Journal Of The American Pharmacists Association[JOURNAL]
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200 papers
Veteran and nonveteran perceptions of community pharmacists as sources of mental health information and referral.
Stover AN, Vieira LEB, Davis SA … +3 more , Joiner K, Lavigne JE, Carpenter DM
J Am Pharm Assoc (2003) · 2026 · PMID 41791647 · Full text
BACKGROUND: Given the growing prevalence of mental illness in the U.S. and the number of people receiving psychiatric medications, pharmacists are in a unique position to engage willing participants in mental health care...
BACKGROUND: Given the growing prevalence of mental illness in the U.S. and the number of people receiving psychiatric medications, pharmacists are in a unique position to engage willing participants in mental health care. However, most existing training programs fail to address barriers related to patient acceptability of pharmacists as mental health support professionals. OBJECTIVE: We aimed to (a) determine whether veterans and nonveterans find it acceptable to speak with community pharmacy staff about mental health and suicidal behaviors, and (b) identify barriers that may prevent individuals in either group from engaging in mental health conversations with pharmacy staff. METHODS: A formative qualitative study using semi-structured interviews was conducted to assess the acceptability of discussing mental health and suicidal behaviors with community pharmacists among pharmacy consumers. To capture a cross-section of the community, including individuals with a higher prevalence of mental health conditions, both veterans (n = 10) and nonveterans (n = 22) were recruited. Results were analyzed using a thematic analysis approach. RESULTS: Key facilitators to improve patient comfort to discuss mental health with their pharmacists include developing patient-pharmacist relationships, ensuring privacy, improving the physical pharmacy environment, and enhancing pharmacist mental health training. Commonly, participants desired pharmacists to treat them as individuals, remain calm, listen, and provide gentle suggestions without forceful tones. Increasing awareness of pharmacists' roles in mental health through signs, posters, and social media campaigns may result in improved patient interactions. Additionally, participants encouraged pharmacists to build partnerships with mental health providers to integrate pharmacists into the mental health care continuum. CONCLUSION: The present study underscores the complex dynamics surrounding mental health conversations between community pharmacists and patients. Among participants in North Carolina, reluctance to engage pharmacists in mental health discussions stemmed largely from limited rapport and unfamiliarity with pharmacists, concerns about privacy, and the perception that pharmacy environments were not always conducive to sensitive conversations. With targeted training, environmental adjustments, and active partnerships with mental health professionals, pharmacists could more confidently address mental health-related concerns, thus becoming more trusted resources in patient care.
Understanding initial medication adherence amongst major depressive disorder patients: A scoping review.
Ganna S, Khalid J, Aparasu RR
J Am Pharm Assoc (2003) · 2026 · PMID 41786085 · Publisher ↗
BACKGROUND: Initiation of medication, or the first step in adherence, is a critical determinant of pharmacotherapy success in major depressive disorder (MDD). However, inconsistencies in defining and measuring initiation...
BACKGROUND: Initiation of medication, or the first step in adherence, is a critical determinant of pharmacotherapy success in major depressive disorder (MDD). However, inconsistencies in defining and measuring initiation pose challenges in understanding its impact on patient outcomes. OBJECTIVES: This scoping review aims to systematically assess the definitions, operationalization, and measurement of initial medication adherence (IMA) among patients with MDD. METHODS: A literature search was conducted across PubMed, Embase, Scopus, and PsycInfo from inception to March 2025. Studies were included if they defined, measured, and evaluated IMA among patients with MDD prescribed selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors. RESULTS: Out of 1,636 studies, 13 met the inclusion criteria. Definitions of medication initiation varied, with durations ranging from 4 to 27 weeks. Measurement approaches included prescription claims, self-report, pill counts, and electronic monitoring. The operationalization of adherence status during the IMA phase lacked standardization, with studies using different adherence thresholds to define whether a patient was considered adherent. Factors associated with initiation included patient demographics, prior antidepressant use, provider specialty, and socioeconomic factors. CONCLUSIONS: This review found high variability in the definition and evaluation of IMA in MDD. A more standardized and consistent approach is needed to define, operationalize, and evaluate IMA, considering the pharmacologic aspects of first-line therapies for MDD.
Gene-Genie! A web-based artificial intelligence platform supporting site preparedness for gene therapy.
Levy R, Phillips RL, O'Sullivan G … +8 more , Capra S, Penm J, Lee A, Sagnella S, Guiu Segura JM, Forrey RA, Patanwala AE, Rasko J
J Am Pharm Assoc (2003) · 2026 · PMID 41786084 · Publisher ↗
BACKGROUND: Recombinant Adeno-Associated Virus (rAAV) gene therapies are now approved for the treatment of certain rare diseases and require specialized knowledge for clinical implementation. OBJECTIVES: Our objective wa...
BACKGROUND: Recombinant Adeno-Associated Virus (rAAV) gene therapies are now approved for the treatment of certain rare diseases and require specialized knowledge for clinical implementation. OBJECTIVES: Our objective was to develop and evaluate an artificial intelligence (AI) chatbot called 'Gene-Genie' with domain expertise in the implementation of rAAV gene therapies. METHODS: The study was conducted in two phases. The first phase, Gene-Genie development, involved technical scoping, proof-of-concept, and technical testing by a team of pharmacists, medical practitioners, regulatory specialists, and laboratory scientists. In the second phase, Gene-Genie was evaluated using an exploratory pilot pre-post study design, based on feedback from hospital pharmacy leaders before and after using Gene-Genie. The total score on the questionnaire ranged from 0 to 28, with a higher score indicating better perceived knowledge of gene therapy. RESULTS: The AI chatbot was successfully developed in phase 1 to deliver accurate, reliable, and context-aware interactions, aligned with the scope of the intended use case. The chatbot successfully referenced a curated and linked set of resources and avoided off-topic questions and responses. In the second phase, 8 pharmacy leaders tested Gene-Genie and provided feedback on its utility to further improve the chatbot. The mean ± standard deviation score on the perceived knowledge questionnaire was 17.0 ± 5.5 pre and 20.0 ± 2.2 post using Gene-Genie. The majority of participants agreed or strongly agreed (n = 5, 62.5%) that they would recommend Gene-Genie to other hospital Directors of Pharmacy (or similar) to help them with gene therapy implementation. CONCLUSION: We have developed Gene-Genie, which is an AI conversational chatbot that is domain-specific to gene therapy. Exploratory findings suggest that a domain-specific chatbot like Gene-Genie may be useful to those in hospital pharmacy leadership positions to implement gene therapy programs.
Evaluation of an HIV pre-exposure prophylaxis navigation and pharmacist-delivered clinical services model implemented at a municipal sexually transmitted infections clinic, 2017-2023.
Agroia H, Mousli L
J Am Pharm Assoc (2003) · 2026 · PMID 41786083 · Publisher ↗
BACKGROUND: Primary care providers have increasingly become trained in human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) prescribing; however, major barriers persist among patients in being able to comfo...
BACKGROUND: Primary care providers have increasingly become trained in human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) prescribing; however, major barriers persist among patients in being able to comfortably and confidentially engage in PrEP conversations with their primary care provider. OBJECTIVE: Herein, we describe and evaluate an alternative, pharmacist-delivered PrEP care model at a municipal sexually transmitted infection (STI) clinic, implemented in conjunction with PrEP navigators, to serve as a safety-net access point among priority populations. While there has been recent advocacy for increased implementation of pharmacist-delivered PrEP care models, this model of PrEP care has not been widely studied. PRACTICE DESCRIPTION: The County of Santa Clara's STI Clinic is a safety net clinic that provides sexual health evaluation and treatment services, as well as PrEP, to its patient population. PRACTICE INNOVATION: Under a pharmacist-delivered PrEP care model, pharmacists furnish PrEP patients without a physician prescription, and receive support from navigators to enroll patients into payment assistance programs, schedule initial and quarterly follow-up appointments, and provide translation services. EVALUATION METHODS: This evaluation presents the characteristics of patients referred for PrEP navigation as well as those that were either linked or scheduled directly for PrEP initiation and follow-up appointments since the inception of this pharmacist-delivered PrEP care model in 2017. RESULTS: Between 2017 and 2023, a total of 545 patients initiated PrEP with 379 (69%) initiating PrEP following receipt of navigation services. A total of 61% identified as Hispanic or Latino, 97% as male, and 72% were between the 25-44 age range at the time of initiation. The clinic experienced an approximate 3-fold increase in patient encounters with 216 initiating PrEP within the first 12-months of pharmacist-delivered PrEP care model implementation to 608 in 2023. CONCLUSION: Pharmacists have an opportunity to contribute to efforts aiming to end the HIV epidemic by becoming trained and furnishing PrEP to priority populations in local municipalities.
Pharmacist-facilitated enrollment in patient assistance programs in a rural community health-system.
Patterson ML, Jeffers J, Calamia C … +1 more , Fleming E
J Am Pharm Assoc (2003) · 2026 · PMID 41786082 · Publisher ↗
BACKGROUND: Medication affordability is a barrier to medication adherence. Ambulatory clinical pharmacists assist with improving medication access through the use of Patient Assistance Programs (PAPs), but there are few...
BACKGROUND: Medication affordability is a barrier to medication adherence. Ambulatory clinical pharmacists assist with improving medication access through the use of Patient Assistance Programs (PAPs), but there are few studies that quantitatively evaluate the pharmacist's impact through these programs. OBJECTIVE: The objective of this study was to evaluate the financial impact of pharmacist-facilitated PAP enrollments on medication access through estimated out-of-pocket cost savings. METHODS: A retrospective case series was conducted at a rural community health system. This study included patients with ambulatory clinical pharmacist-assisted enrollment in at least one PAP from January 2021 to December 2023. Patients were excluded if they had incomplete or denied PAP applications or were deceased. The primary endpoint was the estimated cost savings of patients' total medication costs from pharmacist-facilitated PAP enrollment. Secondary endpoints included the average time spent enrolling patients in PAPs, average number of pharmacist outreaches regarding PAPs, and number of medications obtained through PAPs per patient. Data were analyzed using descriptive statistics for all endpoints. RESULTS: For the 70 patients in the study across 3 PAP enrollment years, the estimated cost savings amounted to $1,853,746. Pharmacist PAP enrollment facilitation led to an average enrollment of 2 medications per patient and pharmacists performed an average of 4 outreaches per enrollment year. Ambulatory clinical pharmacists devoted 3.3 hours facilitating PAP enrollments per patient per enrollment year and devoted a total of 455 hours facilitating PAP enrollments for the 70 patients in the study. CONCLUSION: In this retrospective case series, pharmacist involvement in PAP enrollments increased medication access.
Corrigendum to "Knowledge of Immunosuppressants and Transplant Patient Management in Community Pharmacy" JAPhA, Volume 65 (2025), Issue November-December.
J Am Pharm Assoc (2003) · 2026 · PMID 41778940 · Publisher ↗
Abstract loading — click title to view on PubMed.
Enhancing community pharmacists' role in research: Insights and challenges in recruiting through pharmacy practice-based research networks.
Stolte AR, Newlon JL, Hettinger-Riddell KN … +6 more , Adeoye-Olatunde OA, Chewning BA, Kreling D, Schommer J, Jaynes H, Snyder ME
J Am Pharm Assoc (2003) · 2026 · PMID 41765102 · Publisher ↗
BACKGROUND: Engaging in research can enhance community pharmacist professional satisfaction, expose pharmacists to practice innovations, and forge stronger connections with academic institutions. Previous research has ex...
BACKGROUND: Engaging in research can enhance community pharmacist professional satisfaction, expose pharmacists to practice innovations, and forge stronger connections with academic institutions. Previous research has explored pharmacists' willingness to join a practice-based research network (PBRN) and the steps taken to launch a new PBRN. Several papers describe recruitment experiences for PBRN projects for other clinician PBRNs, such as physicians. While experiences recruiting pharmacists for research projects in general have been reported, no study yet has shared recruitment experiences for pharmacy PBRN projects. OBJECTIVE: The objective of this research was to describe the experience of recruiting community pharmacies for a large, multi-PBRN, project. METHODS: Data were collected from researcher records and community pharmacists in Indiana, Wisconsin, and Minnesota as part of a broader study aimed at implementing tablet-based technology (PatientToc) to enhance medication adherence. This paper describes the recruitment of community pharmacies for a Pilot Aim, followed by a Scaling Aim. Data on pharmacy characteristics, recruitment process characteristics, timeline (e.g., number of contacts between the research team and pharmacies, days between a pharmacy expressing interest in the project and enrollment), and participants' perceptions of participation in the project were collected from researcher records and through self-administered surveys. Descriptive statistics were used to analyze all data. RESULTS: Fifteen pharmacies were enrolled. The research team initiated contact more often than the pharmacy site. On average, the team initiated contact 5.7 times whereas the pharmacy site initiated contact 1.8 times. Recruitment went faster in the Scaling Aim (28.3 days to determine eligibility compared to 91.0 days to determine eligibility in the Pilot Aim) Overall, pharmacists expressed satisfaction with participation expectations, communication, the study topic, and financial compensation. However, pharmacists struggled with the value proposition of the intervention, which impacted recruitment and retention. CONCLUSION: Recruitment via pharmacy PBRNs demands substantial time and resources. It is also critical that pharmacy teams see a clear value proposition in proposed interventions. Our experiences point to several recommendations that pharmacy and other PBRN researchers can consider when planning a new project.
Outcomes of clinical pharmacists with extended prescribing rights in a hemodialysis unit.
Bacle A, Ferreira V, Pelletier S … +2 more , Bouchard A, Adam JP
J Am Pharm Assoc (2003) · 2026 · PMID 41748072 · Publisher ↗
BACKGROUND: Recent legislative reforms in Quebec, Canada, have expanded the scope of clinical pharmacists (CPs), allowing them to prescribe medications under specific conditions. While the benefits of pharmaceutical inte...
BACKGROUND: Recent legislative reforms in Quebec, Canada, have expanded the scope of clinical pharmacists (CPs), allowing them to prescribe medications under specific conditions. While the benefits of pharmaceutical interventions for patients undergoing hemodialysis are well-documented, the specific impact of autonomous prescribing by CPs remains poorly described. OBJECTIVE: To describe the practice of CPs with prescribing authority in inpatient and outpatient hemodialysis settings and to assess the clinical impact of their pharmaceutical interventions using the CLinical, Economic, and Organizational (CLEO) tool. METHODS: A retrospective observational study was conducted at the Centre hospitalier de l'Université de Montréal between February 1 and May 1, 2023. All pharmaceutical interventions were identified and categorized as autonomous or nonautonomous. The CLEO tool was used to assess the CLEO impact of each intervention. RESULTS: Among 75 patients (mean age 70 ± 14 years; 60% male) across 158 visits, 381 pharmaceutical interventions were recorded, including 89 (23%) performed autonomously. Medication additions frequently involved resumption of previously prescribed therapies, while discontinuations were predominantly proposed to physicians. Major clinical impact was observed across both autonomous and nonautonomous interventions. CONCLUSION: CPs with prescribing authority in hemodialysis units demonstrated meaningful clinical contributions across inpatient and outpatient settings. These findings support the role of pharmacist prescribing within multidisciplinary nephrology teams.
Pharmacist-led interventions to optimize the pharmacotherapy of older adults under evaluation for or living with a neurocognitive disorder in the community: A quasi-experimental study.
Bonnan D, Kröger E, Maheu A … +14 more , Morin M, Bélanger L, Vedel I, Wilchesky M, Sirois C, Dallaire C, Durand É, Couturier Y, Sourial N, Audet AS, Coulombe M, Audet M, Archambault P, Guénette L
J Am Pharm Assoc (2003) · 2026 · PMID 41740796 · Publisher ↗
BACKGROUND: Older adults living with neurocognitive disorders (NCDs) face a higher risk of polypharmacy, exposure to potentially inappropriate medications and related adverse events. Pharmacists can help manage these iss...
BACKGROUND: Older adults living with neurocognitive disorders (NCDs) face a higher risk of polypharmacy, exposure to potentially inappropriate medications and related adverse events. Pharmacists can help manage these issues and improve the appropriateness of pharmacotherapy. OBJECTIVE: To evaluate the impact of pharmacists' interventions, as members of primary care interprofessional teams, on medication use and patient-reported outcome measures among older adults living with or under investigation for a NCD. METHODS: The effect of a 6-month follow-up by a primary care interprofessional team pharmacist on the number of medications, potentially inappropriate medications (PIMs) and anticholinergic burden for older adults living at home under evaluation for or living with a NCD was assessed through a controlled quasi-experimental study. Eligible older adults were 65 years or older and were enrolled between September 2021 and February 2025. The patient-reported outcomes were the evolution of participants' quality of life, treatment burden and satisfaction with care. The outcomes were evaluated using difference in differences (D-I-D) and their 95% confidence interval (95% CI). RESULTS: Pharmacist interventions significantly reduced the mean anticholinergic burden in the intervention arm (n = 177) compared to the control arm (n = 128) (D-I-D: -0.29; 95% CI: [-0.56; -0.11]). A nonstatistically significant trend toward a reduction was also observed for the mean number of PIMs (D-I-D: -0.11; [-0.22; 0.00]). The interventions also improved participants' satisfaction with care (6.97; [0.23; 13.72]). The mean number of medications used, as well as the burden of treatment and quality of life, were stable after follow-up. CONCLUSION: Pharmacist-led interventions in interprofessional primary care settings contributed to the appropriateness of pharmacotherapy and satisfaction of older adults under evaluation for or living with a NCD after a 6-month follow-up.
Impact of pharmacist-led digital interventions on asthma outcomes: A systematic review.
Bell M, Burns B, King A … +2 more , Eller A, Jeminiwa RN
J Am Pharm Assoc (2003) · 2026 · PMID 41724433 · Publisher ↗
BACKGROUND: Effective asthma management is critical to prevent exacerbation, improve asthma control, and reduce health care expenses. Pharmacist-led asthma management tools allow pharmacists to better assist patients ove...
BACKGROUND: Effective asthma management is critical to prevent exacerbation, improve asthma control, and reduce health care expenses. Pharmacist-led asthma management tools allow pharmacists to better assist patients over the course of their disease. OBJECTIVES: This study seeks to assess the impact of pharmacist-led digital interventions on medication adherence and asthma control. Secondary objectives include assessing patient satisfaction, pharmacist perceptions, and identifying behavior change techniques (BCTs) used by pharmacists to support asthma management. METHODS: In September 2024, 2 independent investigators conducted searches on PubMed, PsycINFO, and CINAHL for studies evaluating pharmacist-led digital health tools for asthma management. The search strategy incorporated terms related to asthma, pharmacy practice, and digital health. CLINICALTRIALS: gov and the top 100 Google Scholar citations were also searched to capture grey literature. Eligible studies were those reporting the impact of pharmacist-led digital interventions on asthma outcomes. The literature search was repeated in September 2025 to capture newly published studies. The Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were used to ensure transparent reporting of the study selection process. RESULTS: Nine studies were included in the review. Studies utilized telemedicine follow ups or consults (n = 5), educational videos (n = 2), a self-management app with educational, peer, and pharmacist chat features (n = 1), and a data mining software (n = 1) to identify and offer interventions to at-risk patients. Four out of 5 studies assessing the effect of an intervention on medication adherence reported positive effects. Similarly, 7 of 8 interventions measuring asthma control reported positive effects. Across studies, 8 BCTs were used to promote adherence and inhaler technique. Two studies assessed patient satisfaction and reported positive feedback. One study assessed economic outcomes with direct and indirect cost-savings. None assessed pharmacists' perceptions. CONCLUSIONS: Most studies reported positive effects of pharmacist-led interventions on medication adherence and asthma control, highlighting the potential of these interventions to improve patient outcomes. Although all but one study applied BCTs, the limited diversity in the types of BCTs utilized, and the limited evaluation of satisfaction, costs, and pharmacist perspectives highlights critical research gaps.
Patient reach: A system-level patient coverage indicator for academic detailing programs.
Hamilton CJ, Bounthavong M, Koulis H … +2 more , Roop B, Christopher MLD
J Am Pharm Assoc (2003) · 2026 · PMID 41707806 · Publisher ↗
Academic detailing bridges gaps between clinical practice and evidence-based treatments; however, it lacks a simple and convenient campaign-level coverage measure to optimize impact on the patient population. To address...
Academic detailing bridges gaps between clinical practice and evidence-based treatments; however, it lacks a simple and convenient campaign-level coverage measure to optimize impact on the patient population. To address this, the U.S. Department of Veterans Affairs (VA) Pharmacy Benefits Management Academic Detailing Services introduced the patient reach (PR) measure. This measure represents the share of actionable patients assigned to clinicians receiving an educational outreach session. The PR measure was implemented in March 2024 and provides information on PR coverage across VA regions, medical centers, and clinicians. The PR measure functions as the primary indicator supporting prioritization of clinicians for outreach visits and may apply to other pharmacy-related settings such as chronic disease management programs, opioid and controlled substance stewardship programs, and preventative care and screening initiatives. Future evaluations will assess whether using the PR measure improves clinician selection and contributes to downstream practice change.
The accessibility-sustainability paradox: Optimizing the community pharmacist's role in public health.
Leslie KF, Hobbs C, Okoro ON … +3 more , Hafling B, Kaftan G, Fadipe M
J Am Pharm Assoc (2003) · 2026 · PMID 41698546 · Publisher ↗
Community pharmacists are among the most accessible health professionals and play an increasingly vital role in advancing public health. The COVID-19 pandemic magnified their contributions and highlighted longstanding st...
Community pharmacists are among the most accessible health professionals and play an increasingly vital role in advancing public health. The COVID-19 pandemic magnified their contributions and highlighted longstanding structural vulnerabilities in community pharmacy practice. As community pharmacies close and workload intensifies, the infrastructure that once ensured access to care is eroding. This commentary explores the "accessibility-sustainability paradox" facing community pharmacy: pharmacists are essential to public health, yet their service environments are increasingly untenable due to misalignment between expanded clinical expectations and unsustainable practice and payment models. Contributing factors include the growth of pharmacy deserts, workforce burnout, and payment models that fail to support nondispensing services. Despite demonstrated impact, many pharmacy-based public health initiatives lack mechanisms for reimbursement and, thus, long-term viability. Aligning scope of practice expansion with sustainable reimbursement, workforce support, and practice models is essential to preserving community pharmacy as a public health access point. Without change, pharmacists will continue to face untenable expectations to meet public health needs without the necessary resources. Ensuring sustainable support for community pharmacists is therefore not only a workforce issue but a public health imperative.
Opportunity awaits: Comprehensive medication management for adults with developmental disabilities living in the community.
Erickson S
J Am Pharm Assoc (2003) · 2026 · PMID 41692176 · Publisher ↗
Persons with intellectual or developmental disabilities are at increased risk for medication-related problems. An opportunity awaits pharmacists to conduct comprehensive medication management (CMM) services to ensure saf...
Persons with intellectual or developmental disabilities are at increased risk for medication-related problems. An opportunity awaits pharmacists to conduct comprehensive medication management (CMM) services to ensure safe and effective use of medication, particularly for those living in group home or other supported living settings. As with long-term care consultant practice, pharmacists could perform in home CMM for persons living in these settings.
The 2025 Invitational Summit on Medicaid Payment for Pharmacist Patient Care Services: Meeting proceedings.
Smith MA, Giara K, Bucheit JD … +4 more , Goode JK, Dixon DL, Sisson EM, Salgado TM
J Am Pharm Assoc (2003) · 2026 · PMID 41692175 · Publisher ↗
BACKGROUND: Given the diverse experiences among states on Medicaid payment for pharmacist patient care services, the University of Connecticut and Virginia Commonwealth University Schools of Pharmacy hosted the first Inv...
BACKGROUND: Given the diverse experiences among states on Medicaid payment for pharmacist patient care services, the University of Connecticut and Virginia Commonwealth University Schools of Pharmacy hosted the first Invitational Summit on Medicaid Payment for Pharmacist Clinical Services in March 2025. OBJECTIVES: 1. To share best practices for state policy or legislative approaches, credentialing processes, billing processes, and payment infrastructure for Medicaid payment for pharmacist patient care services. 2. To identify barriers and facilitators related to Medicaid payment for pharmacist provided patient care services. METHODS: This virtual event brought together nearly 200 Medicaid administrators, state and national pharmacy leaders, and policy experts from all 50 states to address barriers and opportunities for securing sustainable Medicaid payments for pharmacist-provided patient care services. Speakers from states with demonstrated experience in implementing Medicaid pharmacist payment policies were invited for their subject matter expertise and leadership in state-level advocacy. RESULTS: Sustainable Medicaid payment for patient care services depends on more than legislative wins alone. Lessons from states at the forefront of reform point to 3 foundational pillars that determine success: infrastructure, collaboration, and time. Many pharmacists are hindered by the complexity of the systems, processes, and administrative support needed to enable pharmacists to enroll, credential, and bill for patient care services. CONCLUSION: Pharmacists and state pharmacist associations must engage with Medicaid agencies, medical societies, and health departments to create policies that support standardized implementation of pharmacist payment. Continued research on patient and population health outcomes will strengthen the case for expansion, and national coordination through a central repository of state legislation, state pharmacy association language, and implementation toolkits.
Expanding access to MOUD through pharmacist independent prescribing: Early findings from a community pharmacy-based clinical service.
O'Connor SK, Adams JL, Kreider K … +3 more , Tracy T, Andrus D, Rosko ZR
J Am Pharm Assoc (2003) · 2026 Feb · PMID 41692174 · Publisher ↗
BACKGROUND: Fewer than one in five patients with opioid use disorder are treated with Medications for Opioid Use Disorder (MOUD). Idaho pharmacists have full practice authority and can independently provide preventative...
BACKGROUND: Fewer than one in five patients with opioid use disorder are treated with Medications for Opioid Use Disorder (MOUD). Idaho pharmacists have full practice authority and can independently provide preventative care and prescribe for acute and chronic conditions. OBJECTIVES: To assess the impact of a newly established MOUD service at a single rural, independent community pharmacy. PRACTICE DESCRIPTION: Medicine Man Prairie Pharmacy is a single-site independent pharmacy located in Hayden, Idaho that offers compounding, compliance packaging, immunizations, and point of care testing and treatment services in addition to dispensing. PRACTICE INNOVATION: Patients who present for the service are evaluated by the pharmacist in a one-on-one meeting (in-person or via telehealth) and therapy decisions are tailored to individual patients. When appropriate, buprenorphine is prescribed and frequency of patient visits is based on patient-specific factors. The pharmacy team provides close monitoring and a 7-day-a-week, after-hours response service for challenges that arise in order to help promote success. EVALUATION METHODS: A retrospective chart review was completed. All patients who were prescribed a buprenorphine-containing product for opioid use disorder by the pharmacist from August 2023 to September 2024 were included. Duration and type of care provided and financial and geographic impact were evaluated. RESULTS: Sixty-five patients were included. The pharmacist-delivered service reduced out-of-pocket costs to patients and 69% of patients had newly established care with a primary care provider with whom they were regularly following up. CONCLUSION: A pharmacist-run MOUD service found success decreasing patient out-of-pocket costs and improving continuity of care with primary care providers.
Management of acute withdrawal from 7-hydroxymitragynine after high-dose chronic use: A case report.
Lybik N, Cone B, Skelton S … +1 more , Elfessi Z
J Am Pharm Assoc (2003) · 2026 · PMID 41690384 · Publisher ↗
BACKGROUND: This study aimed to report acute opioid withdrawal after an abrupt cessation of high-dose 7-hydroxymitragynine (7-OH) in a patient who transitioned from kratom and to outline pharmacist-focused assessment, ma...
BACKGROUND: This study aimed to report acute opioid withdrawal after an abrupt cessation of high-dose 7-hydroxymitragynine (7-OH) in a patient who transitioned from kratom and to outline pharmacist-focused assessment, management, and regulatory counseling strategies including a formal causality assessment. CASE SUMMARY: A 43-year-old male with opioid use disorder presented with nausea, diarrhea, abdominal cramping, restlessness, chills/clamminess, and anxiety after discontinuing concentrated 7-OH (360 mg/d, last 30 mg dose ∼ 48 hours earlier). Vital signs were blood pressure of 138/93 mm Hg, temperature of 37.7°C, heart rate of 84 beats/min, respiratory rate of 16 breaths/min, and pupils of 2-3 mm, with a clinical opioid withdrawal scale score of 5. He had transitioned from kratom to 7-OH approximately 18 months earlier. He met the DSM-V criteria for moderate opiate use disorder, although he never engaged in formal treatment. The patient reported that he transitioned from kratom to concentrated 7-OH products because he perceived stronger, faster opioid-like effects and required smaller quantities to avoid withdrawal. Emergency department management included sublingual buprenorphine-naloxone 4-1 mg, adjuncts (clonidine, ondansetron, loperamide, methocarbamol, nonsteroidal anti-inflammatory drugs, acetaminophen), counseling on precipitated withdrawal, and referral for treatment. A Naranjo assessment supported probable causality (score 6). PRACTICE IMPLICATIONS: Concentrated 7-OH products differ from kratom leaf and can produce dependence and withdrawal; pharmacists should screen for these products, time buprenorphine initiation to moderate withdrawal, provide harm-reduction counseling, and incorporate evolving state regulations into patient education.
Economic evaluation of talazoparib and enzalutamide compared to enzalutamide monotherapy in HRRm metastatic castration-resistant prostate cancer.
Lukan C, Suh K
J Am Pharm Assoc (2003) · 2026 · PMID 41687781 · Publisher ↗
BACKGROUND: The poly (ADP-ribose) polymerase inhibitor talazoparib, in combination with the androgen receptor pathway inhibitor enzalutamide, has demonstrated improved survival outcomes compared with enzalutamide monothe...
BACKGROUND: The poly (ADP-ribose) polymerase inhibitor talazoparib, in combination with the androgen receptor pathway inhibitor enzalutamide, has demonstrated improved survival outcomes compared with enzalutamide monotherapy in homologous recombination repair mutations (HRRm)-positive metastatic castration-resistant prostate cancers (mCRPC) in the TALAPRO-2 trial. However, potential cost-effectiveness of the combination regimen remains limited. OBJECTIVES: Our objective was to evaluate lifetime cost-effectiveness of talazoparib plus enzalutamide (TALA + ENZA) versus enzalutamide (ENZA) alone from a U.S. payer perspective. METHODS: A partitioned survival model with progression-free survival and overall survival inputs were derived from the TALAPRO-2. Costs for drugs, adverse events, disease management, and end-of-life care were included. Health outcomes included life-years (LYs) and quality-adjusted life-years (QALYs). Incremental cost-effectiveness ratios (ICERs) were calculated for TALA + ENZA versus ENZA. Deterministic and probabilistic sensitivity analyses assessed parameter uncertainty, and scenario analyses explored drug price reductions and shorter time horizons. RESULTS: In the base case, TALA + ENZA yielded 4.84 total LYs and 3.25 QALYs, compared with 3.27 LYs and 1.95 QALYs for ENZA alone, resulting in incremental gains of 1.57 LYs and 1.30 QALYs. Total costs were $1,544,791 for TALA + ENZA and $378,932 for ENZA, yielding an ICER of $896,159 per QALY gained. Sensitivity analyses identified utility and drug cost inputs as the most influential parameters. Probabilistic analysis showed a 50% probability of cost-effectiveness at a willingness-to-pay (WTP) threshold of approximately $1.0 million/QALY gained. CONCLUSION: For HRRm-positive mCRPC, TALA + ENZA provided survival and QALY gains compared with ENZA alone but at higher cost, resulting in an ICER exceeding typical U.S. WTP thresholds.
Collaboration with community partners to expand naloxone access in the HEALing Communities Study.
Ingram T, Rubi S, Dantzler S … +5 more , DeFiore-Hyrmer J, Brown JL, Sprunger J, Winhusen TJ, Lyons MS
J Am Pharm Assoc (2003) · 2026 · PMID 41687780 · Full text
BACKGROUND: Increasing naloxone availability is one of the most effective ways to combat opioid-related overdose and death. OBJECTIVE: We describe the implementation of a community-based hub-and-spoke model and highlight...
BACKGROUND: Increasing naloxone availability is one of the most effective ways to combat opioid-related overdose and death. OBJECTIVE: We describe the implementation of a community-based hub-and-spoke model and highlight supportive policies and procedures to address implementation barriers to reduce fatal opioid overdoses. We aim to provide insight into future naloxone distribution efforts. METHODS: The "hub-and-spoke" model functioned as an extension of the Ohio Department of Health's Project DAWN (Deaths Avoided With Naloxone) by establishing secondary Project DAWN sites as part of the HEALing Communities Study in Ohio. State-sponsored naloxone distribution efforts ensured that naloxone was freely and readily accessible through local health departments and various community organizations. RESULTS: This initiative increased the distribution of sustainable naloxone to a wider range of locations, such as workplaces, recreational areas, and places of worship. Ohio's approach exemplifies a coordinated effort, uniting state government and community leaders in a shared commitment to expand access to lifesaving medications to combat the opioid epidemic. CONCLUSION: The "hub-and-spoke" model offers a community-based strategy to extend resources across different organizations and enhance the local infrastructure. Discussions facilitated by experts in the field and trained individuals can combat stigmatizing beliefs within the community. Standardizing medical protocols and promoting flexible legislation can significantly improve distribution efficiency.
Impact of mental health first aid training in California pharmacy professionals.
Duong C, Ketana O, Puzantian T
J Am Pharm Assoc (2003) · 2026 · PMID 41687779 · Publisher ↗
BACKGROUND: Nearly 1 in 4 Americans experience mental illness, yet only half receive treatment. Pharmacy professionals serve and provide care to many in their communities, including those experiencing mental illness. Equ...
BACKGROUND: Nearly 1 in 4 Americans experience mental illness, yet only half receive treatment. Pharmacy professionals serve and provide care to many in their communities, including those experiencing mental illness. Equipping them with knowledge and skills may help facilitate linkages for those struggling with mental health disorders. OBJECTIVE: To evaluate the impact of Mental Health First Aid (MHFA) training in pharmacy professionals on knowledge about mental health and attitudes about assisting individuals experiencing mental health challenges. METHODS: Pharmacy students, technicians, and pharmacists completed certification training in adult MHFA. Participants completed electronic precourse and postcourse surveys and a postcourse evaluation. Questions assessed knowledge about the purpose and use of MHFA and signs and symptoms of mental health and substance use challenges. Questions also assessed attitudes about using skills learned from training. Participants were also asked to evaluate whether training was helpful, if it better prepared them for professional work, and how many referrals and linkages, defined as directing a person to resources or services to further information or action, they made following training. RESULTS: From January 2023 through June 2025, 770 pharmacy professionals were trained across 66 sessions. A statistically significant increase in knowledge was seen in participants' abilities to describe the purpose of MHFA, recognize signs and symptoms of mental health and substance use challenges, and explain ways in which a Mental Health First Aider may cope with discomfort when providing MHFA. Following training, participants were significantly more willing to have supportive conversations with someone experiencing a mental health or substance use challenge and to use the pharmacy-tailored action plan to connect someone with appropriate resources. The majority of participants found the course to be helpful and informative, and that it better prepared them for professional work. CONCLUSION: MHFA training in pharmacy professionals is an effective intervention to promote mental health support, increase awareness, reduce stigma, and equip participants to make linkages.
Facilitators, barriers and intervention strategies for medication adherence in patients receiving thyroid hormone replacement therapy: A mixed-methods systematic review.
Gao H, Chen H, Chen X … +5 more , Lu X, Bai D, Yuan Y, Hou C, Gao J
J Am Pharm Assoc (2003) · 2026 Feb · PMID 41679387 · Publisher ↗
BACKGROUND: Thyroid hormone replacement therapy (THRT) is the lifelong treatment for hypothyroidism, yet persistent non-resolution of the condition necessitates indefinite adherence and systematic evidence on facilitator...
BACKGROUND: Thyroid hormone replacement therapy (THRT) is the lifelong treatment for hypothyroidism, yet persistent non-resolution of the condition necessitates indefinite adherence and systematic evidence on facilitators, barriers, and targeted interventions to optimize medication adherence in THRT remains limited. OBJECTIVES: This mixed-methods systematic review aimed to: 1) identify influential barriers and facilitators of THRT adherence using the Capability, Opportunity, Motivation-Behavior (COM-B) model and Theoretical Domains Framework (TDF); and 2) map potential and effective behavior change techniques (BCTs) to the TDF domains corresponding to the identified barriers. METHODS: Ten databases were searched from inception to November 2024 and then updated in November 2025. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT). For purpose 1: the COM-B model and TDF, were used to code barriers and facilitators extracted from primary studies to one or more of the 14 domains of TDF, then identify the key barriers and ranked the top five influential TDF domains using three criteria. For purpose 2: the potential BCTs were recommended to target key barriers identified in TDF domains. RESULTS: The 44 studies were included and mapped to 14 domains of TDF. Top five influential TDF to medication adherence were environmental context and resources (e.g., inconvenient administration times), social influences (e.g., family support), knowledge (e.g., lack of disease/medication knowledge), belief about consequences (e.g., concerns about side effects), and social/professional role and identity (e.g., older age as a facilitator). Twenty-seven potentially effective BCTs were identified from the included studies and the most frequently used BCTs to target five key TDF domains were social support from their partners, multilevel care intervention and effective physician communication. CONCLUSION: This review highlights multifaceted barriers of medication adherence in patients receiving THRT and proposes theory-informed strategies to address them. Future research should validate these strategies in real-world settings and explore contextual adaptations for diverse populations.
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