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

{"title":"The Impact of Physician-Pharmacist Collaborative Drug Therapy Management in Gender-Affirming Care.","authors":"Anthony Gerber, Josh Rickard","doi":"10.1093/ajhp/zxag278","DOIUrl":"https://doi.org/10.1093/ajhp/zxag278","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the implementation and early experience of a pharmacist-led collaborative drug therapy management (CDTM) service delivering gender-affirming hormone therapy (GAHT) and integrated preventive care within an urban safety-net hospital.</p><p><strong>Summary: </strong>A CDTM pilot program was implemented in November 2023 at the Pride Health Center within NYC Health + Hospitals/Bellevue. Through collaborative agreements with primary care physicians, a board-certified ambulatory care pharmacist independently initiated and titrated hormone therapy and concurrently managed HIV prevention and treatment, sexually transmitted infections, and chronic disease states. Protocols developed jointly with physicians specified medications and laboratory tests the pharmacist could order independently. Between November 2023 and February 2025, 70 patients enrolled and completed 223 visits, during which the pharmacist documented 573 interventions, including 76 GAHT initiations, 28 PrEP initiations, 20 DoxyPEP initiations, and management of 62 adverse drug reactions under protocol. Among 58 patients completing a satisfaction survey, all reported feeling respected and supported by the pharmacist, and 95% strongly agreed they were pleased with the service.</p><p><strong>Conclusion: </strong>A pharmacist practicing under CDTM independently initiated and managed gender-affirming hormone therapy while delivering integrated preventive care in a safety-net setting. The model was well received by patients and may be replicable at institutions with established LGBTQIA+ services and collaborative practice frameworks.</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":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922227","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":"Medication Preparation Errors Involving Very Small and Difficult-to-measure Volumes in a Pediatric Hospital: A 14-year Descriptive Study.","authors":"Pascal Bédard, Denis Lebel, Hélène Roy, Jean-Marc Forest, Marie-Élaine Métras","doi":"10.1093/ajhp/zxag272","DOIUrl":"https://doi.org/10.1093/ajhp/zxag272","url":null,"abstract":"<p><strong>Purpose: </strong>Medication preparation errors are a major source of preventable harm in pediatric hospitals. Oral liquid medications, especially those involving difficult-to-measure or very small volumes, may increase the risk of such errors, yet supporting evidence is limited. This study aims to determine whether difficult-to-measure and very small oral liquid medication volumes are associated with higher rates of preparation errors in a pediatric hospital pharmacy.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of all oral liquid medication preparations produced between January 2010 and December 2023 at a tertiary pediatric hospital. Preparation errors identified by pharmacists were extracted from the pharmacy department's workflow management system. A prospective substudy (December 2023-October 2024) was also carried out to characterize the nature and magnitude of rejected preparations.</p><p><strong>Results: </strong>During the study period, 1,554,986 oral liquid preparations were produced. Difficult-to-measure and very small volumes accounted for 20.4% and 1.4% of preparations, respectively. The overall preparation error rate was 0.9%. Error rates were significantly higher for difficult-to-measure (1.4%) and very small volumes (2.0%) compared to other volume types (p < 0.001). In the prospective substudy (N = 911), 65% of rejected preparations involved inaccurate volumes, with high-magnitude errors disproportionately linked to difficult-to-measure and very small volumes.</p><p><strong>Conclusion: </strong>Difficult-to-measure and very small volumes significantly increase the risk of preparation errors. Volume rounding, standardized concentrations, and age-appropriate formulations should be prioritized to improve pediatric medication safety.</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":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932303","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":"Guidance for antidepressant use during pregnancy: A commentary in response to the 2025 FDA panel.","authors":"Cameron Lanier, Tyler Melton","doi":"10.1093/ajhp/zxag283","DOIUrl":"https://doi.org/10.1093/ajhp/zxag283","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":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922108","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":"Performance evaluation of a large language model for medication management tasks.","authors":"Kelli Henry, Steven Xu, Kaitlin Blotske, Moriah Cargile, Erin F Barreto, Brian Murray, Susan Smith, Seth R Bauer, Xingmeng Zhao, Adeleine Tilley, Yanjun Gao, Tianming Liu, Sunghwan Sohn, Andrea Sikora","doi":"10.1093/ajhp/zxag282","DOIUrl":"https://doi.org/10.1093/ajhp/zxag282","url":null,"abstract":"<p><strong>Purpose: </strong>Large language models (LLMs) have proven performance for certain diagnostic tasks; however, limited studies have evaluated their consistency in recommending appropriate medication regimens for a given diagnosis. Medication management is a complex task that requires synthesis of drug formulation and complete order instructions for safe use. Here, the performance of GPT-4o, an LLM available with OpenAI's ChatGPT, was tested on 3 medication management tasks.</p><p><strong>Methods: </strong>GPT-4o performance was tested on 3 medication tasks: identifying available formulations for a given generic drug name, identifying drug-drug interactions (DDIs) for a given medication regimen, and preparing a medication order for a given generic drug name. For each experiment, the model's raw text response was captured exactly as returned and evaluated using clinician evaluation in addition to standard LLM metrics, including Term Frequency-Inverse Document Frequency (TF-IDF) vectors, normalized Levenshtein similarity, and Recall-Oriented Understudy for Gisting Evaluation (ROUGE-1/ROUGE-L) F1 score between each response and its reference string.</p><p><strong>Results: </strong>For the first task of drug-formulation matching, GPT-4o had 49% accuracy for generic medications being matched to all available formulations, with an average of 1.23 omissions per medication and 1.14 hallucinations per medication. For the second task of drug-drug interaction identification, the accuracy was 54.7% for identifying the DDI pair. For the third task, GPT-4o generated order sentences containing no medication or abbreviation errors in 65.8% of the cases.</p><p><strong>Conclusion: </strong>Model performance for basic medication tasks was consistently poor. This evaluation highlights the need for domain-specific training through clinician-annotated datasets and a comprehensive evaluation framework for benchmarking performance.</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":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922077","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":"Pharmacist-led steroid stewardship in inflammatory diseases: evaluating glucocorticoid use and patient outcomes.","authors":"Vanessa Lopez, Alexandra Ritenour, Kiersi Harmon","doi":"10.1093/ajhp/zxag276","DOIUrl":"https://doi.org/10.1093/ajhp/zxag276","url":null,"abstract":"<p><strong>Purpose: </strong>Glucocorticoids (GCs) are widely used in inflammatory diseases but are associated with significant adverse effects when used long term. Specialty pharmacists are uniquely positioned to monitor and optimize GC use through longitudinal patient management. This study aimed to characterize GC utilization and identify opportunities for pharmacist-led stewardship within a health-system specialty pharmacy.</p><p><strong>Methods: </strong>This prospective, multi-center descriptive study implemented a pharmacist-driven GC questionnaire within CHRISTUS Specialty Pharmacy workflow. The questionnaire was incorporated into initial, and follow-up clinical assessments conducted every four to ten months. Eligible patients included those with inflammatory conditions receiving biologic or targeted synthetic disease-modifying antirheumatic drugs (DMARDs). Data collected between October 1, 2025, and January 15, 2026, were analyzed using descriptive statistics.</p><p><strong>Results: </strong>Among 688 patients, 17.4% reported active GC use. Mean duration of GC therapy was 112 days and was longer in patients receiving biologic DMARDs (184 days) compared to targeted synthetic DMARDs (105 days). GC use was most common in lupus (54.6%), rheumatoid arthritis (25.8%), and ulcerative colitis (25.5%). The majority of GC users had uncontrolled disease (63.9%), while minimal adverse effects were reported.</p><p><strong>Conclusion: </strong>Glucocorticoid use remains prevalent among patients receiving specialty therapies, particularly in those with uncontrolled disease. These findings highlight opportunities for pharmacist-led interventions focused on GC deprescribing, monitoring, and optimization of long-term outcomes.</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":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922213","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":"Enlicitide Decanoate.","authors":"","doi":"10.1093/ajhp/zxag264","DOIUrl":"https://doi.org/10.1093/ajhp/zxag264","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":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921640","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":"Integration of a Board Certified Psychiatric Pharmacist into a Pediatric Psychiatric Emergency Department and Ambulatory Crisis Clinic.","authors":"Amber Lemons, Isabelle Bindseil, Danielle L Stutzman","doi":"10.1093/ajhp/zxag279","DOIUrl":"https://doi.org/10.1093/ajhp/zxag279","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":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922084","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":"A retrospective comparison of pharmacist-managed versus infectious-diseases managed travel health services at an academic medical center.","authors":"Julie MacDougall, Charles Miller, Alyssa Cappelluti, Kavita Vadlamani, Lauren Senesac, Peter W Callas, Amanda G Kennedy","doi":"10.1093/ajhp/zxag266","DOIUrl":"https://doi.org/10.1093/ajhp/zxag266","url":null,"abstract":"<p><strong>Purpose: </strong>International travel is increasing, creating a need for accessible, high-quality travel health services. Pharmacists are positioned to expand access; transitioning services from infectious disease (ID) clinics to pharmacist-managed models may improve access and streamline the delivery system. This study compared vaccine acceptance and travel health recommendations between ID clinician and pharmacist-managed clinics at an Academic Medical Center.</p><p><strong>Methods: </strong>This was a retrospective cohort study of electronic health record data for adults ≥18 years. ID clinician-managed visits (February-August 2023) were compared to pharmacist-managed visits (February-August 2024). The primary outcome was travel-related vaccine acceptance. Secondary outcomes included routine CDC vaccine acceptance, over-the-counter recommendations, and prescribed pharmacotherapy.</p><p><strong>Results: </strong>A total of 337 patients were included (167 pharmacist-managed; 170 ID-managed). Travel vaccine recommendations were largely comparable, with no significant differences in acceptance for frequent recommendations like typhoid (84% vs 85%; P=0.88) and hepatitis A (47% vs 46%; P=0.83). However, routine CDC vaccine recommendations differed by clinic type; pharmacists more frequently recommended COVID-19, influenza, and herpes zoster vaccines (P<0.001). Pharmacists more frequently prescribed traveler's diarrhea treatment (59% vs 24%; P<0.001). Rates of anti-malarial prophylaxis prescriptions were high in both groups and did not differ significantly (62% vs 58%; P=0.50).</p><p><strong>Conclusions: </strong>Pharmacist-managed travel clinic achieved travel-related vaccine acceptance rates comparable to ID-managed clinics. Pharmacists more frequently recommended routine ACIP vaccines and prescribed traveler's diarrhea treatment. These findings suggest that pharmacist-managed travel health services under a collaborative practice agreement can deliver guideline-concordant care while possibly expanding institutional capacity.</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":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932301","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":"Describing pharmacist services provided to clinic patients outside of accredited patient management program responsibilities in a health-system specialty pharmacy.","authors":"Elizabeth Rightmier, Jeremiah Moore, Maria Pinto, Nicole M Acquisto","doi":"10.1093/ajhp/zxag273","DOIUrl":"https://doi.org/10.1093/ajhp/zxag273","url":null,"abstract":"<p><strong>Purpose: </strong>Describe clinical pharmacist services provided for clinic patients not actively enrolled in an integrated health-system specialty pharmacy (HSSP) patient management program or with medications fulfilled externally.</p><p><strong>Methods: </strong>Single-center, quality improvement project evaluating pharmacist actions and interventions, as a result of provider, nurse, or patient requests for pharmacy services, for patients not enrolled in the integrated HSSP. Eighteen clinical pharmacists, covering nine different clinics (oncology and non-oncology), documented medication therapy problem (MTP) and drug information (DI) question type, average workload, and time spent for request completion between September-November 2023. Data are reported descriptively.</p><p><strong>Results: </strong>Clinical pharmacists documented 775 requests involving 630 patients and resulting in 926 actions. MTPs accounted for 26% and DI questions for 74% of all pharmacist actions. Most MTPs were related to adverse medication events/toxicity (40%) and cost (34%) and DI questions to drug-drug interactions (22%) and care coordination (20%). In oncology clinics, most requests involved non-specialty medications (50%) and infusions (32%) and were initiated by providers. In non-oncology clinics, most requests involved specialty medications fulfilled externally (62%) and were initiated by patients. On average, 43 requests and 51 actions were managed per pharmacist over the project period. Most were completed in < 15 minutes (71%).</p><p><strong>Conclusion: </strong>This project highlights clinical pharmacist contributions to non-enrolled patients alongside responsibilities within the scope of traditional specialty pharmacy-accredited patient management programs. These findings show minimal additional workload, however, should continue to be evaluated as HSSP enrollment grows, clinic patient numbers expand, and interest in managing complex chronic conditions are explored.</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":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922570","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":"Atacicept-vymj.","authors":"","doi":"10.1093/ajhp/zxag263","DOIUrl":"https://doi.org/10.1093/ajhp/zxag263","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":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914825","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}