Journal of the American College of Clinical Pharmacy : JACCP最新文献

{"title":"Identification of education gaps for pharmacists treating transgender and gender-diverse patients: A quality initiative at a single academic health system","authors":"Kellyn Engstrom Pharm.D., MPH,&nbsp;Caitlin Brown Pharm.D.,&nbsp;Adley Lemke Pharm.D.,&nbsp;Kate Davis,&nbsp;Elise Moore,&nbsp;Caroline Davidge-Pitts MD,&nbsp;Alicia Mattson Pharm.D.,&nbsp;Jessica Wright Pharm.D.,&nbsp;Nathan Smith Pharm.D.,&nbsp;Francis Manuel Pharm.D.","doi":"10.1002/jac5.70016","DOIUrl":"https://doi.org/10.1002/jac5.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Transgender and gender-diverse (TGD) patients experience challenges and disparities when seeking health care across a multitude of settings. Studies have demonstrated that TGD individuals experience bias when interacting with health care providers, including pharmacists in the community and hospital settings. Without proper training, pharmacists are less likely to be prepared to provide equitable and optimal patient care to TGD patients. This quality improvement initiative aimed to identify gaps in pharmacist knowledge and comfort with regard to TGD health care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 29-item reflective questionnaire was designed to collect information on pharmacist training and experiences in caring for TGD patients. The survey was distributed via email to all 490 pharmacists within a single health system and responses were collected from October 23, 2023 to November 3, 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 116 pharmacists completed the survey, for a response rate of 24%. Although 77% of respondents reported caring for a TGD patient, only 21% reported receiving any formal education or training on TGD health care. While 83% of respondents agreed that formal education on TGD health care is important, and 90% indicated that education on gender-affirming therapy is important, a majority of pharmacists disagreed that they were comfortable with making recommendations and providing counseling on gender-affirming therapy. A majority of pharmacists were interested in formal education and engaging in departmental initiatives to improve TGD care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There was a gap in confidence and education in caring for TGD patients among pharmacists practicing in a single academic institution. Pharmacists reported that more education is warranted to bridge current gaps in pharmacist comfort and TGD health care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 4","pages":"264-270"},"PeriodicalIF":1.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826992","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":"Long-term effect of pharmacist-led interventions on diabetes distress","authors":"Shae L. Martel Pharm.D.,&nbsp;Kam L. Capoccia Pharm.D.,&nbsp;Gladys J. Ekong BPharm, Ph.D.,&nbsp;Katelyn A. Parsons Pharm.D.","doi":"10.1002/jac5.70015","DOIUrl":"https://doi.org/10.1002/jac5.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The authors previously determined that pharmacist-led educational interventions significantly reduced diabetes distress, hemoglobin A1C (A1C), weight, and Patient Health Questionnaire-2 (PHQ-2) scores among people with type 2 diabetes in a pharmacist-run community care clinic. The objective of this study was to evaluate the long-term effects on diabetes distress and clinical outcomes 1 year after the completion of the educational interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this single-center interventional study, participants with type 2 diabetes who completed the original diabetes distress study were recruited for a 1-year post-intervention assessment. In the original study, participants qualified for pharmacist-led educational interventions based on the Association of Diabetes Care and Education Specialists (ADCES)7 Self-Care Behaviors™ depending on Diabetes Distress Scale (DDS) scores. Diabetes distress, A1C, weight, and PHQ-2 were evaluated at 1 year post-intervention and compared with baseline values. Participant satisfaction was also evaluated. Data analysis included descriptive statistics and paired <i>t</i>-tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 45 participants who completed the original study, 31 (68.9%) consented to participate in the 1-year post-intervention assessment. Mean DDS score decreased from 2.2 at baseline to 1.6 at 1-year post-intervention (<i>p</i> = 0.004). Significant reductions in emotional burden, regimen distress, and physician distress were observed from baseline to 1-year post-intervention (<i>p</i> = 0.001, <i>p</i> = 0.004, and <i>p</i> = 0.016, respectively). Reductions in overall DDS, emotional burden, regimen distress, and physician distress were both statistically and clinically significant, as they exceeded the minimal clinically important differences. Changes in A1C, weight, and PHQ-2 scores were not significant at 1-year post-intervention; however, most participants were achieving A1C treatment goals, and the presence of depression was low. Participants remained highly satisfied with the service, their knowledge, and self-management skills at 1-year post-intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Improvements in diabetes distress were maintained 1 year after the completion of pharmacist-led educational interventions. This study supports a role for pharmacists in screening for diabetes distress and the sustainable impact of tailored diabetes education.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 4","pages":"256-263"},"PeriodicalIF":1.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827091","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":"Pharmacists in diabetes management: Enhancing patient care through practice, education, and advocacy","authors":"Jennifer N. Clements Pharm.D., FCCP,&nbsp;Christine A. Schumacher Pharm.D., FCCP","doi":"10.1002/jac5.2077","DOIUrl":"https://doi.org/10.1002/jac5.2077","url":null,"abstract":"","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 2","pages":"74-76"},"PeriodicalIF":1.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.2077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A call to action for ambulatory care pharmacists for the treatment of depression and anxiety in primary care: An opinion paper of the ambulatory care and central nervous system practice research networks of the American College of Clinical Pharmacy","authors":"Richard J. Silvia Pharm.D., M.A., FCCP,&nbsp;Insaf Mohammad Pharm.D.,&nbsp;Clayton English Pharm.D.,&nbsp;Bridget A. Bradley Pharm.D.,&nbsp;Anne Ottney Pharm.D.,&nbsp;M. Lynn Crismon Pharm.D., FCCP","doi":"10.1002/jac5.70009","DOIUrl":"https://doi.org/10.1002/jac5.70009","url":null,"abstract":"<p>The need for mental health care has increased in recent years, especially due to the coronavirus disease 2019 pandemic. Simultaneously, the supply of mental health clinicians has declined alongside decreases in primary care clinicians. As management of depression and anxiety has increasingly moved to primary care, ambulatory care pharmacists must be equipped with the knowledge and skills needed to care for patients with these illnesses. The objective of this collaborative Opinion Paper of the Ambulatory Care and Central Nervous System Practice and Research Networks is to provide practical guidance on the role and educational needs of ambulatory care pharmacists in the management of depression and anxiety within primary care settings and to serve as a call for action. The authors performed a narrative review of the PubMed database from January 1, 1990 to November 10, 2024 using search terms pertaining to primary care pharmacists and mental health care. The reference lists of these articles were then reviewed for additional references. Ambulatory care pharmacists can help meet the increased need for mental health care in primary care. Their knowledge of evidence-based medicine, drug interactions, adverse effects, and other areas of pharmaceutical care, coupled with their training in interprofessional team-based care, make them an ideal addition to the primary care team to provide care for patients with depression and anxiety. A variety of educational programs are available for ambulatory care pharmacists to augment their mental health care knowledge and skills. Similarly, the training of pharmacists at all levels, from student to resident, should incorporate mental health experiences to prepare future pharmacists to address the mental health care needs of their patients. Ambulatory care pharmacists should leverage the skills and training they possess to fill the gap in care for patients living with depression and anxiety in primary care settings.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 4","pages":"293-301"},"PeriodicalIF":1.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826707","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":"Forecasting the impact of artificial intelligence on clinical pharmacy practice","authors":"Adrian Wong Pharm.D., MPH, FCCP,&nbsp;Trenton Flanagan Pharm.D.,&nbsp;Elizabeth W. Covington Pharm.D.,&nbsp;Elaine Nguyen Pharm.D., MPH, MBA,&nbsp;Dustin Linn Pharm.D., MBA,&nbsp;Gretchen Brummel Pharm.D.,&nbsp;Brian Hoffmaster Pharm.D., MBA,&nbsp;Diana Isaacs Pharm.D., FCCP,&nbsp;Sandra L. Kane-Gill Pharm.D., M.Sc., FCCP","doi":"10.1002/jac5.70004","DOIUrl":"https://doi.org/10.1002/jac5.70004","url":null,"abstract":"<p>There is a need to understand contemporary scientific advances as clinical pharmacy evolves. One rapidly expanding area is artificial intelligence (AI), which has grown significantly over the past year because of the public availability of large language models. This commentary reviews published literature describing and evaluating applications of AI to each aspect of the medication use process and forecasts potential future roles for AI in pharmacy practice. Potential challenges in implementation are also described.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 4","pages":"302-310"},"PeriodicalIF":1.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of artificial intelligence on future clinical pharmacy research and scholarship","authors":"Alexandre Chan Pharm.D., MPH, FCCP,&nbsp;William L. Baker Pharm.D., MPH, FCCP,&nbsp;Daniel Abazia Pharm.D.,&nbsp;Jerry Bauman Pharm.D., FCCP,&nbsp;C. Lindsay DeVane Pharm.D., FCCP,&nbsp;Kellie J. Goodlet Pharm.D.,&nbsp;Natalie Hall Pharm.D.,&nbsp;James Kevin Hicks Pharm.D., PhD, FCCP,&nbsp;Ellen Jones Pharm.D.,&nbsp;Chi-Hua Lu Pharm.D.,&nbsp;Donald C. Moore Pharm.D., FCCP,&nbsp;Nicholas R. Nelson Pharm.D.,&nbsp;Kaylee Putney Pharm.D., MBA,&nbsp;Aracely Sosa Pharm.D.,&nbsp;Toby Trujillo Pharm.D., FCCP,&nbsp;Crystal Zhou Pharm.D","doi":"10.1002/jac5.70003","DOIUrl":"https://doi.org/10.1002/jac5.70003","url":null,"abstract":"<p>Almost every facet of modern biomedical research involves artificial intelligence (AI). This ACCP commentary forecasts the role of AI in clinical pharmacy research and scholarship. The potential benefits/opportunities together with the limitations/challenges of AI are reviewed for stages of the scientific method including (1) developing the research question(s), study design, and execution; (2) data analysis; and (3) reporting and dissemination of clinical pharmacy research. Benefits and opportunities of AI in clinical pharmacy research include streamlining hypothesis generation and facilitating study design, overcoming limitations of traditional statistical analysis techniques, facilitating manuscript development and dissemination, and expediting peer review. Limitations and challenges of AI include the introduction of biases in subject recruitment; generation of false information, also known as “AI hallucinations”; concern of “black box” analyses that are difficult to validate; potential legal liabilities; lack of accountability; and the need for investigators to ensure the accuracy and integrity of AI-generated content. In summary, rapid progress of AI capabilities has great potential to revolutionize and accelerate clinical pharmacy research and scholarship; however, it is also imperative to recognize and mitigate the challenges and limitations introduced by AI.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 4","pages":"311-316"},"PeriodicalIF":1.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a rubric to assess pharmacy regulatory models","authors":"Veronica P. Vernon Pharm.D.,&nbsp;Shanna O'Connor Pharm.D.,&nbsp;Brandy Seignemartin Pharm.D.,&nbsp;Allie Jo Shipman Pharm.D.,&nbsp;Julie M. Akers Pharm.D.,&nbsp;Jennifer L. Adams Pharm.D., Ed.D","doi":"10.1002/jac5.70011","DOIUrl":"https://doi.org/10.1002/jac5.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Licensure of pharmacy personnel and facilities is overseen by state boards of pharmacy, which varies from state to state. Two broad approaches to the regulation of health care professions are bright line and standard of care. States in which pharmacists are able to deliver the broadest range of services to patients regulate pharmacy personnel using a standard of care regulatory model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this project was to build upon the previous benchmark published in 2021, the Pharmacy Regulatory Innovation Index, which focused on pharmacy personnel, to develop and validate an expanded rubric for assessing innovation in pharmacy regulation including personnel and facilities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Pharmacy Regulatory Innovation Index was expanded by the study team. After an initial validation of the rubric by analyzing four of the original states, a modified Delphi process was used. The rubric categories were converted to a web-based survey, which was sent to executive directors or members of boards of pharmacy in western states. These individuals were then invited to participate in a panel session about their perceptions of pharmacy regulations and the approaches used by their boards of pharmacy to regulate pharmacy personnel and facilities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>An initial rubric was developed using the Pharmacy Regulatory Innovation Index as a baseline. Four changes were made to the rubric based on the results of the Delphi Process and weighting was increased for two categories and decreased for two categories as a result of panel feedback.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The completed Pharmacy Regulatory Assessment Rubric can be used as a tool to evaluate pharmacy regulatory innovation in the United States. It can also be used to support advocacy efforts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 4","pages":"245-255"},"PeriodicalIF":1.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826785","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":"Continuous glucose monitor outcomes in Latino populations across multiple federally qualified health centers","authors":"Ana Hernandez-Calderon Pharm.D.,&nbsp;Jasmine Gonzalvo Pharm.D.,&nbsp;Jessica S. Triboletti Pharm.D.,&nbsp;Todd A. Walroth Pharm.D.,&nbsp;Samuel P. Lewis Pharm.D., M.S.,&nbsp;Lauren Pence Pharm.D.","doi":"10.1002/jac5.70007","DOIUrl":"https://doi.org/10.1002/jac5.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Utilization of continuous glucose monitoring (CGM) leads to a greater reduction in hemoglobin A1C (A1C) in individuals with diabetes compared with fingerstick blood glucose monitoring (BGM) alone. CGM also reduces diabetes-related hospitalizations. Evidence shows CGM is underutilized in racial or ethnic minority groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>There is a need to increase CGM access and evaluate the impact in underrepresented populations to prevent health disparities. Eskenazi Health added CGM devices as a covered product on the Eskenazi Health Financial Assistance Program (EH FAP) formulary. CGMs were approved for patients with diabetes taking insulin or a sulfonylurea. The purpose of this study was to assess the clinical impact of improving CGM access following EH FAP coverage with a focus on Latino populations across multiple Federally Qualified Health Centers (FQHCs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective, cohort study of nine FQHCs was conducted for all adults with EH FAP who were dispensed CGMs at Eskenazi Health outpatient pharmacies between June 1, 2022 and December 31, 2023. The primary outcome was A1C pre- and post-CGM use. Secondary outcomes included CGM adherence as characterized by proportion of days covered (PDC). All outcomes were also assessed in predetermined subgroups comparing Pharm.D. versus Primary Care and Endocrinology providers and Latino versus non-Latino individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 184 individuals were included. Median (interquartile range) A1C at baseline was 9.6% (8.1, 11.8). At 3 months, median A1C decreased to 8.4% (<i>n</i> = 96; change of −0.9%; <i>p</i> &lt; 0.001); at 1 month, median A1C decreased to 7.9% (<i>n</i> = 19; change of −1.1%; <i>p</i> = 0.028); and at 6 months, median A1C decreased to 8.4% (<i>n</i> = 55; change of −0.7; <i>p</i> = 0.007). PDC resulted as a median of 100% (77, 100). No difference in A1C outcomes were observed between Pharm.D. versus other prescribers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A1C significantly improved post-CGM use at 1, 3, and 6 months in a population that has historically experienced disparities in diabetes care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 3","pages":"192-197"},"PeriodicalIF":1.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pharmacist management on chronic obstructive pulmonary disease in a family medicine residency clinic","authors":"Jacqueline Elaine Figueras Pharm.D.,&nbsp;Christina Putnam Pharm.D.,&nbsp;Carolyn Wong Pharm.D.,&nbsp;Sholeh Bagheri M.D.,&nbsp;Marilyn Darr M.D., Pharm.D.,&nbsp;Luke A Vander Weide Pharm.D.","doi":"10.1002/jac5.70006","DOIUrl":"https://doi.org/10.1002/jac5.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Studies support pharmacist intervention to improve adherence and reduce hospital admissions in the management of chronic obstructive pulmonary disease (COPD); however, evidence is lacking to assess pharmacist management on symptom improvement and disease control using COPD Assessment Test (CAT) scores in a primary care setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The purpose of this study was to assess the impact of pharmacist involvement in performing spirometry and therapeutic management of COPD on symptoms and inhaler use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a prospective cohort study of patients with COPD at a family medicine residency clinic from January 2021 to November 2022. Patients included were 18 years of age or older, had a confirmed diagnosis of COPD with spirometry, and completed at least one COPD management visit with the pharmacist. Pharmacists performed spirometry, modified inhaler therapy, provided COPD and inhaler education, reviewed and ordered immunizations and labs, and provided tobacco cessation education and management if applicable. The primary outcome was the change in CAT scores from baseline to 3 months. The secondary outcome was the percentage of patients on guideline-directed inhaler therapy at 3 months compared with baseline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 77 spirometry visits were completed by the pharmacist, with confirmed COPD in 49 patients who were managed by the pharmacist and included in the final analysis. At baseline, the average age was 66 years old, 53% were males, and only 6% had no smoking history. The mean CAT score improved by 5.0 points (<i>p</i> &lt; 0.001) from baseline. At baseline, 45% were on guideline-directed therapy, which increased to 98% at final follow-up (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study assessed the impact of pharmacist-led spirometry and COPD management at a family medicine residency clinic. Based on the results, pharmacist involvement in COPD management resulted in an improvement in symptoms and increased use of guideline-directed inhaler therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 3","pages":"171-181"},"PeriodicalIF":1.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632615","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":"Comparative analysis of glycemic outcomes following implementation of a pharmacist-led insulin management service in postoperative cardiothoracic surgery patients","authors":"Sydney Kermeen Pharm.D.,&nbsp;Brittany White Pharm.D.,&nbsp;Alicia Stowe M.S.,&nbsp;Christopher Wilson Pharm.D.","doi":"10.1002/jac5.2079","DOIUrl":"https://doi.org/10.1002/jac5.2079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Perioperative hyperglycemia is a predictor of mortality in cardiothoracic surgery (CTS) patients. Cardiothoracic surgery patients with diabetes have improved clinical outcomes with maintained glycemic management, including improved hospital length of stay (LOS), surgical site infection risk, and rates of morbidity and mortality. A pharmacist-led insulin management service was implemented, granting pharmacists autonomy to adjust basal, bolus, and infusion insulin regimens to optimize glycemic management following CTS. Literature evaluating the impact on glycemic management in CTS patients following a pharmacist-led insulin management service is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study objective was to compare postoperative glycemic management in CTS patients before and after implementation of a pharmacist-led insulin management service.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included adult CTS patients with diabetes with a hemoglobin A1c (HbA1c) of 6.5% or greater who received at least 2 basal insulin doses following postoperative intravenous (IV) insulin infusion. The primary outcome was the percentage of blood glucose concentrations within the target range (70–180 mg/dL) until postoperative Day 7 or discharge, if sooner. Secondary outcomes were average daily blood glucose, time to discontinuation of postoperative IV insulin infusion, incidence of hypoglycemia and hyperglycemia requiring re-initiation of an insulin infusion, hospital LOS, and postoperative surgical site infections within 3 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 200 patients were included, 100 in each group. Mean percent of glucose checks within target range was higher in the post-implementation group compared with the pre-implementation group (60.8 vs. 48.9, <i>p</i> = 0.0004). The post-implementation group achieved a lower mean daily blood glucose (170 vs. 191, <i>p</i> &lt; 0.0001) and spent fewer days on postoperative insulin infusion (1.24 vs. 1.85, <i>p</i> &lt; 0.0001). There were no differences in the incidence of hypoglycemia, re-initiation of insulin infusion, LOS, or surgical site infections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Implementation of a pharmacist-led insulin management service was a safe and effective strategy to improve glycemic management in postoperative CTS patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 2","pages":"116-122"},"PeriodicalIF":1.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.2079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}