Journal Of The American Pharmacists Association[JOURNAL]
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200 papers
Scaling the primary care pharmacist: Evaluating the long-term impact of a pharmacist primary care certificate training program.
Frederick KD, Troy J, Hohmeier KC … +1 more , Wheeler J
J Am Pharm Assoc (2003) · 2026 · PMID 41130411 · Publisher ↗
BACKGROUND: In 2021, a Pharmacist Primary Care Certificate Training Program was launched at the University of Tennessee Health Science Center College of Pharmacy. Over the first 3 years and 6 cohorts, 44 pharmacists comp...
BACKGROUND: In 2021, a Pharmacist Primary Care Certificate Training Program was launched at the University of Tennessee Health Science Center College of Pharmacy. Over the first 3 years and 6 cohorts, 44 pharmacists completed the program. At program completion, short-term data showed that 97.73% of learners either partially or fully achieved self-identified SMART goals; however, practice change and long-term impact was unknown. OBJECTIVE: To assess the long-term impact of the Pharmacist Primary Care Certificate Training Program. METHODS: This mixed methods study applied the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework to assess the program's Maintenance domain, including pharmacist-reported job satisfaction and marketability, primary care knowledge and skills, practice change, patient outcomes, and goal achievement. Data were collected via web-based survey and semistructured interviews. All pharmacists who completed the program (n = 44) were invited to participate, ranging from 3 months to 2 years postprogram completion. Survey data was analyzed via descriptive statistics. Interviews were analyzed using inductive thematic analysis. RESULTS: Nineteen pharmacists participated in the survey. Participants reported improved primary care knowledge, skills, confidence, and job marketability, and positive impact on patient outcomes and practice change. Key factors influencing long-term impact and sustainability of the program included time, organizational resources and support, billing and reimbursement of services, and physician buy-in for collaborative practice. Ten pharmacists participated in interviews between May and June 2024. Five themes were identified: Internal Facilitators and Barriers, External Facilitators and Barriers, Impact on Pharmacists Professional Advancement, Impact of Pharmacy Practice and Patient Outcomes, and Certificate Program Components that Influence Impact. CONCLUSION: The Pharmacist Primary Care Certificate Training Program equipped pharmacists with the perceived skills, network, and confidence necessary to practice in outpatient primary care and be more competitive in the job market. However, there are specific barriers that influence long-term program impact, suggesting opportunities for practice transformation and further research.
Mapping the U.S. literature on pharmacists prescribing to initiate medications: A scoping review of terminology, responsibilities, and alignment with international models.
Ahmed S, Kung J, Chiang V … +6 more , Poudel A, Olufemi-Yusuf D, Faruquee CF, Makowsky M, Nissen L, Guirguis L
J Am Pharm Assoc (2003) · 2026 · PMID 41115463 · Publisher ↗
BACKGROUND: Pharmacists play a greater role in patient-centred care, particularly in prescribing to initiate medications. In the United States, pharmacist prescribing evolved to meet healthcare challenges, although state...
BACKGROUND: Pharmacists play a greater role in patient-centred care, particularly in prescribing to initiate medications. In the United States, pharmacist prescribing evolved to meet healthcare challenges, although states vary in prescribing models, pharmacists' responsibilities, and terminology. A literature review is necessary to capture and compare pharmacist practices in prescribing to initiate medications across the United States. OBJECTIVES: This review aims to 1) characterize US prescribing terminology and pharmacists' responsibilities when initiating medication under various U.S. prescribing models, and 2) map the U.S. literature on pharmacists' initiating medication to the international context. METHODS: The study employed Arksey and O'Malley's scoping review framework and adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews. Ovid MEDLINE, Ovid Embase, and CINAHL were searched from 2000 to 2024. Eligible studies were included if they examined pharmacists initiating medication across diverse practice settings and prescribing models. Two independent reviewers conducted screening and data charting. The terminology and pharmacists' responsibilities when initiating medication (i.e., recognizing symptoms/diagnosis, selecting, supplying, and monitoring medications) under U.S. prescribing models were examined and categorized using international pharmacist prescribing models. RESULTS: Out of 92 studies, terminology describing pharmacist-initiated medication models varies widely, from formal legislative language to informal and broadly used descriptions. Most studies (n = 58) reported 3 of 4 pharmacist responsibilities, with diagnosing symptoms (n = 85) and selecting medication (n = 88) the most commonly reported. When using the international pharmacist prescribing models, prescribing by protocol (n = 77) was dominant, followed by independent prescribing in the Veterans Health Administration (n = 9) and formulary prescribing in Idaho state (n = 2). CONCLUSION: This review has uniquely mapped the U.S. literature on pharmacists initiating medication to the international context, highlighting variation in prescribing terminology and responsibilities. The findings underscore the need for a standardized reporting guide with clear terminology and definitions of pharmacist prescribing responsibilities to facilitate meaningful international comparisons.
New Mexico community pharmacists' knowledge and perspectives of mifepristone and misoprostol for early pregnancy loss.
Herman A, Trujillo VY, Krashin JW … +1 more , Gallegos Aragon K
J Am Pharm Assoc (2003) · 2026 · PMID 41109673 · Publisher ↗
BACKGROUND: Early pregnancy loss (EPL) is common, affecting approximately 25% of pregnancies. Medication management with mifepristone and misoprostol allows patients to choose a nonprocedural option for management. While...
BACKGROUND: Early pregnancy loss (EPL) is common, affecting approximately 25% of pregnancies. Medication management with mifepristone and misoprostol allows patients to choose a nonprocedural option for management. While pharmacy access to reproductive health care such as contraception has expanded in recent years, access to care for other reproductive health care such as EPL in community pharmacies remains limited due to barriers such as Food and Drug Administration Risk Evaluation and Mitigation Strategies (REMS). OBJECTIVES: The objective of this study was to explore New Mexico community pharmacists' experiences, knowledge, and perspectives on pharmacy access to mifepristone and misoprostol for the management of EPL in order to elucidate strategies for expanding access to EPL care. METHODS: This qualitative study utilized semi-structured phone interviews with pharmacists practicing in the community in rural and urban areas of New Mexico. Interviews were transcribed verbatim and underwent thematic analysis by 2 independent coders using Dedoose software (dedoose.com). RESULTS: The majority of pharmacists had experience and were confident in dispensing misoprostol and expressed willingness to dispense mifepristone if current REMS criteria were removed or amended. Pharmacists rated themselves as knowledgeable about misoprostol, with most reporting no or limited familiarity with mifepristone and current guidelines for treatment of EPL. Pharmacists saw themselves in an important role supporting and providing medication counseling for patients experiencing EPL but reported that barriers such as corporate policies, limited availability of qualified prescribers, including obstetrician-gynecologists, in their communities, and lack of training could limit access to medications for EPL. CONCLUSION: New Mexico community pharmacists are supportive of pharmacy access to misoprostol and mifepristone for EPL management, and are interested in more training to increase their knowledge and confidence in providing care for patients experiencing EPL. Further research is needed, particularly in other states, to better understand broader implementation challenges.
Equipping the front lines: Building a harm reduction program for Louisiana first responders.
Horace AE, Below J, Brown A … +1 more , Hill S
J Am Pharm Assoc (2003) · 2026 · PMID 41109672 · Publisher ↗
INTRODUCTION: The opioid epidemic remains a critical U.S. public health crisis. While overdose education for first responders is well-documented, it covers only part of the broader harm reduction (HR) framework. The Univ...
INTRODUCTION: The opioid epidemic remains a critical U.S. public health crisis. While overdose education for first responders is well-documented, it covers only part of the broader harm reduction (HR) framework. The University of Louisiana Monroe Harm Reduction Education and Referral for Opioid Overdose Reversal (ULM HERO) Program was created to expand HR education among Louisiana first responders. OBJECTIVE: To evaluate participant satisfaction with the ULM HERO training program and to explore insights from its implementation. Understanding how first responders receive and respond to in-person HR education provided by pharmacists is essential for informing future HR initiatives in underserved regions. METHODS: This study used a descriptive cross-sectional design to evaluate participant feedback following a single-session educational intervention. First responders participated in 2-hour HR training sessions held from April 2023 to July 2025. Attendees completed demographic surveys and postcourse evaluations, which included multiple-choice and Likert-scale items assessing satisfaction with the content, instructional effectiveness, and willingness to refer individuals to treatment. A series of logistic regressions were used to determine the relationship between subgroups of respondents and the evaluation questions. RESULTS: Among the respondents, the majority were law enforcement officers (74.5%, n = 741/860) identified as white (64.5%, n = 474/732) and male (79.8%, n = 648/812) with an average age of 39 years. Satisfaction with the educational content was high at 88.3% (n = 588/666) of respondents. Furthermore, 87.8% (n = 574/654) expressed a willingness to refer someone to treatmentrecovery services. The analysis of the subgroup parish of jurisdiction showed respondents from Ouachita Parish to be the most receptive to the program. CONCLUSION: The ULM HERO program was well received and associated with improved knowledge, satisfaction, and willingness to engage in HR practices. Findings support the value of structured HR education for first responders.
Access to syringes at pharmacies (ASAP): Preliminary impact of a pharmacy-level intervention.
Meyerson BE, Linde-Krieger LB, Agley J … +3 more , Vadiei N, Crosby RA, Bentele KG
J Am Pharm Assoc (2003) · 2026 · PMID 41109671 · Full text
BACKGROUND: Community pharmacies are important access points for services to reduce bloodborne illnesses (BBIs) like HIV and Hepatitis C. However multiple barriers limit pharmacy provision of these services, including st...
BACKGROUND: Community pharmacies are important access points for services to reduce bloodborne illnesses (BBIs) like HIV and Hepatitis C. However multiple barriers limit pharmacy provision of these services, including stigma toward people who use drugs (PWUD) and staff discomfort with harm reduction practices. OBJECTIVE: This study evaluated a pharmacy-level intervention called Access to Syringes at Pharmacies (ASAP) designed to increase nonprescription syringe sales and reduce stigma. METHODS: A one-armed pilot study was conducted with 18 staff of 3 community pharmacies located in 3 different Arizona counties from January to April 2022. Data were collected through monthly surveys measuring staff comfort with selected harm reduction practices and stigma toward PWUD. Ecological momentary assessment tracked dispensing behaviors. Linear mixed effects models with bootstrapping analyzed changes over time. RESULTS: All 3 pharmacies reported selling syringes without a prescription during the study period, with variation in number of sales events between the pharmacies. The number of pharmacy staff who reported "always" dispensing syringes without a prescription increased from 44.4% at baseline to 77.8% by study end. Comfort with harm reduction practices increased significantly immediately following training (β = 0.39). Stigma scores decreased significantly both immediately post-training (β = -0.41) and at study end (β = -0.34). Throughout the intervention, higher stigma scores were consistently associated with lower likelihood of syringe dispensing (r > -0.45). CONCLUSIONS: The ASAP intervention provides reason for optimism for effective pharmacy-based education to increase nonstigmatized syringe dispensing to reduce BBIs and infections. Future studies should evaluate ASAP in a larger, controlled trial across diverse pharmacy settings to establish causal relationships and optimize implementation strategies.
What is important to them? Occupational values of nationally certified pharmacy technicians in role expansion.
Sparkmon W, Barnard M, Rosenthal M … +4 more , Desselle S, Ballou JM, Cullen-Leste KL, Holmes ER
J Am Pharm Assoc (2003) · 2026 · PMID 41106475 · Publisher ↗
BACKGROUND: Pharmacy technicians are currently presented with more opportunities to expand their scope of practice. Many states have expanded technician scope of practice to ease the work burdens currently being placed o...
BACKGROUND: Pharmacy technicians are currently presented with more opportunities to expand their scope of practice. Many states have expanded technician scope of practice to ease the work burdens currently being placed on pharmacists, enhancing the role of technicians. This has led to more research into the benefits increasing the utilization of technicians in pharmacy practice. However, technician uptake of these expanded roles varies in many states permitting expanded scope of practice. OBJECTIVES: The objective of this study was to build a baseline understanding of which occupational values are important to pharmacy technicians. METHODS: This study employed a cross-sectional, descriptive design using an online survey distributed to a convenience sample of nationally certified pharmacy technicians. Demographics and the perceived importance of 9 occupational values, each of which were classified as intrinsic or extrinsic in nature, were collected on a 5-point linear numeric scale. Mean scores were calculated for each of the 9 values, as well as for intrinsic and extrinsic values overall. RESULTS: Our study found that all 9 measured values were above average importance to technicians. Pharmacy technicians, regardless of setting, were seen to place a higher importance on extrinsic values than intrinsic values. In particular, the organizational values of the salary of the job, the job security and hours, and the ability to help others were the most important to technician. In addition, the mean scores of extrinsic and intrinsic values were with 0.1 of each other on a 5-point linear numeric scale. CONCLUSION: The motivations of pharmacy technicians appear to generally be both intrinsic and extrinsic in nature. Therefore, pharmacists must consider both forms in attempting to motivate their technicians.
Integrating trauma-informed care into ambulatory settings: A practical approach.
Gallimore C, Garling KA
J Am Pharm Assoc (2003) · 2026 · PMID 41106474 · Publisher ↗
BACKGROUND: Outpatient pharmacy settings, such as ambulatory care clinics, serve patients by addressing their medical needs and providing longitudinal pharmacy health care services within their communities. In the United...
BACKGROUND: Outpatient pharmacy settings, such as ambulatory care clinics, serve patients by addressing their medical needs and providing longitudinal pharmacy health care services within their communities. In the United States, approximately 83% of people have experienced a traumatic event in their lifetime, and these exposures can significantly impact their long-term health outcomes. Trauma-informed care (TIC) is an approach to health care that recognizes and responds to the impact of trauma on individuals in ways that promote healing and recovery and avoid re-traumatization. OBJECTIVES: This article aims to guide ambulatory care pharmacists on implementing trauma-informed care (TIC) to improve patient outcomes. METHODS: This guidance includes how to recognize signs and symptoms of trauma, navigate trauma disclosures, build trust with survivors through trauma-informed communication, and report abuse in a pharmacy ambulatory care setting, highlighting the crucial role of pharmacists in this process. RESULTS: Trauma-informed practices and care in ambulatory settings are not just important but essential due to the ongoing nature of care and the management of chronic health conditions in patients who have experienced trauma, underscoring the significance of pharmacists' roles in patient care. Although the Substance Abuse and Mental Health Services Administration has outlined TIC approaches, there is a gap in training within the Doctor of Pharmacy program and a lack of published literature on using TIC in specific settings. CONCLUSION: The effective use of TIC in ambulatory care settings can significantly improve patient care and, ultimately, patient health outcomes, making pharmacists an integral part of the health care process.
Characterization of medication refill models in U.S. ambulatory care: A scoping review of program types, barriers, and facilitators.
Hincapie AL, Schlosser EG, Auteri L … +1 more , Llambi L
J Am Pharm Assoc (2003) · 2026 · PMID 41101564 · Publisher ↗
BACKGROUND: Programs for prescription refill authorization have been implemented within ambulatory care improving work efficiency; however, the breadth of evidence related to their characteristics and outcomes is unknown...
BACKGROUND: Programs for prescription refill authorization have been implemented within ambulatory care improving work efficiency; however, the breadth of evidence related to their characteristics and outcomes is unknown. The primary aim of this scoping review was to describe the characteristics and outcomes of medication refill programs in ambulatory care in the United States. Additionally, barriers and facilitators of implementing these programs were assessed. METHODS: This review was conducted following the Joanna Briggs Institute guidelines. Published abstracts and articles from 2010 through March 2025 were included if they described medication refill programs implemented in ambulatory care in the U.S. PubMed, Embase, CINHAL, and Web of science databases and gray literature were searched. Study descriptive characteristics are reported. The qualitative data were analyzed using thematic analysis. RESULTS: A total of 2449 citations were assessed, and 25 studies were included in the review. Two overarching refill model types were reported. First, single-office models that typically manage low volumes of prescriptions and often focus on a narrow disease group. Second, there were centralized models featuring high levels of automation and protocol use, serving many clinical offices. Most studies reported prescription refill volume as an outcome. Seven themes captured barriers and facilitators related to the implementation of medication refill models. CONCLUSION: This scoping review identified a variety of medication refill models implemented in U.S. ambulatory care settings. These models supported diverse organizational configurations and made extensive use of electronic medical records to streamline processes. Notably, pharmacists played a central role in the majority of most of these programs, highlighting their critical contribution to effective medication management and patient care in this setting. Barriers to program implementation related to professional role negotiation and resistance were reported. Facilitators such as the use of automatic refill protocols, workflow integration, and use of centralization supported the implementation.
The role of the pharmacist in health care nongovernmental organizations (NGOs): Perspectives from key informant interviews.
Shagavah S, Connor S, Jonkman L … +3 more , Spielberger M, Isaac J, Ndung'u M
J Am Pharm Assoc (2003) · 2026 · PMID 41093106 · Publisher ↗
BACKGROUND: Nongovernmental organizations (NGOs) are essential in global health, providing healthcare delivery, socio-economic support, and community empowerment for the populations they serve. Pharmacists' involvement i...
BACKGROUND: Nongovernmental organizations (NGOs) are essential in global health, providing healthcare delivery, socio-economic support, and community empowerment for the populations they serve. Pharmacists' involvement in health-mission focused NGOs is often underrecognized and less defined. OBJECTIVE: This study explores how pharmacists working in global health NGOs perceive their roles, contributions, and professional experiences, to better understand their value in humanitarian settings. METHODS: This qualitative study utilized semi-structured interviews to elicit the perspectives of pharmacists working in multilateral, health-focused NGOs. Each interview, conducted remotely, was audio-recorded and transcribed verbatim. Using content analysis, the research team developed a codebook using the data and each interview was independently coded by the primary investigator and a co-investigator manually. Key themes from the analysis of the interviews informed the discussion. RESULTS: Eight interviews were conducted, representing pharmacists from 5 multinational NGOs. From the interviews, pharmacists identified roles in administration, supply chain management and both direct and indirect patient care. Beyond these roles, pharmacists indicated that their value was rooted in specific skills and attributes deemed important including adaptability, flexibility, continuous learning and growing, networking within and outside of the organization, and a strong sense of responsibility for the NGO's outcomes. CONCLUSION: Pharmacists contribute to the effectiveness of health-focused NGOs through diverse responsibilities and adaptable roles that extend beyond medication management. This study provides a foundational description of how pharmacists working in multinational NGOs perceive their roles, contributions, and professional experiences. Findings highlight key responsibilities, attributes needed for success, and challenges faced in humanitarian contexts, offering a baseline for recognizing pharmacists' value in global health and informing them of their preparation for future NGO service.
Letter to the Editor on: Addressing pharmacy access in a landscape of pharmacy closures.
Chatzipanagiotou OP, Pawlik TM
J Am Pharm Assoc (2003) · 2026 · PMID 41077350 · Publisher ↗
Abstract loading — click title to view on PubMed.
Interventions to improve primary medication nonadherence: A scoping review.
Leong NI, Maharjan S, Nasruddin SZ … +3 more , Gandy C, Strum DW, Yang Y
J Am Pharm Assoc (2003) · 2026 · PMID 41072614 · Publisher ↗
BACKGROUND: Primary medication nonadherence is a multifaceted problem that leads to poor health outcomes. Various interventions have been studied to improve primary nonadherence across different populations and/or diseas...
BACKGROUND: Primary medication nonadherence is a multifaceted problem that leads to poor health outcomes. Various interventions have been studied to improve primary nonadherence across different populations and/or disease areas. However, there is no comprehensive review to understand the scope and depth of available evidence on intervention effectiveness. OBJECTIVE: This study aims to examine recent literature on interventions designed to improve primary medication nonadherence. METHODS: An electronic search of CINAHL, Cochrane Central, Embase, ProQuest, PsycINFO, PubMed, and Scopus was conducted for relevant literature up to July 2025. Articles published in English since 2000 and focused on interventions to improve primary medication nonadherence were included. The Health Pyramid Framework and the Template for Intervention Description and Replication were used for data extraction. RESULTS: Forty articles published after 2000 were included in this review. Thirty-two studies were conducted in the US. Study settings included ambulatory care clinic, inpatient, outpatient, emergency department, and pharmacy. Eighteen studies focused on cardiovascular diseases/medications. Interventions were classified as clinical intervention (n = 6, 15%), patient counseling and education-related (n = 23, 57.5%), and socioeconomics-related (n = 11, 27.5%). Intervention types included national statutory amendments (n = 2, 5%), face-to-face education (n = 4, 10%), hybrid education (n = 3, 7.5%), e-prescribing (n = 6, 15%), patient assistance provided by manufacturers (n = 9, 22.5%), and virtual reminders or education (n = 16, 40%). Most counseling and education-related interventions (n = 13, 32.5%) were conducted by pharmacists. Primary nonadherence was measured using prescription abandonment, failure to initiate medications or reversed claims. Interventions (n = 9, 22.5%) involving face-to-face or hybrid counseling by pharmacists and interventions (n = 10, 25%) that lowered out-of-pocket costs were found to be effective in improving primary nonadherence. CONCLUSION: Various strategies have been employed across different health care settings and patient populations to improve primary medication nonadherence; their effectiveness varied significantly. Face-to-face or hybrid counseling by pharmacists or nurses has been shown to be effective in improving primary nonadherence.
Implementation of a protocol for postcesarean delivery oral cephalexin and metronidazole to prevent surgical site infection in patients with BMI≥30 kg/m.
Denninger J, McNeil K, Herman M … +3 more , Bos A, Wilson K, Herman A
J Am Pharm Assoc (2003) · 2026 · PMID 41072613 · Publisher ↗
BACKGROUND: Cesarean-section surgical site infections (SSIs) are the leading cause of postcesarean complications. Few studies have examined postcesarean antibiotic prophylaxis in patients with obesity (Body mass index >3...
BACKGROUND: Cesarean-section surgical site infections (SSIs) are the leading cause of postcesarean complications. Few studies have examined postcesarean antibiotic prophylaxis in patients with obesity (Body mass index >30 kg/m or greater) in a real-world setting. OBJECTIVES: The aim of this study was to evaluate the implementation of a postcesarean oral cephalexin and metronidazole antibiotic prophylaxis protocol for patients with obesity, describe clinical outcomes in these patients, and describe the pharmacist's role in protocol implementation. METHODS: An interdisciplinary team, including a pharmacist, developed this protocol for post-cesarean antibiotic prophylaxis. The pharmacist later implemented the order sets and screened patients to recommend prophylaxis. We conducted a single center, retrospective cohort study comparing SSI outcomes of patients with obesity at 60-days who received 48-hours of antibiotic prophylaxis with oral cephalexin and metronidazole to patients who received standard of care. RESULTS: Of 397 patients, 202 received 48-hour antibiotic prophylaxis, 41 received partial antibiotic prophylaxis, and 154 did not receive postcesarean antibiotic prophylaxis in addition to standard of care. At 60 days postcesarean, SSIs were significantly lower in the 48-hour prophylaxis group compared to standard of care (7.9% vs. 11%, P = 0.004). There was not a significant reduction in SSIs (9.4% vs. 11%, P = 0.114) when including patients who received partial antibiotic prophylaxis. Higher BMI was associated with an increased risk of infection. When controlling for BMI, patients not receiving prophylactic antibiotics had an increased incidence of SSI (adjusted OR = 2.62, 95% CI; 1.122-6.132). There were no hospital readmissions for patients who received prophylaxis compared to 3.2% (n = 5) patients who did not. CONCLUSION: Postcesarean antibiotic prophylaxis with oral cephalexin and metronidazole for 48 h in patients with obesity was associated with reduced incidence of SSI within 60 day follow up. Pharmacists play a key role in the implementation of protocols which can improve patient outcomes.
"The crux of the community": A qualitative focus group study of the impact of community pharmacy closures in Colorado and Utah.
DiStefano MJ, Chen NC, Asche CV … +2 more , Anderson KE, Mattingly TJ
J Am Pharm Assoc (2003) · 2026 · PMID 41072612 · Publisher ↗
BACKGROUND: Community pharmacies are critical access points for health care in the United States, especially for underserved populations. However, a substantial number of recent pharmacy closures have been widely documen...
BACKGROUND: Community pharmacies are critical access points for health care in the United States, especially for underserved populations. However, a substantial number of recent pharmacy closures have been widely documented. Pharmacies at greater risk of closure are typically found in urban areas, are independently-owned businesses, and disproportionately serve low-income populations. While prior research has quantitatively assessed the impact of pharmacy closures on medication adherence and geographic access, less is known about the broader impacts of pharmacy closures on communities, pharmacy operations, pharmacy staff, and patients. OBJECTIVE: To qualitatively describe the impacts of community pharmacy closures in Colorado and Utah on communities, pharmacy operations, pharmacy staff, and patients from the perspective of pharmacists and technicians. METHODS: We conducted three semistructured focus groups in September and October 2024 with 13 participants who had experienced a community pharmacy closure in Colorado or Utah within the previous 6 years. Focus group transcripts were analyzed using a mixed deductive-inductive approach to identify major themes. RESULTS: Closures negatively impacted communities by creating pharmacy deserts, harming local economies, and complicating workforce recruitment beyond the pharmacy industry. Increased prescription volume, staffing challenges, and operational stress at remaining pharmacies disrupted pharmacy operations. Staff described emotional and psychological tolls, including stress, burnout, and regret over career choices, as well as job loss and increased competition for available positions. Closures also impacted patients by increasing wait times, disrupting continuity of care, and disproportionately affecting vulnerable populations such as those without transportation, older adults, and individuals requiring controlled substances. CONCLUSION: Pharmacy closures have far-reaching consequences that extend beyond access to medications, affecting the social and economic fabric of communities and the overall well-being of both pharmacy staff and patients. These findings can inform future research and policy efforts aimed at mitigating the negative impacts of closures and promoting equitable access to pharmacy services.
Contextual factors affecting implementation of Medicaid billing for community-based pharmacist services in Virginia: A qualitative study.
Amayreh R, Shah S, Goode JK … +4 more , Thomson M, Pontinha VM, Kaefer TN, Salgado TM
J Am Pharm Assoc (2003) · 2026 · PMID 41072611 · Publisher ↗
BACKGROUND: In 2023, Virginia mandated Medicaid payment for services provided by pharmacists under statewide protocols. Despite this legislative action, pharmacist registration as Medicaid providers remains limited, dela...
BACKGROUND: In 2023, Virginia mandated Medicaid payment for services provided by pharmacists under statewide protocols. Despite this legislative action, pharmacist registration as Medicaid providers remains limited, delaying access to expanded patient care services. OBJECTIVES: To identify contextual factors affecting pharmacist registration as Medicaid providers and implementation of Medicaid billing for patient care services in Virginia community-based pharmacies. METHODS: Semi-structured interviews were conducted with 16 community-based pharmacists between November 2024 and May 2025. The Consolidated Framework for Implementation Research 2.0 guided interview development and analysis. Interviews explored pharmacists' experiences with Medicaid provider registration, billing procedures, and implementation challenges. Recruitment continued until thematic saturation was achieved. Data analysis employed two-phase inductive and deductive coding, with 2 independent coders analyzing transcripts to ensure reliability. RESULTS: Procedural complexity, high implementation costs, and poor system design emerged as major barriers to Medicaid billing implementation in community-based pharmacies, despite recognition of the potential financial benefits (innovation domain). Complex regulatory requirements and financing issues limited perceived viability of the innovation (outer setting domain). Inadequate technical infrastructure, insufficient organizational resources (inner setting domain), and knowledge deficits (individual domain) were described as significant obstacles, with mission alignment serving as a facilitator (individual domain). Pharmacists demonstrated unfamiliarity with credentialing and billing processes, and lack of implementation opportunity, while patients' needs for affordable care access were recognized (individual domain). Implementation processes were consistently problematic across planning, strategy development, execution, and evaluation phases (implementation domain). CONCLUSIONS: Medicaid billing for pharmacist services remains in early stages of implementation in Virginia, with limited adoption among community-based pharmacists. Implementation barriers emerged across multiple domains including complex regulatory requirements, inadequate organizational support, and insufficient educational preparation. Targeted interventions addressing credentialing processes, technical infrastructure, and pharmacist education are essential to the implementation of Medicaid billing in pharmacists' clinical practice.
Trends in opioid use among adults with cardiovascular disease, 2001 - March 2020.
Han GE, Hwang AY
J Am Pharm Assoc (2003) · 2026 · PMID 41072610 · Publisher ↗
BACKGROUND: Opioids can cause adverse cardiovascular effects (e.g., hypotension, arrhythmias), which can be concerning in individuals with pre-existing cardiovascular disease (CVD). Currently, little is known regarding t...
BACKGROUND: Opioids can cause adverse cardiovascular effects (e.g., hypotension, arrhythmias), which can be concerning in individuals with pre-existing cardiovascular disease (CVD). Currently, little is known regarding the trends in opioid use among individuals with CVD. OBJECTIVE: To evaluate the long-term trends of prescription opioids among adults with CVD in the United States. METHODS: Using National Health and Nutrition Examination Survey data from 2001 to March 2020, adults ≥20 year old with ≥1 of the following CVDs - heart failure, coronary heart disease, angina, myocardial infarction, and stroke - were identified. Trends in the use of any, short-term (≤90 days), and long-term (>90 days) prescription opioids were evaluated. Subgroup analyses were conducted to test trends in any prescription opioid use by CVD types, pain-related comorbidities, and demographic/socioeconomic characteristics. Multivariable logistic regression, adjusted for age, was used to test the trends in 4-year examination periods. RESULTS: Among 6250 participants with CVD, no significant trends in the use of any prescription opioids were observed throughout the study period (9.4% in 2001-2004% to 11.8% in 2017-March 2020; P = 0.25). The prevalence of long-term prescription opioid use increased from 6.6% in 2001-2004% to 10.4% in 2017-March 2020, with a peak prevalence of 12.6% in 2013-2016 (P = 0.04). During the study period, an increase in the prevalence of any prescription opioid use was seen among individuals aged ≥65 years, from 7.5% in 2001-2004% to 11.3% in 2017-March 2020 (P = 0.006). CONCLUSION: Although overall prescription opioid use among participants with CVD remained relatively consistent between 2001 and March 2020, the use of long-term opioid prescriptions increased, possibly reflecting a growing burden of chronic pain in this population. Prescription opioid use also appeared to have increased among individuals aged ≥65 years, raising concerns due to their heightened risk of cardiovascular adverse effects from opioids.
The minivisit method: Adapting opioid-related educational outreach for community pharmacies.
Roberts MF, Freeman PR, Stinson LK … +2 more , Matson A, Walsh SL
J Am Pharm Assoc (2003) · 2026 · PMID 41067388 · Full text
Community pharmacists are well-positioned to contribute to public health initiatives related to prescription opioid safety and naloxone access, but many barriers, including gaps in knowledge and confidence, prevent them...
Community pharmacists are well-positioned to contribute to public health initiatives related to prescription opioid safety and naloxone access, but many barriers, including gaps in knowledge and confidence, prevent them from fully engaging with their patients and communities on these topics. The Kentucky site of the HEALing (Helping to End Addiction Long-term Initiative) Communities Study sought to involve community pharmacists in the effort to prevent opioid-related overdose deaths. Throughout the study, strategies to provide in-person educational outreach to community pharmacists were developed, implemented, and redesigned, resulting in a new format: the minivisit method. Minivisits are based on the principles of academic detailing but aim to more efficiently meet the needs of busy community pharmacists. Implemented by pharmacists for pharmacists, minivisits deliver key messages in brief, unscheduled visits to all community pharmacies in an identified geographic area. Paired with on-going support, high-quality printed materials, and in-depth continuing education activities, minivisits offer a promising alternative to traditional education formats. The minivisit method can be adapted to the goals, budget, and educational needs of a given program. This commentary details the trial-and-error process by which minivisits were developed and implemented and the key components of the minivisit method. The aim of this commentary is to inspire and inform future efforts to educate community pharmacists and expand practice to improve public health.
Erratum to "The public health impact of the Rx-to-OTC switch of triptan in Germany: Systematic review and framework analysis" [JAPH 65/5 (2025) 102489].
J Am Pharm Assoc (2003) · 2026 · PMID 41060379 · Publisher ↗
Abstract loading — click title to view on PubMed.
A descriptive study of systemic factors that affect ambulatory care pharmacists.
Parry E, Hursman A, Rubinstein E … +5 more , Thooft T, Johnson R, Ford J, Stevenson K, Lowe L
J Am Pharm Assoc (2003) · 2026 · PMID 41016432 · Publisher ↗
BACKGROUND: Ambulatory care pharmacists (ACPs) support patients and the health care team through clinical services such as patient education and comprehensive disease state management. Although multiple studies show the...
BACKGROUND: Ambulatory care pharmacists (ACPs) support patients and the health care team through clinical services such as patient education and comprehensive disease state management. Although multiple studies show the impact of ACPs on others, little research has been done on their own experiences. OBJECTIVES: This study aimed to learn from ACPs about their workplace experiences and identify systemic factors that affect their role as members of interprofessional health care teams. METHODS: This exploratory, qualitative study consisted of digitally recorded, semistructured interviews with ACPs. Interviews were transcribed and analyzed inductively and iteratively by a multidisciplinary research team to determine salient themes. RESULTS: Twenty-one pharmacists (10 in private health systems, 11 in public health systems) participated, 15 of whom described the effects of leadership, metrics, and reimbursement on their roles. Although many pharmacists felt supported by leadership, others noted consistent pressure to meet arbitrary quality metrics and frustration with limited reimbursement options. Public health system pharmacists seemed to be more affected by these systemic factors than their private health system counterparts. CONCLUSION: Leadership, metrics, and reimbursement are all systemic factors that affect ACPs' workplace experiences, as evinced by participant interviews. More research is necessary to determine how best to support ACPs across health systems to ensure that they can continue providing high-quality, accessible patient care.
Pharmacist provider status in Medicaid: A state health director's perspective on policy and practice.
Adams AJ
J Am Pharm Assoc (2003) · 2026 · PMID 41016431 · Publisher ↗
Despite expanded clinical authority, pharmacists often face barriers to full provider status in Medicaid owing to outdated reimbursement policies and administrative restrictions. This paper describes Idaho's comprehensiv...
Despite expanded clinical authority, pharmacists often face barriers to full provider status in Medicaid owing to outdated reimbursement policies and administrative restrictions. This paper describes Idaho's comprehensive approach to pharmacist integration into its Medicaid program through a profession-neutral "what, not who" reimbursement framework coupled with its "standard of care" regulatory framework. Rather than defining eligibility by provider type, Idaho allows any licensed health professional to bill for Medicaid-covered services within their legal scope of practice. Key reforms included statutory changes, regulatory updates, provider enrollment optimization, and alignment of pharmacist reimbursement with midlevel providers. Pharmacists can now enroll as rendering providers and bill directly for services using their National Provider Identifier. Idaho's model demonstrates that full pharmacist integration into Medicaid can be achieved in a framework that is scalable, bipartisan, and adaptable, offering a policy roadmap for other states seeking to enhance access to health care especially in rural settings.
Health care utilization and spending following comprehensive medication review in Medicare part D.
Al Hasan S, Shen TH, Wun Ting FC … +1 more , Farley JF
J Am Pharm Assoc (2003) · 2026 · PMID 41005665 · Publisher ↗
BACKGROUND: The Medicare Part D medication therapy management (MTM) program provides comprehensive medication reviews (CMRs) to eligible patients. Despite its introduction in 2006, benefits of the MTM program are still n...
BACKGROUND: The Medicare Part D medication therapy management (MTM) program provides comprehensive medication reviews (CMRs) to eligible patients. Despite its introduction in 2006, benefits of the MTM program are still not well understood, lacking research in large generalizable Medicare populations. OBJECTIVES: To examine the effectiveness of receiving a CMR on health care utilizations and associated spending. METHODS: A new user retrospective cohort study was used to compare changes in healthcare utilization and spending in CMR recipients to a matched cohort of Medicare beneficiaries who were eligible, but did not receive a CMR. Linking MTM files to inpatient, outpatient, and prescription claims for a 20% random sample of Medicare beneficiaries aged 65 and older, we obtained 533,550 CMR recipients and 1,413,860 non-recipients, and a propensity score matched sample of 531,314 CMR recipients and 531,314 nonrecipients. Difference-in-difference models were used to compare the 1-year probability and number of emergency department (ED) and hospital visits, and inpatient, outpatient, and prescription and total health spending between CMR recipients and nonrecipients. RESULTS: Relative to CMR nonrecipients and the year prior to CMR delivery, CMR recipients experienced a 0.49% (95% confidence interval [CI], 0.33% to 0.64%%) and 1.72% (95% CI, 1.57% to 1.88%) lower probability of an ED visit and hospitalization 1 year after CMR delivery, respectively. Similarly, CMR receipt resulted in a reduction of 80 hospital stays (95% CI, 45 to 115) and 337 ED visits (95% CI, 305 to 370) per 10,000 recipients, respectively. Per beneficiary, non-prescription medical spending declined by $378 (95% CI = 314 to $442) while prescription spending increased by $470 (95% CI = $436 to $503) resulting in an additional $91 in total spending (95% CI = $20 to $164) among recipients. CONCLUSION: Health care utilization reduction associated with CMR, found in this study, suggests that CMR in older adults may help reduce nonprescription health care expenditure in the year following CMR.
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