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Response to “GLP-1 receptor agonists and diabetic retinopathy: Comment on a case report” 对“GLP-1受体激动剂与糖尿病视网膜病变:附一例报告”的反应。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-01 DOI: 10.1016/j.japh.2025.103000
Jennifer Ko PharmD, MPH, BCACP, APh, Yaseman Jahromi
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引用次数: 0
Practices and implementation factors of point-of-care testing for acute upper respiratory tract infections by community pharmacists in Alberta: A cross-sectional survey 艾伯塔省社区药剂师对急性上呼吸道感染的即时检测的实践和实施因素:一项横断面调查。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-01 DOI: 10.1016/j.japh.2025.102927
Omar E. Abdellatife, Scot H. Simpson, Theresa J. Schindel, Jody Shkrobot, Mark J. Makowsky

Background

Community pharmacists in Alberta have a broad scope of practice and may conduct point-of-care (POC) tests for acute and chronic medical conditions. However, little is known about the provision and pharmacists' experiences in POC testing for respiratory infections.

Objectives

To explore the clinical services offered by community pharmacist to patients with acute upper respiratory tract infections (URTI) by describing the types of POC tests performed and differences in implementation factors and confidence between active and inactive URTI POC testing providers.

Methods

Anonymous, online, cross-sectional survey with email invitations sent to 4035 community pharmacists registered with the Alberta College of Pharmacy in February 2024. The survey collected information on demographics and provision of POC testing services. An adapted version of the Determinants of Implementation Behavior Questionnaire (DIBQ) was used to determine barriers and facilitators. The data were summarized descriptively and compared between groups using univariate statistical tests.

Results

A total of 370 responses were included in the final analysis (response rate: 9.2%, 45% < 40 years old, 65% female, 28% rural, 73% have additional prescribing authorization). Most respondents (87%) provide assessments to patients presenting with URTI symptoms. Three quarters (72.7%) provide POC testing, 65% currently provide URTI POC tests, with 59.79% offering strep throat, 26.5% COVID-19 and 5.9% influenza POC tests. Active providers were more likely to agree or strongly agree to 26 out of 30 of the adapted DIBQ items, indicating that these were facilitators of implementation. The largest differences were in having the necessary resources (relative risk: 5.23; 95%CI: 3.34, 8.18), training (RR: 3.89; 95%CI: 2.57, 5.88) and knowing how (RR: 3.16; 95%CI: 2.33, 4.28) to deliver the service. In both groups, areas with low confidence were performing a focused physical assessment, analyzing rapid molecular tests and performing a nasal swab.

Conclusion

Community pharmacists in our sample commonly provide POC testing for Strep pharyngitis. Our results suggest organizational factors, skills, and knowledge were facilitators of service provision.
背景:艾伯塔省的社区药剂师有广泛的实践范围,可以对急性和慢性疾病进行护理点(POC)测试。然而,对呼吸道感染的POC检测的规定和药师的经验知之甚少。目的:探讨社区药师对急性上呼吸道感染(URTI)患者进行POC检测的类型、活跃和不活跃的URTI POC检测提供者在实施因素和置信度方面的差异,为急性上呼吸道感染(URTI)患者提供临床服务。方法:匿名、在线、横断面调查,于2024年2月向4035名在阿尔伯塔药学院注册的社区药剂师发送电子邮件邀请。该调查收集了人口统计数据和提供POC检测服务的信息。一个改编版的实施行为决定因素问卷(DIBQ)被用来确定障碍和促进因素。用单变量统计检验对数据进行描述性总结和组间比较。结果:最终分析共纳入370份应答者(应答率:9.2%,45% < 40岁,65%女性,28%农村,73%有额外处方授权)。大多数应答者(87%)对出现尿路感染症状的患者进行评估。四分之三(72.7%)提供POC检测,65%目前提供URTI POC检测,57.9%提供链球菌性咽喉炎检测,36.5%提供COVID-19检测,5.9%提供流感POC检测。积极的提供者更有可能同意或强烈同意30个经调整的DIBQ项目中的26个,这表明这些是实施的促进者。最大的差异是拥有必要的资源(相对风险:5.23;95%CI: 3.34, 8.18)、培训(相对危险度:3.89;95%CI: 2.57, 5.88)和知道如何提供服务(相对危险度:3.16;95%CI: 2.33, 4.28)。在这两组中,低可信度区域正在进行集中的物理评估,分析快速分子测试并进行鼻拭子。结论:本区社区药师普遍提供链球菌性咽炎POC检测。我们的研究结果表明,组织因素、技能和知识是服务提供的促进因素。
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引用次数: 0
Evaluating the financial sustainability of pharmacist-led primary care services: Real-world evidence from Idaho 评估药剂师主导的初级保健服务的财务可持续性:来自爱达荷州的真实证据。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-01 DOI: 10.1016/j.japh.2025.102970
Jordin Millward, Zachary Rosko

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%.
目的:评估在农村初级保健环境中使用商业付款人E/M计费代码的药剂师主导的慢性病管理服务的财务可行性和可扩展性。实践描述:2023年6月,一名临床药剂师被嵌入爱达荷州一家医生拥有的家庭医学诊所。该药剂师的执业时间约为0.25个全职当量(FTE),与转诊提供者协作管理糖尿病和多种药房。患者由提供者直接转介或通过图表审查确定。CPT代码包括商业和医疗补助受益人的99212-99214和医疗保险受益人的慢性护理管理(CCM)代码99490。药剂师索赔首次付款发生在2024年10月,报销数据评估截止到2025年6月(9个月)。在整个研究期间(24个月)评估HbA1c改善情况。实践创新:该模式利用了爱达荷州药剂师独立开处方的权力。药剂师拥有六个商业支付者和爱达荷州医疗补助的独立证书,并遵循标准的E/M和CCM编码实践。实时数据告知迭代服务改进。评估方法:从电子病历中提取描述性报销数据,计算每次就诊的平均报销率。收支平衡情景使用爱达荷州特定的工资和福利基准进行建模。评估了不同的人员配备模式。结果:平均每次就诊报销为123.25美元。盈亏平衡阈值(1.0 FTE,无支持人员,30%福利)为每8小时门诊日6例患者。在有支持人员的1.0个工作时间,可持续性需要每个门诊日8名患者。为了使配备辅助人员的1.0专职药剂师每年获得10万美元的额外利润,阈值为每个门诊日接待12名患者。在整个评估期内,药师所见患者的平均糖化血红蛋白降低了1.8%,糖化血红蛋白低于7%的患者糖化血红蛋白升高了35%。
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引用次数: 0
Lessons learned in optimizing recruitment and data collection for a pharmacy-based implementation trial 优化基于药房的实施试验的招聘和数据收集的经验教训。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-01 DOI: 10.1016/j.japh.2025.102972
Abigail G. Shackley, Delesha M. Carpenter, Heidi Charton, Benjamin S. Teeter, Megan Smith, Tessa J. Hastings, Tamera Hughes, Geoffrey Curran

Background

In Fall 2023, we initiated a National Institutes of Health-funded study to test the effectiveness of implementation strategies to support pharmacy implementation of a COVID-19 vaccine hesitancy counseling intervention. Our stepped-wedge trial compared a standard implementation condition (training and technical assistance) to a virtual facilitation (or one-on-one coaching) intervention. Within 6-8 weeks, problems emerged related to pharmacist engagement and data collection that threatened the study's success.

Objective

To describe formative evaluation results for the initial trial year and the strategies we developed and deployed in Fall 2024 to address identified engagement and data collection problems.

Methods

The formative evaluation consisted of 5 semistructured key informant interviews with highly-engaged and unengaged pharmacists and a review of coaches' notes. All qualitative data were coded using a rapid template analysis method. To interpret the results and identify solutions, we consulted rural patient and implementation science expert advisory panels. Consensus was reached on study modification recommendations, which received funder approval.

Results

Numerous barriers impacted pharmacist engagement and data collection, such as poor demand for the COVID-19 vaccine, most patients declining to be audio-recorded to assess our primary outcome of pharmacist counseling fidelity, difficulties submitting encounter forms (our secondary outcome), staffing shortfalls, and pharmacist reluctance to approach “very hesitant” patients.

Discussion

Study modifications included changes to data collection (e.g., shift to using standardized patients for fidelity assessments), pharmacy recruitment, and the standard implementation approach (e.g., more training and tools). These modifications were deployed in the new first year of our implementation trial (August 2024 – April 2025) and we saw major improvements in study engagement and data collection.

Conclusion

Implementation trials often encounter potentially fatal problems due to shifting contexts. Studies can be salvaged if the team takes quick action, in partnership with funders and other constituents, to systematically understand the problems and develop solutions.
背景:2023年秋季,我们启动了一项由美国国立卫生研究院资助的研究,以测试支持药房实施COVID-19疫苗犹豫咨询干预的实施策略的有效性。我们的阶梯形试验比较了标准实施条件(培训和技术援助)和虚拟促进(或一对一指导)干预。在6-8周内,出现了与药剂师参与和数据收集有关的问题,威胁到研究的成功。目的:描述最初试验年的形成性评估结果,以及我们在2024年秋季制定和部署的策略,以解决已确定的参与和数据收集问题。方法:采用5个半结构化的关键信息访谈,分别对高敬业度和非敬业度的药师进行访谈,并回顾教练员的笔记。所有定性数据采用快速模板分析方法编码。为了解释结果并确定解决方案,我们咨询了农村患者和实施科学专家顾问团。就研究修改建议达成了共识,并得到了资助者的批准。结果:许多障碍影响了药剂师的参与和数据收集,例如对COVID-19疫苗的需求不佳,大多数患者拒绝录音以评估药剂师咨询保真度的主要结局,提交就诊表困难(我们的次要结局),人员短缺以及药剂师不愿接近“非常犹豫”的患者。讨论:研究修改包括数据收集的变化(例如,转向使用标准化患者进行保真度评估),药房招聘和标准实施方法(例如,更多的培训和工具)。这些修改在我们实施试验的第一年(2024年8月至2025年4月)进行了部署,我们在研究参与和数据收集方面取得了重大进展。结论:由于环境的变化,实施试验经常遇到潜在的致命问题。如果团队迅速采取行动,与资助者和其他成员合作,系统地了解问题并制定解决方案,研究就可以得到挽救。
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引用次数: 0
Implementation of community pharmacy-based testing and treatment for Chlamydia trachomatis and Neisseria gonorrhoeae in Nova Scotia (Swab-Rx study) 在新斯科舍省实施沙眼衣原体和淋病奈瑟菌的社区药物检测和治疗(拭子- rx研究)。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-01 DOI: 10.1016/j.japh.2025.102973
Mackenzie d’Entremont-Harris, Tasha D. Ramsey, Shea J.L. McInnis, Connor Booker, Dylan DeYoung, Andrea Bishop, Kirk Furlotte, Todd F. Hatchette, Kyle John Wilby

Background

Chlamydia and gonorrhea are the most reported bacterial sexually transmitted infections in North America. Accessible, efficient, and convenient testing mechanisms are essential to identify infections, reduce transmission, access treatment, and prevent complications.

Objective

This study aimed to implement pharmacy-based asymptomatic chlamydia and gonorrhea management in Nova Scotian community pharmacies and evaluate effectiveness and patient acceptability.

Methods

The study occurred in 4 community pharmacies in Nova Scotia, Canada. Pharmacists offered chlamydia and gonorrhea testing using patient self-collected swabs and first-catch urine. Specimens were tested at the Central Zone Microbiology Laboratory and reported back to the pharmacist who then provided results to the patient and prescribed treatment for any identified infection(s). An electronic questionnaire and posttesting interview explored patient acceptability. Pharmacist workload was explored in time per encounter and tests per week. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework and Theoretical Framework of Acceptability informed the study design.

Results

Ninety-seven discrete participants were enrolled for 99 testing encounters. Eighty percent (78/97) of participants responded to the sociodemographic questionnaire, of which 64% were between the ages of 25 and 44, 26% identified as sexually diverse, and 15% as gender diverse. Many respondents reported never having been tested for chlamydia (23%) or gonorrhea (27%). Of the participants tested, 17% had positive test results; 14% had chlamydia and 3% gonorrhea infections. All participants with positive test results were prescribed antibiotic treatment by the pharmacist. Pharmacists required an average of 21 minutes for testing and 17 minutes for treatment encounters. Participants predominantly reported the service was highly acceptable, should always be available, and they would not have been tested if it was not available. Participants raised concerns regarding privacy, increased workload on pharmacists, and cost of the service.

Conclusion

Community pharmacy–based testing and treatment of asymptomatic chlamydia and gonorrhea was highly acceptable to service users. The model successfully identified new cases and pharmacists efficiently prescribed treatment.
背景:衣原体和淋病是北美报道最多的细菌性传播感染(STIs)。可获得、高效和方便的检测机制对于发现感染、减少传播、获得治疗和预防并发症至关重要。目的:在新斯科舍省社区药房实施基于药物的无症状衣原体和淋病管理,并评价其有效性和患者可接受性。方法:研究在加拿大新斯科舍省的四个社区药房进行。药剂师提供衣原体和淋病检测,使用患者自行收集的拭子和首次采集的尿液。在中心区微生物实验室对标本进行检测,并向药剂师报告,药剂师随后将结果提供给患者,并为任何确定的感染开出治疗处方。电子问卷和测试后访谈探讨了患者的可接受性。按每周就诊次数和检查次数及时探讨药师工作量。覆盖、有效性、采用、实施和维护(RE-AIM)框架和可接受性理论框架(TFA)为研究设计提供了依据。结果:97名离散参与者参加了99次测试。80%(78/97)的参与者回答了社会人口调查问卷,其中64%的人年龄在25-44岁之间,26%的人被认为是性别多元化的,15%的人被认为是性别多元化的。许多答复者报告从未接受过衣原体(23%)或淋病(27%)检测。在接受测试的参与者中,17%的测试结果呈阳性;14%有衣原体感染,3%有淋病感染。所有测试结果呈阳性的参与者均由药剂师处方抗生素治疗。药剂师平均需要21分钟进行检测,17分钟进行治疗。大多数参与者报告说,这项服务是高度可接受的,应该始终可用,如果没有可用,他们就不会进行测试。与会者提出了对隐私、药剂师工作量增加和服务成本的担忧。结论:无症状衣原体和淋病的社区药学检测和治疗可被服务用户高度接受。该模型成功地识别了新病例,药剂师有效地开出了治疗处方。
{"title":"Implementation of community pharmacy-based testing and treatment for Chlamydia trachomatis and Neisseria gonorrhoeae in Nova Scotia (Swab-Rx study)","authors":"Mackenzie d’Entremont-Harris,&nbsp;Tasha D. Ramsey,&nbsp;Shea J.L. McInnis,&nbsp;Connor Booker,&nbsp;Dylan DeYoung,&nbsp;Andrea Bishop,&nbsp;Kirk Furlotte,&nbsp;Todd F. Hatchette,&nbsp;Kyle John Wilby","doi":"10.1016/j.japh.2025.102973","DOIUrl":"10.1016/j.japh.2025.102973","url":null,"abstract":"<div><h3>Background</h3><div>Chlamydia and gonorrhea are the most reported bacterial sexually transmitted infections in North America. Accessible, efficient, and convenient testing mechanisms are essential to identify infections, reduce transmission, access treatment, and prevent complications.</div></div><div><h3>Objective</h3><div>This study aimed to implement pharmacy-based asymptomatic chlamydia and gonorrhea management in Nova Scotian community pharmacies and evaluate effectiveness and patient acceptability.</div></div><div><h3>Methods</h3><div>The study occurred in 4 community pharmacies in Nova Scotia, Canada. Pharmacists offered chlamydia and gonorrhea testing using patient self-collected swabs and first-catch urine. Specimens were tested at the Central Zone Microbiology Laboratory and reported back to the pharmacist who then provided results to the patient and prescribed treatment for any identified infection(s). An electronic questionnaire and posttesting interview explored patient acceptability. Pharmacist workload was explored in time per encounter and tests per week. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework and Theoretical Framework of Acceptability informed the study design.</div></div><div><h3>Results</h3><div>Ninety-seven discrete participants were enrolled for 99 testing encounters. Eighty percent (78/97) of participants responded to the sociodemographic questionnaire, of which 64% were between the ages of 25 and 44, 26% identified as sexually diverse, and 15% as gender diverse. Many respondents reported never having been tested for chlamydia (23%) or gonorrhea (27%). Of the participants tested, 17% had positive test results; 14% had chlamydia and 3% gonorrhea infections. All participants with positive test results were prescribed antibiotic treatment by the pharmacist. Pharmacists required an average of 21 minutes for testing and 17 minutes for treatment encounters. Participants predominantly reported the service was highly acceptable, should always be available, and they would not have been tested if it was not available. Participants raised concerns regarding privacy, increased workload on pharmacists, and cost of the service.</div></div><div><h3>Conclusion</h3><div>Community pharmacy–based testing and treatment of asymptomatic chlamydia and gonorrhea was highly acceptable to service users. The model successfully identified new cases and pharmacists efficiently prescribed treatment.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102973"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454507","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}
引用次数: 0
Best practices and barriers to implementing value-based payer programs in community pharmacies: An application of the EPIS framework 在社区药房实施基于价值的付款人项目的最佳实践和障碍:EPIS框架的应用。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-01 DOI: 10.1016/j.japh.2025.102980
Jordan Marie Ballou, La’Kendra Bell, Anna Greer Johnson, Reagan Page, Meagen Rosenthal

Background

The advancement of clinical services in the community pharmacy setting hinges on workflow augmentations that will assist pharmacies in successful implementation. Community Pharmacy Enhanced Services Network (CPESN) Mississippi is a network of community-based pharmacies collaborating to optimize medication use to promote positive patient health outcomes.

Objective

The purpose of this study was to evaluate barriers to and best practices for implementing patient care services while participating in payer engagements.

Methods

This qualitative, quality improvement study was approved as exempt by the University of Mississippi Institutional Review Board. Subjects included owners or managers of pharmacies participating in CPESN Mississippi, an accountable pharmacy organization. Investigators developed two interview guides using the Exploration, Preparation, Implementation, Sustainment (EPIS) Framework. One interview guide was intended to gather information on best practices for the implementation of services, while the other was geared toward assessing barriers to implementation. Pharmacies were sorted into 2 groups to receive either the barriers or best practices questions based on their participation in a payer program in the fall of 2021. Interviews were conducted via telephone and were digitally recorded. Three attempts to contact each pharmacy were made on different days and times. Interviews were transcribed via Trint and underwent analysis for thematic content.

Results

A total of 21 pharmacists at community pharmacies in CPESN Mississippi were interviewed for a response rate of 41%. There were 8 interviews in the best practices group and 13 in the barriers group. The content analysis identified 4 themes in best practices (role specialization, clear communication, support from leadership, and patient engagement) and 4 themes in barriers (infrastructure needs, documentation complications, staff buy-in, and reimbursement).

Conclusion

Study findings concluded that community pharmacists are eager to find alternative sources of revenue but require support with implementation. The use of the EPIS Framework allows for the identification of specific implementation strategies for testing in future studies and creating sustainable and scalable change in the community pharmacy setting.
背景:在社区药房设置临床服务的进步取决于工作流程的增加,这将有助于药房成功实施。社区药房增强服务网络(CPESN)密西西比州是一个以社区为基础的药房网络,合作优化药物使用,促进积极的患者健康结果。目的:本研究的目的是评估在参与付款人约定时实施患者护理服务的障碍和最佳做法。方法:本定性、质量改进研究获得密西西比大学机构审查委员会的豁免批准。受试者包括参与CPESN密西西比州药房的业主或经理,这是一个负责任的药房组织。调查人员使用探索、准备、实施、维持(EPIS)框架制定了两份访谈指南。一份访谈指南的目的是收集关于执行服务的最佳做法的信息,而另一份访谈指南的目的是评估执行方面的障碍。药店被分为两组,根据他们在2021年秋季参加的付款人计划,接受障碍或最佳实践问题。采访是通过电话进行的,并进行了数字记录。他们在不同的日期和时间三次尝试联系每家药店。访谈通过Trint®进行转录,并对主题内容进行分析。结果:对密西西比州CPESN社区药房的21名药师进行了访谈,回复率为41%。最佳实践组有8次面试,障碍组有13次面试。内容分析确定了最佳实践中的四个主题(角色专业化、清晰的沟通、领导的支持和患者参与)和障碍中的四个主题(基础设施需求、文档复杂性、员工支持和报销)。结论:研究结果表明,社区药剂师渴望找到替代收入来源,但需要支持实施。使用EPIS框架可以确定具体的实施策略,以便在未来的研究中进行测试,并在社区药房环境中创造可持续和可扩展的变化。
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引用次数: 0
Pharmacy staff willingness to establish pre-exposure prophylaxis-based collaborative practice agreements in the Southeast United States 药房员工愿意在美国东南部建立基于预科的合作实践协议。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-01 DOI: 10.1016/j.japh.2025.102986
Annabel Nicholas, Christina Chandra, Seth Zissette, Alexis Hudson, Chante Hamilton, Donald Klepser, Alvan Quamina, David P. Holland, Natalie D. Crawford

Background

A collaborative practice agreement (CPA) allows a pharmacist to provide various patient care functions (i.e., ordering labs and modifying drug therapies) under the supervision of a provider. CPAs could facilitate pharmacists to provide human immunodeficiency virus (HIV) prevention services such as pre-exposure prophylaxis screening and prescribing, which could enhance HIV prevention services in places with historically low access.

Objective

We evaluate correlates of pharmacy staff willingness to establish CPAs and to provide specific patient care functions.

Methods

The Collaborative Agreement-based pre-exposure prophylaxis Using Pharmacists study conducted online surveys among pharmacy staff from 8 states in the Southeast United States. Data collection began in January 2024 and is ongoing. Survey questions were developed using Consolidated Framework for Implementation Research constructs and capture the history of CPA usage, attitudes about CPAs, and willingness to establish CPAs. Descriptive analysis and Poisson regression were performed using preliminary data to evaluate pharmacy staff willingness to offer specific patient care functions through CPAs.

Results

Among 246 respondents, 67 (27%) currently have at least 1 CPA in place, with 20 (30%) of those CPAs involving infectious disease care. About 75% were willing to establish a CPA to provide additional services to their patients. Most pharmacy staffs were willing to provide medication therapy management (91%), patient counseling (82%), and modification of existing therapy (73%); fewer were willing to interpret laboratory tests (54%), order laboratory tests (52%), and perform laboratory tests (39%). The strongest correlate of willingness to establish a CPA was having received formal training on CPAs.

Conclusion

Most pharmacy staffs were willing to establish CPAs to provide additional services beyond their current scope of practice, but few have experience with infectious disease CPAs. Future research is needed to identify factors that will allow for successful development and implementation of HIV prevention-specific CPAs and understand barriers to willingness for pharmacy staff who are unwilling to establish CPAs.
背景:合作实践协议(CPA)允许药剂师在提供者的监督下提供各种患者护理功能(即,订购实验室,修改药物治疗)。注册会计师可以促进药剂师提供暴露前预防(PrEP)筛查和处方等艾滋病毒预防服务,从而可以在历史上低可及性的地方加强艾滋病毒预防服务。目的:我们评估药房员工建立注册会计师和提供特定病人护理功能的意愿的相关因素。方法:基于合作协议的PrEP使用药剂师(CAP-UP)研究对美国东南部8个州的药房工作人员进行了在线调查。数据收集始于2024年1月,目前正在进行中。调查问题是使用实施研究的统一框架构建的,并捕获注册会计师使用的历史、对注册会计师的态度和建立注册会计师的意愿。采用描述性分析和泊松回归对初步数据进行评估,以评估药房员工通过注册会计师提供特定患者护理功能的意愿。结果:在246名受访者中,67名(27%)目前至少有一名注册会计师,其中20名(30%)注册会计师涉及传染病护理。大约75%的人愿意成立注册会计师,为他们的病人提供额外的服务。大多数药房工作人员愿意提供药物治疗管理(91%)、患者咨询(82%)和现有治疗修改(73%);更少的人愿意解释实验室检查(54%)、订购实验室检查(52%)和进行实验室检查(39%)。建立注册会计师的意愿与接受过注册会计师的正式培训最相关。结论:大多数药学人员愿意建立注册会计师,以提供超出其现有业务范围的额外服务,但很少有传染病注册会计师的经验。未来的研究需要确定能够成功开发和实施艾滋病毒预防特异性注册会计师的因素,并了解不愿意建立注册会计师的药房工作人员的意愿障碍。
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引用次数: 0
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-01 DOI: 10.1016/j.japh.2025.102995
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引用次数: 0
Contextual factors affecting implementation of Medicaid billing for community-based pharmacist services in Virginia: A qualitative study 影响弗吉尼亚州社区药剂师服务的医疗补助计费实施的背景因素:一项定性研究。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-01 DOI: 10.1016/j.japh.2025.102939
Rana Amayreh, Sadia Shah, Jean-Venable (Kelly) Goode, Maria Thomson, Vasco M. Pontinha, Tana N. Kaefer, Teresa M. Salgado

Background

In 2023, Virginia mandated Medicaid payment for services provided by pharmacists under statewide protocols. Despite this legislative action, pharmacist registration as Medicaid providers remains limited, delaying access to expanded patient care services.

Objectives

To identify contextual factors affecting pharmacist registration as Medicaid providers and implementation of Medicaid billing for patient care services in Virginia community-based pharmacies.

Methods

Semi-structured interviews were conducted with 16 community-based pharmacists between November 2024 and May 2025. The Consolidated Framework for Implementation Research 2.0 guided interview development and analysis. Interviews explored pharmacists' experiences with Medicaid provider registration, billing procedures, and implementation challenges. Recruitment continued until thematic saturation was achieved. Data analysis employed two-phase inductive and deductive coding, with 2 independent coders analyzing transcripts to ensure reliability.

Results

Procedural complexity, high implementation costs, and poor system design emerged as major barriers to Medicaid billing implementation in community-based pharmacies, despite recognition of the potential financial benefits (innovation domain). Complex regulatory requirements and financing issues limited perceived viability of the innovation (outer setting domain). Inadequate technical infrastructure, insufficient organizational resources (inner setting domain), and knowledge deficits (individual domain) were described as significant obstacles, with mission alignment serving as a facilitator (individual domain). Pharmacists demonstrated unfamiliarity with credentialing and billing processes, and lack of implementation opportunity, while patients' needs for affordable care access were recognized (individual domain). Implementation processes were consistently problematic across planning, strategy development, execution, and evaluation phases (implementation domain).

Conclusions

Medicaid billing for pharmacist services remains in early stages of implementation in Virginia, with limited adoption among community-based pharmacists. Implementation barriers emerged across multiple domains including complex regulatory requirements, inadequate organizational support, and insufficient educational preparation. Targeted interventions addressing credentialing processes, technical infrastructure, and pharmacist education are essential to the implementation of Medicaid billing in pharmacists' clinical practice.
背景:2023年,弗吉尼亚州根据全州协议规定,为药剂师提供的服务支付医疗补助。尽管有这项立法行动,药剂师注册为医疗补助提供者仍然有限,延迟获得扩大的病人护理服务。目的:确定影响弗吉尼亚州社区药房药剂师注册为医疗补助提供者和实施医疗补助计费的环境因素。方法:于2024年11月至2025年5月对16名社区药师进行半结构化访谈。实施研究综合框架(CFIR) 2.0指导了访谈的开发和分析。访谈探讨了药剂师在医疗补助提供者注册、计费程序和实施挑战方面的经验。征聘工作继续进行,直到专题饱和为止。数据分析采用两相归纳和演绎编码,由两名独立编码器对转录本进行分析,确保可靠性。结果:尽管认识到潜在的经济效益(创新领域),但程序复杂性、高实施成本和糟糕的系统设计成为社区药房实施医疗补助计费的主要障碍。复杂的监管要求和融资问题限制了创新的可行性(外部设置领域)。技术基础设施不足、组织资源不足(内部设置领域)和知识不足(个人领域)被描述为重要的障碍,任务一致性作为促进者(个人领域)。药剂师表现出对认证和计费流程的不熟悉,缺乏实施机会,而患者对负担得起的医疗服务的需求得到了认可(个人领域)。实现过程在计划、策略开发、执行和评估阶段(实现领域)中始终存在问题。结论:在弗吉尼亚州,针对药剂师服务的医疗补助计费仍处于实施的早期阶段,社区药剂师的采用有限。实现障碍出现在多个领域,包括复杂的监管要求、组织支持不足和教育准备不足。有针对性的干预措施解决资格认证过程,技术基础设施,和药剂师教育是必不可少的医疗补助计费在药剂师的临床实践的实施。
{"title":"Contextual factors affecting implementation of Medicaid billing for community-based pharmacist services in Virginia: A qualitative study","authors":"Rana Amayreh,&nbsp;Sadia Shah,&nbsp;Jean-Venable (Kelly) Goode,&nbsp;Maria Thomson,&nbsp;Vasco M. Pontinha,&nbsp;Tana N. Kaefer,&nbsp;Teresa M. Salgado","doi":"10.1016/j.japh.2025.102939","DOIUrl":"10.1016/j.japh.2025.102939","url":null,"abstract":"<div><h3>Background</h3><div>In 2023, Virginia mandated Medicaid payment for services provided by pharmacists under statewide protocols. Despite this legislative action, pharmacist registration as Medicaid providers remains limited, delaying access to expanded patient care services.</div></div><div><h3>Objectives</h3><div>To identify contextual factors affecting pharmacist registration as Medicaid providers and implementation of Medicaid billing for patient care services in Virginia community-based pharmacies.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with 16 community-based pharmacists between November 2024 and May 2025. The Consolidated Framework for Implementation Research 2.0 guided interview development and analysis. Interviews explored pharmacists' experiences with Medicaid provider registration, billing procedures, and implementation challenges. Recruitment continued until thematic saturation was achieved. Data analysis employed two-phase inductive and deductive coding, with 2 independent coders analyzing transcripts to ensure reliability.</div></div><div><h3>Results</h3><div>Procedural complexity, high implementation costs, and poor system design emerged as major barriers to Medicaid billing implementation in community-based pharmacies, despite recognition of the potential financial benefits (innovation domain). Complex regulatory requirements and financing issues limited perceived viability of the innovation (outer setting domain). Inadequate technical infrastructure, insufficient organizational resources (inner setting domain), and knowledge deficits (individual domain) were described as significant obstacles, with mission alignment serving as a facilitator (individual domain). Pharmacists demonstrated unfamiliarity with credentialing and billing processes, and lack of implementation opportunity, while patients' needs for affordable care access were recognized (individual domain). Implementation processes were consistently problematic across planning, strategy development, execution, and evaluation phases (implementation domain).</div></div><div><h3>Conclusions</h3><div>Medicaid billing for pharmacist services remains in early stages of implementation in Virginia, with limited adoption among community-based pharmacists. Implementation barriers emerged across multiple domains including complex regulatory requirements, inadequate organizational support, and insufficient educational preparation. Targeted interventions addressing credentialing processes, technical infrastructure, and pharmacist education are essential to the implementation of Medicaid billing in pharmacists' clinical practice.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102939"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276921","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}
引用次数: 0
Implementing payer partnerships for patient care programs within clinically integrated networks of community pharmacies: A qualitative study 在社区药房临床整合网络中实施患者护理项目的付款伙伴关系:一项定性研究。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2026-01-01 DOI: 10.1016/j.japh.2025.102951
Christopher Daly, Durdana N. Iqbal, Jessica B. Finke, Kim C. Coley, William R. Doucette, Stefanie P. Ferreri, Sophia M.C. Herbert, David M. Jacobs, Randy McDonough, Melissa A. Somma McGivney, Wesley Nuffer, Megan G. Smith, Jennifer L. Bacci

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.
背景:通过临床整合,社区药房合作伙伴关系扩大了患者护理机会。通过社区药房增强服务网络(CPESN美国)的实践转型努力已经支持了100多个州和国家付款人计划。虽然先前的工作确定了持续项目成功的主题,但项目促进者指出需要对项目设计、执行和评估进行额外的了解。目的:确定在全国社区药房网络中与健康支付者合作实施患者护理计划的成功实践。方法:本定性研究包括在线人口调查和半结构化访谈,于2023年与CPESN美国项目主持人进行。实用、稳健、实施和可持续性模型(PRISM)框架用于开发研究材料。采用描述性统计方法对调查结果进行分析。使用快速分析方法来评估和总结访谈中的主要主题。结果:在40个网络的43名合格的项目协调员中,有14人完成了调查和访谈。参与者的经验年数各不相同,6人(43%)有1-3年,8人(57%)有4-6年。药店网络平均有119家药店,累计平均有7个付款人项目。在社区药房内制定和实施患者护理计划的共23个主题分为以下部分:1)参与,2)计划干预和设计,3)合同建立,4)计划合作者之间的沟通,5)培训(为服务实施做准备),6)结果评估,7)数据收集,8)支付机制。结论:社区药房付款人项目成功的关键包括合作项目设计、持续对话、有效评估、技术利用和不断发展的支付模式。研究结果可用于实施与支付方的成功伙伴关系,支持将社区药房纳入基于价值的护理模式。
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引用次数: 0
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Journal of the American Pharmacists Association
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