Journal of the American Pharmacists Association最新文献

英文中文

Bringing providers into the community pharmacy: Experiential education 将供应商带入社区药房：体验式教育。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-11-04 DOI: 10.1016/j.japh.2024.102276

Rebecca M. Lahrman

引用次数: 0

Feasibility of reaching populations at high risk for HIV in community pharmacies 社区药房接触艾滋病高危人群的可行性。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-11-01 DOI: 10.1016/j.japh.2024.102239

Natalie D. Crawford, Kristin R.V. Harrington, Christina Chandra, Daniel I. Alohan, Alvan Quamina, Omarri Beck, Henry N. Young

Background

Growing evidence has shown feasibility for human immunodeficiency virus (HIV) prevention service integration in pharmacies, including HIV testing and screening for pre-exposure prophylaxis (PrEP). Yet, further work is needed to determine whether pharmacies can effectively reach those at increased risk of HIV transmission.

Objective

We aimed to describe the HIV risk profiles and willingness to obtain HIV prevention services from a sample of pharmacy clients.

Methods

This was a cross-sectional pilot study aimed to develop a culturally appropriate pharmacy-based PrEP delivery model among Black men who have sex with men. Two pharmacies were recruited from low-income, underserved communities and participants were recruited within pharmacies for screener and social and behavioral surveys. Individuals were grouped by PrEP eligibility due to sexual risk, injection drug use risk, or both, and demographic and willingness measures were compared.

Results

Among 460 pharmacy clients, 81 (17.6%) would have been eligible for PrEP due to sex or injection drug use risk. Most were eligible due to sexual risk (58.0%), while a substantial proportion were eligible due to injection drug use (27.2%) or a combination of sexual and injection drug use risk behaviors (42.0%). Of these eligible, the median age was 31 years (interquartile range = 28.32) and most had ≥1 female (75.3%) or male (96.3%) partner in the past 6 months. There was high willingness to receive a free HIV test in a pharmacy (90.1%). Most were willing to screen for PrEP in a pharmacy (95.1%) despite these services not being available in the state where this study was performed. There were no differences in willingness to obtain pharmacy-based HIV prevention services across risk groups.

Conclusion

This study shows that pharmacies in disadvantaged areas can serve a key role in preventing and decreasing the transmission of HIV by reaching populations with high HIV burden and providing HIV prevention services.

背景：越来越多的证据表明，在药房整合 HIV 预防服务是可行的，包括 HIV 检测和接触前预防（PrEP）筛查。然而，要确定药房能否有效地帮助那些艾滋病传播风险较高的人群，还需要进一步的工作：我们旨在描述药房客户的 HIV 风险概况以及获得 HIV 预防服务的意愿：这是一项横断面试点研究，旨在为黑人男男性行为者（MSM）开发一种基于药房的文化适宜的 PrEP 服务模式。我们从低收入、服务不足的社区招募了两家药店，并在药店内招募参与者进行筛选和社会行为调查。根据性行为风险、注射吸毒风险或两者兼而有之的 PrEP 资格对个人进行分组，并对人口统计学和意愿测量进行比较：在 460 名药房客户中，有 81 人（17.6%）因性风险或注射吸毒风险而符合 PrEP 条件。大多数人是因为性风险而符合条件（58.0%），而相当一部分人是因为注射吸毒（27.2%）或性风险行为和注射吸毒风险行为相结合而符合条件（42.0%）。在这些符合条件的人中，年龄中位数为 31 岁（IQR=28,32），大多数人在过去 6 个月内有≥1 个女性（75.3%）或男性（96.3%）伴侣。在药房接受免费 HIV 检测的意愿很高（90.1%）。大多数人愿意在药房接受 PrEP 筛查（95.1%），尽管本研究所在的州并不提供这些服务。不同风险群体在接受药房艾滋病预防服务的意愿上没有差异：本研究表明，贫困地区的药店可以通过接触艾滋病高负担人群并提供艾滋病预防服务，在预防和减少艾滋病传播方面发挥关键作用。

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引用次数: 0

A shared passion for providing care 提供护理的共同激情

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-11-01 DOI: 10.1016/j.japh.2024.102269

Diana D. Martínez-Nava BA, BS

引用次数: 0

Pharmacists are the medication, and medication literacy, experts 药剂师是药物和药物知识专家

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-11-01 DOI: 10.1016/j.japh.2024.102267

Heather A. Johnson PharmD, BCACP

引用次数: 0

Addressing health literacy and patient communication from the lens of science 从科学角度解决健康知识普及和患者沟通问题

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-11-01 DOI: 10.1016/j.japh.2024.102268

Aleda M.H. Chen PharmD, PhD, MS, FAPhA

引用次数: 0

Cover

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-11-01 DOI: 10.1016/S1544-3191(24)00308-X

引用次数: 0

Implementation of an outpatient clinical pharmacy service at an adult cystic fibrosis center 在成人囊性纤维化中心实施门诊临床药学服务。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-10-29 DOI: 10.1016/j.japh.2024.102270

Olga Marshall, Engy Dous, Kaitlyn Simpson, Cheng-Shiun Leu, Jiying Han, Claire Keating, Emily DiMango

Background

High treatment burden can adversely impact health outcomes in people with cystic fibrosis (PwCF). There is a continued need for medication adherence education and further research to evaluate impact of cystic fibrosis (CF) pharmacist interventions in an ambulatory care setting.

Objectives

To evaluate whether pharmacist integration into an outpatient adult CF clinic can positively impact patient satisfaction and medication adherence through various pharmacist-based interventions.

Methods

At a single urban medical center, a clinical pharmacist on an adult CF care team conducted comprehensive counseling sessions with PwCF. During these visits, types of pharmacist interventions were documented. Patients were provided a baseline and postcounseling survey to assess satisfaction with the pharmacist visit. Adherence to cystic fibrosis transmembrane regulator (CFTR) modulator and mucolytics were tracked 12 months before and 12 months after the counseling session.

Results

A total of 723 pharmacist interventions were performed throughout 100 pharmacist visits in 100 PwCF. Most common interventions were inhaler technique education (17%), drug interaction identification (12%), provision of drug education material (12%), and medication refills (12%). Prior to any intervention, 97% of patients felt they could benefit from a pharmacist visit. Postcounseling survey results demonstrated that 98% of patients found pharmacist counseling to be beneficial. Medication adherence rate prior to pharmacy intervention was 81.9% for CFTR modulators and 62.5% for mucolytics, and 86.9% (P = 0.143) and 63.6% (P = 0.773), respectively, after pharmacist intervention.

Conclusion

Integration of a clinical pharmacist within the CF clinic can help improve satisfaction and understanding of medication use among PwCF. Nearly all PwCF favorably perceived pharmacist counseling. We report that various pharmacist interventions including optimizing medication use knowledge, reinforcing adherence strategies, and streamlining timely access to treatment can contribute to enhanced care of PwCF.

背景：沉重的治疗负担会对囊性纤维化患者（PwCF）的健康状况产生不利影响。目前仍需开展用药依从性教育，并进一步研究评估非住院治疗环境中 CF 药剂师干预措施的影响：评估将药剂师纳入成人 CF 门诊是否能通过各种药剂师干预措施对患者满意度和用药依从性产生积极影响：在一家城市医疗中心，成人 CF 护理团队中的一名临床药剂师对 PwCF 进行了综合咨询。在这些访问期间，药剂师的干预类型都被记录在案。对患者进行了基线和咨询后调查，以评估其对药剂师访问的满意度。在咨询前 12 个月和咨询后 12 个月，对囊性纤维化跨膜调节器（CFTR）调节剂和粘液溶解剂的依从性进行了跟踪调查：在药剂师对 100 名患者进行的 100 次访问中，共进行了 723 次药剂师干预。最常见的干预措施是吸入器技术教育（17%）、药物相互作用识别（12%）、提供药物教育材料（12%）和药物补充（12%）。在采取任何干预措施之前，97% 的患者认为他们可以从药剂师的访问中受益。咨询后的调查结果显示，98% 的患者认为药剂师的咨询有益。在药剂师干预前，CFTR 调节剂和粘液溶解剂的用药依从率分别为 81.9% 和 62.5%，而在药剂师干预后分别为 86.9% (p=0.143) 和 63.6% (p=0.773)：结论：将临床药剂师纳入 CF 诊所有助于提高 PwCF 对药物使用的满意度和理解。几乎所有 PwCF 都对药剂师的咨询有好感。我们的报告显示，药剂师的各种干预措施，包括优化用药知识、加强依从性策略和简化及时获得治疗的途径，都有助于加强对 PwCF 的护理。

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引用次数: 0

A community pharmacist intervention for people living with epilepsy 社区药剂师对癫痫患者的干预。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-10-28 DOI: 10.1016/j.japh.2024.102275

Jennifer L. Bacci, Ifechukwu Benedict Nwogu, Sabra Zaraa, Michelle Guignet, H. Steve White, Andy Stergachis, Derek Ems, Edward J. Novotny

Background

Epilepsy is a complex spectrum of seizure disorders. Antiseizure medications are the first-line treatment for most patients. Community pharmacists are among the most accessible health care providers with extensive knowledge of pharmacotherapy yet are seldom engaged in epilepsy care.

Objective

The objective of this project was to pilot a community pharmacist-led intervention for people living with epilepsy (PWE).

Methods

The Community Pharmacist Epilepsy Services Program was a 6-month disease state management intervention that included 4 components: patient-pharmacist consultation, care plan development, regular check-ins, and care coordination. A pilot was conducted in 4 independent community pharmacies (2 intervention and 2 comparator) in western Washington State. A prospective, 2-arm, pre-post study was planned to evaluate the impact of the intervention on patient-reported quality of life (QoL), health, and satisfaction outcomes. The approach shifted to a 1-arm pre-post design due to low patient recruitment. The primary QoL outcome was the patient-weighted Quality of Life in Epilepsy Inventory-10 (QOLIE-10-P). Staff at intervention and comparator pharmacies were surveyed to evaluate perceived barriers to patient recruitment.

Results

Ten patients, including 7 intervention and 3 usual care patients, enrolled in the study. Five intervention patients completed the pre- and postsurveys. The median pre-QOLIE-10-P score was 1.09 and the median postscore was 1.73, indicating a slight nonsignificant decrease in QoL. Eleven pharmacy staff completed the survey evaluating perceived patient recruitment barriers. Limited number of eligible PWE at each pharmacy was perceived as significant barriers.

Conclusion

While low patient enrollment limited the ability to observe trends and draw conclusions about the potential impact of the intervention, enrollment barriers and lessons learned highlight opportunities to refine the intervention with the goal of improving the outcomes and well-being of PWE.

背景：癫痫是一种复杂的发作性疾病。抗癫痫药物 (ASM) 是大多数患者的一线治疗药物。社区药剂师是最容易获得的医疗服务提供者之一，拥有丰富的药物治疗知识，但却很少参与癫痫护理：本项目的目的是为癫痫患者（PWE）试行一项由社区药剂师主导的干预措施：社区药剂师癫痫服务计划是一项为期 6 个月的疾病状态管理干预措施，包括 4 个组成部分：患者-药剂师咨询、护理计划制定、定期检查和护理协调。在华盛顿州西部的 4 家独立社区药房（2 家干预药房和 2 家比较药房）进行了试点。计划开展一项前瞻性、双臂、前-后研究，以评估干预措施对患者报告的生活质量（QoL）、健康和满意度结果的影响。由于招募的患者人数较少，研究方法改为单臂、前-后设计。主要的生活质量结果是患者加权的癫痫生活质量量表-10（QOLIE-10-P）。对干预药房和比较药房的员工进行了调查，以评估他们在招募患者时遇到的障碍：10名患者参加了研究，其中包括7名干预患者和3名常规护理患者。五名干预患者完成了前后调查。前QOLIE-10-P得分中位数为1.09，后得分中位数为1.73，表明QoL略有下降，但不明显。11 名药剂师完成了评估患者招募障碍的调查。每家药房符合条件的病患人数有限被认为是重大障碍：虽然患者招募率低限制了观察趋势和得出干预潜在影响结论的能力，但招募障碍和吸取的经验教训凸显了完善干预的机会，其目标是改善 PWE 的结果和福祉。

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引用次数: 0

Chain community pharmacists’ requests for patient information during routine care 连锁社区药剂师在日常护理过程中对患者信息的要求。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-10-24 DOI: 10.1016/j.japh.2024.102273

Elizabeth G. Riley-Jensen, Katelyn N. Hettinger-Riddell, Jonathan E. Sarky, Margie E. Snyder

Background

To optimize service provision, community pharmacists need information (e.g., laboratory values and updated medication lists), which can be difficult to obtain. Contacting prescriber offices is a common approach to obtain information but is often ineffective. Health information exchange (HIE) is one potential solution to this problem, and recent survey research has identified the information needs of independent pharmacists that could be addressed through HIE. However, the information needs of chain community pharmacists are unknown.

Objective

The objective of this study was to characterize the patient information requests made by chain community pharmacists during routine practice.

Methods

This electronic card study captured cross-sectional observational data on patient information requests made by chain pharmacists in central Indiana during routine practice. Only one pharmacist meeting eligibility criteria per pharmacy could submit data. Pharmacists were randomized to a 2-week data collection period. In real-time, pharmacists recorded the following: type of information requested, reason for request, information source, whether initial or follow up request, modality of communication, and the time required to make the request. Data analysis occurred via descriptive statistics. The Indiana University Institutional Review Board approved all study procedures.

Results

Nineteen of the 33 eligible pharmacists (57.6%) consented to the study. Most participants held a Doctor of Pharmacy degree (78.9%) and were the pharmacy manager (89.5%) at their location. Updated medication orders/lists (41.3%) and insurance (33.7%) were the most common type of requested information and were primarily used for prescription clarification/filling (93.4%). The prescriber office (53.6%), as well as the patient/caregiver (39.8%), was the most frequent source of this information. Requests were largely completed by telephone (61.2%) and averaged 6.0 minutes (standard deviation: 4.8).

Conclusion

Community pharmacists require key patient data during routine practice. There is a need to develop mechanisms, like HIE, to address gaps in needed information in the community pharmacy setting, regardless of the offered services.

背景：为了优化服务，社区药剂师需要信息（如化验值和更新的药物清单），但这些信息可能很难获得。联系处方医生办公室是获取信息的常用方法，但往往效果不佳。健康信息交换 (HIE) 是解决这一问题的潜在方法之一，最近的调查研究已经确定了独立药剂师的信息需求，可以通过 HIE 解决。然而，连锁社区药剂师的信息需求尚不清楚：本研究旨在了解连锁社区药剂师在日常工作中对患者信息需求的特点：这项电子卡片研究收集了印第安纳州中部连锁药剂师在日常工作中提出的患者信息请求的横断面观察数据。每个药店只能有一名符合资格标准的药剂师提交数据。药剂师被随机分配到为期两周的数据收集期。药剂师实时记录以下内容：请求信息的类型、请求原因、信息来源、初次请求还是后续请求、沟通方式以及请求所需时间。数据分析通过描述性统计进行。印第安纳大学机构审查委员会批准了所有研究程序：33 名符合条件的药剂师中有 19 人（57.6%）同意参与研究。大多数参与者拥有药学博士学位（78.9%），并且是所在单位的药房经理（89.5%）。更新的用药单/清单（41.3%）和保险（33.3%）是最常见的信息请求类型，主要用于处方澄清/填写（93.4%）。开处方者办公室（53.6%）和病人/护理者（39.8%）是最常见的信息来源。大部分请求通过电话完成（61.2%），平均耗时 6.0 分钟（标清：4.8 分钟）：结论：社区药剂师在日常工作中需要病人的关键数据。社区药剂师在日常工作中需要关键的患者数据。有必要开发 HIE 等机制，以解决社区药房环境中所需信息的缺口，无论提供的服务如何。

{"title":"Chain community pharmacists’ requests for patient information during routine care","authors":"Elizabeth G. Riley-Jensen, Katelyn N. Hettinger-Riddell, Jonathan E. Sarky, Margie E. Snyder","doi":"10.1016/j.japh.2024.102273","DOIUrl":"10.1016/j.japh.2024.102273","url":null,"abstract":"<div><h3>Background</h3><div>To optimize service provision, community pharmacists need information (e.g., laboratory values and updated medication lists), which can be difficult to obtain. Contacting prescriber offices is a common approach to obtain information but is often ineffective. Health information exchange (HIE) is one potential solution to this problem, and recent survey research has identified the information needs of independent pharmacists that could be addressed through HIE. However, the information needs of chain community pharmacists are unknown.</div></div><div><h3>Objective</h3><div>The objective of this study was to characterize the patient information requests made by chain community pharmacists during routine practice.</div></div><div><h3>Methods</h3><div>This electronic card study captured cross-sectional observational data on patient information requests made by chain pharmacists in central Indiana during routine practice. Only one pharmacist meeting eligibility criteria per pharmacy could submit data. Pharmacists were randomized to a 2-week data collection period. In real-time, pharmacists recorded the following: type of information requested, reason for request, information source, whether initial or follow up request, modality of communication, and the time required to make the request. Data analysis occurred via descriptive statistics. The Indiana University Institutional Review Board approved all study procedures.</div></div><div><h3>Results</h3><div>Nineteen of the 33 eligible pharmacists (57.6%) consented to the study. Most participants held a Doctor of Pharmacy degree (78.9%) and were the pharmacy manager (89.5%) at their location. Updated medication orders/lists (41.3%) and insurance (33.7%) were the most common type of requested information and were primarily used for prescription clarification/filling (93.4%). The prescriber office (53.6%), as well as the patient/caregiver (39.8%), was the most frequent source of this information. Requests were largely completed by telephone (61.2%) and averaged 6.0 minutes (standard deviation: 4.8).</div></div><div><h3>Conclusion</h3><div>Community pharmacists require key patient data during routine practice. There is a need to develop mechanisms, like HIE, to address gaps in needed information in the community pharmacy setting, regardless of the offered services.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102273"},"PeriodicalIF":2.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bridging PrEP Access Gaps: Mapping Geospatial Accessibility Across the US and Leveraging Community Pharmacies for Expansion. 缩小 PrEP 获取差距：绘制全美地理空间可及性地图并利用社区药房进行扩展。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-10-24 DOI: 10.1016/j.japh.2024.102274

Jacinda Tran, Anu Mishra, Marita Zimmermann, Ryan Hansen

Background: Pre-exposure prophylaxis (PrEP) is key to ending the US HIV epidemic, but uptake remains low. Federal legislation permitting community pharmacists to initiate PrEP nationwide could expand access to PrEP services.

Objectives: This study aimed to evaluate census tract-level geospatial access to PrEP facilities and community pharmacies across the US and characterize geographic areas and populations where community pharmacies could help bridge the gap in care.

Methods: We identified census tracts with limited or no access ("deserts") to PrEP facilities and community pharmacies in 2022 using two primary definitions: 1) a tract with no PrEP facilities or pharmacies within a 30-minute drive of the tract centroid; and 2) a tract with low income and low access (no PrEP facilities or pharmacies within one mile of the centroid for low vehicle access tracts, two miles in urban tracts, 10 miles in suburban tracts, 20 miles in rural tracts). Tracts with access were "oases," and "PrEP desert, pharmacy oasis" tracts represented areas without PrEP facilities where community pharmacies could expand access. We characterized the social determinants of health associated with desert status and conducted sensitivity analyses exploring additional access definitions.

Results: Of the 82,729 census tracts in our analysis, most were classified as dual PrEP and pharmacy oases. We categorized 13.3% as PrEP deserts under the 30-minute definition, and 94.3% of these tracts were pharmacy oases. Under the low income and low access definition, 17.0% of all tracts were PrEP deserts, 78.2% of which were pharmacy oases. PrEP deserts were predominantly located in the Midwest and South and associated with higher poverty, social vulnerability, and uninsurance.

Conclusion: Our analysis confirmed inequitable access to PrEP facilities across the US. Federal recognition of pharmacists as health care providers empowered to initiate PrEP nationwide has the potential to substantially bridge access gaps for underserved communities.

背景：暴露前预防（PrEP）是结束美国艾滋病流行的关键，但接受率仍然很低。允许社区药剂师在全国范围内启动 PrEP 的联邦立法可以扩大 PrEP 服务的可及性：本研究旨在评估全美人口普查区一级的 PrEP 设施和社区药房的地理空间使用情况，并确定社区药房可帮助缩小医疗差距的地理区域和人群的特征：我们使用两个主要定义确定了 2022 年 PrEP 机构和社区药房使用受限或无法使用（"荒漠"）的人口普查区：1）距离普查区中心点 30 分钟车程内没有 PrEP 机构或药店的普查区；以及 2）低收入且交通不便的普查区（低车速普查区中心点 1 英里内没有 PrEP 机构或药店，城市普查区中心点 2 英里内没有 PrEP 机构或药店，郊区普查区中心点 10 英里内没有 PrEP 机构或药店，农村普查区中心点 20 英里内没有 PrEP 机构或药店）。交通便利的地区是 "绿洲"，而 "PrEP 沙漠，药房绿洲 "地区则是没有 PrEP 设施的地区，社区药房可以在这些地区扩大服务范围。我们描述了与沙漠状态相关的健康社会决定因素，并进行了敏感性分析，探讨了更多的获取定义：在我们分析的 82 729 个人口普查区中，大多数被归类为 PrEP 和药房双重绿洲。根据 30 分钟的定义，我们将 13.3% 的地区归类为 PrEP 沙漠，其中 94.3% 的地区为药房绿洲。根据低收入和低获取率的定义，17.0% 的地区属于 PrEP 沙漠，其中 78.2% 属于药房绿洲。PrEP 沙漠主要位于中西部和南部，与较高的贫困率、社会脆弱性和无保险率有关：我们的分析证实了美国各地在使用 PrEP 设施方面存在的不公平现象。联邦承认药剂师是有权在全国范围内启动 PrEP 的医疗服务提供者，这有可能大大缩小医疗服务不足社区在获取服务方面的差距。

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