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

{"title":"Effect of a pharmacy-driven rapid bacteremia response program on outcomes in adult patients with extended-spectrum beta-lactamase bacteremia: A retrospective, quasi-experimental study","authors":"Elena A. Swingler Pharm.D., MBA,&nbsp;Madison Clark Pharm.D.,&nbsp;Sarah E. Moore Pharm.D.,&nbsp;Matthew Song Pharm.D.,&nbsp;Jamison Montes de Oca Pharm.D.,&nbsp;Stephen Furmanek MPH, M.S.,&nbsp;Thomas Chandler MPH,&nbsp;Ashley M. Wilde Pharm.D.","doi":"10.1002/jac5.2063","DOIUrl":"https://doi.org/10.1002/jac5.2063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Rapid diagnostic technology can improve patient outcomes, particularly when combined with Antimicrobial Stewardship Program (ASP) intervention. Bacteremic patients due to drug-resistant organisms are most likely to benefit from rapid diagnostic technologies as they are more likely to be prescribed inadequate empiric therapy. The purpose of this study was to analyze the impact of a pharmacy-driven Rapid Bacteremia Response Program (RBRP) on the process and clinical outcomes of patients with bacteremia due to an extended-spectrum beta-lactamase (ESBL)-producing organism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective, quasi-experimental study was conducted at a large healthcare system. The RBRP was implemented in 2017 to expedite antimicrobial therapy for bacteremia based on Gram stain and Verigene® system (Luminex Corp, Austin, TX, USA) results. Adults hospitalized with ESBL bacteremia were evaluated pre-intervention and post-intervention (utilizing the RBRP). The primary outcome was time to active therapy. Secondary outcomes included in-hospital and 30-day mortality, length of hospital and intensive care unit (ICU) stay, and factors associated with mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 200 patients were included: 100 patients in the pre-intervention and 100 patients in the post-intervention group. The post-intervention group resulted in 6.4 h faster time to active therapy from blood culture collection (median 22.8 h pre-intervention vs. 16.4 h post-intervention, <i>p</i> = 0.001). No statistical difference was identified for the length of hospital or ICU stay and in-hospital or 30-day mortality between groups. Multivariable analysis identified age, male sex, quick Pitt bacteremia score, and hospital-acquired infection to be significantly associated with 30-day mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The pharmacy-driven RBRP resulted in decreased time to active therapy for patients with ESBL bacteremia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 1","pages":"20-27"},"PeriodicalIF":1.3,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143114984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication therapy management: The evolution of clinical pharmacy services in U.S. Community-Based Pharmacy Practice—An opinion of the community-based practice and research network of the American College of Clinical Pharmacy","authors":"Emily Eddy Pharm.D., MSLD,&nbsp;Jordan Marie Ballou Pharm.D.,&nbsp;Jessica B. Finke Pharm.D.,&nbsp;Wesley Nuffer Pharm.D.,&nbsp;Carmela Avena – Woods Pharm.D.,&nbsp;Veronica T. Bandy Pharm.D., M.S.,&nbsp;William Doucette Ph.D.,&nbsp;Kendall Guthrie Pharm.D.,&nbsp;Randy McDonough Pharm.D.,&nbsp;Margie E. Snyder Pharm.D., MPH, FCCP,&nbsp;Jason Varin Pharm.D.","doi":"10.1002/jac5.2047","DOIUrl":"https://doi.org/10.1002/jac5.2047","url":null,"abstract":"<p>Pharmacists in all settings are continually expanding their roles and responsibilities and advocating for the profession. Pharmacists, as medication experts, are trained to identify and resolve medication therapy problems. The act of providing clinical pharmacist expertise is not tied to a specific practice setting, but rather is the mindset in which a pharmacist approaches patient-centered practice. In community-based pharmacy settings, pharmacists have been providing clinical services for years through Medication Therapy Management (MTM) and other enhanced services which prioritize quality care. This manuscript will outline the history of the pharmacist's role in managing patients utilizing MTM, present evidence of positive patient care outcomes from pharmacist-led services in the community-based setting, and provide recommendations for United States payers to acknowledge and increase payment for pharmacist-led services. This paper represents the opinion of the Community-Based Practice and Research Network of the American College of Clinical Pharmacy (ACCP) in the United States. It does not necessarily represent an official ACCP commentary, guideline, or statement of policy or position.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"7 12","pages":"1228-1234"},"PeriodicalIF":1.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.2047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851319","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":"Tools for clinical pharmacists to identify medications that can cause drug-induced cognitive impairment: A systematic review","authors":"Jacob Stanton B.S.,&nbsp;Michael R. Gionfriddo Pharm.D., Ph.D.,&nbsp;Gail B. Rattinger Pharm.D., Ph.D.,&nbsp;Yuan Fang Ph.D.,&nbsp;Mia E. Lussier Pharm.D., M.S.","doi":"10.1002/jac5.2049","DOIUrl":"https://doi.org/10.1002/jac5.2049","url":null,"abstract":"<p>Cognitive impairment affects around 19% of community-dwelling older adults in the United States. Pharmacists can play a significant role in identifying and deprescribing cognitive-impairing medications through cognitive-focused medication reviews or as part of comprehensive medication management. Multiple tools exist to help pharmacists and other practitioners identify these medications, yet a comprehensive description of these tools has not been undertaken. We searched EBSCO MEDLINE, PubMed, EMBASE, CINAHL, and PsycInfo from inception to August 4, 2023, using search terms relative to medications and cognition. Studies were included if they detailed a tool to assess the cognitive burden of a medication regimen. Abstracts and full texts were screened independently and in duplicate. Any disagreements at the level of full-text screening were resolved by consensus. Eligible studies underwent data extraction by two authors independently and in duplicate using a data extraction form. Our search identified 13 126 articles of which only four tools were initially included. Additionally, we identified seven articles from the reference lists of excluded review articles for a final inclusion count of 11 tools. Articles were published between 2001 and 2017. Nine of 11 tools (82%) were focused solely on anticholinergic medications, while only one tool indicated a clinically relevant cutoff value and alternative medication recommendations. While there are many tools to assess the cognitive burden from medications, many are limited by the development date, focus on anticholinergic medications, or lack clinically useful information. Further research is needed to develop more comprehensive, up-to-date, and readily implementable tools that clinical pharmacists can utilize to assess medication-induced cognitive risks. Such as tool could be applied by pharmacists in many settings to optimize medication use and improve patient outcomes.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"7 12","pages":"1207-1227"},"PeriodicalIF":1.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.2049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851309","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":"Clinical impact of a tiered, pharmacist-driven remote patient monitoring protocol utilizing self-measured blood pressure readings","authors":"Zachary Hovis Pharm.D.,&nbsp;Ryan Hanson M.S.,&nbsp;Erin DeJarlais DPT, MBA","doi":"10.1002/jac5.2059","DOIUrl":"https://doi.org/10.1002/jac5.2059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Pairing self-measured blood pressure (SMBP) with protocolized, non-physician follow-up consistently improves hypertension (HTN) management. However, these interventions are often resource-intensive and rely on a degree of technological proficiency that may exclude a vulnerable subset of the population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The primary objective of this study was to determine the rate of attainment of blood pressure (BP) control (defined as &lt;140/&lt;90 mmHg) based on the most recent clinic-measured BP readings 12 months or more after enrollment in the Digital Care Monitoring program. The secondary objective was to determine if there was a difference between the most recent clinic-measured systolic and diastolic BP readings before enrollment compared with 12 months or more after the enrollment eligibility period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study examined the impact of a tiered, non-physician SMBP program, engaging patients through a familiar communication medium to relay home BP readings. A pre-post quality improvement study was conducted in the outpatient arm of an integrated delivery network. Patients meeting selection criteria were invited to voluntarily enroll bi-monthly from October 2021 to July 2023. Patients consenting to enrollment received reminders twice weekly to respond with home BP readings, and an outreach protocol was established utilizing a medical assistant and clinical pharmacist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The rate of attainment of BP control 12 months or more after the enrollment eligibility period was found to be 79.2% (<i>p</i> &lt; 0.01). BP dropped significantly over the 12-month treatment course with a mean systolic BP difference of 19.97 mmHg (<i>p</i> &lt; 0.001) and a mean diastolic BP difference of 12.34 mmHg (p &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results indicate that a tiered, pharmacist-driven remote patient monitoring protocol utilizing SMBP readings is an effective management strategy to reduce BP in patients with uncontrolled HTN.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 1","pages":"6-11"},"PeriodicalIF":1.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143113753","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 an intern-supported antiviral stewardship program for cytomegalovirus prophylaxis and management in high-risk abdominal solid organ transplant recipients","authors":"Lindsey Mahn B.S.,&nbsp;Mary Moss Chandran Pharm.D., FCCP,&nbsp;Christina Teeter Doligalski Pharm.D., FCCP,&nbsp;Laura Mincemoyer Chargualaf Pharm.D.","doi":"10.1002/jac5.2061","DOIUrl":"https://doi.org/10.1002/jac5.2061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cytomegalovirus (CMV) infection is associated with increased graft loss and mortality after solid organ transplantation (SOT). CMV infection risk is highest among seronegative recipients of seropositive donors (D+/R-). Careful monitoring is imperative to ensure appropriate care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study investigates the impact of intern-supported pharmacist-driven monitoring on CMV outcomes in D+/R- abdominal SOT recipients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-center retrospective cohort study was conducted in CMV D+/R- abdominal SOT recipients transplanted between August 1, 2021, and July 31, 2023 to compare recipients undergoing pharmacy intern review versus standard monitoring. A pharmacy student intern reviewed a list of recipients maintained in the electronic health record weekly to ensure proper CMV prophylaxis and management. Following institutional protocols, the intern identified and recommended interventions to the pharmacists for implementation. Primary outcomes included the incidence of CMV infection within 9 months posttransplant and time to CMV eradication after infection. Secondary outcomes included the incidence of antiviral resistance, viral breakthrough, allograft loss, and recipient death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>69 D+/R- SOT recipients were included (36 control, 33 intervention). Baseline demographics were similar. There was a nonsignificant decrease in CMV infection within 9 months posttransplant in the intervention group. However, the mean time to CMV eradication after infection was significantly shorter in the intervention group (63 days vs. 24 days, <i>p</i> = 0.004). No differences in secondary outcomes were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CMV infection rates remained elevated in D+/R- SOT recipients after transplant despite frequent reviews of prophylaxis and laboratory monitoring, which is likely a result of seronegative status and global immunosuppression. However, eradication of CMV infection can be significantly impacted by close monitoring, such as that provided by a pharmacy student intern, to reduce the time of active infection. This dramatic reduction in time to eradication has the potential to reduce the risk for negative allograft and recipient outcomes associated with CMV infection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 1","pages":"12-19"},"PeriodicalIF":1.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143113563","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":"Addressing code response challenges: Development of a pharmacist-focused training program at an Academic Medical Center","authors":"Lindsay Jacobs Pharm.D., MPH,&nbsp;Jennifer Tawwater Pharm.D.,&nbsp;Lisa Skariah Pharm.D.,&nbsp;Bhavyata Parag Pharm.D.,&nbsp;Klayton Ryman Pharm.D.,&nbsp;Chephra McKee Pharm.D.,&nbsp;Kathryn Cox Pharm.D.,&nbsp;Whitney Chaney Pharm.D.,&nbsp;Josephine Tenii Pharm.D.,&nbsp;Meagan Johns Pharm.D., MBA","doi":"10.1002/jac5.2062","DOIUrl":"https://doi.org/10.1002/jac5.2062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Pharmacists are essential to the multidisciplinary team during code response. Commercially available basic and advanced-life support training programs are not tailored for the depth of medication-specific content essential for pharmacists to competently respond to codes. Opportunities exist to provide additional training to improve pharmacists' code response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To develop pharmacist-specific didactic education and hands-on assessments for adult code response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>At our institution, acute care clinical staff pharmacists attend all adult codes. A mandatory pharmacist training program was designed to meet minimum institutional expectations for code response and address knowledge gaps. The program included three components: (1) online training module, (2) knowledge-based assessment, and (3) hands-on assessment. Pharmacists were surveyed pre- and post-completion of the training program. The surveys consisted of 15 Likert scale questions and open-ended questions. Chi-square tests were used to compare a “positive” response to pre- and post-survey questions. A “positive” response was defined as “Strongly Agree” or “Agree” on the Likert questions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-three pharmacists completed the training program with 71 passing the hands-on skills training on the first attempt. The pre- and post-intervention survey was completed by 43/74 (58.1%) and 33/82 (40.2%) of pharmacists, respectively. A statistically significant increase in the number of “positive” survey responses was noted in 7 of the 15 Likert scale questions post-intervention, with nominal improvements in the remaining 8. There were notable improvements in pharmacist perceived familiarity and comfort with medication locations (9% vs. 64%) and preparation (44% vs. 76%), and greater confidence in using available resources.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The pharmacist-specific code response training resulted in notable improvements in disclosed familiarity and comfort with code responsibilities. This training was transitioned into an annual competency module that may be used as a framework for other institutions implementing a similar process to maintain a standard level of competence in code response for pharmacists.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 1","pages":"34-46"},"PeriodicalIF":1.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.2062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111997","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":"Pharmacist-managed diabetes care and change in A1C: A retrospective matched cohort study","authors":"Nicholas C. Meyer Pharm.D.,&nbsp;Fatme Younes Pharm.D.,&nbsp;Carlina J. Grindeland Pharm.D.,&nbsp;Monte L. Roemmich Pharm.D.,&nbsp;Douglas W. Gugel-Bryant Pharm.D.","doi":"10.1002/jac5.2058","DOIUrl":"https://doi.org/10.1002/jac5.2058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Studies have demonstrated the positive impact of pharmacist-managed diabetes care (PMDC) on hemoglobin A1C (A1C) reduction from baseline, but data comparing the pharmacist's impact on usual medical care (UMC) are less robust.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study compared the A1C reduction in patients with diabetes enrolled in PMDC plus UMC (PMDC + UMC) with similar patients receiving UMC independent of clinical pharmacy services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective, matched cohort study conducted at a large, not-for-profit healthcare system in North Dakota. Patients with diabetes who received care from an ambulatory care pharmacist in addition to UMC between July 2018 and June 2020 were included in the PMDC+UMC cohort. The comparator cohort included propensity-matched patients solely receiving UMC during the same period. The primary endpoint was the mean change in A1C at 12 months in both cohorts. The secondary endpoint was the percentage of patients in each cohort achieving an A1C &lt;7% at 12 months. Normally distributed continuous variables were analyzed using the Wilcoxon rank sum test. Categorical data were analyzed using Chi-square tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 158 patients managed by a pharmacist met the inclusion criteria for the study. A matched cohort of 158 practitioner-managed patients was used for comparison. Pharmacist-managed patients achieved a greater mean reduction in A1C (−1.70%) at 12 months compared with those managed by practitioners only (−1.31%), a between-means difference of −0.39% (<i>p</i> = 0.0073). More patients managed by pharmacists (24.6%) reached an A1C of &lt;7% compared with patients receiving UMC only (22.8%); however, the difference was not statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Incorporation of PMDC for patients with diabetes is associated with a greater improvement in A1C at 12 months compared with UMC alone. Although not statistically significant, more patients referred to PMDC reached an A1C of &lt;7%. Implementation of similar PMDC programs may help more patients reach their glycemic goals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 1","pages":"28-33"},"PeriodicalIF":1.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111996","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":"Diversity, equity, inclusion, and accessibility: Alignment with the mission and core values of the American College of Clinical Pharmacy","authors":"Jimmi Hatton Kolpek Pharm.D., FCCP,&nbsp;Curtis E. Haas Pharm.D., FCCP,&nbsp;Jill M. Kolesar Pharm.D., M.S., FCCP,&nbsp;James E. Tisdale Pharm.D., FCCP","doi":"10.1002/jac5.2052","DOIUrl":"https://doi.org/10.1002/jac5.2052","url":null,"abstract":"<p>Responding to the changing landscape of health care is a critical responsibility of the American College of Clinical Pharmacy (ACCP). Aligned with its mission of extending the frontiers of clinical pharmacy, ACCP is committed to embracing diversity and inclusion as a core value. Creating a comprehensive organizational strategy reflecting the College's authentic endeavors to embrace the tasks required is an ongoing effort. ACCP is embracing an inclusive vision whereby all members can feel welcomed, valued, respected, and heard. Belief that the journey will bring diverse voices, leadership, and understanding for all clinical pharmacists sustains the College's motivation toward this goal. In this commentary, we, as past presidents of ACCP, are learning the challenges related to this endeavor and systematically addressing each issue. Each ACCP member is an essential partner as the College strives toward being an inclusive organizational home for all clinical pharmacists. This commentary summarizes the rationale for this work and the alignment of ACCP's efforts with its core values. We must remain firm in our belief that inclusive clinical pharmacy leaders can recognize diversity and equity gaps, mobilize as advocates to amplify underrepresented voices, and transform hope into action for future generations.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"7 12","pages":"1240-1244"},"PeriodicalIF":1.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851480","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":"Structural factors and their influence on the use of novel antidiabetic agents: Making the case for increased awareness and access to clinical pharmacy services","authors":"Olga Monika Trejos Kweyete Pharm.D.,&nbsp;Desrae Woods A.A.,&nbsp;Joahn Okoumba B.S.,&nbsp;Serena Jingchuan Guo M.D., Ph.D.,&nbsp;John M. Allen Pharm.D., FCCP","doi":"10.1002/jac5.2050","DOIUrl":"https://doi.org/10.1002/jac5.2050","url":null,"abstract":"<p>Type 2 diabetes (T2D) affects over 38 million Americans, leading to significant health complications and substantial healthcare costs. Novel antidiabetic medications, such as SGLT2 inhibitors and GLP-1 receptor agonists, have shown promise in improving glycemic control and reducing cardiovascular risks. However, their underuse, particularly among minority populations, remains a concern. This review examines the impact of structural factors, including socioeconomic determinants and historical practices like redlining, on the utilization of new antidiabetic agents. Disparities in T2D outcomes are driven by inadequate access to care and neighborhood characteristics. Addressing these issues requires comprehensive strategies, including the integration of pharmacist support to enhance medication adherence and overall T2D management. Understanding the influence of structural racism on healthcare disparities is crucial for improving access and outcomes for all patients.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 1","pages":"47-51"},"PeriodicalIF":1.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.2050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143120329","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":"Retrospective cohort study of ambulatory care pharmacist interventions’ impact on incidence of therapeutic response in anxiety and depression","authors":"Ashlyn M. Kiebach Pharm.D.,&nbsp;Tara E. McAlpine Pharm.D.,&nbsp;Mitchell H. Cavanaugh Pharm.D.,&nbsp;Jessica A. Benzer Pharm.D.","doi":"10.1002/jac5.2046","DOIUrl":"https://doi.org/10.1002/jac5.2046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Ambulatory care pharmacists continue to expand their involvement in the management of various disease states across the United States, including anxiety and depression. There is limited literature assessing the clinical impact of these practice advances implemented by pharmacists who do not carry psychiatric training (i.e., psychiatric board certification or mental health training) within primary care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective, multicenter, cohort study of adult patients who had at least one documented visit between February 2020 and August 2023 with an ambulatory care pharmacist who did not carry additional psychiatric training to comanage their diagnosis of depression and/or anxiety. The primary outcome was the achievement of a therapeutic response (a reduction of 50% or greater in Patient Health Questionnaire 9-item depression scale [PHQ-9] and/or the Generalized Anxiety Disorder 7-item scale [GAD-7] scores). Secondary outcomes included the change in PHQ-9 and/or GAD-7 scores, incidence of remission, predictors of therapeutic response, pharmacist intervention subtypes, and percentage use of pharmacogenomics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Therapeutic response for PHQ-9 was achieved for 60 (48.4%) of 124 patients included after utilization of an ambulatory care pharmacist without additional psychiatric training embedded in primary care. While two-thirds of patients had comorbid anxiety, 43 (57.4%) could not be evaluated for clinical improvement as they did not have available GAD-7 scores for analysis. Available PHQ-9 and GAD-7 scores had median score reductions of 5 (−11,0) and 4.5 (−7.75, 3.5), respectively, at approximately 6 months (<i>p</i> &lt; 0.001 and <i>p</i> = 0.023). Patients had a median number of 4 (2, 5) visits with a pharmacist and a median number of 2 (1, 3) interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ambulatory care pharmacists, regardless of additional psychiatric training, can help patients achieve a therapeutic response for depression and anxiety as well as significantly improve PHQ-9 and GAD-7 scores. Additional education on the importance of GAD-7 monitoring is warranted given its lack of routine collection and evaluation among patients presenting with comorbid depression and anxiety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"7 12","pages":"1147-1153"},"PeriodicalIF":1.3,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862171","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}