavirus (HPV) vaccination rates remain low, partially owing to safety concerns from media reports. Pharmacies, as accessible health care facilities, often serve as sources of health information. However, the impact of passive information provision in pharmacies on public awareness and behavioral intentions has not been completely evaluated.</div></div><div><h3>Objectives</h3><div>This study examined whether passive dissemination of HPV vaccine-related information in community pharmacies—through posters and leaflets—could improve visitors' knowledge and motivation to recommend HPV vaccinations.</div></div><div><h3>Methods</h3><div>A cluster randomized controlled trial was conducted in 20 pharmacies, of which 10 assigned were to the intervention group and 10 to the control group. Posters and leaflets on HPV vaccinations were displayed in the intervention group only, without the pharmacist's explanation. Adult visitors (n = 182) aged 20–75 years completed baseline and follow-up questionnaires using the vaccinaTion &amp; Hpv Knowledge scale (THinK) and 7C Vaccination Readiness Scale. The primary endpoint was the change in attitudes toward HPV vaccination (aHPV)—a composite indicator reflecting willingness to receive the vaccine, recommend it to others, and seek related information—at 12 weeks.</div></div><div><h3>Results</h3><div>No significant difference in aHPV score changes was observed between the groups at 12 weeks (mean difference = 0.14; <em>P</em> = 0.18). However, knowledge of HPV infection was significantly improved in the intervention group at 8 and 12 weeks (<em>P</em> &lt; 0.05). No significant changes were observed in any of the subscales of the 7C Vaccination Readiness Scale.</div></div><div><h3>Conclusion</h3><div>Passive information provision in pharmacies improved HPV-related knowledge but did not enhance motivation to recommend vaccination. To enhance promotion, other active modalities—such as dialogue-based communication by professionals—may be more effective.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102901"},"PeriodicalIF":2.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812838","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":"HMG Co-A reductase inhibitor medication management in American Indians with type 2 diabetes: A multiyear view from a rural tribal health system","authors":"Ashley DeVaughan Circles,&nbsp;Anatolia Legaspi,&nbsp;Tarah Nelson,&nbsp;Yingwei Yao,&nbsp;Marilyn Aguila,&nbsp;Richard Segal,&nbsp;William T. Donahoo,&nbsp;R. Turner Goins,&nbsp;Spero M. Manson,&nbsp;Diana J. Wilkie,&nbsp;Lisa Scarton","doi":"10.1016/j.japh.2025.102494","DOIUrl":"10.1016/j.japh.2025.102494","url":null,"abstract":"<div><h3>Background</h3><div>American Indian peoples have the highest prevalence of diabetes among all racial and ethnic groups. Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality in people with type 2 diabetes. Lipid management, including statin medications, is recommended to reduce the risk of ASCVD for patients with type 2 diabetes.</div></div><div><h3>Objectives</h3><div>We described statin medication dispensing patterns and analyzed adherence trends by age group and intensity of statin therapy within the Choctaw Nation Health Services Authority (CNHSA) type 2 diabetes patient population. Our second objective was to compare the frequency and timing of lipid panels to current guidelines.</div></div><div><h3>Methods</h3><div>This was a retrospective secondary analysis of CNHSA electronic health record data from 2017 to 2021 of patients who used CNHSA services and pharmacies. The adherence analysis included patients who were dispensed statins for &gt;180 days. Patients were stratified based on age and statin intensity. The lipid panel analysis included labs obtained yearly and 4-12 weeks after a statin adjustment.</div></div><div><h3>Results</h3><div>Of the 8330 CNHSA patients with diabetes medication, 69.6% were prescribed a statin. Of those, 45.0% were dispensed moderate-intensity statins exclusively; 23.7% were on high-intensity statins only. The age &lt;40 years group had the lowest adherence with mean proportion of days covered 0.69 (0.22). Yearly labs were completed for 85% of the patients in year 1 after first statin dispense and 80%, 77%, and 71% in subsequent years. Of the patients with adjustments, 13% had a follow-up lipid panel within 4–12 weeks after the first adjustment.</div></div><div><h3>Conclusion</h3><div>Statin medications were used by a large percentage of CNHSA patients with type 2 diabetes. Statin adherence was lowest in the younger age groups (&lt;40). Our findings provide insight into statin use, adherence, and laboratory findings. Future studies should examine barriers to adherence specific to the larger CNHSA population.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102494"},"PeriodicalIF":2.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812839","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":"“Counting what we save—and what we never have to spend: Cost savings and cost avoidance from an AI-enabled pharmacy workflow”","authors":"Travis Smith,&nbsp;Camille Walters,&nbsp;Alan Yee","doi":"10.1016/j.japh.2025.102899","DOIUrl":"10.1016/j.japh.2025.102899","url":null,"abstract":"<div><h3>Background</h3><div>Clinical trial protocols are highly complex documents that outline the objectives, design, methodology, statistical considerations, and operational details of a study. Departments, such as nursing, pharmacy, and labs, create tailored summaries that allow others in their field to efficiently access information without combing through hundreds of pages of a protocol. Creating these summaries can be time intensive and are a barrier to study activation. With increasing complexity of study design and momentum towards individualized medicine, artificial intelligence (AI)-assisted workflows may present an opportunity to increase efficiency and reduce study overhead.</div></div><div><h3>Objectives</h3><div>Determine the impact of AI-assisted workflows in preparing pharmacy clinical trial documents.</div></div><div><h3>Methods</h3><div>A generative AI prompt was developed to produce summaries which include elements of manually created summaries. Pharmacists completed summaries manually and with AI assistance in parallel. Studies were selected sequentially, with all new trials submitted within the stated observation timeframe considered for assessment. Time required to complete summaries was compared between manual and AI-assisted methods, and a cost-effectiveness and cost-avoidance analysis was performed.</div></div><div><h3>Results</h3><div>An AI-assisted workflow cut pharmacy summary-sheet preparation time 80% (148 → 30 minutes), yielding a negative incremental cost-effectiveness ratio (ICER) of −$97 per hour saved and a net monetary benefit (NMB) of $423 per task (∼$30,000 annually for six pharmacists). One-way sensitivity analyses across productivity, salary, fringe, and IT overhead ranges all stayed cost-saving; the worst case still delivered a NMB of $465. A 10-year Monte-Carlo analysis varying AI price growth, performance drift, upgrade shocks, and labor inflation never crossed break-even (mean discounted NMB $294 k, (95% CI $265–323 k).</div></div><div><h3>Conclusion</h3><div>AI automation reliably frees pharmacist time, curbs costs, and scales favorably as trial volume grows across diverse settings and future documentation-intensive pharmacy tasks.</div><div>This study evaluates the cost-effectiveness of implementing an AI-assisted workflow for pharmacy summary sheet creation in clinical trials. We compare the AI workflow to a traditional manual process, analyzing labor costs, time efficiency, ICER, and NMB. Findings indicate significant cost savings and efficiency gains, supporting the adoption of AI-driven automation.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102899"},"PeriodicalIF":2.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812837","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 the accessibility and accuracy of pharmacist counseling for continuous glucose monitoring: A secret shopper study of community pharmacies","authors":"Morgan P. Stewart,&nbsp;Lindsey J. Loera,&nbsp;Bruno Onwukwe,&nbsp;Kelly R. Reveles,&nbsp;Kathryn P. Lin","doi":"10.1016/j.japh.2025.102493","DOIUrl":"10.1016/j.japh.2025.102493","url":null,"abstract":"<div><h3>Background</h3><div>Continuous glucose monitors (CGMs) have many benefits in diabetes care and have grown in popularity. CGMs are often dispensed in community pharmacies, placing a growing responsibility on community pharmacists to provide patient education. Limited time and resources may result in suboptimal, or even absent, patient counseling.</div></div><div><h3>Objectives</h3><div>To assess the accessibility and accuracy of CGM counseling offered by community pharmacists in Austin, TX.</div></div><div><h3>Methods</h3><div>All community pharmacies in Austin, TX (N = 125) were visited in person in 2 phases by trained auditors, simulating a patient requesting pharmacist counseling on a CGM device. The devices for counseling were Freestyle Libre 3 (Abbott Diabetes Care) in phase one and Dexcom G7 (Dexcom, Inc.) in phase 2. Competency outcomes measured included glycemic targets, description of components, placement technique, checking/assessing glucose, and other tips for successful use. All responses were recorded immediately following the encounter using an 8-item online form.</div></div><div><h3>Results</h3><div>Data were obtained from 114 (91.2%) community pharmacies in both phases. Counseling was provided more often for Freestyle Libre versus Dexcom (88.6% vs. 71.1%, <em>P</em> &lt; 0.01). A small proportion declined to counsel due to lack of time, limited product comfort, or a combination of the 2. Competency outcomes frequently met for Freestyle Libre and Dexcom included: sensor placement (91.5% vs. 88.7%), CGM components (80.3% vs. 70.4%), and application technique (78.9% vs. 56.3%, <em>P</em> &lt; 0.01). Competency outcomes rarely met included glycemic targets (1.4% vs. 0.0%), alarms and alerts (1.4% vs. 2.8%), when a fingerstick is needed (0.0% vs. 7.0%), and how to interpret glucose/arrows (18.3% vs. 12.7%).</div></div><div><h3>Conclusion</h3><div>Pharmacists remain accessible health care providers for individuals with diabetes, but deficits in CGM counseling and patient education in community pharmacies exist. Barriers may include low pharmacist comfort with CGM devices and potential lack of familiarity based on the type of device a patient is using.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102493"},"PeriodicalIF":2.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777682","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":"Bridging knowledge gaps and misconceptions: Public perceptions of generic medicines in South Korea – A nationwide cross-sectional survey","authors":"Hye Kyung Jin,&nbsp;EunYoung Kim","doi":"10.1016/j.japh.2025.102491","DOIUrl":"10.1016/j.japh.2025.102491","url":null,"abstract":"<div><h3>Background</h3><div>The use of generic medicines is increasing globally; however, few studies have examined public understanding and perceptions of generics in South Korea to date.</div></div><div><h3>Objective</h3><div>The aim of this study was to examine the perceptions, knowledge, attitudes, and experiences of the general public regarding generic medicines, as well as to identify the main factors associated with their attitudes.</div></div><div><h3>Methods</h3><div>A nationally representative, web-based survey of people across South Korea aged between 20 and 65 years was conducted in January 2025. The questionnaire consisted of 4 sections, including 33 closed-ended and 2 open-ended questions. Chi-square and Fisher's exact tests were employed to compare groups. Multivariable logistic regression analysis was performed to identify the factors associated with attitudes toward generics. Statistical analyses were performed using R, version 4.4.3 (R Foundation for Statistical Computing).</div></div><div><h3>Results</h3><div>A total of 3000 people were included (50.0% female; mean [SD] age, 45.3 [11.7] years) in this study. While all participants reported being familiar with the term “generic medicine,” 40.3% demonstrated a low level of knowledge about it. The majority of survey participants (73.7%) expressed positive attitudes toward generic medicines; however, they continued to report concerns about their efficacy, safety, and quality. A statistically significant difference in the attitudes towards generic medicines was observed based on sex (<em>P</em> = 0.007), age (<em>P</em> &lt; 0.001), insurance type (<em>P</em> = 0.002), information source (<em>P</em> = 0.009), and knowledge level (<em>P</em> &lt; 0.001). Results from the multivariable logistic regression analysis indicated that both knowledge of generic medicines (adjusted OR = 2.11, 95% CI; 1.781-2.500) and age (adjusted OR = 1.01, 95% CI; 1.003–1.017) were significantly associated with positive attitudes toward their use. Providing adequate information and public education about generic medicines was recommended by 40.2% of participants to promote generic substitution. Furthermore, 80% of the participants expressed a high degree of trust in pharmacists regarding generic substitution.</div></div><div><h3>Conclusion</h3><div>Participants with higher levels of knowledge were more likely to hold positive attitudes toward generic medicines; therefore, providing accurate and accessible information is essential to enhance patient acceptance. Furthermore, pharmacists may serve a pivotal role in promoting generic substitution.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102491"},"PeriodicalIF":2.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755575","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":"Implementing a community health worker model to address health-related social needs in a community pharmacy network: A pragmatic evaluation","authors":"Christopher J. Daly,&nbsp;Durdana N. Iqbal ,&nbsp;En-ling Chen ,&nbsp;Jessica Anderson,&nbsp;Walter Gibson,&nbsp;Debanjan Paul,&nbsp;Quyen Nguyen,&nbsp;John Croce,&nbsp;Alec Gillies,&nbsp;Surrey M. Walton,&nbsp;David M. Jacobs","doi":"10.1016/j.japh.2025.102490","DOIUrl":"10.1016/j.japh.2025.102490","url":null,"abstract":"<div><h3>Background</h3><div>Health-related social needs (HRSNs) significantly impact health outcomes, and community pharmacies present an opportunity to integrate HRSN screening and referral services. Embedding community health workers (CHWs) within pharmacies may enhance patient engagement and referral uptake, but evidence on program sustainability and economic viability remains limited.</div></div><div><h3>Objective</h3><div>To evaluate key implementation outcomes from statewide implementation of a pharmacy-based HRSN screening and referral program that cross-trained pharmacy staff as CHWs.</div></div><div><h3>Methods</h3><div>A pragmatic evaluation was conducted in 15 community pharmacies in New York State between January and December 2023. Pharmacy staff were cross-trained as CHWs to screen patients using a validated SDoH tool and facilitate referrals through a structured navigation platform. The primary outcome was referral uptake, defined as the proportion of submitted referrals successfully resolved. Secondary outcomes included program fidelity, program reach across urban and rural areas, and economic sustainability assessed using a time-driven activity-based costing framework, implementation framework, and comprehensive cost-benefit analysis.</div></div><div><h3>Results</h3><div>Among the 1034 participants screened, 708 social needs were identified, with food insecurity (24%), housing instability (16%), and transportation barriers (14%) most prevalent. Of the 330 initiated referrals, 154 (47%) were successfully resolved with 64% of screenings conducted in rural regions. The total program cost was $107,107, with estimated annual cost savings of $745,101 yielding a benefit-cost ratio of 6.96 and a return on investment of 596%. Breakeven analysis indicated financial sustainability at varying levels of screening volume, depending on reimbursement rates. Financial viability remained robust under a range of cost and resolution rate assumptions.</div></div><div><h3>Conclusion</h3><div>Cross-training CHWs within pharmacies to address HRSNs is effective and financially sustainable. The program successfully engaged participants across urban and rural areas and resulted in high referral resolution rates. Integrating HRSN programs into pharmacy workflow represents a viable and scalable approach given appropriate policy support and reimbursement mechanisms.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102490"},"PeriodicalIF":2.5,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The public health impact of the Rx-to-OTC switch of triptan in Germany: Systematic review and framework analysis","authors":"Candice Aphroditta Imanuel MPH,&nbsp;Zeenah Atwan PhD,&nbsp;Celine Tabche MSc, PhD","doi":"10.1016/j.japh.2025.102489","DOIUrl":"10.1016/j.japh.2025.102489","url":null,"abstract":"<div><h3>Background</h3><div>Migraine is a prevalent and debilitating condition in Germany, affecting 10%-15% of the population. Triptans are the primary treatment for acute attacks. The switch of triptans from prescription (Rx) to over-the-counter (OTC) status in Germany aims to improve access and timely treatment. However, it also raises concerns regarding patient safety and misuse. The public health impact of the triptan Rx-to-OTC switch remains underexplored. This study aims to evaluate the public health implications of the Rx-to-OTC switch of triptans in Germany.</div></div><div><h3>Objectives</h3><div>Evaluate the public health implications of Rx-to-OTC switch of triptans in Germany.</div></div><div><h3>Methods</h3><div>A systematic literature review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, sourcing data from databases such as Embase, Medline, and PubMed, as well as gray literature. Studies were selected based on relevance to the Rx-to-OTC switch of triptans and its public health impact in Germany. Data extraction and analysis were performed using Covidence and a public health impact framework adapted from the World Health Organization, focusing on patient-relevant, health care system, and socioeconomic aspects.</div></div><div><h3>Results</h3><div>The review identified both public health benefits and risks of the Rx-to-OTC switch of triptans. The switch enhances safety for healthy adults but poses risks for high-risk individuals due to potential contraindications and adverse reactions. It positively impacts health-related quality of life by reducing symptoms, improving employment factors, and increasing access to treatment. The switch also improves quality of care by shifting healthcare delivery from physician-led to pharmacy-led and self-care, resulting in better access and care. In health care–related aspects, the switch benefits pharmacists by expanding their role but presents challenges for physicians. Socioeconomically, the switch leads to substantial cost savings.</div></div><div><h3>Conclusion</h3><div>Overall, the Rx-to-OTC switch of triptans in Germany has a positive public health impact. It improves access, safety, quality of life, quality of care, pharmacists' roles, and socioeconomic benefit but poses risks for vulnerable groups and physicians' roles in the health care system.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102489"},"PeriodicalIF":2.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736647","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}