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

{"title":"Evaluation of hemoglobin A1c reduction in Hispanic patients versus non-Hispanic patients with type 2 diabetes managed by a clinical pharmacist","authors":"Mayela Warner Pharm.D.,&nbsp;Ife Anachebe Pharm.D.,&nbsp;Samuel Newman M.S.,&nbsp;Somer Blair Ph.D.,&nbsp;Haley Leverett Pharm.D.","doi":"10.1002/jac5.70005","DOIUrl":"https://doi.org/10.1002/jac5.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hispanic people are 1.6 times as likely to be diagnosed with type 2 diabetes mellitus (T2DM) as non-Hispanic White people. Clinical pharmacists can play a significant role in helping patients disproportionately affected by diabetes meet hemoglobin A1c (A1c) goals through medication management via collaborative practice agreements (CPAs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to evaluate A1c reduction in Hispanic and non-Hispanic patients with T2DM when managed by a clinical pharmacist utilizing a CPA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-center, retrospective, observational cohort study was conducted from August 30, 2019 to August 30, 2022. Patients were included if they were at least 18 years of age, diagnosed with T2DM, and had at least one office visit with a clinical pharmacist for diabetes management at John Peter Smith (JPS) Health Network. The study population was subdivided into two groups: Hispanic and non-Hispanic patients. The primary outcome was mean A1c reduction, defined as the difference in A1c at baseline and 12 months. Secondary outcomes included differences in variables for Hispanic patients who reached A1c goals versus those who did not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data points were collected within 1 year from the first encounter with a clinical pharmacist. Three hundred patients were enrolled in the study, with 150 patients in each group. The mean A1c reduction in the Hispanic group was 1.6% (standard deviation [SD] = 2.654, 95% confidence interval [CI] [1.180–2.030]) and 2.0% (SD = 2.369, 95% CI [1.598–2.356]) in the non-Hispanic group (<i>p</i> = 0.20). There were no significant differences in variables for Hispanic patients who met A1c goals compared to Hispanic patients who did not achieve A1c goals. There was no significant difference in A1c reduction between Hispanic and non-Hispanic patients with T2DM who were managed by a clinical pharmacist utilizing a CPA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings from this study suggest that clinical pharmacist management of T2DM does not further contribute to the disparities experienced by Hispanic patients, but rather, it can serve as a valuable resource in their care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 3","pages":"205-213"},"PeriodicalIF":1.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632997","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":"Screening and treatment of iron deficiency among heart failure patients with impaired ejection fraction: The impact of a pharmacist-led protocol","authors":"Jamila Alaryani BSPharm,&nbsp;Yosef Manla M.D.,&nbsp;Emna Abidi Ph.D.,&nbsp;Obada Kholoki M.D.,&nbsp;Mohamed Hisham Pharm.D.,&nbsp;Firas Al Badarin M.D., M.Sc,&nbsp;Feras Bader M.D., M.S.,&nbsp;Bassam Atallah Pharm.D.","doi":"10.1002/jac5.2081","DOIUrl":"https://doi.org/10.1002/jac5.2081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite guideline-recommended routine screening and iron deficiency (ID) treatment among heart failure (HF) patients, these practices are often underutilized. Currently, limited data are available on the outcomes of pharmacists' programs to enhance ID screening and management. Accordingly, we sought to describe the frequency and yield of screening for ID and intravenous (IV) iron replacement rates among our cohort of HF patients and examined the impact of implementing a pharmacist-led protocol (PLP) aimed at enhancing these rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective study involving HF patients with left ventricular ejection fraction (LVEF) &lt;45% at a quaternary care hospital in the Middle East/Gulf region. The PLP was introduced in August 2022. Data on demographics, comorbidities, echocardiographic parameters, laboratory findings (including ID screening and its findings), and rates of treatment with IV iron replacement were analyzed and compared between the pre-implementation group (<i>n</i> = 432, October 2015–February 2020) and the post-implementation group (<i>n</i> = 154, August 2022–January 2023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Before the PLP, 63.2% (<i>n</i> = 273) of eligible patients underwent ID screening, with 80.6% (<i>n</i> = 220) found to have ID. Following the implementation of the PLP, screening rates significantly increased to 86.4% (<i>n</i> = 133) (<i>p</i> = 0.03), with 53.4% (<i>n</i> = 71) diagnosed with ID. The rate of IV iron replacement in ID patients improved from 30.4% (<i>n</i> = 67) in the pre-PLP group to 73% (<i>n</i> = 52) in the post-PLP group (<i>p</i> &lt; 0.001). Multivariable logistic regression identified baseline glomerular filtration rate (GFR) and hemoglobin levels as significant predictors of IV iron replacement in the pre-PLP cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Implementing a pharmacist-led protocol was significantly associated with enhancing the screening and treatment of ID in patients with HF and LVEF &lt;45%. This study demonstrates the crucial role of pharmacists in optimizing guideline-directed therapies, which can be replicated in various healthcare settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 3","pages":"182-191"},"PeriodicalIF":1.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.2081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632657","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":"Impact of continuous glucose monitoring in underserved adults with type 2 diabetes within the United States: A scoping review","authors":"Martha Ndungu Pharm.D.,&nbsp;R. Oluwafunmito Babalola Pharm.D.,&nbsp;Melissa Brand MSIS,&nbsp;Ravi Patel Pharm.D.","doi":"10.1002/jac5.2078","DOIUrl":"https://doi.org/10.1002/jac5.2078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Continuous glucose monitoring (CGM) has improved diabetes management but remains underused among low-income populations who have a higher diabetes prevalence. With the additional consideration of socioeconomic factors limiting resources to maintain health, further understanding of the effectiveness of CGM in marginalized patients is needed. This scoping review synthesizes evidence on health outcomes impacted by CGM use in adults with type 2 diabetes mellitus (T2DM) receiving care in low-income settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PRISMA-ScR guidelines were used to identify studies through PubMed, Embase, and CINAHL. A search strategy combined MeSH terms and keywords reviewing titles and abstracts. The review included English-language studies using CGM from inception to May 2024; participants 18 years or older with T2DM, and with the majority of patients meeting the pre-defined low-income status or the study being conducted in a pre-defined low-income setting. Studies in pregnant patients, meta-analyses, and systematic reviews were excluded. Two reviewers independently performed study selection, data extraction, and quality assessment. The authors received no financial support for this research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The review identified 1176 studies, with 198 duplicates, resulting in 978 screened titles and abstracts. Forty-six studies underwent full text review, and 31 were excluded. Ultimately, 15 studies (5 abstracts, 9 manuscripts, and 1 case report) met the review criteria. CGM use led to reductions in hemoglobin A1C levels across settings such as Federally Qualified Health Centers, clinics serving the underinsured, county health departments, and rural clinics. Other benefits included reduced hypoglycemia, improved glucose levels, and increased time in range.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Studies described showed an improvement in diabetes-related clinical outcomes with CGM use in low-income patients. Limited amount of data in the studies was the main limitation of this review. Insights highlight the need for research on interventions to enhance CGM access and address barriers to promote health equity in underserved populations, especially as CGM becomes available over the counter.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 2","pages":"149-162"},"PeriodicalIF":1.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.2078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456105","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":"What we have learned from trying to remove oral phenylephrine from the market","authors":"Randy C. Hatton Pharm.D., FCCP,&nbsp;Leslie Hendeles Pharm.D., FCCP","doi":"10.1002/jac5.2080","DOIUrl":"https://doi.org/10.1002/jac5.2080","url":null,"abstract":"<p>A 2023 United States Food and Drug Administration (FDA) Nonprescription Drug Advisory Committee unanimously voted that oral phenylephrine is not Generally Recognized As Safe and Effective (GRASE). This decision resulted, in part, from our nearly 20 years as clinical pharmacists advocating for patients with nasal congestion. As a result, the FDA recently posted a proposal to remove oral phenylephrine from the market, and the American College of Clinical Pharmacy (ACCP) has been a key stakeholder supporting the removal of oral phenylephrine from the market. ACCP members are encouraged to submit comments to the FDA regarding the market status of oral phenylephrine. In this article, we describe the role of a Freedom of Information request for unpublished data, our systematic review and meta-analysis of the data upon which the FDA relied to approve oral phenylephrine, our two Citizen Petitions, and modern data, including an unpublished study from clinicaltrials.gov.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 3","pages":"214-223"},"PeriodicalIF":1.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633126","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":"Integrating continuous glucose monitoring into Doctor of Pharmacy curricula","authors":"Kathryn Litten Pharm.D.,&nbsp;Heather Folz Pharm.D.,&nbsp;Alison Lobkovich Pharm.D.,&nbsp;Christina H. Sherrill Pharm.D.,&nbsp;Helen Berlie Pharm.D.","doi":"10.1002/jac5.2076","DOIUrl":"https://doi.org/10.1002/jac5.2076","url":null,"abstract":"<p>The use of digital health technology is on the rise. Within diabetes care, continuous glucose monitoring (CGM) is transforming how we monitor and manage patients with diabetes. Pharmacists play pivotal roles in CGM education, accessibility, utility, and application. In turn, pharmacy students should have a working knowledge of these devices. Currently, CGM inclusion in Doctor of Pharmacy (Pharm.D.) curricula is variable, and little is known about the best way to incorporate this content. This article highlights the critical need to intentionally integrate CGM into didactic and experiential teaching. Incorporating CGM education should be individualized to the institution and the level of the trainee. Educational approaches such as patient cases and hands-on activities can enhance CGM-related knowledge, skills, confidence, and empathy, which may empower trainees to be practice-ready and provide essential CGM services after graduation. This guide will provide a suggested framework for integrating CGM into Pharm.D. curricula.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 2","pages":"129-135"},"PeriodicalIF":1.3,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.2076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455815","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":"Implementation of a pharmacist-driven continuous glucose monitoring program within an American Indian/Alaska Native community","authors":"DeAnne L. Udby Pharm.D.,&nbsp;Dena K. Smith Pharm.D.,&nbsp;Nicholas Cushman Pharm.D.,&nbsp;Mary Vue B.S.,&nbsp;David Reyes-Gastelum M.S.,&nbsp;Austin Klapperich Pharm.D.,&nbsp;Tori Ohman Pharm.D.,&nbsp;Alyssa J. Hromika Pharm.D.,&nbsp;Emily R. Mackler Pharm.D.","doi":"10.1002/jac5.2075","DOIUrl":"https://doi.org/10.1002/jac5.2075","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Ambulatory care pharmacists can help overcome systemic barriers in diabetes management for American Indians and Alaska Natives (AI/AN) by facilitating the adoption and management of continuous glucose monitoring (CGM) technology. Despite the proven clinical benefits of CGM, its use in AI/AN populations remains limited and underexplored. The aim of this study was to evaluate the impact of a pharmacist-driven CGM program on glycemic control in AI/AN patients with diabetes and to characterize the implementation of the intervention in clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a retrospective, single-center, observational study using data from a pharmacist-driven CGM program at a rural, Indian Health Service, ambulatory health center in the midwestern United States serving AI/AN individuals. The study included a pilot phase with a matched-cohort design and a subsequent post-pilot implementation. Participants in the intervention group received comprehensive CGM education and management from clinical pharmacists, with follow-up visits for 6 months. The primary outcome was the change in hemoglobin A1c (HbA1c) levels, analyzed using multilevel linear regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the pilot phase, 79% of the intervention group achieved a 1% reduction in HbA1c at 6 months, with an average reduction of 2%. The control group showed no significant change (<i>p</i> = 0.032 for CGM vs. control arms). Post-pilot implementation maintained these improvements, with a mean HbA1c reduction of 1.5% in a larger patient cohort (<i>p</i> &lt; 0.001 for pre- vs. post-CGM implementation). Patient confidence in managing diabetes and satisfaction with care also increased.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Implementing a pharmacist-driven CGM program in AI/AN communities can address health care disparities and improve diabetes outcomes. This model holds promise for broader application in managing chronic diseases in underserved populations, highlighting the critical role of pharmacists in interdisciplinary health care teams. Further research should focus on long-term outcomes and economic impacts to support the widespread adoption of this approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 2","pages":"98-107"},"PeriodicalIF":1.3,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.2075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455843","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":"Teaching experiences in pharmacy residency","authors":"Jennifer N. Clements Pharm.D., FCCP,&nbsp;Katie McClendon Pharm.D., FCCP,&nbsp;Jill Borchert Pharm.D., FCCP,&nbsp;Stephanie R. L. Ciapala Pharm.D.,&nbsp;Lindsay A. Courtney Pharm.D.,&nbsp;Jamessa Cummings Pharm.D.,&nbsp;Julianne M. Fallon Pharm.D.,&nbsp;Megan Kunka Fritz Pharm.D.,&nbsp;Caitlin M. Gibson Pharm.D., MEd,&nbsp;Alex N. Isaacs Pharm.D., M.S.,&nbsp;Emily N. Israel Pharm.D.,&nbsp;Peter Johnson Pharm.D.,&nbsp;Abby Krauter Pharm.D.,&nbsp;Aubrey R. Stolte","doi":"10.1002/jac5.2066","DOIUrl":"https://doi.org/10.1002/jac5.2066","url":null,"abstract":"<p>Postgraduate pharmacy residencies equip trainees with advanced clinical skills for patient care and prepare them for specialized roles in their careers. Teaching is a core responsibility for most pharmacists, yet postgraduate residency training often lacks standardization in teaching and learning experiences. The American Society of Health-System Pharmacists (ASHP) provides residency accreditation standards; however, the activities related to teaching objectives may lack consistency across institutions and programs. The 2024 American College of Clinical Pharmacy (ACCP) Publications Committee updated a previous publication on standardized teaching experiences for all residencies and programs offering a teaching certificate or other teaching experiences. The current paper highlights information and activities for residency programs to promote diverse teaching experiences, including the introduction of a tier system. Postgraduate pharmacy residencies should adopt these guidelines to offer consistent teaching experiences with personalization for trainees. Residents should also inquire about the teaching components of programs to choose the best fit for their career goals. There should be a balance between standardization and flexibility in teaching experiences to prepare residents for diverse roles in clinical practice or academia.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 1","pages":"62-69"},"PeriodicalIF":1.3,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143115727","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":"Not just a collection of papers","authors":"Stuart T. Haines Pharm.D., FCCP","doi":"10.1002/jac5.2065","DOIUrl":"https://doi.org/10.1002/jac5.2065","url":null,"abstract":"","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 1","pages":"4-5"},"PeriodicalIF":1.3,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143115729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Pharmacists should be held to high standards, not hindered by bright-line rules”","authors":"Alex J. Adams Pharm.D., MPH","doi":"10.1002/jac5.2068","DOIUrl":"https://doi.org/10.1002/jac5.2068","url":null,"abstract":"","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 1","pages":"70"},"PeriodicalIF":1.3,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143115728","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":"If we build it, will they come? Exploring feasibility of community pharmacy diabetes care services","authors":"Wesley Nuffer Pharm.D.,&nbsp;Deborah Gallegos Pharm.D.,&nbsp;Andrea Segerstrom-Nunez Pharm.D.,&nbsp;Kelsey Schwander Pharm.D.","doi":"10.1002/jac5.2074","DOIUrl":"https://doi.org/10.1002/jac5.2074","url":null,"abstract":"<p>Pharmacists have been well established for their role in diabetes care services, both in improving patient health outcomes as well as decreasing overall costs of care. The community pharmacy environment is currently challenging, and there are efforts to transform these practices to become more patient-centered. There are two standardized programs, the diabetes self-management education and support program and the national diabetes prevention program, that are available for pharmacists to deliver in the community setting. These programs offer some revenue generation for services but pose some challenges in their delivery as well. Exploring facilitators and barriers to these programs, and to diabetes care services in general, with a focus on community pharmacy practice, is important. Revenue generation needs to offset personnel cost and justify the resources dedicated to expand community practice beyond traditional dispensing. Further payer reform, likely with integrating medical billing, is essential for further progress to be made in this area.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 2","pages":"141-148"},"PeriodicalIF":1.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.2074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455953","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}