Journal of the American Pharmacists Association最新文献

{"title":"Implementation modifications and outcomes of a pharmacist-led primary care remote hypertension service","authors":"Jennifer A. Sabatino,&nbsp;Natalie S. Lee,&nbsp;Kelli D. Barnes,&nbsp;Cory P. Coffey,&nbsp;Daniel E. Jonas,&nbsp;Neeraj H. Tayal","doi":"10.1016/j.japh.2025.102971","DOIUrl":"10.1016/j.japh.2025.102971","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Practice description</h3><div>Guided by the Exploration, Preparation, Implementation, and Sustainment framework, we describe the key practice contextual factors that contributed to implementation of RPM for hypertension.</div></div><div><h3>Practice innovation</h3><div>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.</div></div><div><h3>Evaluation methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>P</em> &lt; 0.01), while the proportion of patients achieving target BP improved but was not statistically significant (<em>P</em> = 0.53).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102971"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring workflows for long-acting antiretroviral therapy administration in community pharmacies","authors":"Valerie Clinard,&nbsp;Kevin Bumanglag,&nbsp;Parya Saberi,&nbsp;Kelly Hester,&nbsp;Michael Sigua,&nbsp;George Udeani,&nbsp;Elizabeth Sherman,&nbsp;Yvette Cuca,&nbsp;Jennifer Cocohoba","doi":"10.1016/j.japh.2025.102979","DOIUrl":"10.1016/j.japh.2025.102979","url":null,"abstract":"<div><h3>Background</h3><div>Long-acting injectable antiretroviral therapy (LA-ART) can improve adherence and virologic suppression in people with human immunodeficiency virus (HIV). While some clinics have successfully implemented these services, others face staffing and system barriers. Community pharmacies offer an alternative venue for LA-ART administration, but little is known about how workflows might be optimized.</div></div><div><h3>Objective</h3><div>This study aims to outline key considerations in an ideal workflow to implement LA-ART into community pharmacies from the perspective of clinic, pharmacy, and patient stakeholders.</div></div><div><h3>Methods</h3><div>Data were derived from a convergent-parallel mixed-methods parent study. Surveys and semi-structured interviews were conducted to explore perspectives on the feasibility of LA-ART administration in community pharmacies. Using thematic analysis, excerpts specific to ideal pharmacy workflows were extracted, coded, and analyzed. A process map was developed to visualize pharmacy workflow activities.</div></div><div><h3>Results</h3><div>Of the 63 study participants, 59 provided insights on ideal workflows for LA-ART administration in pharmacies. Seven primary themes emerged: (1) communication across stakeholders, (2) staffing and logistical operational structure, (3) patient management and follow-up, (4) insurance and reimbursement barriers, (5) physical space and infrastructure, (6) pharmacist and patient education, and (7) patient choice and flexibility. Effective communication, appointment-based systems, and private spaces were emphasized. Participants identified challenges such as unclear protocols for patient management, insurance and reimbursement complexities, and the need for pharmacists and patient education to ensure successful implementation.</div></div><div><h3>Conclusion</h3><div>Community pharmacies are a promising venue for LA-ART administration. Key workflow issues must be addressed to ensure successful implementation. Understanding stakeholder perspectives provides a foundation for developing scalable models to expand access to HIV treatment and prevention.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102979"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145461173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using implementation science to evaluate perceived feasibility of pharmacy-based HIV services in the Southeastern United States","authors":"Chante Hamilton,&nbsp;Alexis Hudson,&nbsp;Samruddhi N. Borate,&nbsp;Seth Zissette,&nbsp;Christina Chandra,&nbsp;Annabel Nicholas,&nbsp;Henry N. Young,&nbsp;Natalie D. Crawford","doi":"10.1016/j.japh.2025.102969","DOIUrl":"10.1016/j.japh.2025.102969","url":null,"abstract":"<div><h3>Background</h3><div>The Southern United States accounts for over half of new HIV diagnoses despite representing just over one-third of the population and remains a priority region in the Ending the HIV Epidemic (EHE) initiative. Community pharmacies are accessible, trusted health care sites with potential to expand HIV prevention services, yet limited evidence exists on pharmacy staff perspectives across the Southeast.</div></div><div><h3>Objectives</h3><div>Guided by the Consolidated Framework for Implementation Research (CFIR), we assessed implementation related factors and demographic characteristics to identify correlates of perceived feasibility of tailoring HIV services to community pharmacies in EHE priority counties across eight Southeastern states.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional survey (November 2023–June 2025) of community pharmacy staff in eight Southeast states. Eligible participants were recruited from independent and chain pharmacies using the National Council for Prescription Drug Programs database. Survey items, informed by CFIR, captured constructs across intervention characteristics, outer setting, inner setting, and characteristics of individuals. The primary outcome was perceived feasibility of tailoring HIV services (yes/no). Descriptive statistics summarized all variables, chi-square and Fisher's exact test examined bivariable associations, and modified Poisson regression with robust standard errors estimated adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>Of 291 respondents, 48.8% perceived that it was feasible to tailor HIV services to their pharmacy. In adjusted models higher feasibility was associated with being Asian (PR = 1.51; 95% CI: 1.17–1.96) or Black (PR = 1.37; 95% CI: 1.15–1.62), having a private area available for HIV testing (PR = 1.36; 95% CI: 1.01–1.84) and perceiving that there is enough evidence to support HIV testing in pharmacies (PR = 2.12; 95% CI: 1.32–3.58).</div></div><div><h3>Conclusion</h3><div>Guided by the CFIR, perceived feasibility of pharmacy-based HIV services was strongly associated with intervention characteristics and inner setting factors. Strengthening evidence dissemination and addressing structural barriers may be critical for advancing scalable, pharmacy-based HIV prevention in the US Southeast.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102969"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between state policies enabling pharmacist-led human immunodeficiency virus pre-exposure prophylaxis and need for human immunodeficiency virus prevention: An ecological analysis","authors":"Christina Chandra,&nbsp;Chante Hamilton,&nbsp;Henry N. Young,&nbsp;David P. Holland,&nbsp;Natalie D. Crawford","doi":"10.1016/j.japh.2025.102983","DOIUrl":"10.1016/j.japh.2025.102983","url":null,"abstract":"<div><h3>Background</h3><div>Models of pharmacist-led pre-exposure prophylaxis (PrEP) services have been shown to effectively reach populations disproportionately affected by human immunodeficiency virus (HIV). Pharmacist prescriptive authority for PrEP varies across states, limiting the potential scale up of these models.</div></div><div><h3>Objective</h3><div>We investigated whether states with the most restrictive policies were also the states that could benefit the most from expanded PrEP access.</div></div><div><h3>Methods</h3><div>We classified U.S. states and the District of Columbia into 5 distinct policy categories ranked from most restrictive to least restrictive and estimated the association between these categories and the state PrEP-to-need ratio, the ratio of current PrEP users to new HIV diagnoses in the state.</div></div><div><h3>Results</h3><div>Most states had restrictive policies that limit pharmacists' ability to initiate PrEP for their clients. States with the most restrictive policy of patient-specific collaborative practice agreements may be more likely to benefit from expanded PrEP access compared to states with the least restrictive policy (i.e., unrestricted authority/statute).</div></div><div><h3>Conclusion</h3><div>In the absence of a national strategy or policy to expand pharmacist-led PrEP, state-level efforts are needed to improve access to PrEP in pharmacies.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102983"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of health data analytics in pharmacy: An innovative approach to developing a heart failure dashboard","authors":"Viviane Khalil,&nbsp;Hannah Doody,&nbsp;Adam J. Nelson,&nbsp;Stephen J. Nicholls,&nbsp;Sriram D. Rao,&nbsp;Sue Kirsa","doi":"10.1016/j.japh.2025.102914","DOIUrl":"10.1016/j.japh.2025.102914","url":null,"abstract":"<div><h3>Background</h3><div>There has been increasing interest in the utilisation of health data analytics for decision support systems and prioritising pharmacy clinical work. Despite this potential, there remains limited evidence in the Australian context regarding the design and implementation of data-driven dashboards tailored specifically for pharmacists.</div></div><div><h3>Objectives</h3><div>We aimed to develop a disease state dashboard in an Australian hospital to assist clinicians in identifying and prioritising the review of heart failure (HF) patients when admitted for other reasons, enabling timely optimisation of their care.</div></div><div><h3>Practice Description</h3><div>This project was undertaken to enhance clinical pharmacy services through the integration of health data analytics.</div></div><div><h3>Practice innovation</h3><div>Using agile methodology to develop the dashboard to accurately identify HF patients regardless of their admission reason or specialty.</div></div><div><h3>Evaluation methods</h3><div>A prospective validation was conducted to evaluate the sensitivity, specificity, and accuracy of the HF dashboard parameters. A random sample of 100 patients with confirmed HF diagnoses was reviewed by a clinical pharmacist to establish a reference standard. The same patient list was used to test the dashboard’s ability to accurately identify HF cases using five key clinical indicators, including any form and dose of loop diuretics, intravenous loop diuretics, ICD-10 coding taxonomy, guidelines-directed medical therapy (GDMT), and BNP levels.</div></div><div><h3>Results</h3><div>A stakeholder group designed and built the dashboard from a set of 18 carefully chosen HF clinical and non-clinical parameters. Testing and validation of the dashboard demonstrated overall calculated accuracy to be &gt; 70% for the 5 HF main clinical parameters built in the dashboard. Positive predictive values for all parameters were also &gt; 80%, indicating a low likelihood identifying incorrect patients.</div></div><div><h3>Conclusion</h3><div>The dashboard is scalable and transferable due to its flexible, parameter-driven design and use of standardized clinical data. Its agile development and real-time integration support expansion to other conditions and settings.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102914"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From implementation to impact: Evaluation of a Pharmacist Primary Care Certificate Training Program using the RE-AIM framework","authors":"Kelsey D. Frederick,&nbsp;James S. Wheeler,&nbsp;John Troy,&nbsp;Kenneth C. Hohmeier","doi":"10.1016/j.japh.2025.102962","DOIUrl":"10.1016/j.japh.2025.102962","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102962"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and provider perspectives on the implementation of DPYD testing in oncology care clinics in an academic health system","authors":"Victoria Wittner,&nbsp;Jasmine Purcell,&nbsp;Mari Cayabyab,&nbsp;Glenda Hoffecker,&nbsp;Jillian Kalman,&nbsp;Ursina Teitelbaum,&nbsp;Robert Schnoll,&nbsp;Katharine A. Rendle,&nbsp;Sony Tuteja","doi":"10.1016/j.japh.2025.102990","DOIUrl":"10.1016/j.japh.2025.102990","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacogenomic variants in dihydropyrimidine dehydrogenase (<em>DPYD)</em> are associated with increased risk of severe treatment related adverse events (TRAEs) with standard fluoropyrimidine dosing. Pretreatment testing with preemptive dose reductions in variant carriers can prevent TRAEs. However, testing is not widely implemented, highlighting the need to understand barriers to increase adoption and maintenance.</div></div><div><h3>Objectives</h3><div>Guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) and Consolidated Framework for Implementation Research (CFIR) frameworks, we implemented <em>DPYD</em> testing within gastrointestinal oncology clinics. Our study aimed to collect qualitative data from key stakeholders to identify barriers and facilitators of testing following the initial implementation phase into practice.</div></div><div><h3>Methods</h3><div>We conducted key informant interviews and focus groups with oncology clinicians, gastrointestinal oncology patients, and caregivers. Semi-structured interview guides informed by EPIS/CFIR were developed. Purposeful sampling was utilized to identify potential participants. Interviews were recorded and transcribed. Research team notes were used where recordings were unavailable, and rapid qualitative methods were used to summarize findings and complete a priori coded matrices based on the EPIS framework. Barriers and facilitators were extracted and categorized by themes.</div></div><div><h3>Results</h3><div>From 8/2022 to 3/2025, 20 patients, 4 caregivers, and 26 clinicians from 7 sites participated. Immediately after the implementation phase, clinicians mentioned electronic health record integration of test results, availability of blood-based testing, and improved patient safety as main facilitators while cost, evidence uncertainty, and integration into pre-existing workflows were identified as barriers. After clinical testing was implemented, clinician barriers shifted toward lack of clarity in drug labeling and workflow challenges with early patient identification and timely test ordering. Patients were generally unaware of testing and emphasized education as the key facilitator.</div></div><div><h3>Conclusion</h3><div>Patients, caregivers, and providers were in favor of clinical <em>DPYD</em> testing to prevent fluoropyrimidine TRAEs but identified key barriers that can guide efforts toward scaling and maintenance.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102990"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145484617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of budesonide/glycopyrrolate/formoterol fumarate compared with glycopyrrolate/formoterol fumarate for the treatment of COPD: A systematic review and meta-analysis","authors":"Piyush Thathera,&nbsp;Aakriti Garg,&nbsp;Shaista Ahmed,&nbsp;Mohd Ashif Khan","doi":"10.1016/j.japh.2025.102906","DOIUrl":"10.1016/j.japh.2025.102906","url":null,"abstract":"<div><h3>Background</h3><div>Chronic obstructive pulmonary disease (COPD) is a progressive illness characterized by persistent respiratory symptoms and restricted airflow, often owing to smoking and prolonged exposure to environmental irritants. COPD affects the pulmonary vasculature, lung parenchyma, and airways, leading to structural abnormalities such as emphysema. This study compares the safety and effectiveness of budesonide/glycopyrrolate/formoterol fumarate (BGF) metered-dose inhaler (MDI) with glycopyrrolate/formoterol fumarate (GFF) MDI in patients with moderate to severe COPD, focusing on adverse events and forced expiratory volume in 1 second (FEV1).</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search encompassed databases such as PubMed, MEDLINE, <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, Cochrane Library, ScienceDirect, Web of Science, and Google Scholar up to April 2024. Search terms included “COPD,” “dual therapies,” “triple therapies,” “LABA,” “LAMA,” “BGF MDI,” “FEV₁,” and “COPD exacerbation.” Only English-language randomized controlled trials involving patients aged 40-80 years who were current or former smokers with confirmed COPD were included. In addition, reference lists of included studies were screened. Study quality was assessed using the Cochrane Risk of Bias 2.0 tool.</div></div><div><h3>Results</h3><div>Through an initial literature review, we obtained 4022 articles, 4 of which were included in the current study. Results showed a statistically significant rise in FEV1 with BGF MDI compared with GFF MDI at 4, 24, and 52 weeks. At 52 weeks, the pooled mean difference in FEV1 was 46.48 mL (95% CI 25.26–67.71). Safety profiles were similar, with adverse events such as nasopharyngitis and upper respiratory tract infections observed in both treatments.</div></div><div><h3>Conclusion</h3><div>BGF MDI significantly improves lung function compared with GFF MDI in moderate to severe COPD and has a comparable safety profile. Further large-scale studies are needed to confirm long-term safety.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102906"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creation of the CAP center: Advancing pharmacy practice through implementation science integration","authors":"Elizabeth Skoy,&nbsp;Heidi Eukel,&nbsp;Brody Maack,&nbsp;Lisa Nagel,&nbsp;Mark Strand,&nbsp;Amy Werremeyer","doi":"10.1016/j.japh.2025.102961","DOIUrl":"10.1016/j.japh.2025.102961","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Practice description</h3><div>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.</div></div><div><h3>Practice innovation</h3><div>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.</div></div><div><h3>Evaluation methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102961"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacy HIV pre-exposure prophylaxis/post-exposure prophylaxis furnishing: The benefits of collaborating with peer navigators","authors":"Alicia Morehead-Gee,&nbsp;Dino Selders,&nbsp;Kalaya Hill,&nbsp;Alejandro Chavez,&nbsp;Johanna Gonzalez,&nbsp;Lindsey Takata,&nbsp;Jacqueline Nazarian,&nbsp;David Mosqueda","doi":"10.1016/j.japh.2025.102978","DOIUrl":"10.1016/j.japh.2025.102978","url":null,"abstract":"<div><h3>Background</h3><div>California Senate Bill 159 (2019) enables pharmacists to furnish oral human immunodeficiency virus pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) without a clinician's prescription; however, its implementation has been limited by barriers including time and space constraints. Noting these barriers, a peer navigator-led pharmacy PrEP/PEP program was created within a Southern California Federally Qualified Health Center (FQHC).</div></div><div><h3>Objective</h3><div>The program aimed to enable pharmacist PrEP/PEP furnishing through collaboration with navigators and increase the FQHC's number of PrEP patients by 25% in 2 years.</div></div><div><h3>Methods</h3><div>In 2021, a multidisciplinary team developed a program that involved navigators meeting with patients, conducting eligibility assessments, and providing human immunodeficiency virus testing to facilitate pharmacists' PrEP/PEP furnishing. From 2021 to 2023, the team implemented the program at 11 FQHC pharmacies by providing SB-159-required online trainings followed by in-person simulation trainings, allowing pharmacists to practice the workflow with navigators. This study evaluates the program using components of the RE-AIM framework, assessing the program's reach (number/type of encounters and demographics of program users) and efficacy (percentage of encounters that led to follow-up PrEP/PEP clinic visits) in its first 2 years.</div></div><div><h3>Results</h3><div>The pharmacy program had 238 total encounters within its first 2 years; 161 (67.6%) were for PrEP and 77 (32.4%) were for PEP. Of the 216 unique program users, 166 (76.9%) were documented as having Hispanic/Latinx ethnicity, and 145 (67.1%) were documented as LGBTQ+. Encounters led to 195 (81.9%) follow-up appointments scheduled, of which 156 (80.0%) were attended. The FQHC's number of enrolled PrEP patients increased from 239 in January 2022 to 339 in December 2023 (41.8%).</div></div><div><h3>Conclusion</h3><div>This pharmacy program successfully increased PrEP/PEP access by creating a collaborative workflow led by peer navigators. Navigators are key to facilitating PrEP/PEP furnishing by aiding pharmacists in completing requirements and offering individuals a nonjudgmental peer encounter to obtain PrEP/PEP.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102978"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145461142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}