Journal Of The American Pharmacists Association[JOURNAL]
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200 papers
Disparity implications of machine-learning-based MTM eligibility criteria.
Tsang CCS, Cui Y, Cushman WC … +3 more , Crill CM, Stracner K, Wang J
J Am Pharm Assoc (2003) · 2026 · PMID 41478507 · Full text
BACKGROUND: Although Medicare Medication Therapy Management (MTM) programs have demonstrated clinical and economic benefits, racial/ethnic minority groups face challenges meeting eligibility criteria for enrollment. In 2...
BACKGROUND: Although Medicare Medication Therapy Management (MTM) programs have demonstrated clinical and economic benefits, racial/ethnic minority groups face challenges meeting eligibility criteria for enrollment. In 2017, the Centers for Medicare and Medicaid Services launched the 5-year Enhanced MTM demonstration, granting Part D plans flexibility in identifying eligible beneficiaries. However, because participating plans adopted predictive modeling to determine eligibility, concerns persist that this approach may perpetuate existing racial/ethnic disparities. OBJECTIVES: To assess whether health cost-based MTM eligibility differs across race/ethnicity and whether machine learning models reproduce observed disparities in predicted eligibility. METHODS: This study analyzed 2019 Medicare administrative data linked to the Area Health Resource File for a 10% random sample of fee-for-service beneficiaries. Outcomes were binary indicators of top-quartile medication and health care costs, each measured from the Medicare and health care system perspectives. Multivariable logistic regression was employed to assess racial/ethnic disparities in top-quartile costs, using 6 algorithms - regularized logistic regression, random forest, gradient boosted trees, support vector machine, multilayer perceptron, and a consensus model. Predicted probabilities were computed to assess disparities in model outputs using multivariable fractional logistic regression. RESULTS: Among 1,848,654 Medicare beneficiaries, Black and Hispanic individuals had significantly lower adjusted odds of top-quartile costs across all cost outcomes compared to their non-Hispanic White counterparts. For instance, the odds of being in the top quartile for total medication costs were 28% lower for Black beneficiaries (odds ratio [OR] = 0.72, 95% confidence interval [CI] = 0.70-0.75) and 21% lower for Hispanic beneficiaries (OR = 0.79, 95% CI = 0.74-0.84). Machine learning models reproduced these disparities in predicted probabilities, mirroring patterns in the empirical data. CONCLUSION: Implementing cost-based MTM eligibility through predictive algorithms may perpetuate racial/ethnic disparities in MTM program access. Future research should explore strategies to mitigate such a potential when using such modeling to determine MTM eligibility.
Public messaging on acetaminophen use in pregnancy: Balancing evidence and uncertainty.
Adebayo UO, Md Mosaddek AS, Bhatt A … +4 more , Bhavani P, Sapate A, Ahamed F, Jamil S
J Am Pharm Assoc (2003) · 2026 · PMID 41475594 · Publisher ↗
Recent commentary has rekindled public discourse regarding the potential correlation between maternal consumption of acetaminophen and the incidence of autism spectrum disorder (ASD). While such discussions attract publi...
Recent commentary has rekindled public discourse regarding the potential correlation between maternal consumption of acetaminophen and the incidence of autism spectrum disorder (ASD). While such discussions attract public attention, they risk oversimplifying a complex scientific issue and may inadvertently heighten anxiety among expectant mothers who rely on acetaminophen as one of the few analgesic and antipyretic agents considered relatively safe during pregnancy. Epidemiological investigations and systematic reviews have identified a correlation between prenatal exposure to acetaminophen and an elevated risk of neurodevelopmental disorders, notably attention-deficit/hyperactivity disorder and, to a lesser degree, ASD in offspring. Nevertheless, these conclusions predominantly rely on observational studies, which are intrinsically constrained by potential confounding variables such as maternal health conditions, genetic predispositions, and environmental exposures, in addition to measurement inaccuracies and biases in the assessment of outcomes. Systematic reviews and clinical perspectives consistently underscore the variability and limitations inherent in the existing evidence, culminating in the assertion that a definitive causal relationship has yet to be established and that the noted associations may be subject to the influence of unmeasured familial or environmental variables. Consequently, prevailing guidelines persist in endorsing the use of acetaminophen during pregnancy when clinically warranted, while recommending the administration of the lowest effective dose for the briefest necessary duration. Public communications that mistakenly interpret correlation as causation risk jeopardizes maternal health. Fear-driven avoidance of acetaminophen may compel pregnant individuals to endure unaddressed fever or pain, both of which have the potential to adversely influence pregnancy outcomes. Equally alarming is the possibility of substitution with nonsteroidal anti-inflammatory agents or opioids, which pose more evident and severe risks to both maternal and fetal health. The emerging discourse therefore demands a balanced and evidence-informed communication strategy.
How individuals choose medications: Tool development for a discrete choice experiment on eye allergy treatment decisions.
Formosa L, Vargas R, Wilson L
J Am Pharm Assoc (2003) · 2026 · PMID 41453642 · Publisher ↗
BACKGROUND: Allergic conjunctivitis affects nearly 40% of the U.S. population, triggered by allergens like pollen or pet dander. Since only 10% of individuals seek medical attention, most rely on over-the-counter (OTC) t...
BACKGROUND: Allergic conjunctivitis affects nearly 40% of the U.S. population, triggered by allergens like pollen or pet dander. Since only 10% of individuals seek medical attention, most rely on over-the-counter (OTC) treatments. The condition can be managed with OTC and prescription (Rx) medications, depending on symptom severity. However, little is known about how individuals decide between treatment approaches. OBJECTIVES: This study aimed to develop and pilot-test a choice-based conjoint (CBC) tool to measure preferences for 3 treatment approaches: 1) self-selected OTC treatment, 2) pharmacist-advised OTC treatment, and 3) physician-prescribed Rx treatment. METHODS: We developed a CBC tool following ISPOR guidelines for conjoint analysis and discrete choice experiments. Key steps included identifying relevant attributes through literature review, validating them through interviews (n = 9), and designing the CBC in Sawtooth Software (Sawtooth Software, Inc) with 10 random and 3 fixed scenarios. Validity testing was conducted with 22 participants to evaluate the tool's ability to capture variability across preference responses. RESULTS: The CBC tool included 7 attributes: speed of access to treatment, first treatment decision, accuracy of treatment, ease and comfort of administration, cost, time and duration of relief, and side effects, each with 2-3 levels. Validity results showed capture of variability in responses and ability to respond to fixed questions. CONCLUSION: This research developed a CBC tool using discrete choice methods to measure how individuals make trade-offs among access, symptom relief, and other factors when selecting treatment approaches for allergic conjunctivitis. The tool offers a replicable framework for measuring individual's treatment management decisions in health care across the health care continuum. This tool will allow measurement of individual preferences for medication choices across the spectrum from self- or pharmacy-assisted OTC, to physician prescribed treatments.
Expanding pharmacogenomics in the community pharmacy setting: A survey of Alabama community pharmacists' confidence, perceptions, interest, and preparedness.
Watts Alexander CS, Tocco LG, McDowell LD … +4 more , Hohmann LA, Lloyd KB, Chafe OG, Gamston CE
J Am Pharm Assoc (2003) · 2026 · PMID 41448273 · Publisher ↗
BACKGROUND: Pharmacogenomics (PGx) clinical decision support (CDS) is essential for effective PGx implementation, yet most tools remain confined to institutional settings. Community pharmacists, who make up nearly half o...
BACKGROUND: Pharmacogenomics (PGx) clinical decision support (CDS) is essential for effective PGx implementation, yet most tools remain confined to institutional settings. Community pharmacists, who make up nearly half of the U.S. pharmacy workforce, are among the most accessible health care providers, offering care without appointments and reaching patients across both urban and rural areas. This accessibility positions them as critical entry points for delivering PGx services and advancing equitable access. However, many lack the training and resources necessary to provide informed PGx care. OBJECTIVE: The purpose of this study was to survey Alabama community pharmacists to assess confidence in PGx knowledge and experiences, perceived benefits and barriers, and interest and preparedness for implementation, with attention to the role of CDS tools. METHODS: A cross-sectional survey was distributed via email to Alabama pharmacists between September and October 2024. Items included Likert-type scales, multiple-choice, yes/no, and open responses. Descriptive statistics characterized responses, and Mann-Whitney U tests compared responses between subgroups. RESULTS: Of 1638 invited pharmacists, 233 responded (14.2%), with 135 included in the analysis. Participants were primarily female (70.9%), urban (81.5%), and averaged 45.4 years of age. Only 19% reported prior PGx training. Confidence in foundational knowledge was low (mean scale score = 2.74, standard deviation [SD] = 0.44). Perceived benefits were high (mean scale score = 4.06, SD = 0.17). Interest and preparedness varied (interest = 3.52 [SD = 0.15]; preparedness = 2.69 [SD = 0.32]). Fifty percent desired PGx-CDS tools, and 53% expressed interest in offering PGx services; however, few reported adequate site resources. CONCLUSION: Alabama pharmacists expressed strong PGx interest and perceived benefits, but reported gaps in knowledge, confidence, and infrastructure. Given their accessibility, community pharmacists represent a critical bridge to equitable PGx adoption. Expanding PGx education, training, and CDS integration is essential to enable sustainable PGx delivery in community pharmacy.
A unifying vision for pharmacy: Defining professional identity through stakeholder perspectives.
Rhoney DH, Daugherty KK, Chen AMH … +9 more , Churchwell M, Sibicky S, Thornby KA, Nelson NR, Kleppinger EL, Parker D, Ragucci KR, Stowe CD, Brock TP
J Am Pharm Assoc (2003) · 2026 · PMID 41448272 · Publisher ↗
BACKGROUND: Amid evolving health care demands, pharmacy faces a critical identity inflection point that requires a cohesive vision. OBJECTIVE: This study aimed to define a cohesive, stakeholder-informed vision for the U....
BACKGROUND: Amid evolving health care demands, pharmacy faces a critical identity inflection point that requires a cohesive vision. OBJECTIVE: This study aimed to define a cohesive, stakeholder-informed vision for the U.S. pharmacist's societal role by analyzing perceptions from across education, practice, and policy. METHODS: The study applied a multimethod qualitative design guided by constructivist epistemology incorporating thematic analysis, metaphor discourse analysis, force field mapping, and analysis of alignment with national forecast reports. Data were collected from 27 focus groups and 8 individual interviews with 148 participants representing 8 stakeholder categories. RESULTS: From these themes, five metaphorical roles emerged, medication safety and optimization; access and equity in health care; chronic disease management; health promotion and preventative services; and patient education, counseling, and advocacy, highlighting broad agreement on pharmacists' contributions. Five metaphorical roles, safety net, steward, coach, navigator, and advocate, reflected a multidimensional professional identity. Force field analysis demonstrated a balance between driving forces, such as accessibility, medication safety, and public health leadership, and restraining forces, including lack of provider status, regulatory variation, and workforce instability. Comparative analysis showed strong alignment with national pharmacy forecasts, though gaps emerged in areas such as digital readiness, economic literacy, and global practice models. CONCLUSION: This study provides an empirically grounded framework to inform a unifying vision for pharmacy's future. Stakeholder insights reinforce the need for education reform, policy realignment, and narrative clarity to reposition pharmacists as essential contributors to health-system transformation. By embracing a hybrid identity and dismantling structural barriers, the profession can fulfill its societal mandate in safety, accessibility, and care innovation.
Pharmacists' propensity to trust automated technologies: A demographic analysis.
Whitaker M, Rowell B, Kim JY … +3 more , Al Kontar R, Yang XJ, Lester CA
J Am Pharm Assoc (2003) · 2026 · PMID 41448271 · Publisher ↗
BACKGROUND: Artificial intelligence (AI), in conjunction with automated technologies, is being deployed in pharmacies. Little research has been published regarding pharmacists' general willingness to trust AI. Understand...
BACKGROUND: Artificial intelligence (AI), in conjunction with automated technologies, is being deployed in pharmacies. Little research has been published regarding pharmacists' general willingness to trust AI. Understanding pharmacists' propensity to trust (PTT) AI may help guide the successful implementation and adoption of AI tools. OBJECTIVE: The objective is to assess pharmacists' PTT AI with automated technology and identify factors that may influence this tendency. METHODS: As part of a larger study, licensed pharmacists completed a demographics survey and the PTT survey before testing AI advice on medication fills. The PTT survey consisted of 6 statements about AI and pharmacists indicated their level of agreement using a 5-point Likert scale, with higher numbers indicating more agreement. Summary statistics, Kruskal-Wallis tests, linear regressions, and confidence intervals were calculated. RESULTS: Ninety-nine pharmacists completed the surveys. The mean pharmacist age was 38.1 years and the median PTT score was 3.83 (P < 0.001). Age was a statistically significant predictor of PTT (β = 0.02, P < 0.001, and R = 0.11). Linear regressions yielded statistically significant results for age and the work experience category of 21 or more years. No significant differences were found between the PTT scores and gender, ethnicity, race, or pharmacy setting. CONCLUSIONS: Older and more experienced pharmacists had higher PTT scores. Exposure to AI tools during pharmacy education may help younger pharmacists optimize their PTT AI.
Implementation and outcomes of a pharmacist-led social determinants of health screening and intervention program in an integrated health system specialty pharmacy model.
Lakada I, Stutsky M, Huynh C … +2 more , Periyasamy S, Idusuyi A
J Am Pharm Assoc (2003) · 2026 · PMID 41421420 · Publisher ↗
BACKGROUND: Social determinants of health (SDOH) are nonmedical factors that impact health outcomes. Pharmacists within integrated health system specialty pharmacies (HSSPs) are positioned to identify and address SDOH ba...
BACKGROUND: Social determinants of health (SDOH) are nonmedical factors that impact health outcomes. Pharmacists within integrated health system specialty pharmacies (HSSPs) are positioned to identify and address SDOH barriers. OBJECTIVE: The objective was to implement and evaluate a pharmacist-led SDOH program for HSSP patients. PRACTICE DESCRIPTION: The practice innovation was implemented within 4 health systems in Michigan and Massachusetts with associated HSSPs and a standard specialty pharmacy clinical management model incorporating initial patient counseling and periodic reassessments. PRACTICE INNOVATION: A SDOH screening and intervention program was developed and piloted at 4 health systems with associated HSSPs. Patients with HIV, rheumatoid arthritis (RA), and hyperlipidemia meeting pre-defined inclusion criteria were enrolled in the program from September 2023 through September 2024. After screening patients for SDOH barriers, pharmacists offered targeted interventions and structured follow-ups to ensure resolution of challenges. EVALUATION METHODS: Patients enrolled in the program were analyzed using data extracted from the electronic medical record and patient management platform. The primary outcome was intervention acceptance rate; secondary outcomes included intervention categories, patient-perceived value of interventions, ongoing support needs, pharmacist time spent, and clinical outcomes. RESULTS: Of the 50 patients (HIV: n = 6; RA: n = 27; hyperlipidemia: n = 17) enrolled, 56% completed screening and 79% of those accepted interventions. Of the 19 patients who received follow-up, 63% found the interventions beneficial, and 4 required ongoing support. The most frequent interventions included food security/nutrition (46%) and physical activity (25%). The average time per intervention was 60 min (range: 15-180 min). Patients with interventions demonstrated clinical outcomes improvements, including a mean Routine Assessment of Patient Index Data 3 score reduction of 3 points (range: 1.3-27.3) and mean low-density lipoprotein reduction of 29.8 mg/dL (range: 44-137) for RA and hyperlipidemia, respectively. CONCLUSIONS: These pilot results suggest that a pharmacist-led SDOH program may be effective in addressing patient barriers, demonstrated by high acceptance rate and perceived benefit of interventions and improved clinical outcomes.
Methemoglobinemia induced by dapsone, hydroxychloroquine, and rifampin combination for post-treatment Lyme disease syndrome: A case report.
Worden J, Baumeister T, Stogner S … +2 more , Henin N, Stern RA
J Am Pharm Assoc (2003) · 2026 · PMID 41421419 · Publisher ↗
BACKGROUND: A patient presented to the emergency department with drug-induced methemoglobinemia due to a combination of medications prescribed for post-treatment Lyme disease syndrome (PTLDS). This case highlights the po...
BACKGROUND: A patient presented to the emergency department with drug-induced methemoglobinemia due to a combination of medications prescribed for post-treatment Lyme disease syndrome (PTLDS). This case highlights the potential risks of dapsone, hydroxychloroquine (HCQ), and rifampin for the management of PTLDS. CASE SUMMARY: A 62-year-old female presented to the hospital with shortness of breath and low oxygen saturation. Past medical history included a diagnosis of PTLDS, for which she was prescribed a combination of dapsone, HCQ, doxycycline, rifampin, and ivermectin at home. The patient had an oxygen saturation of 88% on room air but was otherwise clinically stable. Arterial blood gas was obtained and demonstrated an elevated methemoglobin level (11.2%). Analysis of peripheral blood smear revealed oxidative hemolysis, indicating medication-induced methemoglobinemia. Glucose-6-phosphate-dehydrogenase (G6PD) testing was ordered to assess for G6PD deficiency, as this is a known risk factor for methemoglobinemia and had not previously been evaluated for this patient. Testing did not demonstrate a G6PD deficiency for this patient. A negative Lyme total antibody test confirmed no active infection. Both dapsone and HCQ are known to induce methemoglobinemia and the addition of rifampin may enhance this effect. Patient improved on supplemental oxygen, ascorbic acid, and discontinuation of dapsone, HCQ, ivermectin, doxycycline, and rifampin therapy. PRACTICE IMPLICATIONS: There is no strong evidence for any anti-infectives used for the treatment of PTLDS, with either short- or long-term use. Dapsone and HCQ can each cause methemoglobinemia. That effect may be increased when used together, especially in combination with rifampin. Appropriate risk assessment and monitoring should be considered when utilizing this combination.
Factors that can impact community pharmacists' role in reducing health disparities.
Goins J, Unni E
J Am Pharm Assoc (2003) · 2026 · PMID 41397583 · Publisher ↗
BACKGROUND: Social determinants of health (SDoH) significantly impact health outcomes but are often overlooked in community health care settings. Community pharmacists, as highly accessible providers, are well positioned...
BACKGROUND: Social determinants of health (SDoH) significantly impact health outcomes but are often overlooked in community health care settings. Community pharmacists, as highly accessible providers, are well positioned to address these social factors and reduce health disparities. However, limited research has examined their preparedness, resource access, or current engagement in SDoH interventions. OBJECTIVE: This study assessed New York State community pharmacists' knowledge, access to, and use of SDoH-related resources using the theoretical framework proposed by Kiles et al., which examines pharmacist roles at the patient, practice, and community levels. METHODS: A cross-sectional survey of 37 items was distributed electronically to licensed community pharmacists across New York State. The survey captured data on demographics, SDoH knowledge and resource awareness, and practice-based engagement. Descriptive and inferential statistics identified key trends and associations. Two composite scores-SDoH resource awareness and availability-were generated to evaluate pharmacist familiarity with and access to social support services. RESULTS: A total of 355 pharmacists met eligibility criteria and completed the survey. Those with training in health disparities demonstrated significantly higher awareness of cultural practices, health screening availability, and mental health resources. While many reported availability of naloxone, immunizations, and smoking cessation services, fewer than a quarter offered disease state education, and just a fifth had training in depression screening. Fewer than one-third routinely recommended Medicare Part D enrollment. A moderately strong positive correlation was found between awareness and availability of SDoH resources. Pharmacists who spoke another language or had long-term tenure at their practice site reported greater familiarity with local needs and resources. CONCLUSION: While community pharmacists in New York are positioned to address SDoH, gaps in training, mental health screening, and community engagement persist. Structured training in health disparities and mental health, along with policies to support sustainable implementation of SDoH interventions, are needed to expand pharmacists' capacity to serve vulnerable populations and advance health equity.
Telehealth-enabled pill swallowing training for a pediatric patient living with HIV: A multidisciplinary approach.
Howze TJ, Carr SD, Wilkins ML … +2 more , Nason TM, Patel ND
J Am Pharm Assoc (2003) · 2026 · PMID 41380940 · Publisher ↗
BACKGROUND: This case report aims to describe the implementation of a telehealth-based, multidisciplinary intervention designed to support pill swallowing in a pediatric patient with HIV preparing to transition from liqu...
BACKGROUND: This case report aims to describe the implementation of a telehealth-based, multidisciplinary intervention designed to support pill swallowing in a pediatric patient with HIV preparing to transition from liquid to tablet-based antiretroviral therapy (ART). The objective was to overcome geographic and access-related barriers to in-person behavioral training by leveraging virtual care, interdisciplinary collaboration, and the use of compounded placebo tablets. This approach sought to demonstrate how specialty pharmacists and behavioral health professionals can work together to ensure medication readiness, promote adherence, and facilitate safe transitions to more sustainable ART regimens in pediatric patients-particularly those in rural or underserved settings. CASE SUMMARY: A pediatric patient with vertically acquired HIV who was residing in a rural community was preparing to transition from liquid ART to a fixed-dose combination tablet. Transportation barriers rendered in-person training infeasible. The care team, comprising a specialty pharmacist, clinical psychologist, and compounding pharmacy staff, designed a remote intervention. Placebo tablets matching the target medication were mailed to the patient's home. A telehealth session was conducted by using the Epic electronic medical record platform, and real-time, behavioral coaching and pharmacist-led guidance were provided. The patient successfully swallowed 2 placebo tablets during the telehealth session, indicating readiness for the transition. At the next clinic visit, the patient initiated the new fixed-dose combination ART without complications. Follow-up confirmed continued adherence to pill formulation and no reported adverse effects. PRACTICE IMPLICATIONS: This case highlights the value of telehealth in overcoming pill swallowing training barriers in pediatric HIV care. Interdisciplinary collaboration, particularly involving specialty pharmacists and behavioral health providers, can provide equitable, patient-centered solutions for families in underserved areas. The use of compounded placebo tablets in virtual training represents a practical and scalable strategy to support medication transitions in pediatric populations.
Description and impact of a community pharmacy-based Collaborative Practice Agreement.
Hill L, Kissel J, Pauvlinch P … +2 more , Seifert J, Lahrman R
J Am Pharm Assoc (2003) · 2026 · PMID 41371406 · Publisher ↗
BACKGROUND: As of 2021, Ohio community pharmacists can enter into collaborative practice agreements to solve drug-related problems related to medication access, drug safety, and improve workflow for both community pharma...
BACKGROUND: As of 2021, Ohio community pharmacists can enter into collaborative practice agreements to solve drug-related problems related to medication access, drug safety, and improve workflow for both community pharmacists and health care providers. OBJECTIVES: The primary objective is to describe and quantify the usage of the Community Collaborative Practice Agreement (CPA) at 5 community pharmacies within an integrated clinic. The secondary objective is to evaluate the impact of the Community CPA on pharmacists and other providers at the practice. PRACTICE DESCRIPTION: This study was conducted at 5 community pharmacies within a clinic throughout Ohio that provides primary care, pharmacy, dental, mental health, and social services. PRACTICE INNOVATION: A community CPA covering 8 conditions under which pharmacists may prescribe medications and durable medical equipment to solve drug-related problems was implemented at 5 community pharmacies in Ohio. EVALUATION METHODS: A retrospective review of prescriptions written by pharmacists was conducted to assess the primary objective. A survey was created and completed by pharmacists and health care providers at the practice sites to assess the secondary objective. RESULTS: A total of 954 prescriptions were written by the pharmacists. The conditions most frequently written for include gender affirming care (629, 65.9%), diabetes (219, 23%), and asthma/chronic obstructive pulmonary disease (87, 9.1%). The average number of prescriptions written per month was 80 in the first year. Overall, a majority of pharmacists and providers agreed or strongly agreed that the Community CPA improved access to medications and patient safety. Workflow impact varied depending on the pharmacist or provider. CONCLUSIONS: The Community CPA allows pharmacists to take a more active role in providing access to medications and improving patient safety while minimally impacting workflow. This type of innovative practice may help other pharmacists improve medication access and patient safety while maintaining workflow efficiency.
Standing for science: How pharmacists can lead in an era of doubt.
Heaton PC
J Am Pharm Assoc (2003) · 2026 · PMID 41371405 · Publisher ↗
Abstract loading — click title to view on PubMed.
Implementation is the key to success.
Harpe SE
J Am Pharm Assoc (2003) · 2026 · PMID 41371404 · Publisher ↗
Abstract loading — click title to view on PubMed.
Evaluating the implementation of an analgesia sedation protocol for adult mechanically ventilated patients.
Kaupp K, McKinnon K, Vardy J … +4 more , Koppernaes S, Eichhorn V, Trenaman S, MacKenzie M
J Am Pharm Assoc (2003) · 2026 · PMID 41338392 · Publisher ↗
BACKGROUND: Protocol-based pain and sedation protocols reduce sedative requirements, duration of mechanical ventilation, intensive care unit (ICU) length of stay (LOS), and pain intensity in critically ill adults. An ana...
BACKGROUND: Protocol-based pain and sedation protocols reduce sedative requirements, duration of mechanical ventilation, intensive care unit (ICU) length of stay (LOS), and pain intensity in critically ill adults. An analgesia sedation protocol for mechanically ventilated adults was created and implemented in 2022. OBJECTIVES: This study aimed to assess the implementation and impact of an analgesia sedation protocol for mechanically ventilated adults on opioid and sedative medication administration, level of sedation, and duration of mechanical ventilation. PRACTICE DESCRIPTION: The creation and implementation of the analgesia sedation protocol was a pharmacist-led, multidisciplinary effort. The protocol is an assessment-driven, stepwise, nurse-protocolized approach to pain and sedation management. PRACTICE INNOVATION: The protocol emphasizes standardized, routine pain assessment and treatment using an analgosedation approach. EVALUATION METHODS: This was a single-center, retrospective, cohort study with a pre-post design. RESULTS: Preprotocol implementation patients received 13% more propofol (odds ratio [OR] 1.1354 [95% CI 1.1310-1.1399]) and 14% less opioid analgesic medications (OR 0.8597 [95% CI 0.8564-0.8630]) relative to the postimplementation cohort. The median Richmond Agitation Sedation Scale score was -2 in both cohorts, and the median Critical Care Pain Observation Tool was 0 in both cohorts. The median duration of mechanical ventilation decreased by 11 hours or 22% (P < 0.001), and the median ICU LOS decreased by 17 hours or 3.9% (P < 0.001) after protocol implementation. CONCLUSIONS: This study confirms successful implementation of an analgosedation protocol through evaluation of opioid and sedative medication exposure. After the implementation, patients received 13% less propofol and 14% more opioid analgesic medications. After protocol implementation, there was a decrease in the duration of mechanical ventilation and ICU LOS.
GLP-1 receptor agonists and diabetic retinopathy: Comment on a case report.
Wang JY
J Am Pharm Assoc (2003) · 2026 · PMID 41308788 · Publisher ↗
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Response to "GLP-1 receptor agonists and diabetic retinopathy: Comment on a case report".
Ko J, Jahromi Y
J Am Pharm Assoc (2003) · 2026 · PMID 41297883 · Publisher ↗
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ADVANCE-ing patient care: Implementation of the academic detailing program Illinois ADVANCE.
Caballes N, Aneziris C, Hiemenz S … +2 more , Rathod CS, Hudak BM
J Am Pharm Assoc (2003) · 2026 · PMID 41295926 · Publisher ↗
BACKGROUND: Academic detailing (AD) is a unique educational resource that provides evidence-based decision-making tools for health care clinicians and is commonly done by pharmacists. Implementation of an AD program requ...
BACKGROUND: Academic detailing (AD) is a unique educational resource that provides evidence-based decision-making tools for health care clinicians and is commonly done by pharmacists. Implementation of an AD program requires intentional planning, evaluation, and adaptation. OBJECTIVES: This brief report aimed to describe the creation of a pharmacist-led AD program, Illinois ADVANCE (Academic Detailing Visits and New Evidence Center, or ILA), and lessons learned from the process, framed through the 4 phases of the quality implementation framework (QIF), to inform future AD program development. METHODS: ILA program implementation is described using the 4 phases of QIF: initial considerations regarding the host setting, creating a structure for implementation, ongoing structure once implementation begins, and improving future applications. RESULTS: The clinical pharmacists of ILA had expertise in providing AD and clinician outreach, making it an ideal fit for an AD program. Additional staff were hired, and all were trained on AD knowledge and skills. An initial structure was created based on best practices in the AD space. Through staff experience and feedback, the structure was adapted and future applications improved with the development of teams and the clarity of roles. CONCLUSION: This brief report describes the implementation and adaptation of a pharmacist-led AD program, ILA, through the QIF framework. ILA's current structure resulted from several sources of feedback, primarily from staff input and experiences. Ultimately, this work serves as a guide for future AD program implementation.
Evaluating the success of a pharmacy technician training program at a large health system.
Wat SKS, Roberts P, Rogers J
J Am Pharm Assoc (2003) · 2026 · PMID 41270962 · Publisher ↗
BACKGROUND: Current literature on retention rates is limited. This study aimed to assess the University Hospitals' (UH) Pharmacy Technician Training Program (UHPTTP) at program completion and retention rates at graduatio...
BACKGROUND: Current literature on retention rates is limited. This study aimed to assess the University Hospitals' (UH) Pharmacy Technician Training Program (UHPTTP) at program completion and retention rates at graduation and at 1 year after graduation. OBJECTIVE: This study aimed to measure the success of UHPTTP using retention rates. METHODS: All pharmacy technician trainees enrolled in UHPTTP at UH from November 2020 to September 2023 were included in the study. Data collection began in September 2022 and was completed by December 2023. The primary end points evaluated program completion rates, retention rates at graduation, and retention rates at 1 year. For the secondary end point, the rate of retention at 1 year of externally hired pharmacy technician was compared with the total rate of retention at 1 year of program graduates. All retention data were summarized using descriptive statistics. Categorical variables are analyzed using Fisher's exact test. RESULTS: The total program completion rate of 77.8% (n = 95). The total retention rate at graduation was 93.2%. The 1-year retention rates of pharmacy technicians who were hired as graduates and external hires are 68.3% and 61.3%, respectively. The total retention rate of UHPTTP graduates was approximately 7.0% higher than external hires (P = 0.688159). CONCLUSION: This study attempted to measure the success of an American Society of Health-System Pharmacists and Accreditation Council for Pharmacy Education-accredited pharmacy technician training program at a large health system. There was no statistically significant difference noted in 1-year retention rates between UHPTTP graduates and external hires. This suggests that UHPTTP was successful in producing qualified pharmacy technician candidates for internal vacant positions.
Systematic review of interest-holder perceptions of pharmacist-prescribed ulipristal acetate emergency contraception.
Delanoy AC, Hutcherson TC, Cieri-Hutcherson NE
J Am Pharm Assoc (2003) · 2026 · PMID 41270961 · Publisher ↗
BACKGROUND: Emergency contraception (EC) is important for the prevention of unintended pregnancy. OBJECTIVES: This systematic review aimed to evaluate literature assessing interest-holder perceptions of pharmacist-prescr...
BACKGROUND: Emergency contraception (EC) is important for the prevention of unintended pregnancy. OBJECTIVES: This systematic review aimed to evaluate literature assessing interest-holder perceptions of pharmacist-prescribed ulipristal acetate (UPA) EC. METHODS: A search of Embase, MEDLINE, and PubMed was conducted from inception to March 3, 2025, using the following search terms and permutations: ulipristal, ella, emergency contraception, pharmacist, and pharmacy. Eligibility criteria included the following: primary literature pertaining to pharmacist-prescribed UPA EC, studies reporting on data collected in the United States, studies related to interest-holder (pharmacist, patient, and other interest-holder) perceptions, and full reports in English. Abstract-only records were excluded. Reviewers extracted and synthesized data including study characteristics and interest-holder perceptions of pharmacist-prescribed UPA. Qualitative data were coded for themes. Risk of bias (ROB) was assessed using the Appraisal tool for Cross-Sectional Studies and the Joanna Briggs Institute Narrative Critical Appraisal tool. RESULTS: The search yielded 1906 records; 1298 were screened after deduplication and limited to English and humans. Seven records met the inclusion criteria: 6 California-based cross-sectional studies and 1 Indiana-based pilot study. Eleven outcomes regarding pharmacist, patient, and other interest-holder perceptions were identified; 5 reports included outcomes regarding pharmacists' perceptions, 3 included patient perceptions, and 2 included a small amount of other interest-holder perceptions. Pharmacists in 3 of 5 reports cited barriers to pharmacist-prescribed UPA; the most common included time, reimbursement for services, and support via staffing, workflow, and management. Pharmacists in 2 of 5 reports expressed desire for additional training. Patients reported benefits of pharmacist-prescribed UPA including reduced cost, time, and improved accessibility in 1 of 2 reports. Other interest holders supported pharmacist-prescribed UPA. All 7 reports had high ROB owing to the response rate. CONCLUSION: Pharmacist-prescribed UPA can enhance access to EC. Education, reimbursement, and support barriers must be addressed, in addition to legislation expansion, to enhance implementation.
Addressing pharmacy access in a landscape of pharmacy closures.
Gong C, Blankenship B, Berenbrok LA … +2 more , Rodis JL, Murphy EM
J Am Pharm Assoc (2003) · 2026 · PMID 41270960 · Publisher ↗
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