Journal of the American Pharmacists Association : JAPhA最新文献

{"title":"Strengthening rural pandemic preparedness: Lessons from Nova Scotia's COVID-19 response for pharmacy practice.","authors":"Chiranjeev Sanyal","doi":"10.1016/j.japh.2026.103513","DOIUrl":"10.1016/j.japh.2026.103513","url":null,"abstract":"<p><p>The COVID-19 pandemic exposed longstanding structural inequities in rural health care systems, including shortages of primary care providers, transportation barriers, geographic isolation, workforce limitations, and unequal access to digital health technologies. Rather than creating these challenges, the pandemic magnified existing weaknesses that limited equitable access to testing, vaccination, chronic disease management, and preventive health care. Nova Scotia provides an informative Public Health Mobile Units (PHMU) implementation of how innovative, community-based models of care can mitigate these inequities. During the pandemic, the province deployed PHMUs to deliver testing, vaccination, and health promotion services directly within underserved communities while pharmacists assumed expanded responsibilities in immunization, point-of-care testing, medication management, prescribing for minor ailments, and public health education. The Nova Scotia experience demonstrates that decentralizing healthcare delivery and optimizing pharmacists' scope of practice can substantially improve healthcare access in rural communities. Beyond increasing service availability, pharmacists enhanced continuity of care, strengthened public trust, and alleviated pressure on overstretched primary care services. These innovations, however, were largely implemented as emergency measures rather than embedded within routine health system planning.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103513"},"PeriodicalIF":2.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842801","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":"Filling gaps in reproductive health care: Women's interest in pharmacist-delivered services in areas with limited obstetric access in Georgia.","authors":"Rebecca H Stone, Madison Reyome, Shelby Webb","doi":"10.1016/j.japh.2026.103503","DOIUrl":"10.1016/j.japh.2026.103503","url":null,"abstract":"<p><strong>Background: </strong>Community pharmacies are widely distributed and often located in areas with limited obstetric access, positioning pharmacists to help expand reproductive health services, including pregnancy prevention, preconception, and maternal care.</p><p><strong>Objective: </strong>To evaluate women's perceived access to obstetric care and their interest in receiving pharmacist-delivered reproductive health services within community pharmacies across Georgia.</p><p><strong>Methods: </strong>In this cross-sectional survey, women aged 18 to 45 years were recruited at community pharmacies purposively sampled within 90 min of 4 college of pharmacy campuses to include counties with both adequate and inadequate obstetric services. A 9-page REDCap instrument assessed demographics, reproductive history, health risk factors, and interest in services from the National Alliance of State Pharmacy Associations Maternal Health Service Set. Counties were classified by obstetric service adequacy and stratified by NCHS urbanicity code. Data were collected February through May 2022. Descriptive statistics and chi-square tests were used.</p><p><strong>Results: </strong>Of 103 respondents, 79 were analyzed. Although 82% resided in metropolitan counties, 37% lived in counties with inadequate obstetric services; 52% of those with inadequate access were metropolitan residents, whereas all 14 non-metropolitan participants had inadequate access. Sixty-eight percent agreed that access to women's health care is a serious problem in their community. Overall, 89% expressed interest in at least one pharmacist-delivered service. Interest was not uniform: 7 of 22 services drew interest from 70% or more of participants, led by medication review in pregnancy (77%), hypertension screening and counseling (76%), vaccinations (75%), nausea medication recommendations in pregnancy (75%), and contraception prescribing (70%). Interest was lowest for alcohol (33%) and tobacco (38%) screening. No significant differences were observed between groups stratified by obstetric access.</p><p><strong>Conclusion: </strong>Women in Georgia with limited obstetric access, both in metropolitan and non-metropolitan areas, reported modifiable risk factors and interest in pharmacist-delivered reproductive health services, supporting community pharmacies as a pragmatic setting for expanding access.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103503"},"PeriodicalIF":2.5,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805168","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":"Immersive learning in rural settings: A key to rural health care workforce recruitment.","authors":"Rachel C Lucas, Jacqueline McGinley","doi":"10.1016/j.japh.2026.103502","DOIUrl":"10.1016/j.japh.2026.103502","url":null,"abstract":"","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103502"},"PeriodicalIF":2.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763562","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 evaluation of pharmacogenomics alerts for high-risk drug-gene interactions in a community pharmacy practice setting.","authors":"Amanda Massmann, Jordan F Baye, Karly Blaalid, Natasha J Petry, April Schultz","doi":"10.1016/j.japh.2026.103501","DOIUrl":"https://doi.org/10.1016/j.japh.2026.103501","url":null,"abstract":"<p><strong>Background: </strong>Integration of pharmacogenomics (PGx) into clinical care has primarily occurred within academic medical centers. Clinical decision support (CDS) is vital to the incorporation of PGx into clinical care, however, efforts have not capitalized on the integration within community pharmacy settings.</p><p><strong>Objective: </strong>To describe the implementation efforts for community pharmacy CDS alerts and assess effectiveness.</p><p><strong>Methods: </strong>A retrospective manual chart review was conducted to evaluate the effectiveness of deploying PGx alerts across 14 community pharmacies within a single health system. A report was created to capture all PGx CDS alerts generated during the eight-month study period (October 2024-May 2025). Alerts were categorized as actionable when documentation was sparse for medication adjustments based on PGx results from the prescribing clinician upon transmission of the prescription to the community pharmacy.</p><p><strong>Results: </strong>A total of 74 alerts were generated, of which 36 were unique alerts. Thirty-eight alerts were excluded as duplicates when the pharmacist re-entered the dispensing function. Clinicians adjusted 17 chemotherapy prescriptions prior to order transmission. Additionally, five alerts for chemotherapy medications were considered not actionable as the patient had previously tolerated therapy. The remaining 13 alerts comprised of 11 for clopidogrel and 2 for tramadol. Pharmacists intervened in 8 of the 11 clopidogrel orders which resulted in 3 medication modifications. The overall alert acceptance was 23%.</p><p><strong>Conclusion: </strong>This study describes one of the first institutions to deploy PGx alerts through the community pharmacy module across a health system's electronic health record. PGx alerts in the medication dispensing module provide an additional safeguard for precision medicine, enabling pharmacists to make targeted interventions and provide patient education. Continuous evaluation of PGx alerts affords opportunities for alert refinement and further optimizing patient care.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103501"},"PeriodicalIF":2.5,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709385","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":"Corrigendum to Evaluation of the \"Follow Your Heart\" project: Academic detailing to improve hypertension composite quality measure [JAPhA, Volume 66, Issue 3, 103041, May-June 2026].","authors":"","doi":"10.1016/j.japh.2026.103499","DOIUrl":"https://doi.org/10.1016/j.japh.2026.103499","url":null,"abstract":"","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103499"},"PeriodicalIF":2.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805136","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":"It's not in stock: Community pharmacists' decision-making and communication when refusing to dispense controlled substance prescriptions.","authors":"Ayobami A Aiyeolemi, Marissa A Johnson, Mattie Sullivan, Lindsey Loera, J Douglas Thornton, Tyler J Varisco","doi":"10.1016/j.japh.2026.103484","DOIUrl":"https://doi.org/10.1016/j.japh.2026.103484","url":null,"abstract":"<p><strong>Background: </strong>Pharmacists play a vital role in ensuring that controlled substances (CS) are used safely and appropriately and may refuse to dispense a CS prescription as part of this responsibility. Such decisions, while often appropriate, can have unintended consequences for patients. Despite this, little is known about how pharmacists navigate CS dispensing decisions and how they communicate refusals to patients.</p><p><strong>Objectives: </strong>To qualitatively describe pharmacists' decision-making process and communication strategies when declining CS prescriptions.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 11 pharmacists recruited from the Texas State Board of Pharmacy Registry between March 2023 and April 2024. Data were analyzed using Braune and Clarke's thematic analysis approach.</p><p><strong>Results: </strong>Patient characteristics, professional values, practice environment, prescribing clinician relationships, regulatory oversight, stigma, safety concerns, and gaps in training were identified as important contextual influences on decision-making. Participants also described employing risk management practices to mitigate perceived dispensing risks, including verifying prescriptions and conducting due diligence, seeking external guidance, and documenting patient interactions. Three strategies for communicating denial were identified: transparent and constructive denial, tactful evasive responses, and deceptive denial. Additionally, employer policies were noted to play a role in guiding how pharmacists implemented risk management practices and communicated refusals to patients.</p><p><strong>Conclusion: </strong>Pharmacists' decisions to decline CS prescriptions are complex and influenced by multiple contextual and risk management considerations that require balancing professional judgment, regulatory responsibilities, and patient-centered care. Future research is needed to better understand how these factors shape dispensing decisions and to inform interventions that support safe dispensing practices and optimal patient care.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103484"},"PeriodicalIF":2.5,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633548","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":"Geographic Disparities in Board-Certified Ambulatory Care Pharmacists in Appalachia.","authors":"Carolina Davis, Rick Hess","doi":"10.1016/j.japh.2026.103473","DOIUrl":"10.1016/j.japh.2026.103473","url":null,"abstract":"<p><strong>Background: </strong>The Appalachian region experiences persistent health disparities and limited access to health care services. Ambulatory care pharmacists, including Board-Certified Ambulatory Care Pharmacists (BCACPs), can help address these gaps, but their distribution in Appalachia is not well described.</p><p><strong>Objective: </strong>To evaluate the distribution and population density of BCACPs in the United States, the Appalachian region, and rural Appalachian counties.</p><p><strong>Methods: </strong>This cross-sectional study used publicly available data from the Board of Pharmacy Specialties (BPS) and the Appalachian Regional Commission (ARC). BCACP data, including ZIP codes, were obtained from the BPS registry in August 2025. Counties were classified as Appalachian and further categorized as rural or non-rural using ARC definitions. BCACP density per 1,000,000 residents was calculated and compared across regions. Rate ratios (RRs) with 95% confidence intervals (CIs) were calculated using Poisson regression, with U.S. density as the reference.</p><p><strong>Results: </strong>BCACP density was lower in the Appalachian region compared to the United States overall and was lowest in rural Appalachian counties. Compared with the national BCACP density, the BCACP rate was 24% lower in Appalachia (RR 0.76, 95% CI 0.69-0.85; P < 0.001) and 73% lower in rural Appalachian counties (RR 0.27, 95% CI 0.15-0.47; P < 0.001).</p><p><strong>Conclusions: </strong>BCACPs are underrepresented in Appalachia, highlighting a gap in access to specialized ambulatory care services. Addressing this gap will require targeted recruitment and retention strategies, including early pipeline development, financial incentives such as loan forgiveness, and ensuring practice sites are ready to support pharmacist integration. Expanding access to ambulatory care pharmacists may help improve care delivery and reduce health disparities in these communities.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103473"},"PeriodicalIF":2.5,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304530","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 preceptor-learner care process: Applying person-centered thinking in pharmacy education.","authors":"Jessica E Lendoiro, Dana A Strachan, Jeremy Hughes, Krystal L Edwards, Kayla R Stover, Rachel A Allen","doi":"10.1016/j.japh.2026.103124","DOIUrl":"https://doi.org/10.1016/j.japh.2026.103124","url":null,"abstract":"<p><p>Preceptors are essential partners in pharmacy education, supporting experiential learning that represents approximately 25-33% of pharmacy curricula and a substantial portion of residency training experiences. Effective interactions between preceptors and learners are essential for learner success; however, many preceptors lack formal training in providing support and addressing learners' holistic needs, including professional development and well-being. The Joint Commission of Pharmacy Practitioners' Pharmacists' Patient Care Process (PPCP), updated in 2025, offers a standardized approach to patient care delivery in any setting. This manuscript proposes a novel. Preceptor-Learner Care Process (PLCP), adapted from the PPCP framework, as a standardized, structured, and repeatable framework to guide the preceptor-learner relationship in experiential education and to support intentional learner development. The PLCP provides preceptors a systematic approach to collect, assess, plan, implement, and follow-up on learner-specific challenges or opportunities. This framework integrates clinical skills, professionalism, communication, emotional intelligence, and situational and self-awareness enabling preceptors to provide consistent and individualized approaches to learner-specific development.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103124"},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849184","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":"RETRACTED: Facilitators, barriers and intervention strategies for medication adherence in patients receiving thyroid hormone replacement therapy: A mixed-methods systematic review.","authors":"Huiting Gao, Huan Chen, Xinyu Chen, Xianying Lu, Dingxi Bai, Yijia Yuan, Chaoming Hou, Jing Gao","doi":"10.1016/j.japh.2026.103042","DOIUrl":"10.1016/j.japh.2026.103042","url":null,"abstract":"<p><strong>Background: </strong>Thyroid hormone replacement therapy (THRT) is the lifelong treatment for hypothyroidism, yet persistent non-resolution of the condition necessitates indefinite adherence and systematic evidence on facilitators, barriers, and targeted interventions to optimize medication adherence in THRT remains limited.</p><p><strong>Objectives: </strong>This mixed-methods systematic review aimed to: 1) identify influential barriers and facilitators of THRT adherence using the Capability, Opportunity, Motivation-Behavior (COM-B) model and Theoretical Domains Framework (TDF); and 2) map potential and effective behavior change techniques (BCTs) to the TDF domains corresponding to the identified barriers.</p><p><strong>Methods: </strong>Ten databases were searched from inception to November 2024 and then updated in November 2025. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT). For purpose 1: the COM-B model and TDF, were used to code barriers and facilitators extracted from primary studies to one or more of the 14 domains of TDF, then identify the key barriers and ranked the top five influential TDF domains using three criteria. For purpose 2: the potential BCTs were recommended to target key barriers identified in TDF domains.</p><p><strong>Results: </strong>The 44 studies were included and mapped to 14 domains of TDF. Top five influential TDF to medication adherence were environmental context and resources (e.g., inconvenient administration times), social influences (e.g., family support), knowledge (e.g., lack of disease/medication knowledge), belief about consequences (e.g., concerns about side effects), and social/professional role and identity (e.g., older age as a facilitator). Twenty-seven potentially effective BCTs were identified from the included studies and the most frequently used BCTs to target five key TDF domains were social support from their partners, multilevel care intervention and effective physician communication.</p><p><strong>Conclusion: </strong>This review highlights multifaceted barriers of medication adherence in patients receiving THRT and proposes theory-informed strategies to address them. Future research should validate these strategies in real-world settings and explore contextual adaptations for diverse populations.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"103042"},"PeriodicalIF":2.5,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146184123","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":"Using medications containing lactose as an excipient for lactose intolerance patients: Insights of clinical practices and regulators roles.","authors":"May Almukainzi, Reem Alanazi, Reem Alzahrani, Lujean Almujhad","doi":"10.1016/j.japh.2025.102476","DOIUrl":"10.1016/j.japh.2025.102476","url":null,"abstract":"<p><strong>Background: </strong>Around 70% of the global populations have lactose intolerance (LI) that presents with symptoms like bloating and diarrhea due to the inability to digest lactose. This challenge is compounded as lactose is used as an excipient in 60%-70% of medications, potentially exacerbating LI symptoms and complicating treatment for affected patients.</p><p><strong>Objectives: </strong>Explore health care providers (HCPs) knowledge and practice pattern of lactose presence in medications used for patients with LI; the study also aimed to examine the transparency of lactose content disclosure in drug leaflets.</p><p><strong>Methods: </strong>A descriptive cross-sectional study targeted HCPs using online questionnaires were conducted. Additionally, medication leaflets were reviewed to assess lactose content present and amount.</p><p><strong>Results: </strong>A total of 651 HCPs, physicians 54.68%, pharmacists 34%, and dietitians 10.9%, who are practicing and agreed to complete the survey have participated in the study. Out of them, only 58% know about the presence of lactose as an excipient material in most drugs and 45% do not think that using medication containing lactose could affect patients with LI. Most pharmacists rely on drug leaflets to look at the presence of lactose in medication. However, scanning 635 medication leaflets for lactose content presence and amount revealed that 50% contain lactose, and only 25.35% of them have specified the exact amount of lactose in their formulation.</p><p><strong>Conclusion: </strong>Despite lactose being the most prevalent excipient ingredient in medications, a lack of knowledge among surveyed HCPs about lactose as an excipient in medications and its impact on patients with LI. Moreover, drug leaflets, as a primary source of drug content, lack transparency in determining the specific amount of lactose. Enhanced education among health practitioners on lactose-containing medications and the impact of using these medications for LI conditions is necessary. Moreover, facilitating finding this information on drug leaflets is required to avoid complications for patients with LI.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"102476"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621721","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}