Journal of the American Pharmacists Association : JAPhA最新文献

{"title":"Geographic access to community pharmacies based on walking, driving, and public transportation in the 10 most populated U.S. areas.","authors":"Nasser Sharareh, Shangbin Tang, Adam Bress, Walter S Mathis, Lucas A Berenbrok, Inmaculada Hernandez","doi":"10.1016/j.japh.2025.102479","DOIUrl":"10.1016/j.japh.2025.102479","url":null,"abstract":"<p><strong>Background: </strong>Previous analyses measuring geographic access to community pharmacies (pharmacy access) have relied solely on driving distance or time, without considering other modes of transportation such as walking and public transportation. This omission represents an important limitation, particularly in metropolitan areas where other transportation modes are regularly used, which potentially can lead to the underestimation of inequities in pharmacy access.</p><p><strong>Objectives: </strong>To investigate whether measuring pharmacy access based on driving underestimates inequities in access, given the fact that not everyone has access to a vehicle.</p><p><strong>Methods: </strong>We used geographic information system analysis to measure pharmacy access. We selected the top 10 metropolitan and micropolitan statistical areas with the largest population in the United States because of the feasibility and availability of different transportation modes in those areas.</p><p><strong>Results: </strong>We found that across the top 10 populated U.S. areas and based on a 20-minute travel time, pharmacy access will be overestimated for approximately 702,708 and 2,430,764 individuals if we consider driving as the transportation mode instead of walking and public transportation, respectively.</p><p><strong>Conclusion: </strong>Results suggest that measures of pharmacy access derived solely from driving time will underestimate inequities in pharmacy access, specifically in areas with a low rate of private vehicle ownership.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"102479"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677204","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 'Assessment of medication adherence after enrollment in a health system funded medication assistance program for patients with diabetes' [JAPH 63/4 (2023) 1222-1229.e3].","authors":"","doi":"10.1016/j.japh.2025.102430","DOIUrl":"10.1016/j.japh.2025.102430","url":null,"abstract":"","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"102430"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562638","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":"","authors":"","doi":"10.1016/j.japh.2025.102485","DOIUrl":"10.1016/j.japh.2025.102485","url":null,"abstract":"","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"102485"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736645","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":"Adolescent with osteomyelitis after intramuscular administration of a vaccine: A case report.","authors":"Sarah S Smith,&nbsp;Yuman Lee,&nbsp;Lisa Wang","doi":"10.1016/j.japh.2020.03.015","DOIUrl":"https://doi.org/10.1016/j.japh.2020.03.015","url":null,"abstract":"<p><strong>Objective: </strong>To emphasize adverse outcomes associated with applying adult immunization protocols to the pediatric population.</p><p><strong>Case summary: </strong>A 15-year-old female with no past medical history developed severe pain in her left arm and decreased range of motion 11 days after receiving an intramuscular injection of the human papillomavirus vaccine. Over the following month, she was treated with a short course of steroids for frozen shoulder and gabapentin for Parsonage-Turner syndrome. During the third visit to a specialist for severe pain and loss of left arm mobility, she was sent to the emergency department for further workup. An x-ray and magnetic resonance imaging of the left arm were suspicious for osteomyelitis. The diagnosis was confirmed by incision and drainage of the abscess and a bone biopsy. A 6-week course of antibiotic therapy was initiated after the biopsy results. The injury was attributed to overpenetration by the needle during the intramuscular injection she had received in the previous month.</p><p><strong>Practice implications: </strong>As the number of states allowing pharmacists to vaccinate patients of all ages grows, pharmacists must be prepared to safely provide vaccinations to patients of varying sizes. Assessing body habitus while balancing the constant responsibilities of a community pharmacy will be a challenge. Introduction of a guidance document with specific needle lengths based on weight, age, and sex can address potential errors before they occur.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"e357-e360"},"PeriodicalIF":2.1,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37873957","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 clinical microsystems approach: Does it really work? A systematic review of organizational theories of health care practices.","authors":"André Côté, Idrissa Beogo, Kassim Said Abasse, Maude Laberge, Maman Joyce Dogba, Clémence Dallaire","doi":"10.1016/j.japh.2020.06.013","DOIUrl":"10.1016/j.japh.2020.06.013","url":null,"abstract":"<p><strong>Objectives: </strong>Faced with increased expectations regarding the quality and safety of health care delivery systems, a number of stakeholders are increasingly looking for more efficient ways to deliver care. This study was conducted to provide a critical appraisal and synthesize the best available evidence on the impact of implementing clinical microsystems (CMS) on the quality of care and safety of the health care delivery.</p><p><strong>Data sources: </strong>A comprehensive and systematic search of 6 electronic databases, from 1998 to 2018, was conducted to identify empirical literature published in both English and French, evaluating the impact of implementing CMS in health care settings.</p><p><strong>Study selection: </strong>We included all study designs that evaluate the impact of implementing CMS in health care settings.</p><p><strong>Data extraction: </strong>Independent reviewers screened abstracts, read full texts, extracted data from the included studies, and appraised the methodological quality.</p><p><strong>Results: </strong>Of the 1907 records retrieved, 35 studies met the inclusion criteria. The settings included general practice clinics (n = 18), specialized care units (n = 14), and emergency and ambulatory units (n = 3). The implementation of CMS helped to develop the patient-centered approach, promote interdisciplinarity and quality improvement skills, increase the fluidity of the clinical acts performed, and increase patient safety. It contributed to increasing patients' and clinicians' satisfaction, as well as reducing hospital length of stay and reducing hospital-acquired infections. The implementation of CMS also contributed to the development and refinement of diagnostic tools and measurement instruments.</p><p><strong>Conclusion: </strong>The CMS approach is unique because of the primacy given to the quality of care offered and the safety of patients over any other consideration, and its ability to redesign health care delivery systems. Efforts still need to be made to legitimize the approach in various health care settings worldwide.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"e388-e410"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38181248","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 of a protocol-driven pharmacy technician refill process at a large physician network.","authors":"Elizabeth G Schlosser,&nbsp;Erica Neff,&nbsp;Suzanne M Francis,&nbsp;Hannah Vormohr,&nbsp;Ana L Hincapie","doi":"10.1016/j.japh.2020.07.006","DOIUrl":"https://doi.org/10.1016/j.japh.2020.07.006","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the implementation of a centrally located certified pharmacy technician (CPhT) team to streamline the process of approving medication refills for chronic disease state management within a multisite physician network.</p><p><strong>Setting: </strong>Primary care (PC) offices within a large physician network.</p><p><strong>Practice description: </strong>Incoming medication refill requests from patients and community pharmacies were typically received at each PC office and processed by medical assistants, nurses, or providers.</p><p><strong>Practice innovations: </strong>A centralized team of CPhTs managed medication refill requests for 9 PC offices. Standardized protocols for 14 drug classes were built into the electronic medical record (EMR) system. Incoming medication refills were shifted from PC offices to the centrally located CPhT team.</p><p><strong>Evaluation: </strong>The implementation process was assessed through pharmacists' random audits and feedback from providers, office staff, and patients. Refill reports from January 2020 through March 2020 were obtained. Refill requests' characteristics were summarized and evaluated to determine the volume of refill requests, approved or denied requests, and requests requiring further PC staff analysis.</p><p><strong>Results: </strong>Changes to the protocol process and EMR documentation included modifying or removing laboratory test value parameters, adjusting \"grace period\" refill quantity on the basis of the scheduled office visit date, and expanding the CPhT role to include communicating with patients and pharmacies regarding denied refills. Data showed that the CPhT team processed 81.7% of all refill requests. This averaged 215 requests per CPhT per day. Of the refill requests approved, 22.5% passed the protocol for the maximum quantity and refills permitted, and 17.3% were granted grace supplies until office visit protocol criteria were met.</p><p><strong>Conclusion: </strong>A CPhT team processed 81% of the medication refill requests for 9 PC offices with institution-approved EMR protocols and ambulatory pharmacist supervision. There were many barriers identified and addressed, but through continuous evaluation the workflow and protocol continue to improve.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"e341-e348"},"PeriodicalIF":2.1,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38246115","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":"Tenofovir-induced Stevens-Johnson syndrome in a patient with acute hepatitis B: A rare case report.","authors":"Saju Xavier,&nbsp;Athira P,&nbsp;Abel C Mathew,&nbsp;Hathim Basheer,&nbsp;Rahana K,&nbsp;Muhammed Hashik Pk,&nbsp;Dilip Chandrasekhar","doi":"10.1016/j.japh.2020.06.029","DOIUrl":"https://doi.org/10.1016/j.japh.2020.06.029","url":null,"abstract":"<p><strong>Objective: </strong>To report a rare case of a hepatitis B patient who developed the Stevens-Johnson syndrome (SJS) secondary to tenofovir use.</p><p><strong>Case summary: </strong>A 61-year-old woman presented with complaints of jaundice, difficulty in swallowing, and burning sensation all over the body along with erythematous polymorphic rash on the face, upper limbs, and trunk. She was diagnosed with SJS secondary to tenofovir. The causality of adverse drug reaction was assessed using the World Health Organization-Uppsala Monitoring Centre causality scale, and adverse drug reaction was found to be probable. Tenofovir was withdrawn and the patient was conservatively managed.</p><p><strong>Practice implications: </strong>Through the observation of this event, we could figure out the association between tenofovir and SJS. Prompt withdrawal of the offending agent and the initiation of therapy with systemic corticosteroids and supportive medication were found to be effective.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"e365-e369"},"PeriodicalIF":2.1,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.japh.2020.06.029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38214232","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":"Access to medications among adults with type 2 diabetes using pharmacy- or clinic-based medication assistance programs: A systematic review.","authors":"Lori M Ward, Desiree B Pendergrass, Charles C Chima, Roland J Thorpe, Marino A Bruce, Hillary F Blackburn, Christopher F Palombo, Bettina M Beech","doi":"10.1016/j.japh.2020.07.001","DOIUrl":"10.1016/j.japh.2020.07.001","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this systematic review was to assess the literature regarding access to, and utilization of medication for type 2 diabetes (T2D) and pre-post improvements in diabetes outcomes for adults enrolled in clinic- or pharmacy-based medication assistance programs.</p><p><strong>Data sources: </strong>The databases searched were PubMed, CINAHL, Scopus, Embase, Ovid HealthSTAR, PapersFirst, and OpenGrey.</p><p><strong>Study selection: </strong>Databases were searched from the beginning of each database to Feburary 29, 2020. Articles were included if (1) the population of interest was adults 18 years of age or older with a T2D diagnosis, (2) the study addressed access to medication for diabetes patients in a clinic- or pharmacy-based setting, and (3) the study was conducted in the United States.</p><p><strong>Data extraction: </strong>Data extracted from the selected studies included location of study, patient inclusion criteria, sample size, medication assistance program description, and reported diabetes medication access and medication related adherence outcomes.</p><p><strong>Results: </strong>Eleven articles met the inclusion criteria for the study. The mean reduction in glycated hemoglobin level following the use of medication assistance programs ranged from 0.45 to 0.8. Across studies, the mean number of antihyperglycemic medications used by patients in medication assistance programs ranged from 1 to 1.9. Medication adherence was reported at 45% across studies that reported adherence measures.</p><p><strong>Conclusion: </strong>Among the 11 studies identified that assessed access to medication for adults with T2D using clinic- or pharmacy-based medication assistance programs, study findings indicated that many of these programs showed some positive changes in medication access and diabetes-related outcomes.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"e411-e421"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38249510","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":"Unintentional use of fentanyl attributed to surreptitious cannabis adulteration.","authors":"Taylor Hopwood,&nbsp;Caitlin Dowd-Green,&nbsp;Melissa Mason,&nbsp;Rosalyn W Stewart","doi":"10.1016/j.japh.2020.07.003","DOIUrl":"https://doi.org/10.1016/j.japh.2020.07.003","url":null,"abstract":"<p><strong>Objective: </strong>This case addresses the issue of surreptitious adulteration of cannabis. Many with opioid and substance use disorders use cannabis while receiving office-based opioid treatment (OBOT), making it valuable to understand the rationale for its use. Further study of the effects that cannabis use has on OBOT success or failure is necessary.</p><p><strong>Case summary: </strong>A 50-year-old man receiving OBOT continually tested positive in urine drug screenings (UDSs) for fentanyl, while abstaining from all opiates, but he endorsed smoking cannabis 2-3 times weekly as a self-reported headache reliever and a sleep aid. After changing the source from which he bought cannabis, his UDS became negative for fentanyl. He was maintained on a stable dose of buprenorphine with a consistent UDS after this intervention and was able to make many positive lifestyle changes as a result (i.e., maintaining a relationship with his girlfriend, continuing attendance at support groups, and pursuing employment opportunities).</p><p><strong>Practice implications: </strong>The consequences of cannabis use on OBOT success are highly variable and dependent on many factors. Although the concern regarding adulteration of cannabis exists, there is no systematic monitoring or reliable data on its frequency or the magnitude of its effect, which generates a demand for further research and exploration. Depending on state-specific regulations, patients may be able to obtain cannabis from reliable, regulated (nonadulterated) sources. However, providers must thoroughly consider the barriers to patients obtaining medicinal or legalized cannabis.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"e370-e374"},"PeriodicalIF":2.1,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38249512","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":"Successful use of problem-solving methodology to reduce pharmacy chemotherapy processing time.","authors":"Glenn Fonte,&nbsp;Jordan Bolooki,&nbsp;Lauren N Gjolaj,&nbsp;Gloria G Campos,&nbsp;Angela I Olier-Pino,&nbsp;Gustavo L Fernandez,&nbsp;Blanca Rivera,&nbsp;Suzy D C Bianco","doi":"10.1016/j.japh.2020.07.012","DOIUrl":"https://doi.org/10.1016/j.japh.2020.07.012","url":null,"abstract":"<p><strong>Objectives: </strong>The primary objectives of this study were to (1) reduce pharmacy turnaround time (TAT) without compromising safety and quality and (2) reduce compounding order overload during peak hours (8:00 AM-5:00 PM). The secondary objective was to decrease patient wait time pertinent to pharmacy services.</p><p><strong>Setting: </strong>The setting was a hospital-based pharmacy.</p><p><strong>Practice description: </strong>Pharmacy dispensing more than 1800 doses daily, 30% of which goes to outpatient cancer treatment. Patients usually receive multiple compounded medications; thus, compounding numbers are several folds higher than patient number. High compounded chemotherapy order volume overloaded pharmacy staff during peak hours and was a major contributor to patient wait time.</p><p><strong>Practice innovation: </strong>Using Define Measure Analyze Improve Control Six Sigma and intelligent risk-taking strategies, a dedicated team identified root causes of problems and designed long-lasting solutions that would not compromise quality.</p><p><strong>Evaluation: </strong>The most effective initiative was the advanced preparation of chemotherapy for select patients (Concierge), which addressed pharmacy TAT, patient wait time, and chemotherapy order overload, all without affecting safety or quality of dispensed medications.</p><p><strong>Results: </strong>Pharmacy TAT decreased by 77% for Concierge patients and 31% for standard patients. Comparable decreases were observed for patient wait time: 67% for Concierge and 27% for standard patients. Safety and quality were maintained for all dispensations during and after implementation of Concierge. A concurrent 8% increase in patient number was observed despite no changes in physical capacity.</p><p><strong>Conclusion: </strong>The implementation of Concierge initiatives: markedly reduced pharmacy TAT without compromising safety checks performed by pharmacists; decreased chemotherapy order overload during peak hours; improved distribution of assignments for pharmacy staffand statistically significant decreased wait time for all patients, especially those selected for Concierge. Effective selection of Concierge patients minimized additional costs associated with wasted premixed chemotherapy. Improving workflow for a subset of patients affected a greater patient population, allowing additional patients to be treated daily.</p>","PeriodicalId":520694,"journal":{"name":"Journal of the American Pharmacists Association : JAPhA","volume":" ","pages":"e349-e356"},"PeriodicalIF":2.1,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38293327","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}