American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists最新文献

{"title":"Pharmacy shared governance: A partnership between frontline staff and management in a health-system pharmacy department.","authors":"Brianne K Bakken, Nitish Bangalore, Megan Ose","doi":"10.1093/ajhp/zxag314","DOIUrl":"https://doi.org/10.1093/ajhp/zxag314","url":null,"abstract":"<p><strong>Purpose: </strong>While shared governance in nursing is pervasive in health systems, very little has been written about shared governance in health-system pharmacy. This article describes the development and implementation of a new pharmacy shared governance structure in a health system pharmacy department.</p><p><strong>Summary: </strong>Shared governance is a participatory, collaborative, and democratic model seeking to increase staff engagement, autonomy, and job satisfaction. Shared governance represents a shift from hierarchical, top-down management toward a partnership between management and frontline staff that engages in shared decision making. This article introduces shared governance and describes the rationale, development, and phased implementation of a pharmacy shared governance structure at Children's Wisconsin. The first phase established four standing committees: Pharmacy Clinical Practice Committee, Pharmacy Education Committee, Residency Advisory Committee, and Recognition Committee. The second phase established pharmacist liaison positions and two additional standing committees: Workflow Committee and Medication Safety Committee. The pharmacy governance structure, including charges, membership criteria, membership term limits and benefits, decision-making process, and communication expectations are described, as well as identified opportunities for improvement and future plans to study its effectiveness.</p><p><strong>Conclusion: </strong>The pharmacy governance structure described in this article may provide an example of shared governance that can be used in other health-system pharmacy departments as a mechanism to promote autonomy, engagement, and satisfaction among staff.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operational readiness for twice-yearly long-acting PrEP in health-system pharmacy.","authors":"Esteban Zavaleta-Monestel, Jeaustin Mora-Jimenez, Sebastian Arguedas-Chacon","doi":"10.1093/ajhp/zxag310","DOIUrl":"https://doi.org/10.1093/ajhp/zxag310","url":null,"abstract":"","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structured health-system response to IARC classification of hydrochlorothiazide.","authors":"Esteban Zavaleta-Monestel, Jeaustin Mora-Jimenez, Sebastian Arguedas-Chacon","doi":"10.1093/ajhp/zxag312","DOIUrl":"https://doi.org/10.1093/ajhp/zxag312","url":null,"abstract":"","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to \"ASHP Statement on the Pharmacist's Role in Substance Use Disorder Prevention, Treatment, and Recovery\".","authors":"Kristin Waters, Ashley Maister","doi":"10.1093/ajhp/zxag302","DOIUrl":"https://doi.org/10.1093/ajhp/zxag302","url":null,"abstract":"","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Pharmacy Services among Veterans with Chronic Kidney Disease: Associations with Rural Residence and Primary Care Setting.","authors":"Sophia C Brown, Brian C Lund, Qianyi Shi, Mary K Good, Megan E Dahlke, Heather A Christ, Diana I Jalal, Masaaki Yamada","doi":"10.1093/ajhp/zxag301","DOIUrl":"https://doi.org/10.1093/ajhp/zxag301","url":null,"abstract":"<p><strong>Purpose: </strong>To compare clinical pharmacist practitioner (CPP) service receipt among Veterans with chronic kidney disease (CKD) by rural/urban residence and by primary care site, and to describe CPP telehealth use.</p><p><strong>Methods: </strong>Using Veterans Health Administration data, we identified Veterans with CKD (N=699,273), defined by two eGFR values <60 mL/min/1.73 m2 (≥90 days apart) and ≥1 primary care visit in 2019. Rurality was based on Rural-Urban Commuting Area codes. The primary outcome was ≥1 outpatient CPP encounter; secondary outcomes were CPP encounter frequency and telehealth use. We used multivariable logistic regression with a random intercept for health system.</p><p><strong>Findings: </strong>Overall, 18% of urban and 17% of rural Veterans had ≥1 CPP encounter. After adjustment, rural Veterans were slightly more likely to have a CPP encounter (adjusted odds ratio [aOR] 1.05; 95% confidence interval [CI] 1.03-1.07). Differences were larger by primary care site: 21% at medical centers, 16% at urban clinics (aOR 0.69; 95% CI 0.68-0.70) and 14% at rural clinics (aOR 0.61; 95% CI 0.59-0.62). Among Veterans with ≥1 CPP encounter (n=124,490, 17.8%), rural Veterans had slightly more CPP encounters than urban Veterans (4.6 vs 4.3). CPP telehealth comprised 53.7% of encounters and varied by primary care site (56.5% medical centers, 48.8% urban clinics, 62.8% rural clinics).</p><p><strong>Conclusions: </strong>Rural-urban differences in CPP receipt were small after adjustment, but Veterans receiving primary care in community clinics had lower CPP receipt than those at medical centers. Telehealth may support expanded CPP access for Veterans with CKD.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Garetosmab-grts.","authors":"","doi":"10.1093/ajhp/zxag317","DOIUrl":"https://doi.org/10.1093/ajhp/zxag317","url":null,"abstract":"","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iberdomide Hydrochloride.","authors":"","doi":"10.1093/ajhp/zxag316","DOIUrl":"https://doi.org/10.1093/ajhp/zxag316","url":null,"abstract":"","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation and workload impact of a Veterans Integrated Service Network (VISN) centralized prior authorization program.","authors":"Kimberly Schaffer, Anoli Patel, Cherie Andrews, Nikki Beck, Jenna Tatter, Michelle Agnew, Tiffany Nation, Jen Marin, Barbara Pressley, Janice Taylo","doi":"10.1093/ajhp/zxag308","DOIUrl":"https://doi.org/10.1093/ajhp/zxag308","url":null,"abstract":"<p><strong>Purpose: </strong>This retrospective study evaluated the primary objective of whether centralizing prior authorization drug request (PADR) adjudication across 4 Veterans Integrated Service Network (VISN) 21 healthcare systems reduced local pharmacist workload while maintaining or improving timely prior authorization completion. The study was determined to be institutional review board exempt.</p><p><strong>Summary: </strong>In 2019, VISN 21 piloted a centralized PADR program, funded by the Veterans Health Administration Pharmacy Benefit Management. The program aimed to standardize prior authorization processes, promote pharmacoequity, and reallocate healthcare system (HCS) clinical pharmacy specialists' time toward increasing patient access. A retrospective analysis compared prior authorizations processed 6 months before and 6 months after centralization. Before centralization, 10,922 prior authorizations were adjudicated by 161 clinical staff members (8 pharmacist full-time equivalents [FTEs]), with 95% of the prior authorizations completed within 96 hours. After centralization, 10,779 prior authorizations were handled by 6 VISN staff FTEs (4 pharmacists and 2 technicians), achieving a 98% completion rate within 96 hours. This HCS-to-VISN prior authorization workload shift enabled HCS clinical pharmacists to devote an additional 3,100 hours to patient care.</p><p><strong>Conclusion: </strong>The centralized PADR program in VISN 21 significantly reduced HCS-level administrative burden and improved patient access by increasing clinical pharmacist availability for clinical responsibilities. Centralization reduced the required number of FTEs for prior authorization adjudication by 25%, improved turnaround time by 3.6%, and ensured standardized adjudication practices. This initiative demonstrates an effective strategy to standardize prior authorization adjudication and improve care delivery efficiency within VISNs and across the national Veterans Affairs system.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The moral distress and moral injury of drug diversion.","authors":"Samantha Roberts","doi":"10.1093/ajhp/zxag309","DOIUrl":"https://doi.org/10.1093/ajhp/zxag309","url":null,"abstract":"","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of AI assistance on pharmacist and pharmacy trainee accuracy and automation bias during medication order verification: A randomized simulation trial.","authors":"Dan Surdilla, Ben Michaels, Craig Michael, Dexter Wimer, Yongxin He, Noelle Baptiste, Zlatan Coralic","doi":"10.1093/ajhp/zxag259","DOIUrl":"https://doi.org/10.1093/ajhp/zxag259","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated the impact of artificial intelligence (AI) large language model (LLM) assistance on pharmacist accuracy during cognitive medication order verification and quantified the associated risks of automation bias.</p><p><strong>Methods: </strong>Participants completed 10 clinical scenario questions through a custom web application, with each question randomly assigned to either an unassisted (control) or AI-assisted (intervention) arm. The intervention provided binary recommendations (\"verify\" or \"not verify\") and explanations generated by OpenAI's GPT-4o LLM. The primary outcome was user accuracy compared to a validated ground-truth standard.</p><p><strong>Results: </strong>The study had a total of 77 participants, including 29 students, 14 postgraduate year 1 residents, 11 postgraduate year 2 (PGY2) residents, and 23 pharmacists. AI assistance was associated with significantly higher overall accuracy (adjusted odds ratio, 1.58; 95% confidence interval, 1.16-2.15). Subgroup analysis showed the greatest benefit among students and the least benefit among PGY2 residents. Performance was highly dependent on AI correctness: correct AI recommendations increased user accuracy to 80.2%, while incorrect recommendations reduced accuracy to 26.1%. Participants demonstrated high concordance with AI suggestions, accepting 80.2% of correct recommendations and 73.9% of incorrect recommendations. Notably, when users disagreed with the AI, their accuracy dropped to 21.7%, indicating that participants were rarely successful when attempting to override the model.</p><p><strong>Conclusion: </strong>AI assistance enhances the accuracy of decisions by pharmacists and trainees, particularly for less experienced clinicians. However, the observed susceptibility to automation bias underscores that AI should augment, not replace, pharmacist clinical judgment. Safe integration requires pharmacist-guided model output validation and training focused on trust to ensure AI serves as a supportive adjunct rather than a substitute for professional accountability.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}