Journal Of The American Pharmacists Association[JOURNAL]
Sun
200 papers
Qualitative study of bubble pack use during buprenorphine low dose initiation.
Parizher J, Panigrahi A, Geier M … +5 more , Soran CS, Snyder HR, Knight K, Coffin PO, Suen LW
J Am Pharm Assoc (2003) · 2026 May · PMID 42097485 · Publisher ↗
BACKGROUND: Buprenorphine low-dose initiation (LDI) protocols can reduce the risk of precipitated withdrawal by initiating buprenorphine at low doses without needing to be in opioid withdrawal when starting. However, the...
BACKGROUND: Buprenorphine low-dose initiation (LDI) protocols can reduce the risk of precipitated withdrawal by initiating buprenorphine at low doses without needing to be in opioid withdrawal when starting. However, they are challenging for patients to implement in outpatient settings, in part because they involve splitting doses and following a multi-day regimen with dynamic daily instructions. Blister packs offer a structured approach to completing LDI by providing pre-packaged, pre-split buprenorphine doses with simplified instructions; however there is limited data of buprenorphine blister pack implementation and experiences with their use. OBJECTIVE: To explore attitudes of healthcare providers and patients with outpatient buprenorphine LDI blister packing to provide insight into their use in real-world settings and inform blister-packing implementation. METHODS: A qualitative study of interviews with buprenorphine prescribers, pharmacists, and patients with opioid use disorder who had attempted LDI in the past 3 months to explore attitudes about using blister packs during LDI. Participants were recruited from two safety-net substance use clinics and Community Behavioral Health Services Pharmacy in San Francisco. Interviews were transcribed, coded, and analyzed using thematic analysis to identify major themes. RESULTS: A total of 33 participants were interviewed (9 buprenorphine prescribers, 5 pharmacists, and 19 patients). Major themes included: 1) blister packing facilitated ease of LDI and reduced medication errors; 2) close collaborations with a public health pharmacy, along with dedicated workflows and protocols, facilitated implementation; 3) challenges with blister pack preparation and packaging were identified as barriers for further expansion to other pharmacies. CONCLUSIONS: Blister packing was identified as a tool to allow patients to successfully complete outpatient buprenorphine LDI. Standardized protocols and collaboration with pharmacists at a public health pharmacy were key facilitators. Partnering with local pharmacies to inform implementation strategies and identify barriers, along with pharmacist education, may help expand use of buprenorphine LDI blister-packing.
Pharmacist-led community network approach addressing social needs and adherence (Connect AF).
Liang D, Witkowski M, Abolins N … +14 more , Rush J, Naper K, Gardin V, Freeman M, Gouveia-Pisano J, Baird AB, Barber T, Blum A, Hill M, Maready J, Saint-Amand Davis M, Stout J, Suttles N, Vest MH
J Am Pharm Assoc (2003) · 2026 May · PMID 42092732 · Publisher ↗
BACKGROUND: Social determinants of health (SDOH) are nonmedical factors that impact health outcomes and medication use. As national initiatives and value-based care models prioritize SDOH interventions, pharmacists are u...
BACKGROUND: Social determinants of health (SDOH) are nonmedical factors that impact health outcomes and medication use. As national initiatives and value-based care models prioritize SDOH interventions, pharmacists are uniquely positioned to support these efforts. However, evidence describing pharmacist-led SDOH screening, particularly through collaborations between health-system and community pharmacists, remains limited. OBJECTIVE: To learn how community pharmacists address SDOH-related care gaps among patients with atrial fibrillation (AF) and how vertically integrated partnerships can strengthen these efforts through the Connect AF program. PRACTICE DESCRIPTION: Connect AF was developed through partnership among Community Pharmacy Enhanced Services Network USA (CPESN), UNC Health Pharmacy, Pfizer, and Blue Cross Blue Shield North Carolina. Pharmacists administered an adapted SDOH questionnaire to 75 AF patients receiving care at UNC Health and filling oral anticoagulants at five North Carolina CPESN pharmacies. Domains assessed included housing instability, transportation, mental health, food insecurity, community support, safety, and utilities. Pharmacists provided referrals, facilitated resource navigation, documented patient engagement, and completed pre- and post-program feasibility and acceptability surveys. PRACTICE INNOVATION: Connect AF represents a first-of-its-kind alignment between a health system, community pharmacies, a payer, and an industry partner to gain insights on pharmacist-driven SDOH strategies for AF patients. EVALUATION METHODS: Data were analyzed descriptively using frequencies and percentages. RESULTS: Connect AF fostered a collaborative learning environment that enabled each partner to contribute insights, expertise, data, and resources aligned with their role. Mental health (28%), housing instability (20%), and transportation barriers (20%) were most prevalent. Though 16% of patients screened shared needs, most expressed uncertainty about engaging with referred resources (75%). All pharmacists reported strong confidence and intent to continue providing SDOH-related support. CONCLUSION: Connect AF demonstrates how pharmacists can address SDOH-related care gaps and provides a scalable model for cross-sector collaboration to enhance patient care coordination.
The preceptor-learner care process: Applying person-centered thinking in pharmacy education.
Lendoiro JE, Strachan DA, Hughes J … +3 more , Edwards KL, Stover KR, Allen RA
J Am Pharm Assoc (2003) · 2026 May · PMID 42082018 · Publisher ↗
Preceptors are essential partners in pharmacy education, supporting experiential learning that represents approximately 25-33% of pharmacy curricula and a substantial portion of residency training experiences. Effective...
Preceptors are essential partners in pharmacy education, supporting experiential learning that represents approximately 25-33% of pharmacy curricula and a substantial portion of residency training experiences. Effective interactions between preceptors and learners are essential for learner success; however, many preceptors lack formal training in providing support and addressing learners' holistic needs, including professional development and well-being. The Joint Commission of Pharmacy Practitioners' Pharmacists' Patient Care Process (PPCP), updated in 2025, offers a standardized approach to patient care delivery in any setting. This manuscript proposes a novel. Preceptor-Learner Care Process (PLCP), adapted from the PPCP framework, as a standardized, structured, and repeatable framework to guide the preceptor-learner relationship in experiential education and to support intentional learner development. The PLCP provides preceptors a systematic approach to collect, assess, plan, implement, and follow-up on learner-specific challenges or opportunities. This framework integrates clinical skills, professionalism, communication, emotional intelligence, and situational and self-awareness enabling preceptors to provide consistent and individualized approaches to learner-specific development.
Development and evaluation of a pharmacy-based tool to assess patient social determinants of health.
Saiar A, Scovis N, Bennett M … +2 more , Little J, Bluml BM
J Am Pharm Assoc (2003) · 2026 Apr · PMID 42066904 · Publisher ↗
BACKGROUND: Social Determinants of Health (SDOH) are well-recognized factors that impact health. Efforts are underway across healthcare settings to better assess health needs related to SDOH, but a tool to assess these f...
BACKGROUND: Social Determinants of Health (SDOH) are well-recognized factors that impact health. Efforts are underway across healthcare settings to better assess health needs related to SDOH, but a tool to assess these factors in a pharmacy setting especially as they relate to medication use does not heretofore exist. OBJECTIVES: This research describes the development and evaluation of SDOHRx, a pharmacy-specific SDOH screening tool. MethodsSDOHRx Screening Tool data was collected and evaluated from 37 community pharmacies as part of the Project IMPACT: Cardiovascular Health+ study protocol. Inclusion criteria for the study were: non-pregnant adults without implanted electronic devices presenting to a pharmacist for usual and customary care and able to provide informed consent. 4,186 responses were collected and 1,697 were utilized for analysis. The scored items of the assessment tool were analyzed using a KR20 Reliability Analysis and Exploratory Factor Analysis. RESULTS: Findings from the KR20 Reliability Analysis and Exploratory Factor Analysis yielded a high degree of internal consistency (KR20=0.87) and a strong primary factor (eigenvalue=10.44), respectively. DISCUSSION: Interpretation of the results are discussed, as well as the limitations to the generalizability and interpretability of the assessment due to limited validity evidence thus far. CONCLUSION: The SDOHRx Screening Tool is a 15-item instrument that is developed for use by pharmacists and pharmacy team members in identifying and addressing the health-related needs of their patients.
Inpatient pharmacist impact on guideline directed medical therapy in heart failure with reduced ejection fraction.
Cox K, Darden B, Parag B … +8 more , Ramos M, Johns M, Nguyen J, Rupert C, Funderburk D, Smith D, Craver K, Thibodeau JT
J Am Pharm Assoc (2003) · 2026 Apr · PMID 42055247 · Publisher ↗
BACKGROUND: Pharmacists play a vital role in optimizing care for patients with heart failure with reduced ejection fraction (HFrEF), as this subtype has well-established, evidence-based pharmacotherapy with proven positi...
BACKGROUND: Pharmacists play a vital role in optimizing care for patients with heart failure with reduced ejection fraction (HFrEF), as this subtype has well-established, evidence-based pharmacotherapy with proven positive clinical outcomes. OBJECTIVES: This retrospective observational cohort study aimed to assess the impact of inpatient pharmacist workflow designed to manage optimization of maximally tolerated guideline-directed medical therapy (GDMT) in patients with non-advanced HFrEF. METHODS: The primary outcome was implementation of maximally tolerated GDMT via inpatient clinical and transition-of-care (TOC) pharmacist interventions specifically measured by new therapies added, price checks completed, barriers of therapy documented, medication counseling performed by TOC pharmacists and pillar assessment on discharge. The secondary outcome was 30-day all-cause readmission rates stratified by pharmacist involvement. All pharmacist efforts were measured using documentation provided via intervention reports generated from January 1, 2024, to December 31, 2024. RESULTS: Both inpatient clinical pharmacists and TOC pharmacists participated with making interventions. 575 patient encounters were included in the pharmacist analysis, with 146 patients receiving therapy optimization through 218 pharmacist interventions, the majority of which were therapy initiation. TOC pharmacist discharge review and/or counseling was performed for 486 patient encounters during same time frame, 52% (299/575) of which were included in the analysis as they overlapped with inpatient clinical pharmacist review. Regarding secondary outcomes, 180 patients with heart failure were readmitted in 2024 with 31 meeting the criteria for non-advanced HFrEF. Amongst these 31, 12 (38.7%) had received clinical and TOC pharmacist review during their previous admission, while the remaining 19 (61.3%), serving as the control group, had not received comprehensive pharmacist review. CONCLUSION: Inpatient and TOC pharmacist clinical review is associated with improved optimization of GDMT and may enhance value-based outcomes such as hospital readmissions.
Can college women identify contraceptive misinformation found on TikTok?
Ifeakanwa J, DiPietro Mager N
J Am Pharm Assoc (2003) · 2026 Apr · PMID 42055246 · Publisher ↗
BACKGROUND: Social media is frequently used in the United States, with college-age women often accessing TikTok. Misinformation about reproductive health and contraception is common on TikTok, making it important for use...
BACKGROUND: Social media is frequently used in the United States, with college-age women often accessing TikTok. Misinformation about reproductive health and contraception is common on TikTok, making it important for users to be able to differentiate factual and false information to avoid unintended consequences. OBJECTIVES: The primary objective of this study was to determine college women's ability to identify misinformation about reproductive health and contraception found on TikTok. The secondary objective was to examine the impact of a student pharmacist-led educational intervention on participants' knowledge and self-reported confidence to assess the quality of information found online. METHODS: Statements about contraception, emergency contraception, and folic acid found on TikTok were collected and fact-checked using evidence-based literature to identify misinformation. A pre-test with 9 knowledge-based questions based on TikTok content and 1 question assessing confidence in evaluating online health information was administered to undergraduate women attending a private university in the rural Midwest. After a student pharmacist-led educational intervention covering reproductive health, contraception, and the SIFT framework to discern credible online content, participants took the post-test containing identical knowledge and confidence questions. The frequency of correct answers for knowledge-based questions was calculated, and binomial tests were used to compare responses between the unmatched pre- and post-tests. RESULTS: Seventy-three women participated in the educational intervention. Knowledge improved significantly for 8 of the 9 questions after the educational intervention (p<0.001). Self-reported confidence in the ability to identify false information on social media improved to 62% on post-test from 19% on pre-test (p<0.001). CONCLUSION: There is a need to educate college women about reproductive health/contraception and critical evaluation of online sources to mitigate the spread of medical misinformation. A pharmacist- or student pharmacist-led educational intervention is a promising practice to provide factual information about contraception, emergency contraception, folic acid, and the SIFT framework to college women.
Relationship between anemia after chemotherapy for cancer and use of diuretics: a descriptive epidemiological study.
Tamura H, Nakao YM, Yoshida S … +1 more , Kawakami K
J Am Pharm Assoc (2003) · 2026 Apr · PMID 42025962 · Publisher ↗
BACKGROUND: Diuretics are frequently used for patients with cancer. Anemia is a factor of body fluid retention frequently observed after these patients receive chemotherapy. OBJECTIVES: To describe the severity of anemia...
BACKGROUND: Diuretics are frequently used for patients with cancer. Anemia is a factor of body fluid retention frequently observed after these patients receive chemotherapy. OBJECTIVES: To describe the severity of anemia in patients with cancer according to whether diuretics were used after chemotherapy, pursuing evaluation of any relationship between anemia and diuretic use. METHODS: In an anonymized electronic medical record database, a study population comprising patients with lung cancer, breast cancer and/or non-Hodgkin lymphoma was captured. Observation started on the last date of the first chemotherapy course, and ended on the date for earliest event from death, chemotherapy resumption, loss to follow-up or 180 days since observation started. We collected the lowest hemoglobin level within 90 days since observation started (Measure 1 of anemia) in patients prescribed diuretics for ≥ 3 days within 180 days since observation started (diuretic-user group) and the remaining population (comparison group). To evaluate association between Measure 1 of anemia and diuretic use, we performed a multivariate analysis in patients with non-Hodgkin lymphoma adjusting for age, anti-hypertensives use, corticosteroid use, renal function and serum albumin level. RESULTS: 72,276 patients constituted the population for analysis, with 4,809 in the diuretic-user group. Measure 1 of anemia was < 8 g/dl and 8 - 10 g/dl for 24.8% (1,194/4,809) and 29.4% (1,416/4,809) of patients in the diuretic-user group, respectively, in contrast to 5.8% (3,924/67,467) and 14.4% (9,704/67,467) for the comparison group. In the multivariate analysis in patients with non-Hodgkin lymphoma, odds ratio for diuretic use was 2.18 (95% confidence interval: 1.86, 2.54) for Measure 1 of anemia in the range of 8 - 10 g/dl and 4.06 (95% confidence interval: 3.45, 4.78) for < 8 g/dl, compared to > 10 g/dl. CONCLUSION: Our study may contribute to understanding the pathophysiology necessitating diuretic use in patients with cancer.
Semaglutide for obesity management: A narrative review of efficacy, safety, and future directions.
Hajibandeh S, Tao YA, Hsieh MH … +5 more , Liu HG, Cheng YF, Lee KH, Hsieh SY, Lu CH
J Am Pharm Assoc (2003) · 2026 Apr · PMID 42025961 · Publisher ↗
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), particularly semaglutide, have demonstrated substantial efficacy for glycemic control and weight management and are increasingly prescribed across divers...
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), particularly semaglutide, have demonstrated substantial efficacy for glycemic control and weight management and are increasingly prescribed across diverse populations. Rapid expansion of indications, formulations, and real-world use has outpaced comprehensive evaluation of long-term safety, tolerability, and adherence, raising important concerns for clinical practice. OBJECTIVES: This narrative review aims to synthesize current evidence on the efficacy and safety profile of semaglutide, with a focus on adverse events, treatment persistence, perioperative considerations, and use in special populations, to support clinical decision-making and pharmacist-led patient care. METHODS: A review of clinical trials, observational studies, pharmacovigilance reports, regulatory communications, and professional guidelines was conducted. Evidence was drawn from randomized controlled trials, post-marketing safety reports, systematic reviews, and relevant clinical and regulatory documents. RESULTS: From 1525 records, 34 studies and reports were included. Clinical trials consistently demonstrated meaningful weight reduction with semaglutide. Evidence regarding acute pancreatitis remains limited, although cases have been reported in clinical trials and postmarketing safety analyses. Evidence regarding suicidal ideation associated with semaglutide is mixed, with some analyses suggesting potential safety signals while others report no increased risk. Recent multi society clinical guidelines have addressed perioperative management of GLP-1 RAs, generally supporting individualized perioperative assessment. Emerging literature also examines semaglutide use in special populations, including patients with Alzheimer disease and individuals following bariatric surgery, although long-term neurologic and post-bariatric safety outcomes remain incompletely characterized. CONCLUSIONS: Semaglutide represents an important therapeutic option for chronic weight management. As clinical use expands, continued evaluation of long-term safety, tolerability, and treatment persistence will be important. Pharmacists play a key role in counseling patients, monitoring adverse effects, supporting adherence, and contributing to multidisciplinary obesity care.
Impact of a charitable medication program and social vulnerability index on clinical outcomes in uninsured adults with diabetes.
Walter J, Campisi L, Khalla S … +2 more , Romelus A, O'Donnell B
J Am Pharm Assoc (2003) · 2026 Apr · PMID 42025960 · Publisher ↗
BACKGROUND: Adults with diabetes mellitus (DM) and poor social vulnerability index (SVI) have been shown to have worse clinical outcomes with uncontrolled DM. Patient assistance programs (PAPs), free clinics, and charita...
BACKGROUND: Adults with diabetes mellitus (DM) and poor social vulnerability index (SVI) have been shown to have worse clinical outcomes with uncontrolled DM. Patient assistance programs (PAPs), free clinics, and charitable medication programs have been shown to improve hemoglobin A1C (HbA1c) for uninsured adults. OBJECTIVES: The primary objective of this study was to evaluate the impact of a charitable medication program on HbA1c as well as other clinical outcomes [blood pressure (BP), low-density lipoprotein (LDL) and body mass index (BMI)] in adults with type 2 diabetes mellitus (T2DM). Secondly, this study aimed to evaluate the impact of SVI on patient follow-up practices. METHODS: This retrospective chart review evaluated patients who were dispensed any T2DM-related medication from the Healthy Connections Medication (HCM) program at Hackensack Meridian Health (HMH) pharmacies from January 1st, 2023, to December 31st, 2024. Clinical outcomes were measured at baseline (30 days within fill date) and again within 6 months from baseline. All included and excluded patients' SVI were measured to determine vulnerability. RESULTS: Of 624 patients with T2DM medications, 87 met inclusion criteria. Statistically significant improvements were observed in HbA1c (11.30% to 9.60%; p < 0.001) and BP (SBP: 128 to 123 mmHg, p = 0.002; DBP: 78 to 75 mmHg, p = 0.005). Median LDL and BMI also decreased from baseline but missed statistical significance. Patients who did not have a repeat HbA1C within 6 months had a higher SVI (0.51 vs 0.45, p=0.01). CONCLUSION: Healthy Connections Medications improved all clinical outcomes with statistically significant reductions in HbA1c and BP within 6 months. Patients who did not obtain a repeat HbA1c had a higher SVI which may indicate a greater vulnerability among those patients who did not follow-up. Future studies should examine the implications of SVI and patient follow-up.
A descriptive analysis of social determinant of health needs and medication therapy problems in a comprehensive medication management population.
Garcia S, O'Donnell RM, Schlichte A … +1 more , Zagel AL
J Am Pharm Assoc (2003) · 2026 Apr · PMID 42019866 · Publisher ↗
BACKGROUND: Comprehensive medication management (CMM) pharmacists routinely care for patients with uncontrolled chronic conditions, optimizing medications regimens and collaborating to improve patient outcomes and reduce...
BACKGROUND: Comprehensive medication management (CMM) pharmacists routinely care for patients with uncontrolled chronic conditions, optimizing medications regimens and collaborating to improve patient outcomes and reduce healthcare costs. Social determinants of health (SDOH) needs are associated with chronic disease burden, medication nonadherence, and higher healthcare expenditures. Many CMM patients have unmet SDOH needs, but little is known about their prevalences or associations with medication therapy problems (MTPs). OBJECTIVES: To describe how SDOH needs are associated with CMM service utilization and MTPs identified within the course of CMM pharmacist care. METHODS: This retrospective, descriptive analysis included patients with uncontrolled chronic conditions from a CMM registry within a large health system. Patients were compared by CMM visit completion following registry inclusion. CMM patients were then described by presence of self-reported SDOH needs, and initial-visit MTPs. Chi-squared tests assessed group differences. RESULTS: Of 23,654 registry patients, 8% completed a CMM visit. Provider referrals were associated with CMM visit completion (CMM visit: 59% vs. no CMM visit: 8%, p<0.0001). Patients completing CMM visits were more likely to report SDOH needs (25% vs. 17%, p<0.0001) and have ≥3 chronic physical diagnoses (55% vs. 22%, p<0.0001) compared to those without CMM visits. Among CMM patients, those reporting SDOH needs had similar rates of any MTP at the first CMM visit compared to those without SDOH needs (76% vs. 74%, p=0.33). Adherence-related MTPs were more common among patients with SDOH needs (25% vs. 20%, p=0.0026), while other MTP types did not differ (p>0.05 for all). CONCLUSIONS: Patients meeting CMM registry criteria who completed CMM visits had high rates of SDOH needs, which may warrant different interventions, such as referrals or education by CMM pharmacists. Including SDOH needs evaluations into CMM referral and care prioritization processes may provide an opportunity to promote health equity and positive health outcomes.
Benefits of integrating comprehensive medication management pharmacists into specialty clinics: Lessons learned from primary care.
Schweim K, Zagel AL, Brummel A
J Am Pharm Assoc (2003) · 2026 Apr · PMID 41985716 · Publisher ↗
BACKGROUND: Comprehensive medication management (CMM) pharmacists have demonstrated value in primary care through optimizing medications and improving clinical outcomes. Given the complexity, cost, and adherence challeng...
BACKGROUND: Comprehensive medication management (CMM) pharmacists have demonstrated value in primary care through optimizing medications and improving clinical outcomes. Given the complexity, cost, and adherence challenges associated with specialty medications, integrating CMM services into specialty clinics may enhance the management of complex disease states. OBJECTIVE: To describe the implementation of a program embedding CMM pharmacists within 3 specialty inflammatory clinics. PRACTICE DESCRIPTION: Within a large, academic health system, CMM services were expanded to dermatology, gastroenterology, and rheumatology clinics. PRACTICE INNOVATION: The CMM program expanded to support patients in inflammatory clinics through ensuring patient safety, improving medication adherence and enhancing patient outcomes through personalized care and standardized medication optimization. EVALUATION METHODS: Adult patients seen by CMM pharmacists between July 2023 and June 2024 in 3 specialty inflammatory clinics were examined to determine the completion of health maintenance metrics (including baseline screenings and vaccines), and medication therapy problems (MTPs) documented. The Net Promoter Score measured patient satisfaction with CMM services. RESULTS: A total of 2856 patients completed 5218 CMM pharmacist specialty visits. Most patients (N=2344, 82.1%) were prescribed a specialty medication, and most patients on specialty medications had all baseline screening accomplished (N=1807, 77.1%), with vaccine rates ranged from 54.6% (zoster) to 91.4% (TDaP). There were 3759 MTPs documented, of which needing additional medication therapy (N=1691, 45.0%) was most common; 94.0% of MTPs were accepted. Overall, patient satisfaction scores were 86.3%. CONCLUSION: Pharmacist-led CMM visits, traditionally rooted in primary care, can be successfully integrated into specialty clinics to bolster health maintenance needs and resolve MTPs to help optimize therapies, while maintaining patient satisfaction rates. This model of pharmacy supports broader adoption of CMM within specialty care, offering potential benefits to patients, providers, and payers such as reduced healthcare costs, decreased provider administrative burden, and improved patient outcomes.
Impact of medical billing education support on billing practices in Arkansas community pharmacies.
Smith MG, Moore L
J Am Pharm Assoc (2003) · 2026 Apr · PMID 41966307 · Publisher ↗
BACKGROUND: Third-party insurers now allow pharmacies to bill for services, in which a statewide protocol exists for prescribing, under the medical benefit in Arkansas. Community pharmacists face significant challenges i...
BACKGROUND: Third-party insurers now allow pharmacies to bill for services, in which a statewide protocol exists for prescribing, under the medical benefit in Arkansas. Community pharmacists face significant challenges implementing these covered services and navigating medical billing opportunities to obtain reimbursement. OBJECTIVE: This study evaluates the effectiveness of educational support efforts- medical billing bootcamps, on-site visits, and continuing education presentations-on the implementation of medical billing in Arkansas community pharmacies. METHODS: A retrospective analysis was conducted using data from the Arkansas Community Pharmacy Enhanced Services Network (AR CPESN) and the Arkansas Pharmacists Association (APA). The AR CPESN surveyed 185 pharmacies from May to June 2024, assessing their implementation of billing practices. The survey included questions about the types of covered services offered, billing methods, and pharmacist credentialing with Arkansas Blue Cross and Blue Shield (AR BCBS). APA supplied pharmacy participation in medical billing bootcamps, on-site visits, and continuing education presentations. Data were analyzed using Pearson's chi-square test and logistic regression to determine the relationship between educational support efforts and billing practices. RESULTS: Out of 185 pharmacies surveyed, 161 responded (87%). Among these, 85 pharmacies (53%) provided at least one covered service included in an Arkansas statewide protocol. Of the pharmacies providing services, 70 (82%) had credentialed pharmacists, 74 (87%) offered cash-based services, and 41 (48%) billed medical claims to AR BCBS. Participation in educational support efforts did not show a statistically significant correlation with credentialing or billing practices. Pharmacies with credentialed pharmacists were more likely to offer cash-based services and bill AR BCBS (p<0.001). CONCLUSION: The study highlights the need for improved educational support efforts to enhance medical billing practices in Arkansas. Current efforts have not shown a direct correlation with increased billing practices, however the presence of credentialed pharmacists appears to facilitate cash-based and medical billing.
Assessing the impact of pharmacist led weight loss surgery medication evaluation.
Winar J, Doycich E, Bardaro S … +1 more , Gothard D
J Am Pharm Assoc (2003) · 2026 Apr · PMID 41966306 · Publisher ↗
BACKGROUND: Weight loss surgery (WLS) can lead to nutrient deficiencies and altered medication absorption and distribution. Optimizing medication management, including dose changes, initiation, or discontinuation of medi...
BACKGROUND: Weight loss surgery (WLS) can lead to nutrient deficiencies and altered medication absorption and distribution. Optimizing medication management, including dose changes, initiation, or discontinuation of medications, addressing medication adherence, and patient education, is crucial for positive outcomes. OBJECTIVES: The primary objective of this initiative was to evaluate the impact of a single pre-WLS pharmacist-led medication reconciliation and education visit on medication adherence, measured by self-reported missed doses over the preceding seven days. The secondary outcome was an assessment of provider acceptance of pharmacist-driven medication recommendations during routine clinical care. PRACTICE DESCRIPTION: MetroHealth System, a large public academic safety net hospital serving a predominantly under- or uninsured population in Northeast Ohio. Wherein WLS patients have appointments with a weight management provider, surgeon, behavioral health specialist, and registered dietician. PRACTICE INNOVATION: The current health care team caring for patients undergoing WLS does not include a clinical pharmacist. The pharmacist reviewed medication regimens pre- and post-WLS, assessed for patient adherence, provided patient education, and made recommendations to the WLS care team to ensure safe and effective medication use. EVALUATION METHODS: Medication adherence changes, adherence barriers, and acceptance of pharmacist recommendations were evaluated and reported using descriptive statistics. RESULTS: This initiative found a statistically significant decrease in medication adherence. The average number of missed doses per week increased significantly from baseline (0.06) to follow-up (1.15) (p=0.001). Providers accepted at least one pharmacist recommendation for 28 out of 49 patients (57.1%). CONCLUSION: This initiative demonstrates the value of pharmacist involvement in WLS care. Medication adherence remained high, and the strong acceptance of pharmacist recommendations supports the benefit of pharmacist led medication review. The minor decline in follow up adherence may reflect reduced post-WLS motivation. Controlled studies are needed to more clearly define the impact of pharmacist services.
Real-world weight impact upon tirzepatide discontinuation at a single-center endocrinology clinic in patients with overweight or obesity.
Huang L, Lee A, Kim D … +3 more , Tungate S, Komé A, Yang A
J Am Pharm Assoc (2003) · 2026 Apr · PMID 41962807 · Publisher ↗
BACKGROUND: Overweight and obesity are major contributors to cardiovascular-kidney-metabolic (CKM) disease. Tirzepatide (TZP-MJ), originally approved for type 2 diabetes (T2D), has demonstrated significant weight loss be...
BACKGROUND: Overweight and obesity are major contributors to cardiovascular-kidney-metabolic (CKM) disease. Tirzepatide (TZP-MJ), originally approved for type 2 diabetes (T2D), has demonstrated significant weight loss beyond glycemic improvement. Despite these benefits, real-world medication access barriers may lead to abrupt therapy discontinuation. Currently, there is a lack of real-world data of TZP-MJ discontinuation in outpatient settings. OBJECTIVES: To assess the real-world impact of TZP-MJ discontinuation on body weight in patients with overweight or obesity managed in an endocrinology and weight management clinic with clinical pharmacist support. METHODS: A 12-month, single-center retrospective study in adult patients with obesity or overweight with a weight-related comorbidity and active prescription for TZP-MJ from 5/13/2022-6/30/2023 for > 3 months prior to discontinuation. Primary outcome was percent change in body weight 12-months following TZP-MJ discontinuation. Secondary outcomes included rates of transitioning to alternate obesity medications (OMs). RESULTS: 83 patients met inclusion criteria and had remained on TZP-MJ for a mean of 11 months, achieving a mean body weight reduction of 6.7%. The most common reason for TZP-MJ discontinuation was due to medication access related due to cost (80.7%). At 12-months following TZP-MJ discontinuation, mean body weight change was not statistically significant (+1.9%, p=0.11). Most patients transitioned to alternative OMs (n=68; 81.9%) CONCLUSION: Although TZP-MJ is associated with meaningful weight loss, medication cost is a barrier to therapy continuation. In real-world practice, weight loss achieved on TZP-MJ may be sustained by transitioning to alternate OMs to mitigate potential rebound weight gain following discontinuation, demonstrating a critical role for clinical pharmacists.
Social determinants of health screening and referral services in community pharmacies: A payor program analysis.
Hake KL, Schneider SN, Coley KC … +2 more , McGrath SH, Carroll JC
J Am Pharm Assoc (2003) · 2026 Apr · PMID 41956245 · Publisher ↗
BACKGROUND: Community pharmacists are one of the most accessible healthcare providers and often interact with patients affected by Social Determinants of Health (SDOH). By leveraging their trusting relationships with pat...
BACKGROUND: Community pharmacists are one of the most accessible healthcare providers and often interact with patients affected by Social Determinants of Health (SDOH). By leveraging their trusting relationships with patients, pharmacists can identify and discuss SDOH barriers. An obstacle to implementation and sustainability of pharmacist-provided SDOH services is reimbursement. Contracts with payors were recently established by a clinically integrated network (CIN) of community pharmacies in Pennsylvania where community pharmacies receive payment for providing SDOH screening and referral services. However, there is limited understanding of how reimbursement impacts adoption of pharmacist-provided SDOH services. OBJECTIVES: The objectives were to: (1) design and implement SDOH screening and referral services within community pharmacies as part of Pennsylvania Medicaid payor programs; and (2) evaluate the adoption of these services within a Pennsylvania community pharmacy CIN. PRACTICE DESCRIPTION: The Pennsylvania Pharmacists Care Network (PPCN) is a statewide network of community pharmacies made up of 200 member pharmacies. PPCN is affiliated with the national pharmacy CIN, CPESN USA. PRACTICE INNOVATION: Since 2022, the PPCN established four payor contracts with regional Medicaid Managed Care Organizations (MCOs) to provide SDOH screening and referrals. Pharmacists documented SDOH encounters using the Pharmacist Electronic Care Plan (PeCP). These were the first Medicaid payor programs in Pennsylvania that reimbursed pharmacy teams for SDOH services. EVALUATION METHODS: A retrospective quantitative analysis of deidentified PPCN Pharmacist PeCP data from August 2022 - April 2024 for all Medicaid MCO SDOH programs was conducted. Patient encounters eligible for payment were analyzed using descriptive statistics. Systemized Nomenclature of Medicine - Clinical Terms codes in the PeCP were used to quantify SDOH services provided. RESULTS: A total of 15,441 reimbursed SDOH services (11,661 screenings and 3,780 referrals) were provided to 5,421 unique patients from August 2022- April 2024 by 108 pharmacies. Of the 5,421 patients who received at least one SDOH screening, 1,375 patients (25.4%) received at least one referral. Referral categories included: food insecurity (22.4%); financial strain (18.9%); healthcare access/affordability (14.1%); utilities (11.6%); clothing (8.9%); housing (8.7%); transportation (8.2%); employment (5.2%); and childcare (2.0%). CONCLUSION: Payment from MCOs promoted the adoption and implementation of community pharmacy-provided SDOH services across Pennsylvania.
Exploring public preference for medication pick-up in the United States: A cross-sectional study.
Unni E, Budhu A, Goins J … +1 more , Gualtieri L
J Am Pharm Assoc (2003) · 2026 Apr · PMID 41956244 · Publisher ↗
BACKGROUND: Medication delivery preferences are gaining importance in the United States as prescription use increases, and patients are presented with more options for accessing their medications. While many patients sti...
BACKGROUND: Medication delivery preferences are gaining importance in the United States as prescription use increases, and patients are presented with more options for accessing their medications. While many patients still rely on traditional in-person pharmacy pickup, the availability of mail-order services, home delivery options, drive-through lanes, and online pharmacy platforms has increased. Despite the significant expansion of delivery options in the U.S., there is limited information on how patients choose between delivery and in-person. OBJECTIVE: This study examines patient perspectives on medication access and identifies factors influencing their use of delivery services in the United States. METHODS: A survey-based cross-sectional study was conducted at the national level using SurveyMonkey Audience Panel among English-speaking U.S. adults who have filled at least one prescription medication in the last six months. The 27-item survey instrument included questions about the respondents' sociodemographic characteristics, their ratings of convenience, privacy, and preference for picking up medications from various types of pharmacies, as well as their preferences when communicating with pharmacists. Descriptive statistics were used to identify key trends and associations. RESULTS: A total of 489 participants completed the survey. Mail-order use was reported by 61% of the respondents, mainly driven by time savings and insurance requirements. Chain pharmacies were viewed as the most convenient option, while local community pharmacies ranked highest in terms of preference and privacy. For urgent medications, participants preferred community pharmacies, while chain pharmacies were favored for chronic therapies. CONCLUSION: Overall, these findings indicate that pharmacy choice is influenced by several factors, including the type of medication, the setting in which it is obtained, and how patients balance preference, convenience, and privacy. The study also demonstrated that despite the growth of digital health, patients continue to rely heavily on traditional pharmacies and face-to-face communication with pharmacists for trusted and accessible care.
Evaluation of a community health worker certification program and participants' self-assessed preparedness.
Chu M, Landolt L, Lou M … +2 more , Abraham J, Chen S
J Am Pharm Assoc (2003) · 2026 Mar · PMID 41933613 · Publisher ↗
BACKGROUND: Community Health Workers (CHWs) play a crucial role in enhancing patient care. Many CHW roles overlap with the expanded roles of pharmacy technicians, who often share the patients' cultural and linguistic bac...
BACKGROUND: Community Health Workers (CHWs) play a crucial role in enhancing patient care. Many CHW roles overlap with the expanded roles of pharmacy technicians, who often share the patients' cultural and linguistic backgrounds. To leverage this alignment, the CHW certificate program was launched. OBJECTIVES: To evaluate the CHW program on knowledge gains and self-assessed preparedness. PRACTICE DESCRIPTION: The CHW program comprises two online modules, covering foundational health knowledge, communication skills, patient outreach and advocacy, and care coordination. The in-person session focuses on demonstrating key skills from online modules. This curriculum meets state and national CHW certificate standards. PRACTICE INNOVATION: The CHW program builds on participants' clinical experience while emphasizing medication and chronic disease management and motivational interviewing. It also supports pharmacies in leveraging Medi-Cal reimbursement to sustainably integrate CHWs into practice. EVALUATION METHODS: The study analyzed pre- and post-assessment scores and post-program survey data. The descriptive analysis was used for both categorical and continuous variables. The Wilcoxon signed-rank, Chi-square, Fisher's exact tests, and the Mixed Model for Repeated Measures analysis were used to test for association. RESULTS: There was a significant increase in assessment scores from pre to post in online modules (P< 0.0001), with pharmacy technicians and the non-pharmacy workforce showing the greatest improvement (P<0.0001). The post-program survey revealed that patient engagement and communication, outreach, and service coordination were the most frequently used CHW skills (81.8%) at workplaces. It also indicated that the program improved participants' knowledge (84.8%) and confidence (57.6%) and enhanced their daily CHW work (84.8%). CONCLUSION: The CHW program enhanced participants' knowledge, skills, and demonstrated applicability to real-world practice. This program supported professional growth and highlighted the potential progression for pharmacy technicians' advancement.
Integration of a complexity billing tool to evaluate unrealized pharmacist revenue and productivity in an academic primary care network.
Marshall K, Leupold S, Grandominico JM … +2 more , Tayal NH, Coffey CP
J Am Pharm Assoc (2003) · 2026 Mar · PMID 41921664 · Publisher ↗
BACKGROUND: Pharmacists are not recognized as healthcare providers under the Social Security Act. This limitation often confines pharmacists to "incident-to" billing for clinical services, which is commonly used for the...
BACKGROUND: Pharmacists are not recognized as healthcare providers under the Social Security Act. This limitation often confines pharmacists to "incident-to" billing for clinical services, which is commonly used for the simplest level of care, equating to the lowest reimbursement from payers. OBJECTIVES: Primary objectives of this study were to (1) compare the actual and potential unrealized revenue for pharmacist-provided services using a complexity billing tool adjusted for the level of care provided and (2) compare the actual and simulated work relative value unit (wRVU) for pharmacist-provided services. The secondary objective was to measure the proportion of pharmacist-provided services billed at lower Evaluation and Management (E/M) codes due to payer restrictions compared to the simulated complexity code. PRACTICE DESCRIPTION: Serving over 70,000 patients, the clinic network operates within an interdisciplinary team of ∼100 residents and 80 attending physicians, supported by a pharmacy group of 12 pharmacists (7.7 clinical FTEs) and three residents. PRACTICE INNOVATION AND EVALUATION: To more accurately capture the level of service provided during scheduled pharmacy visits, a complexity billing tool aligned with the 2021 American Medical Association Medical Decision-Making Criteria was applied to each pharmacist encounter. This tool served as a proxy to accurately demonstrate the level of care delivered by the pharmacists, regardless of payer restrictions. All encounters with a pharmacist listed as the service provider from July 1, 2024, to June 30, 2025, were identified using Qlik®, a secure, analytics-integrated platform. Remote physiologic monitoring (RPM) encounters were excluded. RESULTS: Implementation of the complexity billing tool revealed that approximately 50% of visits were classified as underbilled due to billing restrictions. On average, reimbursement based on the actual level of service was 39% lower and the mean work relative value unit (wRVU) was approximately 0.45 points lower when calculated using the actual level of service billed. CONCLUSION: Implementation of a complexity billing tool in a primary care setting provided an effective method for capturing the actual complexity of pharmacist visits through calculation of simulated revenue and wRVUs.
A cross-sectional study of prescribing rates for SGLT2 inhibitors and GLP-1 receptor agonists among primary care clinics with and without embedded pharmacists.
Dixon DL, Salgado TM, Robinson A … +7 more , Carbone S, Wagner TD, Hyder H, Kirschner B, Musselman KT, Buffington TM, Sabo RT
J Am Pharm Assoc (2003) · 2026 Mar · PMID 41905685 · Full text
BACKGROUND: Sodium-glucose co-transporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) are cardio- and kidney-protective, yet their uptake in clinical practice has been suboptimal. The a...
BACKGROUND: Sodium-glucose co-transporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) are cardio- and kidney-protective, yet their uptake in clinical practice has been suboptimal. The association between pharmacists embedded in primary care clinics and prescribing rates of SGLT2i and GLP-1RA is unknown. OBJECTIVE: To compare the prescribing rates of SGLT2i and GLP-1 RA among primary care clinics with and without embedded pharmacists. METHODS: A cross-sectional study using electronic health record data from Bon Secours Mercy Health outpatient clinics across Virginia (2019, 2020, 2021) included patients ≥18 years old with type 2 diabetes and either cardiovascular disease (CVD), including atherosclerotic cardiovascular disease (ASCVD) and heart failure (HF), or chronic kidney disease (CKD), and ≥1 outpatient visit. Adults with type 1 diabetes, CKD stage 4/5, end-stage kidney disease, on dialysis, pregnant, or on hospice or palliative care were excluded. Overall and condition-specific prescribing rates were compared between the eight clinics with embedded pharmacists versus five matched clinics without pharmacists using generalized linear mixed modeling with a random practice-level effect. RESULTS: The 6,377 included patients had a mean age of 68.6 years, 49.8% were female, 36.8% were Black, and 73.2% were Medicare beneficiaries. The overall raw prescribing rate was higher at clinics with embedded pharmacists (16.2%) versus those without (13.8%), and for patients with ASCVD or CKD, but not HF, though this difference did not reach statistical significance when adjusting only for the pharmacist group (P=0.76) or after adjusting for age, sex, race, and insurance coverage (P=0.49). Factors associated with higher prescribing rates included being older, male, or commercially insured. CONCLUSION: Prescribing rates for SGLT2i and GLP-1 RA were numerically higher in primary care clinics with embedded pharmacists than those without; however, the difference was not statistically significant.
Challenges and facilitators to implementing a Veterans Affairs-wide pharmacy call center: A qualitative study of frontline staff perspectives.
Egelfeld JR, Gray CP, Lerner B … +3 more , Urech TH, Robinson JS, Vashi AA
J Am Pharm Assoc (2003) · 2026 · PMID 41895604 · Publisher ↗
BACKGROUND: Virtual pharmacy contact centers represent an innovative approach for improving health care access across the U.S. Department of Veterans Affairs (VA). While these services have the potential to enhance care...
BACKGROUND: Virtual pharmacy contact centers represent an innovative approach for improving health care access across the U.S. Department of Veterans Affairs (VA). While these services have the potential to enhance care quality and expand patient reach, there remains a limited understanding of the experiences faced by the frontline personnel responsible for implementing this initiative. OBJECTIVE: To explore frontline staff and supervisor experiences within a VA-wide pharmacy contact center modernization. METHODS: From May to September 2023, we conducted semi-structured qualitative interviews with 14 contact center pharmacy technicians, 3 lead technicians, 6 supervisors, and one clinical pharmacist from 6 VA regional sites. Qualitative themes were organized within the Theoretical Domains Framework (TDF) to identify salient domains related to the grounded experiences of delivering virtual pharmacy care to Veterans. RESULTS: Eight TDF domains surfaced from interviews: (1) Social/Professional Role and Identity, (2) Reinforcement, (3) Beliefs About Capabilities, (4) Beliefs About Consequences, (5) Memory, Attention, and Decision Processes, (6) Emotion, (7) Knowledge, and (8) Social Influences. Within these domains, we identified 21 themes related to facilitators and challenges described by staff. Facilitators include technicians' intrinsic motivation to support Veterans, effective interprofessional collaboration, positive team dynamics, and well-structured remote work arrangements. Conversely, challenges involve role ambiguity, perceived pressure from performance metrics, training gaps, and the strain from emotionally taxing calls. CONCLUSION: Pharmacy staff's commitment to Veterans and professional collegiality provide a strong foundation for VA pharmacy contact center services. Clarifying roles, refining training and respite opportunities, and balancing performance expectations with patient-centered care may further strengthen implementation and help ensure sustainable, high-quality service delivery.
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