Journal of the American Pharmacists Association : JAPhA最新文献

{"title":"Advancing antimicrobial stewardship with streamlining pharmacist management of culture results through implementation of a collaborative practice agreement in a community hospital emergency department.","authors":"Benjamin Miles, Shems Alkhatib, Mandana Eimen, Christopher Keeys, Paul Norris","doi":"10.1016/j.japh.2026.103534","DOIUrl":"https://doi.org/10.1016/j.japh.2026.103534","url":null,"abstract":"<p><strong>Background: </strong>Emergency departments (EDs) often discharge patients before final microbiology results are available, which can delay necessary adjustments to antibiotic therapy. Post-discharge culture follow-up has traditionally been performed by physicians and advanced practice providers (APPs), though clinical pharmacists are increasingly recognized as well-suited for this role. Involving clinical pharmacists more directly in this process may improve both workflow efficiency and antimicrobial stewardship (AS) efforts.</p><p><strong>Objectives: </strong>To describe the development and iterative implementation of a collaborative practice agreement (CPA) enabling ED clinical pharmacists to review post-discharge positive cultures and prescribe antibiotics under a defined protocol, and to present post-implementation utilization and protocol compliance data.</p><p><strong>Practice description: </strong>Sibley Memorial Hospital (SMH) is a community hospital in the District of Columbia within the Johns Hopkins Health System. Clinical pharmacists in the ED were already reviewing culture results and providing therapy recommendations in collaboration with APPs; however, they were not permitted to prescribe independently prior to this initiative.</p><p><strong>Practice innovation: </strong>A CPA was developed through a multi-year, iterative process to enable clinical pharmacists to follow defined treatment protocols and prescribe antibiotics under a \"per protocol\" model, marking a significant expansion of their scope in ED follow-up care.</p><p><strong>Evaluation methods: </strong>A pre-implementation audit of pharmacist culture review activities was performed from April through June 2021 to establish baseline workload data. Following CPA approval and implementation in May 2025, a post-implementation process evaluation was conducted from May 2025 through March 2026 (11 months) using embedded pharmacy intervention tracking (i-Vent) data from the electronic health record. All cases of independent pharmacist prescribing under the CPA per protocol model were identified and assessed for protocol compliance on five criteria: protocol formulary concordance, appropriate dosing, appropriate duration, documentation of patient education, and intervention documentation.</p><p><strong>Results: </strong>During the pre-implementation audit, 350 culture reviews were documented with an intervention rate of 6.0% (21/350). During the 11-month post-implementation period, 898 i-Vent entries were recorded by 2 clinical pharmacists authorized for CPA prescribing, with 129 therapy interventions (14.4%). Twenty-four cases of independent pharmacist prescribing under the CPA per protocol model were verified, performed by 2 authorized pharmacists. Protocol compliance was 100% (24/24) across all five criteria. The most common organisms requiring per protocol intervention were ESBL-producing Enterobacteriaceae (6 cases) and non-ESBL E. coli (5 cases).</p><p><strong>Con","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103534"},"PeriodicalIF":2.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077327","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":"Letter to the Editor Response to \"Assessment of comprehensive medication management incorporating a patient-completed medical and medication history form in community practice\".","authors":"Richard L Lucarotti, Francine D Salinitri, Melissa Lipari","doi":"10.1016/j.japh.2026.103531","DOIUrl":"10.1016/j.japh.2026.103531","url":null,"abstract":"","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103531"},"PeriodicalIF":2.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067040","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":"Comment on \"Assessment of comprehensive medication management incorporating a patient-completed medical and medication history form in community practice\".","authors":"Kiran Barik","doi":"10.1016/j.japh.2026.103530","DOIUrl":"10.1016/j.japh.2026.103530","url":null,"abstract":"","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103530"},"PeriodicalIF":2.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067035","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":"Frequency and characteristics of prescription adaptations requested and made by chain community pharmacists.","authors":"Clare E Hooper, Elizabeth G Riley-Jensen, Laura Sosinski, Austin M Herzog, Margie E Snyder","doi":"10.1016/j.japh.2026.103532","DOIUrl":"https://doi.org/10.1016/j.japh.2026.103532","url":null,"abstract":"<p><strong>Background: </strong>Community pharmacists in Indiana have the ability to make some prescription adaptations which do not require a collaborative practice agreement. The frequency and characteristics of prescription adaptations requested and made by chain community pharmacists in Indiana during routine practice is unknown.</p><p><strong>Objectives: </strong>The objective of this study was to determine the frequency and characteristics (e.g., type of adaptation, time required) of prescription adaptations requested and made by chain community pharmacists during routine care delivery.</p><p><strong>Methods: </strong>An electronic card study was used to collect observational, cross-sectional data. During an assigned two-week period, pharmacists documented each prescription adaptation requested or made via an online data collection form that took less than one minute to complete. The form consisted of a minimum of five questions and a maximum of 15 questions in a multiple-choice format with branching logic. Years in practice, budgeted pharmacist and technician hours, store prescription volume, age, and time in minutes making requests were described with means and standard deviations.</p><p><strong>Results: </strong>A total of 188 prescription adaptations were documented by the 17 participating pharmacists. Over half (101, 53.7%) were adaptation requests where the prescriber was contacted. The remaining were completed by the pharmacist without prescriber contact. Some reasons pharmacists reported the need to contact the prescriber included: Indiana law not permitting the adaptation (56, 55.4%), clinical nuance (35, 34.7%), company policy (10, 9.9%), and \"other\" (10, 9.9%). Of the 56 adaptation requests made because the pharmacist perceived the adaptation was not permitted per Indiana law for the pharmacist to make independently, 31 (55.4%) were actually legally permissible. The adaptations pharmacists most commonly completed on their own included: changing quantity/package size (47, 54.0%) and changing dosage form (23, 26.4%). Notably, 36 (19%) adaptations were needed due to missing or incorrect information included on the prescription.</p><p><strong>Conclusion: </strong>These findings point to potential opportunities to educate chain community pharmacists on current Indiana prescription adaptation rules, while also identifying potential opportunities to widen the scope of practice. These actions could help decrease time spent reaching out to prescribers and delays in patient care.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103532"},"PeriodicalIF":2.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032901","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":"We need a new plan: A public health approach to increasing prescription dispensing safety.","authors":"Caroline Gaither, Candace Haugtvedt, Nancy Lewis, Larry Selkow, Batoul Senhaji-Tomza, Lindsey Weis, Audrey Kostrzewa","doi":"10.1016/j.japh.2026.103528","DOIUrl":"https://doi.org/10.1016/j.japh.2026.103528","url":null,"abstract":"<p><p>Patient safety is paramount to the pharmacy profession. Outpatient pharmacies have been facing enormous pressures in recent years; pharmacists and staff have been raising concerns about patient safety through multiple professional and public channels. While national organizations and some boards of pharmacy have done some work to promote pharmacist well-being and patient safety, it is not enough; we need a new plan. This commentary shares the important work done by the American Public Health Association (APHA) Pharmacy Section - through a task force and subsequent American Public Health Association (APHA) adopted policy in response to the outpatient pharmacy environment. The policy and call to action urges stakeholders to view dispensing safety in outpatient pharmacies as a public health issue. By doing this, it shifts the conversation beyond individual practitioners and pharmacies to include the broader systems, policies, and stakeholders that influence dispensing safety. The policy's three-pronged approach-improved data collection and transparency, a stronger culture of safety, and enhanced external accountability-provides a framework for addressing the underlying causes of dispensing errors rather than simply responding to their consequences.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103528"},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027409","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":"Effects of a multicomponent intervention for clinical pharmacists on patient recall of pharmacist visits and satisfaction with care.","authors":"Anne-Julie Lapensée, Rémi St-Germain, Bogdan Andrei Panait, Élisabeth Le Blanc, An Ngo Phong, Marie-Claude Langevin, Nathalie Letarte, Jean-Philippe Adam","doi":"10.1016/j.japh.2026.103529","DOIUrl":"https://doi.org/10.1016/j.japh.2026.103529","url":null,"abstract":"<p><strong>Background: </strong>Pharmaceutical practice in the hospital setting has undergone major transformations in recent years, increasingly focusing on direct patient care. Limited evidence is available regarding patient-pharmacist interaction even though patients' satisfaction with care has been correlated with clinical outcomes.</p><p><strong>Objective: </strong>This study evaluated whether a multicomponent intervention for inpatient clinical pharmacists was associated with changes in two co-primary outcomes: patient recall of pharmacist visits and satisfaction with pharmacist-provided care.</p><p><strong>Methods: </strong>This single-center, prospective, uncontrolled before-after quasi-experimental study was conducted at a tertiary academic center in Canada. Patients with documented clinical pharmacist involvement were enrolled before the intervention (February 6 to April 30, 2023; n=350) and after the intervention (July 1 to September 15, 2023; n=406). The interventions combined four hours of pharmacist training on implicit bias awareness and partnership care with pharmacy-student support for admission medication reconciliation. Patient recall was compared between groups using a chi-square test, and satisfaction scores were compared using an independent-samples t test.</p><p><strong>Results: </strong>Patient recall of a pharmacist visit was 58.9% (206/350) before the intervention and 64.3% (261/406) after the intervention, although this difference was not statistically significant (absolute difference, 5.4 percentage points; 95% CI, -1.5 to 12.4; P = .126). The surgical-unit subgroup showed an absolute difference of 21.0 percentage points. Among patients who recalled a pharmacist visit, mean satisfaction scores with pharmaceutical care were 76.6/80 and 77.4/80 before and after the intervention, respectively (mean difference, 0.75 points; 95% CI, -0.41 to 1.91).</p><p><strong>Conclusion: </strong>The multicomponent intervention was not associated with a statistically significant improvement in overall patient recall of a pharmacist visit. The improvement observed in the surgical subgroup should be considered exploratory and warrants confirmation in future studies. Future research should consider the long-term impact of these interventions on pharmacists' practice and patient outcomes.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103529"},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027429","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":"Strengthening medication safety infrastructure in U.S. community pharmacies: Lessons from national survey data, Ontario's AIMS, and California policy.","authors":"Roberto Maldonado, Elizabeth Unni, Batoul Senhaji-Tomza","doi":"10.1016/j.japh.2026.103526","DOIUrl":"https://doi.org/10.1016/j.japh.2026.103526","url":null,"abstract":"<p><p>Community pharmacies dispense most medications in the United States and represent a high-frequency point of patient interaction, yet medication-safety policy in this setting remains fragmented compared to inpatient pharmacy settings. Hospitals benefit from established safety reporting infrastructures, while comparable system-level mechanisms for learning from medication errors and near misses are absent in community pharmacy practice. This commentary draws on publicly available U.S. data from the Agency for Healthcare Research and Quality (AHRQ) Community Pharmacy Survey on Patient Safety Culture (SOPS) (2015 and 2019) to illustrate persistent gaps in medication-error documentation, near-miss reporting, and workplace conditions. Across both survey years, documentation was consistently high when errors reached patients but lower for near misses, limiting preventive learning. Staffing, work pressure, and pace were the lowest-performing safety culture factors, reflecting organizational conditions that constrain safety practices. Guided by the American Public Health Association's multicomponent framework and the American Pharmacists Association's call for just culture, these findings are contextualized with two illustrative models: Ontario's standardized medication incident reporting system, and California's Assembly Bill 1286, which links workforce protections to patient safety. Together, these examples show that transparency alone is insufficient. Effective medication-safety improvement requires standardized reporting infrastructures, reporting safeguards, and workforce conditions that enable continuous learning, feedback, and adaptive change. Strengthening medication safety in U.S. community pharmacies will require coordinated investment by federal and state regulators, professional boards, and pharmacy organizations in standardized reporting infrastructures, non-punitive reporting safeguards, workforce protections, and sustained surveillance systems to reduce preventable patient harm.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103526"},"PeriodicalIF":2.5,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013520","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":"Bibliometric analysis of diversity, equity, and inclusion in U.S. pharmacy literature, 2000-2024.","authors":"Stephen M Small, Regis A Lucia, Pamela D Reiter","doi":"10.1016/j.japh.2026.103523","DOIUrl":"https://doi.org/10.1016/j.japh.2026.103523","url":null,"abstract":"<p><strong>Background: </strong>Healthcare and social disparities contribute to poor outcomes in underserved and marginalized groups. Recent federal policy changes in 2025 have deemed diversity, equity, and inclusion (DEI) practices to be illegal. Research describing trends in DEI scholarship and literature within the pharmacy discipline is lacking.</p><p><strong>Objective: </strong>The primary objective of this descriptive, cross-sectional bibliometric analysis was to measure pharmacy publication trends in DEI between 2000 and 2024, before presidential executive orders banned DEI. Secondary objectives included authorship, funding relationships, and document theme analysis.</p><p><strong>Methods: </strong>The Web of Science and Scopus databases identified DEI-related pharmacy documents published in the US during the study period. Articles were included if they contained DEI topics and were within the pharmacy and pharmacology subject area. Bibliometrix software generated publication-related metrics and network visualizations for document themes. Descriptive statistics summarized document types, citations, authors, keywords, and funding.</p><p><strong>Results: </strong>A total of 248 documents met inclusion criteria. Most publications were defined as articles (53.2%) followed by reviews (21%). There was a 20.1% annual growth rate in pharmacy DEI literature during the study period. There were 1,338 distinct authors with a median of 4 authors per document. Southern states had the most corresponding authors (44.7%). Common themes focused on demographic populations, health equity, and pharmacy education. Federal funding was reported in 16.7% of documents published between 2000 and 2020 and 20.6% between 2021 and 2024.</p><p><strong>Conclusion: </strong>Pharmacy DEI publication rates grew between 2000 and 2024. Although federal funding was noted in less than one-fourth of publications, the new funding ban coupled with the threat of backlash, criticism, and possible termination are expected to have a greater detrimental effect on future publication rates and DEI scholarship. The current work may serve as a comparator to measure the before-and-after impacts of these US policy changes.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103523"},"PeriodicalIF":2.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002470","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 license verification in the United States: Availability, content, and transparency across jurisdictions.","authors":"Sami J Gangji, Natalya S Salganik, Jeffrey P Bratberg, Joseph A Nardolillo","doi":"10.1016/j.japh.2026.103519","DOIUrl":"https://doi.org/10.1016/j.japh.2026.103519","url":null,"abstract":"<p><strong>Background: </strong>Public-facing licensure information is intended to improve transparency and allow patients and employers to verify healthcare provider credentials. For pharmacists, the scope and format of publicly available licensure information may differ across US jurisdictions, limiting cross-jurisdictional comparisons, workforce evaluations, and policy research.</p><p><strong>Objective: </strong>The objective of this study is to describe and summarize the availability, content, and transparency of pharmacist licensee data across US states, districts, and territories.</p><p><strong>Methods: </strong>This cross-sectional observational study evaluated publicly accessible pharmacist license verification tools in the US, defined as jurisdiction-operated online databases, search portals, or web-based lookup systems used to verify pharmacist licensure information. Extraction included 56 US jurisdictions and occurred from May to September 2025. Using a standardized tool, 45 prespecified variables were collected and analyzed across categories, including core identifiable, contact, disciplinary, training, and practice information. Jurisdiction-level transparency was calculated as the proportion of all 45 possible variables in each jurisdiction's tool. This proportion was refined to 29 variables after excluding fields that were rarely observed, inconsistently reported, or duplicative. Higher scores indicated increased publicly available licensure information.</p><p><strong>Results: </strong>License verification tools were identifiable for 54 of 56 jurisdictions (96.4%). Across jurisdictions with tools, core verification fields were consistent: licensee name, license number, and license expiration date were present in 54 (96.4%), and license status and issue date were present in 53 (94.6%). Jurisdiction-level transparency was overall low, with jurisdictions publicly displaying, on average, approximately 41% of the 29 refined variables.</p><p><strong>Conclusion: </strong>Most US jurisdictions provide pharmacist license verification tools with consistently reported core licensure fields; however, the transparency of additional licensee information varies across jurisdictions. Greater consistency in the reporting of publicly available pharmacist licensure data may enhance employer verification, policy evaluation, workforce research, and public trust.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103519"},"PeriodicalIF":2.5,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914986","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":"Beyond the Medications: Student Pharmacists in Public Health.","authors":"Victoria Pham, Kevin Cleveland, Elaine Nguyen","doi":"10.1016/j.japh.2026.103518","DOIUrl":"https://doi.org/10.1016/j.japh.2026.103518","url":null,"abstract":"","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103518"},"PeriodicalIF":2.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883314","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}