Journal of the American Pharmacists Association最新文献_第6页

A 2023 Washington State pharmacist workforce survey: Employment and patient care roles 2023年华盛顿州药剂师劳动力调查：就业和患者护理角色。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2025-01-01 DOI: 10.1016/j.japh.2024.102314

Jennifer L. Bacci, Clayton English, Peggy S. Odegard, Andy Stergachis, Cyndy R. Snyder, Jennifer Hookstra Danielson

Background

The pharmacy workforce is evolving rapidly, and while national data reveal broad trends, they often overlook the impact of state-level policies on local pharmacy practice and education.

Objective

To describe employment status and patient care roles of pharmacists in Washington State.

Methods

A cross-sectional survey of pharmacists licensed in Washington State was conducted in June–July 2023. The survey assessed participants’ personal and professional demographics; employment status, including changes in employment status since 2020 and consideration of a change in the next 12 months; and patient care roles, including time spent in patient care roles and services provided. Data were analyzed using descriptive statistics.

Results

We received 856 responses (10.6% response rate) and 810 responses were included in the final analysis. Participants’ median age was 43 years. Most participants were female (64%) and White (73%). Over 3-quarters of participants reported practicing in community (37%), hospital (27%), and/or ambulatory care/clinic (21%) settings. Over one-third of participants (39%) reported a job or employment change since 2020 and 17% reported they were considering a job or employment change in the next 12 months. The 5 most frequently reported patient care services were medication education or counseling (83%), medication dispensing (70%), prescribing via a collaborative drug therapy agreement or protocol (59%), medication therapy management (53%), and medication reconciliation (52%).

Conclusion

This study offers important insights into pharmacist employment and practice in Washington State. Certain trends in Washington State, particularly in pharmacist employment shifts within clinic settings and patient care roles such as prescribing and medication education, stand out when compared to national patterns. These findings highlight the importance of ongoing state-level workforce assessments to guide educational strategies and the supply of pharmacists with local needs.

背景：药房劳动力正在迅速发展，虽然国家数据揭示了广泛的趋势，但他们往往忽视了州一级政策对当地药房实践和教育的影响。目的：描述华盛顿州药剂师的就业状况和病人护理角色。方法：于2023年6 - 7月对华盛顿州执业药师进行横断面调查。调查评估了参与者的个人和职业特征；就业状况，包括自2020年以来就业状况的变化以及未来12个月的变化考虑；以及患者护理角色，包括在患者护理角色中花费的时间和提供的服务。数据分析采用描述性统计。结果：共收到回复856份，回复率10.6%，最终纳入810份。参与者的中位年龄为43岁。大多数参与者是女性（64%）和白人（73%）。超过四分之三的参与者报告在社区（37%）、医院（27%）和/或门诊/诊所（21%）环境中执业。超过三分之一（39%）的受访者表示，自2020年以来他们换了工作或工作，17%的受访者表示，他们正在考虑在未来12个月内换工作或工作。五种最常见的患者护理服务是药物教育或咨询（83%）、药物调剂（70%）、通过合作药物治疗协议（CDTA）或协议开处方（59%）、药物治疗管理（53%）和药物和解（52%）。结论：本研究为华盛顿州的药剂师就业和实践提供了重要的见解。与全国模式相比，华盛顿州的某些趋势，特别是在诊所设置和患者护理角色（如处方和药物教育）中药剂师就业的转变，显得尤为突出。这些发现强调了正在进行的国家级劳动力评估的重要性，以指导教育战略和满足当地需求的药剂师供应。

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引用次数: 0

Specialty pharmacy services compared with community-based pharmacy services on HIV viral load 专业药房服务与社区药房服务的HIV病毒载量比较。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2025-01-01 DOI: 10.1016/j.japh.2024.102307

Laura L. Pedersen, Patricia Fulco, Rachel Pryor, Gonzalo Bearman

Objectives

People with human immunodeficiency virus (HIV) (PWH) on antiretroviral therapy (ART) with viral load (VL) suppression eliminate the risk of sexual transmission. Many factors including decreased ART adherence and medication access barriers decrease the success of treatment as an HIV prevention strategy. ART access may be enhanced with specialty pharmacy services (SPS), but the impact compared with community-based practices is variably reported. This study aimed to compare the impact of specialty vs community pharmacies on medication adherence via VL assessment.

Design

This retrospective cohort medical record study investigated whether the use of specialty pharmacies compared with community-based practices improves VL suppression. A record review was performed to collect the most recent HIV VL Demographic data collected included age range, race, ethnicity, and patient-reported gender identity. Pharmacy type was determined via review of prescription refill history linked to the medical record.

Setting and participants

Patients included were enrolled in the Ryan White HIV/AIDS Program (RWHAP) (May 31, 2022, to May 30, 2023) at an HIV/infectious diseases academic medical center clinic.

Outcome measures

An undetectable VL was defined as the most recent HIV VL being < 50 copies/mL or suppressed as < 200 copies/mL.

Results

A total of 1631 PWH were eligible, 179 were excluded, and 1452 were included in the analysis; 91.3% were virologically suppressed (n = 1326) with an undetectable VL in 83.3% (n = 1210). When adjusting for age, self-reported gender identity, race, and ethnicity, PWH using SPS were more likely to have a suppressed (adjusted odds ratio [AOR] 1.469 [95% CI 1.007–2.142]) and undetectable VL (AOR 1.396 [95% CI 1.051–1.854]), respectively, than the use of community-based practices.

Conclusions

The use of specialty compared with community-based pharmacies had a statistically significant, yet modest association with VL suppression in PWH enrolled in RWHAP services in this single academic medical center retrospective analysis. Further studies are needed to determine whether mail-order services, specifically those without specialty service support, are sufficient for high rates of virologic control.

背景：人类免疫缺陷病毒（PWH）感染者通过抗逆转录病毒治疗（ART）抑制病毒载量（VL）消除了性传播的风险。许多因素，包括抗逆转录病毒治疗依从性降低和/或药物获取障碍，降低了作为艾滋病毒预防战略的治疗的成功。专业药房服务可提高抗逆转录病毒治疗的可及性，但与基于社区的做法相比，报告的影响各不相同。目的：通过VL评估比较专科药房与社区药房对药物依从性的影响。方法：这项回顾性队列医疗记录研究调查了与社区实践相比，使用专业药房是否能显著改善VL抑制。纳入的患者在HIV/传染病学术医疗中心诊所参加了Ryan White HIV/AIDS项目（2022年5月31日至2023年5月30日）。结果：1631名PWH符合条件，179名被排除，1452名被纳入分析。91.3%的人被病毒学抑制（N=1326）， 83.3%的人无法检测到VL （N=1210）。当调整年龄、自我报告的性别认同、种族和民族时，与使用社区实践相比，使用专业药房服务的PWH更有可能抑制VL （AOR 1.469 95% CI 1.007-2.142）和无法检测VL （AOR 1.396, 95% CI 1.051-1.854）。结论：在这项单一学术医疗中心的回顾性分析中，与社区药房相比，专业药房的使用与在Ryan White HIV/AIDS服务中心登记的PWH的VL抑制有显著但适度的关联。需要进一步的研究来确定邮购服务，特别是在没有专业服务支持的情况下，是否足以实现高病毒学控制率。

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引用次数: 0

Pharmacists enhance national security through medical countermeasure program leadership 药剂师通过医疗对策项目领导加强国家安全。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2025-01-01 DOI: 10.1016/j.japh.2024.102310

Alexandria VanBuren, Dakota McMurray, Alexander Eastman

Background

Chemical, biological, radiological, or nuclear threats and emerging infectious diseases are significant threats to public health and national security. U.S. Customs and Border Protection plays a vital role in safeguarding the nation's borders and protecting against all threats. Pharmacists, with their expertise in medication and public health, can play a crucial role in medical countermeasure (MCM) programs.

Objectives

The study aims to identify pharmacist-led quality improvements and explain expanded pharmacist roles through advancing a federal MCM program.

Practice description

U.S. Customs and Border Protection is the nation’s largest law enforcement agency charged with protecting the American people and safeguarding the nation’s borders.

Practice innovation

Program management for MCM transitioned to the Office of the Chief Medical Officer under pharmacist leadership, better aligning the program with the agency’s health security mission.

Evaluation methods

Pharmacists conducted a baseline program analysis then spearheaded 5 improvements over 1 year to fill identified gaps. Pharmacist-led improvements include development of a Standard Operating Procedure for accountability, SharePoint site development for inventory tracking/reporting, inventory analysis through SharePoint utilization, creation of a MCM channel in Microsoft Teams for information sharing, and establishment of a Point of Dispensing exercise schedule for readiness.

Results

Pharmacist-led improvements resulted in Standard Operating Procedure recognition as best practice guidance by the Department of Homeland Security, improved inventory completion rates from 0% to 99%, initiation of 29 new MCM sites protecting 3,000 additional U.S. Customs and Border Protection workforce and persons in custody, inventory distribution to 55 sites protecting 35,000 additional personnel and persons in custody, enrollment of 247 members to the MCM channel in Microsoft Teams, improved Point of Dispensing exercise completion from 5% to 66%, and scheduled 90 Point of Dispensing exercises.

Conclusion

Pharmacists play a vital role in MCM program advancement and contribute to national security efforts against chemical, biological, radiological, or nuclear threats and emerging infectious diseases.

背景：化学、生物、放射或核（CBRN）威胁和新出现的传染病是对公共卫生和国家安全的重大威胁。美国海关和边境保护局（CBP）在保卫国家边境和防范所有威胁方面发挥着至关重要的作用。药剂师在药物和公共卫生方面具有专业知识，可以在MCM项目中发挥关键作用。目的：本研究旨在通过推进联邦MCM计划，确定药剂师主导的质量改进，并解释扩大药剂师的角色。实践描述：CBP是美国最大的执法机构，负责保护美国人民和保卫国家边界。实践创新：MCM的项目管理移交给首席医疗官办公室，由药剂师领导，更好地使项目与机构的健康安全使命保持一致。评估方法：药剂师进行了基线项目分析，然后在1年内率先进行了5次改进，以填补已确定的空白。药剂师主导的改进包括制定标准操作程序，用于问责制，开发用于库存跟踪/报告的SharePoint网站，利用SharePoint进行库存分析，在Microsoft Teams中创建MCM渠道以进行信息共享，以及建立调剂点演习时间表以做好准备。结果:药剂师领导的改进导致标准操作程序被国土安全部认可为最佳实践指南，库存完成率从0%提高到99%，29个新的MCM站点启动，保护了3,000名CBP员工和被拘留人员，库存分发到55个站点，保护了35,000名额外的人员和被拘留人员，在微软团队中注册了247名MCM渠道成员。将调剂点演习完成率从5%提高到66%，并计划90次调剂点演习。结论：药师在MCM项目的推进中发挥着至关重要的作用，为国家安全应对CBRN威胁和新发传染病做出了贡献。

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引用次数: 0

Updates to a pharmacy-technician driven centralized medication refill service in a large community health system 在一个大型社区医疗系统中，对由药剂技术人员驱动的集中补药服务进行更新。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2025-01-01 DOI: 10.1016/j.japh.2024.102142

Elizabeth G. Schlosser, Leandro Llambi, Thomas J. Hoffman, Ana L. Hincapie

In 2020, we published a description of the newly implemented centralized refill service (CRS) led by pharmacy technicians in our large community health system. Since that time, the CRS has been refined, updated, and expanded. We have also received many inquiries with common questions about the process from those who seek to implement a similar process. The purpose of this commentary is to 1) provide updates to the process in the 5 years since its implementation, and 2) provide additional insights on specific topics from inquiries to the organization.

2020 年，我们发表了一篇关于在大型社区医疗系统中新实施的、由药房技术人员领导的集中补药服务（CRS）的介绍。从那时起，CRS 不断完善、更新和扩展。我们也收到了许多寻求实施类似流程的人对该流程提出的常见问题。本评论的目的在于：1）提供该流程实施五年来的最新情况；2）就组织收到的咨询中的特定主题提供更多见解。

引用次数: 0

The Public Health Informatics Fellowship Program: Training pharmacists as data detectives 公共卫生信息学奖学金计划：培训药剂师成为数据侦探。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2025-01-01 DOI: 10.1016/j.japh.2024.102216

Sena Seged, Kevin Lan, Sonya Zhan, Jessica Eloso, Bradley Biggers, Roua El Kalach

引用次数: 0

Beyond the fill: Navigating pharmacy's technological future in 2050 超越填充：引领 2050 年药学技术的未来》（Beyond the Fill: Navigating Pharmacy's Technological Future in 2050）。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2025-01-01 DOI: 10.1016/j.japh.2024.102285

Timothy Dy Aungst

The pharmacy profession stands at a pivotal juncture as it faces unprecedented technological advancements that will rapidly reshape the healthcare landscape by 2050. This commentary explores the implications of technological advancements for pharmacy practice and how it may impact the workforce in the coming decades. The advent of digital health technologies (DHTs), artificial intelligence (AI), and automation is poised to transform patient engagement and care delivery. The Covid-19 pandemic has accelerated this shift, and traditional pharmacy roles have evolved to meet these expectations. As AI and DHT adoption increase, it will push the profession beyond its historical focus on logistics and medication dispensing. Several potential scenarios may unfold by 2050, ranging from a diminished workforce overshadowed by technology to an evolved profession that leverages novel technologies to enhance clinical services and patient care. To prepare for these changes, the profession must address key challenges, including advancing education and training to incorporate new competencies, establishing sustainable financial models for emerging roles, embracing advocacy and navigating regulatory constraints to expand scopes of practice, and overcoming societal resistance to change. By embracing continuous learning and adaptability, pharmacists can seize the opportunity to redefine their roles, ensuring they remain indispensable in an evolving healthcare environment.

药学行业正处于一个关键时刻，因为它面临着前所未有的技术进步，到 2050 年，这些技术将迅速重塑医疗保健行业的格局。这篇评论探讨了技术进步对药学实践的影响，以及它在未来几十年可能对药学人员队伍产生的影响。数字医疗技术 (DHT)、人工智能 (AI) 和自动化的出现将改变患者参与和医疗服务的提供。Covid-19 大流行加速了这一转变，传统的药房角色将不断演变以满足这些期望。随着人工智能和 DHT 应用的增加，它将推动药学行业超越以往对物流和配药的关注。到 2050 年，可能会出现几种潜在的情况，从被技术所掩盖的劳动力减少，到利用新技术加强临床服务和患者护理的专业进化。为了应对这些变化，该行业必须应对主要挑战，包括推进教育和培训以纳入新的能力，为新兴角色建立可持续的财务模式，接受宣传并驾驭监管限制以扩大业务范围，以及克服社会对变革的抵制。通过不断学习和提高适应能力，药剂师可以抓住机遇，重新定义自己的角色，确保他们在不断变化的医疗环境中继续发挥不可或缺的作用。

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引用次数: 0

Provision of maternal health services among Ohio community pharmacists practicing in maternity care deserts 俄亥俄州孕产妇护理荒漠地区社区药剂师提供的孕产妇保健服务。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2025-01-01 DOI: 10.1016/j.japh.2024.102292

Maria Duodu, Natalie DiPietro Mager

Background

Over 2.3 million reproductive-age women in the United States live in a maternity care desert, a county without obstetric services or providers; over 3 million more reside in a county with low access to maternity care. The National Alliance of State Pharmacy Associations (NASPA) issued a toolkit outlining maternal health services community pharmacists are positioned to provide within their scope of practice.

Objectives

The primary objective of this study was to determine whether community pharmacists practicing in maternity care deserts/low access areas in Ohio provide NASPA-recommended maternal health services. Secondary objectives were to assess knowledge and attitudes related to maternal health; interest and barriers for developing new services; and screening and referrals for key social determinants of health.

Methods

An anonymous cross-sectional survey was electronically distributed to Ohio community pharmacists working in maternity care deserts/low access areas (n = 216) in fall/winter 2023 to evaluate their awareness, practices, and attitudes.

Results

Thirty-one pharmacists responded (14%). Almost half knew that maternal mortality had increased in recent years. Although 61% reported familiarity with the term “maternity care desert,” only 35% recognized they are currently practicing in one. Provision of NASPA-recommended services to reproductive-age women ranged from 90% (immunizations) to 11% (alcohol use screening/counseling). About 96% believed that community pharmacists can help optimize women’s health before and during pregnancy. The majority of respondents reported “never” screening for social determinants of health, but 48% were interested in learning more. While 67% of respondents are interested in providing more services for women at their pharmacy, they also reported obstacles like lack of time and staff.

Conclusion

There is a need to raise awareness about maternal mortality and maternity care deserts among Ohio community pharmacists. Given the interest expressed in providing additional services, pharmacists should receive more support to provide needed care for medically-underserved populations.

背景：美国有 230 多万育龄妇女生活在孕产妇保健荒漠中，即没有产科服务或提供者的县；还有 300 多万人生活在孕产妇保健普及率低的县。全美州药学协会联盟（NASPA）发布了一个工具包，概述了社区药剂师在其执业范围内可提供的孕产妇保健服务：本研究的主要目的是确定在俄亥俄州孕产妇护理荒漠/低获取率地区执业的社区药剂师是否提供 NASPA 推荐的孕产妇保健服务。次要目标是评估与孕产妇健康相关的知识和态度；开发新服务的兴趣和障碍；以及健康的主要社会决定因素的筛查和转介：2023 年秋冬季，向俄亥俄州在孕产妇护理荒漠/低获取率地区工作的社区药剂师（n=216）发放了一份匿名横截面电子调查表，以评估他们的认识、实践和态度：结果：31 名药剂师做出了回复（14%）。近一半的药剂师知道近年来孕产妇死亡率有所上升。尽管 61% 的药剂师表示熟悉 "孕产妇护理荒漠 "这一术语，但只有 35% 的药剂师认识到他们目前正在 "孕产妇护理荒漠 "中执业。为育龄妇女提供 NASPA 推荐服务的比例从 90%（免疫接种）到 11%（酒精使用筛查/咨询）不等。约 96% 的受访者认为社区药剂师可以帮助优化孕前和孕期妇女的健康。大多数受访者表示 "从未 "筛查过健康的社会决定因素，但有 48% 的受访者有兴趣了解更多。虽然 67% 的受访者有兴趣在其药房为妇女提供更多服务，但他们也表示存在时间和人员不足等障碍：结论：有必要提高俄亥俄州社区药剂师对孕产妇死亡率和孕产妇护理荒漠的认识。考虑到药剂师对提供更多服务的兴趣，他们应该获得更多支持，以便为医疗服务不足的人群提供所需的护理服务。

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引用次数: 0

Implementation of an adult life-course vaccine review service, VaxCheck, in community pharmacy: A qualitative analysis 在社区药房实施成人生命周期疫苗审查服务 VaxCheck：定性分析。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2025-01-01 DOI: 10.1016/j.japh.2024.102294

Elizabeth Vernon-Wilson, Michaela L. Comrie, Kyla Barrera, Molly Yang, Lisa Dolovich, Nancy M. Waite, Sherilyn K.D. Houle

Background

Community pharmacists are well placed to identify and vaccinate unimmunized or under-immunized individuals who can put themselves and communities at risk of preventable disease. We designed and tested VaxCheck, a novel life-course vaccine review service that can be used to raise awareness and guide personal vaccination action plans, in community pharmacies in Ontario, Canada.

Objective

To understand the experiences of community pharmacists and staff directly involved with providing the VaxCheck service as part of initial testing.

Methods

Semi-structured interviews were performed with pharmacy staff from 9 pharmacies who participated in the study. Interviews were conducted at baseline and following each of 3 Plan-Do-Study-Act quality improvement cycles. Activities undertaken to perform VaxCheck were assessed. An inductive thematic analysis was performed to identify dominant themes and subthemes. Activities and descriptive codes were then correlated to the Consolidated Framework for Implementation Research (CFIR).

Results

Twenty-six interviews were conducted. Pharmacy staff described VaxCheck activities as spanning 3 stages: (1) Promotion/offering of VaxCheck, (2) Completing the VaxCheck, and (3) Enacting recommendations and follow-up. VaxCheck activities were compatible with workflow related to delivery of other vaccines and medication reviews. Thematic analysis found 3 considerations guided VaxCheck adoption: (1) Aligning VaxCheck with workflow through flexible integration, (2) Enabling patient-oriented vaccination services, and (3) Contributing to community healthcare provision. Data aligned with all CFIR domains with strengths noted in constructs from the “Innovation characteristics” and “Individuals” domains. Barriers to implementation were identified in “Inner setting,” “Outer setting,” and “Process” domains, such as pharmacy workflow capacity, patient knowledge about vaccination, availability of vaccine records, and interactions with other healthcare providers.

Conclusion

Community pharmacists found VaxCheck to be a valuable, accessible service that was well-received by patients and supported adult vaccination reviews and individualized recommendations. VaxCheck was compatible with pharmacy workflow but needed additional resources for sustainability and promotion with stakeholders.

背景：社区药剂师非常适合识别未接种疫苗或接种疫苗不足的个人并为其接种疫苗，这些人可能会使自己和社区面临可预防疾病的风险。我们在加拿大安大略省的社区药房设计并测试了 VaxCheck，这是一种新颖的终身疫苗审查服务，可用于提高认识和指导个人疫苗接种行动计划：了解直接参与提供 VaxCheck 服务的社区药剂师和工作人员的经验，作为初步测试的一部分：对参与研究的九家药房的药剂师进行了半结构式访谈。访谈分别在基线和三个 "计划-实施-研究-行动 "质量改进周期之后进行。对为执行 VaxCheck 而开展的活动进行了评估。进行了归纳式主题分析，以确定主导主题和次主题。然后将活动和描述性代码与实施研究综合框架（CFIR）相关联。药房工作人员将 VaxCheck 活动描述为三个阶段：(1) 宣传/提供 VaxCheck，(2) 完成 VaxCheck，(3) 执行建议和后续行动。VaxCheck 活动与提供其他疫苗和药物审查的相关工作流程是一致的。专题分析发现，采用 VaxCheck 有三个考虑因素：(1) 通过灵活整合使 VaxCheck 与工作流程相一致，(2) 实现以患者为导向的疫苗接种服务，以及 (3) 为社区医疗保健服务做出贡献。数据符合 CFIR 的所有领域，其中 "创新特征 "和 "个人 "领域的构建具有优势。在 "内部环境"、"外部环境 "和 "过程 "领域发现了实施障碍，如药房工作流程能力、患者对疫苗接种的了解、疫苗记录的可用性以及与其他医疗服务提供者的互动：社区药剂师发现 VaxCheck 是一项有价值、可获得的服务，深受患者欢迎，并支持成人疫苗接种审查和个性化建议。VaxCheck 与药房工作流程兼容，但需要更多资源才能持续开展并向利益相关者推广。

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引用次数: 0

The role of pharmacy in promoting public health: Pharmacy and public health in 2050 药学在促进公共健康中的作用：2050 年的药学与公共卫生。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2025-01-01 DOI: 10.1016/j.japh.2024.102272

Mark A. Strand

From 2000 to 2025, the profession of pharmacy expanded into vaccinations, point-of-care testing, and chronic disease prevention and management. In the next 25 years, pharmacy will continue to advance in new ways. This paper focuses on expanded roles of community and ambulatory care pharmacy to more directly improve public health. Built around the ten essential services of public health, this paper calls upon the profession of pharmacy to stretch beyond traditional roles to assume roles that would strengthen the public health workforce and make seminal contributions to improved population health. Barriers to be overcome in pursuit of that future are also addressed. The paper will conclude with a public health-focused call to pharmacy.

从 2000 年到 2025 年，药剂学专业扩展到疫苗接种、护理点检测以及慢性病预防和管理。未来 25 年，药学将继续以新的方式向前发展。本文重点关注社区和非住院护理药房在更直接地改善公共卫生方面所发挥的更大作用。本文围绕公共卫生的十项基本服务，呼吁药学专业超越传统角色，承担起加强公共卫生人才队伍的角色，为改善人口健康做出开创性贡献。本文还探讨了实现这一未来需要克服的障碍。最后，本文将向药学界发出以公共卫生为重点的呼吁。

引用次数: 0

Vaccination payments in states with provider status for pharmacists: A claims analysis 有药剂师提供者地位的州的疫苗接种费用：索赔分析。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2025-01-01 DOI: 10.1016/j.japh.2024.102301

Rachel Wittenauer, Jennifer L. Bacci, Parth D. Shah, Andy Stergachis

Background

Federal-level legislation to recognize pharmacists as providers and thus allow insurance reimbursement for health services claims, not just prescription drug claims (known as provider status), has been advocated for by the profession but is yet to be passed into federal law. Several state governments have enacted this recognition for commercial insurance and/or Medicaid plans. However, the impact of these laws on reimbursement and access to health services has yet to be explored empirically.

Objective

Compare commercial reimbursements for influenza and herpes zoster vaccinations for adults in provider status vs. non-provider status states to determine whether these laws have had the intended effect of increasing reimbursement to pharmacists for provided services.

Methods

We used pharmaceutical and outpatient services claims from a national claims database, Marketscan, to examine payments made to pharmacies for all codes billed during vaccination visits. We then used a multivariable logistic regression model to compare the net revenue of vaccination visits in commercial provider status states vs. non-commercial provider-status states.

Results

Our dataset contained 2.3 million vaccination visits for influenza and herpes zoster during 2021–2022. We found that the odds of a vaccination visit having positive net revenue were slightly higher in provider status states (shingles odds ratio [OR]: 1.03, P < 0.001; influenza OR 1.01:, P < 0.001). These findings are limited by the stark lack of health services claims by pharmacies in our dataset; only 0.4% of visits included any outpatient services claims, even among provider status states.

Conclusion

This indicates that pharmacists are not submitting claims for reimbursement to payors for health services they are providing. This absence could be due to several reasons and limits the ability to generate evidence about the effect of these laws on health and economic outcomes for patients and health systems. Further research is needed to identify and address barriers to implementation of provider status laws.

背景：药剂师行业一直在倡导联邦一级的立法，承认药剂师是医疗服务提供者，从而允许对医疗服务报销进行保险补偿，而不仅仅是处方药报销（称为医疗服务提供者身份），但这一立法尚未通过成为联邦法律。一些州政府已经颁布了对商业保险和/或医疗补助计划的认可。然而，这些法律对报销和获得医疗服务的影响还有待实证研究：比较具有提供者地位的州与不具有提供者地位的州对成人流感疫苗和带状疱疹疫苗接种的商业报销情况，以确定这些法律是否对增加药剂师所提供服务的报销产生了预期效果：我们使用了全国性索赔数据库 Marketscan 中的药品和门诊服务索赔，以检查药房在疫苗接种就诊过程中按所有代码计费的支付情况。然后，我们使用一个多变量逻辑回归模型来比较商业提供商地位州与非提供商地位州的疫苗接种就诊净收入：我们的数据集包含 2021-2022 年期间 230 万次流感和带状疱疹疫苗接种。结果：我们的数据集包含 2021-2022 年期间 230 万次流感和带状疱疹疫苗接种。我们发现，在有提供商地位的州，疫苗接种就诊产生正净收入的几率略高（带状疱疹 OR：1.03，pConclusion）：这表明药剂师并未就其提供的医疗服务向支付方提交报销申请。这种缺失可能有多种原因，并限制了就这些法律对患者和医疗系统的健康和经济结果的影响提供证据的能力。需要进一步开展研究，以确定并解决实施提供者身份法律的障碍。

{"title":"Vaccination payments in states with provider status for pharmacists: A claims analysis","authors":"Rachel Wittenauer, Jennifer L. Bacci, Parth D. Shah, Andy Stergachis","doi":"10.1016/j.japh.2024.102301","DOIUrl":"10.1016/j.japh.2024.102301","url":null,"abstract":"<div><h3>Background</h3><div>Federal-level legislation to recognize pharmacists as providers and thus allow insurance reimbursement for health services claims, not just prescription drug claims (known as provider status), has been advocated for by the profession but is yet to be passed into federal law. Several state governments have enacted this recognition for commercial insurance and/or Medicaid plans. However, the impact of these laws on reimbursement and access to health services has yet to be explored empirically.</div></div><div><h3>Objective</h3><div>Compare commercial reimbursements for influenza and herpes zoster vaccinations for adults in provider status vs. non-provider status states to determine whether these laws have had the intended effect of increasing reimbursement to pharmacists for provided services.</div></div><div><h3>Methods</h3><div>We used pharmaceutical and outpatient services claims from a national claims database, Marketscan, to examine payments made to pharmacies for all codes billed during vaccination visits. We then used a multivariable logistic regression model to compare the net revenue of vaccination visits in commercial provider status states vs. non-commercial provider-status states.</div></div><div><h3>Results</h3><div>Our dataset contained 2.3 million vaccination visits for influenza and herpes zoster during 2021–2022. We found that the odds of a vaccination visit having positive net revenue were slightly higher in provider status states (shingles odds ratio [OR]: 1.03, <em>P</em> < 0.001; influenza OR 1.01:, <em>P</em> < 0.001). These findings are limited by the stark lack of health services claims by pharmacies in our dataset; only 0.4% of visits included any outpatient services claims, even among provider status states.</div></div><div><h3>Conclusion</h3><div>This indicates that pharmacists are not submitting claims for reimbursement to payors for health services they are providing. This absence could be due to several reasons and limits the ability to generate evidence about the effect of these laws on health and economic outcomes for patients and health systems. Further research is needed to identify and address barriers to implementation of provider status laws.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 1","pages":"Article 102301"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711181","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}

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