Journal Of The American Pharmacists Association[JOURNAL]
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200 papers
A pharmacist-led mobile pop-up clinic: Development and pilot implementation outcomes.
Miller EE, Ahmed P, Middendorf AW … +3 more , Van Gilder D, Amell JW, Snyder ME
J Am Pharm Assoc (2003) · 2026 · PMID 41192507 · Publisher ↗
BACKGROUND: Mobile health clinic models represent a promising, cost-effective approach to providing health care which pharmacists are well equipped to provide. Implementation science (IS) concepts and frameworks may be p...
BACKGROUND: Mobile health clinic models represent a promising, cost-effective approach to providing health care which pharmacists are well equipped to provide. Implementation science (IS) concepts and frameworks may be particularly valuable when designing such models of health care delivery for populations with limited access to care. We apply IS principles to develop a pharmacy-led mobile pop-up clinic, evaluate its implementation, and identify suggested areas of improvement. OBJECTIVE: To develop a novel pharmacist-led mobile pop-up clinic and describe its appropriateness, adoption, acceptability, feasibility, and fidelity. METHODS: Design of the model incorporated mitigation strategies identified through preimplementation work utilizing the Consolidated Framework for Implementation Research (CFIR) Expert Recommendations for Implementing Change Implementation Strategy Matching Tool. Community stakeholder interviews in the target community were conducted to assess appropriateness prior to site selection. Implementation outcomes were selected from Proctor's Implementation Outcomes Framework. Specifically, acceptability and feasibility were evaluated utilizing questionnaires adapted from the Theory of Informed Acceptability and Feasibility of Intervention Measure, respectively, and debriefing sessions were held with volunteers and the project team. A checklist was utilized to evaluate fidelity. RESULTS: The pop-up clinic had overall positive outcomes. Community stakeholders supported appropriateness of the clinic in their community. Adoption was 100% for the site, collaborators, and services offered. High levels of acceptability were seen from both patients (75% "very acceptable") and volunteers (88.9% "completely acceptable"). Volunteers found the event feasible in all categories. Debriefing sessions with volunteers supported acceptability and feasibility. Fidelity was variable. CONCLUSION: The application of the empirically supported CFIR and Proctor Implementation Outcomes Framework yielded positive results in the delivery of a pharmacy-led pilot mobile pop-up clinic.
Evaluating the financial sustainability of pharmacist-led primary care services: Real-world evidence from Idaho.
Millward J, Rosko Z
J Am Pharm Assoc (2003) · 2026 · PMID 41183595 · Publisher ↗
OBJECTIVE: To evaluate the financial viability and scalability of pharmacist-led chronic disease management services using commercial payor Evaluation and Management (E/M) billing codes in a rural primary care setting. P...
OBJECTIVE: To evaluate the financial viability and scalability of pharmacist-led chronic disease management services using commercial payor Evaluation and Management (E/M) billing codes in a rural primary care setting. PRACTICE DESCRIPTION: In June 2023, a clinical pharmacist was embedded into a physician-owned family medicine clinic in Idaho. The pharmacist practiced at approximately 0.25 full-time equivalent (FTE), managing diabetes and polypharmacy collaboratively with referring providers. Patients were referred directly by providers or identified through chart review. Current Procedural Terminology codes billed included 99212-99214 for commercial and Medicaid beneficiaries and chronic care management (CCM) code 99490 for Medicare beneficiaries. Payment for pharmacist claims first occurred in October 2024 and reimbursement data was evaluated through June 2025 (9 months). Hemoglobin A1c (HbA1c) improvement was evaluated over the entire study period (24 months). PRACTICE INNOVATION: The model leveraged Idaho's independent prescribing authority for pharmacists. The pharmacist was independently credentialed with 6 commercial payors as well as Idaho Medicaid and followed standard E/M and CCM coding practices. Real-time data informed iterative service refinements. EVALUATION METHODS: Descriptive reimbursement data were extracted from the electronic health record and average reimbursement rates per visit were calculated. Break-even scenarios were modeled using Idaho-specific salary and benefit benchmarks. Different staffing models were evaluated. RESULTS: Average reimbursement per visit was $123.25. The break-even threshold (1.0 FTE, no support staff, 30% benefits) was 6 patients per 8-hour clinic day. At 1.0 FTE with support staff, sustainability required 8 patients per clinic day. To target an additional profit of $100,000 per year for a 1.0 FTE pharmacist with support staff, the threshold was 12 patients per clinic day. Over the entire evaluation period, the average HbA1c of patients seen by the pharmacist was reduced by 1.8% and patients with HbA1c value below 7% increased by 35%.
Multilevel factors associated with timeliness of care along the lung cancer care continuum: A systematic review.
Nduaguba S, Khadka S, Stout N … +2 more , Almubarak M, Kelly K
J Am Pharm Assoc (2003) · 2026 · PMID 41183594 · Full text
BACKGROUND: Factors affecting time to lung cancer care may occur at multiple levels of influence. OBJECTIVE: The study aimed to identify multilevel factors associated with delays in lung cancer care. METHODS: Following P...
BACKGROUND: Factors affecting time to lung cancer care may occur at multiple levels of influence. OBJECTIVE: The study aimed to identify multilevel factors associated with delays in lung cancer care. METHODS: Following Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines, Medline (PubMed), CINAHL, and SCOPUS were searched using validated search terms for lung cancer and factors, health disparities and time/delay. Eligible studies included original articles with quantitative, qualitative, or mixed-methods designs that investigated health disparities in, risk factors for, or barriers to timely screening, confirmatory diagnosis, or treatment among patients with lung cancer or those at risk for lung cancer. Title/abstract (TIAB), and full-text screening, study quality assessment (QA), and data extraction were conducted by 2 reviewers. RESULTS: 13,068, 2608, and 424 TIAB were identified from PubMed, CINAHL, and SCOPUS, respectively. After deduplication, 14,405 articles were screened and 74 full-texts were assessed. Fifteen studies (all quantitative) were selected for QA and data extracted. Based on the National Institutes of Health QA tool, 5, 6, and 4 studies were rated good, fair, and poor, respectively. Multilevel factors associated with diagnosis to treatment interval were: Patient (demographic - age, sex, race/ethnicity, marital status, region, health insurance; disease - comorbidity, lung cancer type, stage, tumor size, brain metastasis, and treatment), clinic setting (facility type), environmental (income, poverty, hospital supply, and subspecialist supply). Other intervals assessed include: screening to diagnosis, symptom to initial primary care provider visit, suspicious image to diagnostics, suspicious image to diagnosis, suspicious image to surgical referral, and surgical referral to surgery. CONCLUSION: We did not identify any qualitative or mixed-methods study. The quality of the included quantitative were fair-good. Qualitative and mixed-methods studies on the timeliness of lung cancer care are recommended to provide context on multilevel factors. The identified multilevel factors will help in intervention planning to select intervention components that address gaps in the timeliness of lung cancer care.
Implementation modifications and outcomes of a pharmacist-led primary care remote hypertension service.
Sabatino JA, Lee NS, Barnes KD … +3 more , Coffey CP, Jonas DE, Tayal NH
J Am Pharm Assoc (2003) · 2026 · PMID 41183593 · Publisher ↗
BACKGROUND: National guidelines recommend team-based remote blood pressure (BP) management as standard care, but implementation in actual clinical settings is complex and requires more insights from real-world practices....
BACKGROUND: National guidelines recommend team-based remote blood pressure (BP) management as standard care, but implementation in actual clinical settings is complex and requires more insights from real-world practices. OBJECTIVES: We offer practical insights and share lessons learned regarding challenges and potential solutions for advancing pharmacist-led remote physiologic monitoring (RPM) for hypertension. We aim to: (1) detail key contextual factors that informed and shaped the intervention; (2) describe intervention components, noting when and why specific modifications were introduced; and (3) analyze how implementation decisions impacted outcomes over time. PRACTICE DESCRIPTION: Guided by the Exploration, Preparation, Implementation, and Sustainment framework, we describe the key practice contextual factors that contributed to implementation of RPM for hypertension. PRACTICE INNOVATION: Applying the Framework for Reporting Adaptations and Modifications to Evidence-based Interventions, we identify when and why modifications were made. We detail intervention components and various strategies used for dissemination, implementation processes, innovation integration, capacity-building, and scale-up. EVALUATION METHODS: We use descriptive statistics to report measures of reach, effectiveness, adoption, and implementation outcomes over time. Additionally, for reach and effectiveness, we use unadjusted chi-squared analyses to compare trends in proportions across early, mid, and late implementation periods. RESULTS: Over time, there was a trend toward increasing provider referrals (73 by year 3), new patient enrollments (362 in year 3), and RPM codes billed (1579 by year 3). Payor mix, a measure of program reach, saw a statistically significant improvement over time (P < 0.01), while the proportion of patients achieving target BP improved but was not statistically significant (P = 0.53). CONCLUSION: Multilevel alignment and continuous adaptation efforts contributed to successful implementation of a pharmacist-led RPM intervention for hypertension with improvement in reach over time. We share our insights as a resource for primary care practitioners, organizations, and policy makers seeking to implement RPM for hypertension.
From blueprint to practice: Implementation strategies for behavioral health programs in community pharmacy.
Livet M, Watson A
J Am Pharm Assoc (2003) · 2026 · PMID 41177283 · Publisher ↗
BACKGROUND: Despite the need for practical implementation systems, few studies have focused on operationalizing and exploring use of clearly articulated implementation strategies to support uptake of patient care interve...
BACKGROUND: Despite the need for practical implementation systems, few studies have focused on operationalizing and exploring use of clearly articulated implementation strategies to support uptake of patient care interventions in community pharmacies. This project involved implementation of a behavioral health (BH) intervention for depression and anxiety at 7 pharmacy sites over a 6-11 month period. OBJECTIVES: This study describes the comprehensive, multifaceted blueprint that guided pharmacies through the implementation process, and summarizes the lessons learned related to use of its implementation strategies. METHODS: The implementation blueprint involved operationalization of 8 strategy clusters adapted from Waltz and colleagues' Expert Recommendations for Implementing Change taxonomy. Lessons learned were generated through 30-45 minutes interviews with 7 pharmacists leading the implementation. These interviews focused on successes, barriers, and key insights related to implementation. The transcripts were analyzed using directive content analysis involving an a-priori coding structure. RESULTS: Five lessons learned emerged: (1) offering the BH intervention as an add-on to already existing patient care services facilitates integration; (2) patient engagement strategies hinge on clarifying the role the pharmacist can play in behavioral health care; (3) level of connectivity between the pharmacist and the local BH community influence follow-on care; (4) convenience of patient care workflows and availability of implementation supports are critical implementation strategies; and (5) intent to continue offering the BH services is dependent on perceived value for both patients and pharmacists. CONCLUSION: Beyond the immediate improvements that can be made to the original blueprint, results highlight 3 key findings with implications for advancing community pharmacy practice through implementation science: the importance of customizing implementation strategies for community pharmacy; the need to further emphasize and integrate relational strategies into implementation blueprints and frameworks; and the value of leveraging the interdependencies among implementation strategies to improve effective implementation.
Effectiveness, challenges, and improvement strategies for active tuberculosis case-finding practices by community pharmacy personnel: A scoping review.
Florencia C, Aprilio K, Eka Pitaloka DA … +2 more , Aarnoutse RE, Pradipta IS
J Am Pharm Assoc (2003) · 2026 · PMID 41177282 · Publisher ↗
BACKGROUND: Tuberculosis (TB) remains a major health challenge, with delayed detection accelerating its spread. Pharmacies are often the first contact for individuals with TB symptoms, yet their role in active case findi...
BACKGROUND: Tuberculosis (TB) remains a major health challenge, with delayed detection accelerating its spread. Pharmacies are often the first contact for individuals with TB symptoms, yet their role in active case finding is underutilized. OBJECTIVE: This scoping review aims to comprehensively map the current studies, challenges, and potential strategies for effective and sustainable implementation. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines, we searched PubMed and Scopus for relevant studies up to October 26, 2023. We included studies on community pharmacy personnel (PP) engaged in active TB case-finding. Outcomes covered effectiveness, challenges, and potential strategies for active TB case finding involving PP. Two reviewers independently screened and extracted data, which were synthesized using the Consolidated Framework for Implementation Research. RESULTS: Twelve of 2003 articles met the inclusion criteria. All studies showed a contribution to TB case finding. However, key challenges identified include the complexity of integrating TB case-detection into routine workflows, patients' access barriers to clinics, and lack of resources. PP also faced issues such as their lack of confidence in TB screening and inadequate knowledge regarding TB referral. Improvement strategies are electronic referral, capacity building for PP, free diagnostic services, incentives for PP, and improved coordination between PP and TB program staff. CONCLUSION: Enhancing active TB case detection by PP requires addressing challenges in workflow integration, patient access, and resource limitations. Capacity building, electronic referrals, free diagnostics, and incentives are key strategies to support PP involvement. Strengthening collaboration between the PP and TB program staff is essential for effective and sustainable referral processes.
Utilization of an electronic health record dashboard report to monitor unreconciled controlled substance dispenses.
Le C, Mellett J, Barreto J … +1 more , Lopez B
J Am Pharm Assoc (2003) · 2026 · PMID 41175973 · Publisher ↗
BACKGROUND: A medication is considered unreconciled when there is no documented administration or the dispensed amount does not match the amount administered, wasted, or returned. Unreconciled dispenses pose several issu...
BACKGROUND: A medication is considered unreconciled when there is no documented administration or the dispensed amount does not match the amount administered, wasted, or returned. Unreconciled dispenses pose several issues, including inaccurate accounting of controlled substances, potential financial discrepancies, possible masking of controlled substance diversion, and patient safety concerns. Utilization of an electronic health record (EHR) report of unreconciled dispenses is one of several possible surveillance methods to track unreconciled dispenses and detect potential controlled substance diversion. OBJECTIVES: The objective of this study is to determine the extent to which the utilization of an EHR reporting dashboard by nursing leaders decreases the number of unreconciled controlled substance dispenses. METHODS: An existing report available through the EHR will be used to identify a baseline of unreconciled dispenses. A dashboard was built to include the unreconciled dispenses report that provided real-time data as well as a visualization of historical data. This dashboard was integrated into the nursing leadership workflow on several pilot units covering different levels of care and reviewed regularly for potential intervention. Nurse managers were expected to communicate directly with nurses that had unreconciled controlled substance dispenses and re-educate on appropriate documentation procedures. RESULTS: During the preintervention period, there were a total of 26,101 controlled substance dispenses with 256 unreconciled dispenses (0.98%). Following implementation of the dashboard report, there was a nonsignificant decrease of 0.13% (P = 0.14) with a total of 24,731 controlled substance dispenses and 211 unreconciled dispenses (0.85%). CONCLUSION: The use of an EHR dashboard report has the potential to improve the documentation of controlled substances by identifying opportunities to correct unreconciled dispenses. However, workflow barriers can impact the utility of and engagement with the dashboard report.
Consumer data insights on pharmacy utilization: Comparative study of 2015 and 2021 surveys.
Presingu P, Sawesi S, Irungu M … +4 more , Kane K, Rashrash M, Schommer J, Brown L
J Am Pharm Assoc (2003) · 2026 · PMID 41175972 · Publisher ↗
BACKGROUND: Understanding the evolution of consumer behavior in pharmacy selection is crucial for delivering patient-centered and technology-driven health care. OBJECTIVE: To identify factors influencing consumer pharmac...
BACKGROUND: Understanding the evolution of consumer behavior in pharmacy selection is crucial for delivering patient-centered and technology-driven health care. OBJECTIVE: To identify factors influencing consumer pharmacy choice using 2021 National Consumer Survey on the Medication Experience and Pharmacists' Roles and to examine how these factors have evolved over time using 2015 data as a baseline. METHODS: All variables were harmonized with the 2015 dataset to ensure comparability. Guided by the Andersen Behavioral Model, descriptive analyses and logistic regression were performed on 2021 survey data (N = 1521) to evaluate factors influencing pharmacy selection, and results were compared with 2015 findings to assess evolving trends. RESULTS: Younger adults (18-33) increasingly favored prescription-only pharmacies (odds ratios [OR] = 3.523), while older adults (70+) preferred mail-order pharmacies. Use of mail prescriptions rose by 11.7% and remained a strong predictor of mail pharmacy use (OR = 30.29). Vaccination (+20%) and drive-thru utilization (+7.8%) increased substantially and were associated with chain pharmacies (OR = 1.404; OR = 2.500). In contrast, traditional predictors such as education, financial hardship, over-the-counter/herbal use, and medication side effects declined in relevance. CONCLUSION: Consumer preferences have shifted toward convenience-based and contactless pharmacy models, a trend that has continued beyond 2021. These changes highlight the need for pharmacists to adapt service delivery approaches and for health informatics professionals to strengthen digital infrastructure supporting patient-centered care.
Implementation of statewide protocols for community-based pharmacist services in Virginia: A qualitative study using the Consolidated Framework for Implementation Research.
Amayreh R, Shah S, Goode JK … +4 more , Thomson M, Pontinha VM, Kaefer TN, Salgado TM
J Am Pharm Assoc (2003) · 2026 · PMID 41173322 · Publisher ↗
BACKGROUND: Despite the 2020 legislation authorizing Virginia pharmacists to provide clinical services under statewide protocols, utilization remains low at 24%. Understanding implementation barriers and facilitators is...
BACKGROUND: Despite the 2020 legislation authorizing Virginia pharmacists to provide clinical services under statewide protocols, utilization remains low at 24%. Understanding implementation barriers and facilitators is crucial for expanding health care access through pharmacy services. OBJECTIVE: To identify contextual factors affecting the implementation of statewide protocols for pharmacist-provided clinical services in Virginia community-based pharmacies. METHODS: Semistructured interviews were conducted with 16 community-based pharmacists between November 2024 and May 2025. The Consolidated Framework for Implementation Research (CFIR) 2.0 guided interview development and analysis. Interviews were transcribed verbatim and analyzed using inductive coding followed by deductive mapping to CFIR constructs. RESULTS: Statewide protocol implementation was facilitated by clear relative advantage in improving patient access and strong alignment with pharmacists' professional mission. Key barriers included resource limitations, complexity, and structural characteristics namely physical space and workflow integration. Independent pharmacists reported greater implementation autonomy compared to chain pharmacists. Rural pharmacists faced unique challenges but emerged as innovators when protocols addressed critical health care access gaps. CONCLUSIONS: Statewide protocols show promise for expanding health care access but require targeted interventions addressing resource constraints, workflow integration, and implementation support. Tailored implementation strategies are needed for independent and chain community-based pharmacies to expand adoption.
Barriers and facilitators to implementing pharmacist-driven mobile health clinics: Identification of implementation strategies using the Consolidated Framework for Implementation Research-Expert Recommendations for Implementing Change (CFIR-ERIC) matching tool.
Schweitzer S, Middendorf AW, Van Gilder D … +2 more , Amell JW, Miller EE
J Am Pharm Assoc (2003) · 2026 · PMID 41173321 · Publisher ↗
BACKGROUND: Pharmacist-driven mobile health clinics (MHCs) offer an innovative solution to increasing health care access, yet limited information exists on barriers, facilitators, and strategies for their successful impl...
BACKGROUND: Pharmacist-driven mobile health clinics (MHCs) offer an innovative solution to increasing health care access, yet limited information exists on barriers, facilitators, and strategies for their successful implementation. OBJECTIVES: To use implementation science methodology to identify strategies for implementing pharmacist-driven mobile-health clinics using the Consolidated Framework for Implementation Research (CFIR), Expert Recommendations for Implementing Change (ERIC) taxonomy, and CFIR-ERIC strategy matching tool. METHODS: A secondary analysis was conducted on semi-structured interviews involving 16 participants from 10 pharmacist-driven MHCs. A mixed deductive strategy was applied where barrier and facilitator codes were inductively tagged, extracted, and mapped to CFIR constructs. Identified barriers mapped to CFIR constructs were matched into the CFIR-ERIC Strategy Matching Tool, which was based on expert consensus. Facilitators were mapped directly to ERIC strategies. A team consensus discussion was held to prioritize, select, and rank strategies to integrate into a pharmacist-driven MHC model. RESULTS: The top 5 CFIR-ERIC matched strategies to address barriers were: 1) identify and prepare champions; 2) assess readiness and identify barriers and facilitators; 3) promote adaptability; 4) capture and share local knowledge; and 5) conduct local consensus discussions. The top 5 directly mapped ERIC strategies for facilitators included: 1) tailor strategies; 2) assess readiness and identify barriers and facilitators; 3) identify and prepare champions; 4) promote network weaving; and 5) work with educational institutions. After consensus discussion, 11 strategies were selected for our model incorporation and ranked based on team prioritization. CONCLUSIONS: Implementation science methodology provides a systematic approach to mitigate barriers, leverage facilitators, and select evidence-based strategies to enhance the implementation of pharmacist-driven MHCs. The findings of this project will be integrated into a pharmacist-driven MHC model to improve access to care and management of chronic disease in rural South Dakota.
From implementation to impact: Evaluation of a Pharmacist Primary Care Certificate Training Program using the RE-AIM framework.
Frederick KD, Wheeler JS, Troy J … +1 more , Hohmeier KC
J Am Pharm Assoc (2003) · 2026 · PMID 41173320 · Publisher ↗
BACKGROUND: As the pharmacy profession transforms toward practice centered around direct patient care and clinical services, retooling the existing workforce may be required for pharmacists to take on expanded roles, esp...
BACKGROUND: As the pharmacy profession transforms toward practice centered around direct patient care and clinical services, retooling the existing workforce may be required for pharmacists to take on expanded roles, especially in an increasingly competitive job market. To help meet this need, a 12-week, 30-hour Pharmacist Primary Care Certificate Training Program was developed, accredited, and implemented in 2021, aiming to prepare pharmacists to engage in direct patient care and develop the skills and expertise necessary to practice in outpatient primary care settings. OBJECTIVE: The purpose of this study was to apply the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to evaluate the Pharmacist Primary Care Certificate Training Program. METHODS: This mixed-methods study applied the RE-AIM framework to evaluate the primary care certificate program. Data sources included enrollment and completion records, immediate postprogram evaluations, and follow-up surveys and interviews. Quantitative data were analyzed descriptively; qualitative data were analyzed using inductive thematic analysis. RESULTS: Fifty-eight pharmacists across 9 states and 2 countries completed the program between May 2021 and November 2024. Most reported improved primary care knowledge (96.4%), confidence applying skills (94.6%), and enhanced job marketability (87.5%) at the end of the program. Learners valued the flexible online format, simulation activities, and mentorship. Follow-up surveys and interviews conducted between April and May 2024 indicated sustained practice change, self-efficacy, and career advancement among participants. Common barriers to sustained change and implementation of clinical services included time, reimbursement, and employer support. CONCLUSION: The RE-AIM framework provided a comprehensive approach to evaluate the Pharmacist Primary Care Certificate Training Program's implementation and long-term impact. Results support certificate-based training as a feasible, scalable strategy to expand pharmacist skills and roles in outpatient primary care. Findings offer a replicable model for designing and assessing similar programs.
Creation of the CAP center: Advancing pharmacy practice through implementation science integration.
Skoy E, Eukel H, Maack B … +3 more , Nagel L, Strand M, Werremeyer A
J Am Pharm Assoc (2003) · 2026 · PMID 41173319 · Publisher ↗
BACKGROUND: Community pharmacies are increasingly recognized for their potential to deliver innovative patient care services. However, implementation of these services is often hindered by barriers. Implementation scienc...
BACKGROUND: Community pharmacies are increasingly recognized for their potential to deliver innovative patient care services. However, implementation of these services is often hindered by barriers. Implementation science (IS) offers a framework to address these challenges, yet its application in pharmacy practice remains limited. North Dakota is a rural state with one school of pharmacy and a unique pharmacy landscape. OBJECTIVES: To describe the creation and impact of the Center for Collaboration and Advancement in Pharmacy (CAP Center), designed to support pharmacies in implementing and sustaining innovative patient care services using IS frameworks such as Practical, Robust Implementation and Sustainability Model and the Reach, Effectiveness, Adoption, Implementation, and Maintenance Model. PRACTICE DESCRIPTION: Launched in 2021, the CAP Center was created by faculty and is focused on the principles of IS to increase uptake and sustainability of pharmacy services to meet patient demand and improve population health. PRACTICE INNOVATION: The CAP Center operates on 4 core principles: Program and Implementation, Education and Training, Coaching and Support, and Data and Outcomes. It uses the principles of IS to provide guidance, resources, and evaluation strategies to pharmacy teams, by supporting projects from conception through sustainability. The Center's application of IS and the core principles allow for successful implementation of pharmacy services. EVALUATION METHODS: CAP Center engagement is assessed through metrics such as continuing education credits offered, pharmacy participation, symposium attendance, and project volume. Individual projects are evaluated on adherence to IS principles and implementation outcomes. RESULTS: Since inception, 93% of North Dakota's community pharmacies have engaged with the CAP Center. Notable projects have demonstrated successful application of IS frameworks, leading to sustainable service delivery and improved patient care. CONCLUSION: The CAP Center exemplifies how IS can be operationalized in pharmacy practice to aid in pharmacy program implementation and improve health outcomes. Its model may serve as a blueprint for similar efforts to expand pharmacy services nationwide.
Evaluating the implementation and sustainment potential of a pharmacy-embedded community health worker model.
Smith MG, Breckling M, Williams A … +3 more , Charton H, Curran G, Teeter B
J Am Pharm Assoc (2003) · 2026 · PMID 41173318 · Full text
BACKGROUND: Rural communities in the United States face ongoing disparities in health care access and outcomes. Community pharmacies, as highly accessible health care settings, offer a promising platform for addressing t...
BACKGROUND: Rural communities in the United States face ongoing disparities in health care access and outcomes. Community pharmacies, as highly accessible health care settings, offer a promising platform for addressing these gaps. Embedding Community Health Workers (CHWs) in pharmacies may improve care coordination and health outcomes in underserved communities. OBJECTIVES: To evaluate the implementation and sustainment potential of a pharmacy-embedded CHW model in rural community pharmacies. METHODS: We used a sequential explanatory mixed-methods design to evaluate the model. All CHWs (n = 53) and pharmacy supervisors (n = 49) in Project Reaching Everyone to Achieve Community Health-a federally funded initiative embedding CHWs in 49 rural Arkansas pharmacies-were surveyed. Surveys assessed implementation outcomes of acceptability, feasibility, and appropriateness using validated instruments. Additional items addressed satisfaction and sustainability intentions beyond the funding period. Descriptive statistics were used to analyze survey data. Ten pharmacies-5 with higher and 5 lower composite implementation scores-were selected for qualitative interviews. We conducted semi-structured interviews with one CHW and one supervisor from each selected pharmacy (n = 20). A rapid qualitative analysis technique was utilized and themes were mapped to the Consolidated Framework for Implementation Research. RESULTS: Survey response rates were 89% of CHWs (n = 47) and 86% of supervisors (n = 41). Overall, CHWs and supervisors rated the model as rated the service as acceptable, feasible and appropriate in the pharmacy setting. Most CHWs (85%) were satisfied with their role, and 91% felt the model worked well in the pharmacy setting. The majority of supervisors (83%) recognized clear benefits, and 79% would recommend the model in other pharmacies. Facilitators included adaptable materials, community need, leadership support, and CHWs' familiarity with patients. Barriers included intensive training demands and a limited rural applicant pool. CONCLUSION: Both CHWs and supervisors found the model acceptable, feasible, and appropriate. This model shows promise for improving rural health care delivery. Further research is needed to assess cost-effectiveness, long-term outcomes, and strategies to address implementation barriers.
Organizational preparedness for implementing an evidence-based multilevel intervention to improve the timeliness of lung cancer treatment.
Nduaguba S, Stout N, Kelly K … +1 more , Almubarak M
J Am Pharm Assoc (2003) · 2026 · PMID 41167524 · Full text
BACKGROUND: Delayed time to treatment is a key determinant of poor survival among patients with lung cancer. Factors affecting the timeliness of lung cancer treatment are multilevel in nature. Most interventions target o...
BACKGROUND: Delayed time to treatment is a key determinant of poor survival among patients with lung cancer. Factors affecting the timeliness of lung cancer treatment are multilevel in nature. Most interventions target only 1 level of influence. Existing evidence-based interventions that work in 1 setting may fail to work in a different setting owing to poor fit in the new setting or deviations from the original intervention. Our study evaluated the feasibility of adopting a Veterans Health Administration (VHA) evidence-based multilevel intervention (EBMLI) within an academic health system. METHODS: The VHA EBMLI is a multilevel lung cancer care coordination program previously used by the VHA targeting the individual, provider team, and organization levels. The intervention effectively reduced time to treatment for Veterans with lung cancer over 7 years with statistically significant individual-level reductions by approximately 50%. We conducted a survey of providers across 5 sites on the acceptability, appropriateness, and feasibility toward the EBMLI using the following validated scales: (1) acceptability of intervention measure (AIM) (score range 1-5), (2) intervention appropriateness measure (IAM) (1-5), (3) feasibility of intervention measure (FIM) (1-5), (4) implementation climate scale (ICS) (0-4), and (5) implementation leadership scale (ILS) (0-4). RESULTS: A total of 45 providers consented to participate in the survey, and 36 (mean age 46 ± 11 years) across 5 sites completed the survey. Most had MD or PhD degrees (46%), were physicians (42%), and had >10 years' health care experience (49%) with 20 ± 20 patients with lung cancer seen per week, of whom 60% of providers saw only adult patients. Mean scores on the scales were AIM (4.1 ± 0.8), IAM (4.0 ± 0.8), FIM (4.1 ± 0.8), ICS (2.7 ± 0.7), and ILS (3.2 ± 0.9). CONCLUSION: Although the proposed EBMLI may be well received by providers and leadership, acknowledgment of contexts affecting organizational climate is needed to ensure the feasibility of the adaptation, implementation, and sustainability of the VHA EBMLI.
Evaluation of digital health technology literacy among community pharmacists in Serbia.
Vukmirović D, Krajnović D, Odalović M
J Am Pharm Assoc (2003) · 2026 · PMID 41161664 · Publisher ↗
BACKGROUND: Community pharmacists' roles are expanding beyond traditional tasks to include digital health interventions. Despite the growing integration of digital health technologies, gaps remain in understanding pharma...
BACKGROUND: Community pharmacists' roles are expanding beyond traditional tasks to include digital health interventions. Despite the growing integration of digital health technologies, gaps remain in understanding pharmacists' digital health technology literacy (DHTL). Adequate DHTL is essential for supporting patients and ensuring the effective implementation of digital tools in pharmacy practice. OBJECTIVES: To assess general digital literacy (gDL) and identify specific levels of DHTL among community pharmacists. METHODS: A version of the DHTL Assessment Questionnaire (DHTL-AQ), specifically validated for use by community pharmacists, was distributed via online and paper-based formats. In addition to the DHTL-AQ, the questionnaire also included supplementary items assessing gDL. The sample size was calculated on the basis of the targeted pharmacist population. The data were analysed via SPSS. Receiver operating characteristic curves were used to determine cut-off scores, whereas chi-square and Kruskal-Wallis tests were used to assess group differences and associations. RESULTS: A total of 368 valid responses were collected. Among the respondents, 15.2% had low, 68.8% had medium, and 16.0% had high gDL. On the basis of these findings, DHTL cut-off scores were defined as low (35.9%), medium (19.6%), and high (44.5%). Significant differences in DHTL levels were associated with years of working experience. While 41.3% did not use social media professionally, Facebook, YouTube, Instagram, and Viber were the most commonly used platforms among pharmacists. CONCLUSION: This study provides the first comprehensive assessment of DHTL among Serbian community pharmacists, revealing high gDL but highlighting the need for targeted DHTL training. Future research should focus on expanding the sample size and addressing specific DHTL gaps. The approach used in this study offers a practical framework for assessing DHTL that can be applied internationally to inform the development of relevant, tailored training programs and support the expansion of pharmacist-led services in an increasingly digital health environment.
The three-fer: How biosimilars reduce cost, expand access, and improve margin.
Seekamp TM, Hamacher M, Kemper JA … +5 more , Toner RW, Sigrist JK, Suter K, Newman JS, Jensen CJ
J Am Pharm Assoc (2003) · 2026 · PMID 41161663 · Publisher ↗
BACKGROUND: Traditional Medicare Fee for Service (FFS) covers both reference biologics and biosimilars without requiring prior authorization. Biosimilars offer a safe and effective alternative to reference biologics at a...
BACKGROUND: Traditional Medicare Fee for Service (FFS) covers both reference biologics and biosimilars without requiring prior authorization. Biosimilars offer a safe and effective alternative to reference biologics at a lower cost. OBJECTIVE: This study aimed to reduce Medicare FFS patient use of reference biologics in oncology and oncology-supportive care by 50%, lower Mayo Clinic Community Accountable Care Organization (MCC ACO) spending, achieve institutional cost savings, and improve revenue by increasing biosimilar use. PRACTICE DESCRIPTION: Using the quality improvement (QI) framework, we expanded upon Mayo Clinic's biosimilar-first strategy through the use of targeted electronic health record (EHR) reports to identify Medicare patients using reference biologics when biosimilars were available. We requested pharmacists or physicians to convert these patients to less costly, formulary-preferred biosimilars. PRACTICE INNOVATION: We developed custom EHR reports to pinpoint Medicare patients still on reference biologics despite biosimilar availability and leveraged cost and margin data to promote change. Providers and pharmacists received targeted outreach and education, and pharmacists facilitated transitions to lower-cost biosimilars. EVALUATION METHODS: EHR reports tracked Medicare patients treated with reference biologics (trastuzumab, rituximab, bevacizumab, pegfilgrastim prefilled syringe, filgrastim) and their biosimilars during baseline and postintervention periods using the QI framework. MCC ACO spend impacts were analyzed using EHR data for Medicare beneficiaries treated at a MCC ACO location. Medication margin impact was extrapolated from internal data using the average sales price minus the contracted acquisition cost for each medication. RESULTS: Reference biologic use among Medicare patients dropped 47%. MCC ACO spending decreased by $2.62 million, patient count rose by 4.3%, and per-utilizer-per-month spending fell by 13.9% from fiscal year 2022-2023. Medication margin improved by more than $2.2 million for a modeled patient volume of 1000 per drug category. CONCLUSION: QI efforts largely reduced reference biologic use in Medicare patients, lowered spending, increased patient access, and improved margins by shifting to biosimilars.
Key informant perspectives on facilitators for pharmacist payment of medication therapy management services.
Hu A, Pincus KJ, Cooke CE … +3 more , Elonge E, Larson S, Brandt N
J Am Pharm Assoc (2003) · 2026 · PMID 41161662 · Publisher ↗
BACKGROUND: Opportunities for pharmacist payment of medication therapy management (MTM) services vary significantly by state and payer. While previous research has identified barriers and facilitators with setting up pha...
BACKGROUND: Opportunities for pharmacist payment of medication therapy management (MTM) services vary significantly by state and payer. While previous research has identified barriers and facilitators with setting up pharmacist MTM services, adoption of payment remains low. OBJECTIVE: The primary objective of this qualitative key informant (KI) study was to identify themes for successful payment of pharmacist MTM services. METHODS: KIs who were obtaining or pursuing compensation for pharmacist MTM services were recruited via a Qualtrics survey to evaluate their eligibility for the study. If eligible, semistructured interviews were conducted via Zoom from November 2024 to March 2025. Interview transcripts were coded for thematic analysis, and themes were mapped to the Consolidated Framework for Implementation Research domains. RESULTS: Code saturation was reached with 15 interviews. All KIs were pharmacists, with 53% in leadership roles and MTM billing duration ranging from 3 months to 19 years. Payment modalities included MTM codes, incident-to, other Evaluation and Management and care management codes, grants, cash pay, and fee-for-service contracts. Eighteen themes were identified in individual, process, inner setting, and outer setting domains. Six key actionable steps for pharmacists interested in pursuing billing included the use of external individuals or community partnerships to navigate billing issues, use of pilot testing to generate outcomes, use of integrated billing and documentation systems to increase operational efficiency, use of support staff to increase financial sustainability, establishment of a workflow to address payment issues, and creation of a tracking system to support ongoing billing. CONCLUSION: While current pharmacist MTM payment modalities do not entirely compensate for pharmacist costs, pharmacists are successfully obtaining payment for their services. Future advocacy efforts need to focus on establishing consistent billing requirements and increasing payment for service sustainability, as well as educating pharmacists and billing professionals on billing opportunities.
Assessing attitudes toward community pharmacy services and a pharmacist's role in substance use treatment by those utilizing day center and harm reduction services.
Knebel J, Chapa S
J Am Pharm Assoc (2003) · 2026 · PMID 41135728 · Publisher ↗
BACKGROUND: People who inject drugs (PWID) often face significant barriers to health care, including stigma and mistrust. Pharmacists, as accessible health care providers, have the potential to bridge these gaps, yet the...
BACKGROUND: People who inject drugs (PWID) often face significant barriers to health care, including stigma and mistrust. Pharmacists, as accessible health care providers, have the potential to bridge these gaps, yet the attitudes of PWID toward pharmacy services remain underexplored. Understanding these attitudes is essential for tailoring interventions that improve involvement in substance use treatment and health outcomes for this population. OBJECTIVES: To capture the viewpoints of those that utilize day center services on the pharmacy profession and its role in substance use treatment. METHODS: This prospective field study investigated the perceptions of those who used the services of a syringe services program and day center toward pharmacists. Past prescription and illicit drug use, attitudes toward pharmacy services, and disposal methods of medications were assessed. RESULTS: A total of 179 patients completed the voluntary survey, with 42% believing that a pharmacist could aid them with their substance use disorder. From the patients who completed the survey, 66% reported previous usage of an illicit substance, with methamphetamine (78%) and cocaine (62%) having the highest reported rates of use. CONCLUSION: This study provides the framework for assessing patient preferences for expanding pharmacy services in an underserved clinical setting. Patients reported baseline trust in pharmacy services but reported that they do not believe a pharmacist could help them quit using illicit substances. Further studies are needed to fully quantify how pharmacists can fill the perceived needs and garner increased trust with PWID.
Implementing payer partnerships for patient care programs within clinically integrated networks of community pharmacies: A qualitative study.
Daly C, Iqbal DN, Finke JB … +10 more , Coley KC, Doucette WR, Ferreri SP, Herbert SMC, Jacobs DM, McDonough R, Somma McGivney MA, Nuffer W, Smith MG, Bacci JL
J Am Pharm Assoc (2003) · 2026 · PMID 41135727 · Publisher ↗
BACKGROUND: Community pharmacy partnerships expanding patient care opportunities are growing through clinical integration. Practice transformation efforts through the Community Pharmacy Enhanced Services Networks (CPESN...
BACKGROUND: Community pharmacy partnerships expanding patient care opportunities are growing through clinical integration. Practice transformation efforts through the Community Pharmacy Enhanced Services Networks (CPESN USA) have supported over 100 state and national payer programs. While previous work identified themes for sustained program success, program facilitators indicated a need for additional insight into program design, execution, and evaluation. OBJECTIVE: To identify successful practices for implementing patient care programs in collaboration with health payers across community pharmacy networks nationwide. METHODS: This qualitative study consisted of an online demographic survey and semistructured interviews conducted in 2023 with CPESN USA program facilitators. The Practical, Robust, Implementation, and Sustainability Model framework was used for developing study materials. Descriptive statistics were utilized to analyze the survey. A rapid analysis approach was used to evaluate and summarize major themes from the interviews. RESULTS: Of 43 eligible program facilitators across 40 networks, 14 completed the survey and interview. Participants varied in years of experience, with 6 (43%) having 1-3 years and 8 (57%) having 4-6 years. Pharmacy networks averaged 119 pharmacies and a cumulative average of 7 payer programs. Twenty-three total themes for developing and implementing patient care programs within community pharmacies were categorized in the following sections: 1) engagement, 2) program intervention and design, 3) contract set-up, 4) communication across program collaborators, 5) training (preparing for service implementation), 6) outcomes assessment, 7) data collection, and 8) payment mechanisms. CONCLUSION: Keys to successful community pharmacy-payer programs include collaborative program design, ongoing dialog, effective evaluations, technology utilization, and evolving payment models. Findings can be utilized to implement successful partnerships with payers, supporting the integration of community pharmacies into value-based care models.
Evaluation of recruitment methods and promotional strategies for sexual health services and research.
Gonzalez PR, Black E, Trenaman S … +1 more , Wilby KJ
J Am Pharm Assoc (2003) · 2026 · PMID 41130412 · Publisher ↗
BACKGROUND: Recruitment of diverse participant cohorts has been a long-standing challenge in clinical and health care system research. Diversity is necessary to gain representation of underserved demographics and further...
BACKGROUND: Recruitment of diverse participant cohorts has been a long-standing challenge in clinical and health care system research. Diversity is necessary to gain representation of underserved demographics and further our understanding of how to address health inequities and systemic barriers. OBJECTIVES: Identify facilitators and barriers to access and uptake of pharmacist-led sexually transmitted infection (STI) health care services, evaluate recruitment strategies and identify facilitators and barriers associated with recruitment/promotional strategies, and determine strategies to improve reach of promotion and recruitment strategies to underserved communities to improve equity in pharmacy-based STI services. METHODS: This was a qualitative evaluation case study using in-depth semi structured interviews with pharmacists engaged in pharmacy practice research and community advocacy representatives. Interviews were inductively coded and underwent thematic analysis. RESULTS: Five themes were identified which encompass facilitators and barriers to uptake of pharmacy-based sexual health services by underrepresented communities: convenience, misunderstandings, historical harm and past experiences, current forms of systemic oppression, perceptions and fears. Four themes were identified which encompass facilitators and barriers for the effectiveness of recruitment strategies employed by pharmacy practice research: type of recruitment strategy, service type and its perceived benefits/relevance, awareness of service options, difficulties requesting a service. Four themes were identified encompassing strategies for increasing reach of underserved communities in future to improve equity in pharmacy-based STI services: multipronged approaches, accessible promotional material and recruitment strategies, collaboration, dismantling of systemic oppression. CONCLUSION: This study highlighted strategies to improve the reach of pharmacist provided STI services and recruit diverse participants to health research and promote the uptake of pharmacist provided STI services by underserved groups in future.
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