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

Empowering and educating the next generation of pharmacists through children’s books: A quality assurance initiative 通过儿童读物培养和教育下一代药剂师：质量保证计划。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-07-19 DOI: 10.1016/j.japh.2024.102190

Objective

The objective of this quality assurance initiative was to internally measure children’s perceptions of the book, “All Aboard the Rx-Express!” and knowledge gained from its content.

Methods

This pharmacy-focused children’s book was read to elementary-age youth at a rural, Pennsylvania elementary school in the Spring of 2022. A brief, optional, anonymous prepost survey was administered to the youth before and after the reading to measure the book’s impact on third through fifth graders’ perceptions and knowledge of the pharmacy profession. Descriptive statistics, chi squared analysis, independent samples t-tests, and one sample proportions tests were used to analyze survey responses.

Results

One hundred ninety-one students participated in the presurvey to assess baseline knowledge about the pharmacy profession before the book was read. One hundred eighty-five students answered the postsurvey. Prepost respondent demographics were collected in aggregate and were not significantly different between the pre- and postcohorts. Survey results demonstrated an increase in all questions that asked about students’ perceptions of pharmacists and the profession, and students reported favorable perceptions of the book itself.

Conclusion

Early interventions such as this can increase elementary-age youth’s perceptions and knowledge of the roles of pharmacists. Future work in early intervention will be needed to increase interest in the profession and admissions to pharmacy schools.

目的这项质量保证活动的目的是对儿童对《All Aboard the Rx-Express！》一书的看法以及从书中内容获得的知识进行内部测量：方法： 2022 年春季，在宾夕法尼亚州的一所农村小学为小学年龄段的青少年阅读了这本以药学为主题的儿童读物。在阅读前后，对青少年进行了简短、可选、匿名的事前事中调查，以衡量该书对三至五年级学生对药学专业的看法和知识的影响。我们使用了描述性统计、卡方分析、独立样本 t 检验和单样本比例检验来分析调查反馈：结果：191 名学生参加了预调查，以评估他们在阅读本书之前对药剂学专业的基本了解。185 名学生回答了后期调查。调查前和调查后的受访者人口统计数据是汇总收集的，两者之间没有显著差异。调查结果显示，在所有询问学生对药剂师和药剂师职业看法的问题上，学生的看法都有所提高，而且学生对这本书本身的看法也很好：结论：像这样的早期干预可以提高小学适龄青少年对药剂师角色的看法和认识。未来需要开展早期干预工作，以提高对药剂师职业的兴趣和药剂学校的录取率。

{"title":"Empowering and educating the next generation of pharmacists through children’s books: A quality assurance initiative","authors":"","doi":"10.1016/j.japh.2024.102190","DOIUrl":"10.1016/j.japh.2024.102190","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of this quality assurance initiative was to internally measure children’s perceptions of the book, “All Aboard the Rx-Express!” and knowledge gained from its content.</p></div><div><h3>Methods</h3><p>This pharmacy-focused children’s book was read to elementary-age youth at a rural, Pennsylvania elementary school in the Spring of 2022. A brief, optional, anonymous prepost survey was administered to the youth before and after the reading to measure the book’s impact on third through fifth graders’ perceptions and knowledge of the pharmacy profession. Descriptive statistics, chi squared analysis, independent samples t-tests, and one sample proportions tests were used to analyze survey responses.</p></div><div><h3>Results</h3><p>One hundred ninety-one students participated in the presurvey to assess baseline knowledge about the pharmacy profession before the book was read. One hundred eighty-five students answered the postsurvey. Prepost respondent demographics were collected in aggregate and were not significantly different between the pre- and postcohorts. Survey results demonstrated an increase in all questions that asked about students’ perceptions of pharmacists and the profession, and students reported favorable perceptions of the book itself.</p></div><div><h3>Conclusion</h3><p>Early interventions such as this can increase elementary-age youth’s perceptions and knowledge of the roles of pharmacists. Future work in early intervention will be needed to increase interest in the profession and admissions to pharmacy schools.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735527","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

Pharmacist initiated interventions using RxChange message communication with prescribers for electronic prescriptions: A retrospective descriptive study 药剂师利用 RxChange 信息与处方者沟通，对电子处方进行干预：回顾性描述研究。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-07-17 DOI: 10.1016/j.japh.2024.102188

Background

RxChange messages improve patient medication management by enhancing pharmacist-prescriber communication, but their usage patterns in the United States are not well-documented.

Objective

To determine intervention characteristics by pharmacists and prescribers using RxChange messages.

Methods

A retrospective analysis of electronic prescription and RxChange messages from 2022 to 2023, using data from Surescripts, LLC, was conducted. This included NewRx messages and RxChange Responses, categorized by 7 RxChange use cases and Anatomical Therapeutic Chemical level 4 medication classes. Descriptive statistics and nonparametric tests were used for statistical analysis.

Results

The study analyzed 1,361,528 RxChange messages. Therapeutic interchange was the predominant use case (76.14%). Direct approvals accounted for 10.44% of requests, approvals with changes for 42.55%, and denials for 47.01%. Script clarification had the highest approval rate (64.21%), while prior authorization faced the most frequent denials (73.38%). The top denial reason was "Request addressed through alternate methods such as phone or fax (41.50%).” The most frequent drug classes observed in the data were selective beta-2 adrenoreceptor agonists, extended-spectrum penicillins, selective serotonin reuptake inhibitors, and glucagon-like peptide 1 analogues. Time from new e-prescription issuance to RxChange request submission was longer than from request to response, with a significant statistical difference (median 1.57 vs 0.27 days, P-value < 0.05).

Conclusion

This study highlights interventions pharmacists make using RxChange with electronic prescriptions to improve patient care and medication safety. It underlined the need for improved RxChange message content and data on the effectiveness of RxChange messages in improving medication use.

背景：改变药方 "信息通过加强药剂师与处方医生之间的沟通来改善患者的用药管理，但其在美国的使用模式并没有得到很好的记录：目的：确定药剂师和处方者使用 RxChange 信息的干预特点：利用 Surescripts, LLC 提供的数据，对 2022 年和 2023 年的电子处方和 RxChange 信息进行了回顾性分析。其中包括新处方信息和处方变更回复，并按照七种处方变更使用案例和解剖治疗化学 4 级药物类别进行了分类。统计分析使用了描述性统计和非参数检验：研究分析了 1,361,528 条 RxChange 信息。治疗交换是最主要的使用情况（76.14%）。直接批准的请求占 10.44%，带更改的批准占 42.55%，拒绝占 47.01%。脚本澄清的批准率最高（64.21%），而事先授权的拒绝率最高（73.38%）。最常见的拒绝原因是 "要求通过电话或传真等其他方式解决"（41.50%）。数据中最常见的药物类别是选择性 beta-2 肾上腺素受体激动剂、广谱青霉素类、选择性血清素再摄取抑制剂和胰高血糖素样肽 1 类似物。从新的电子处方签发到提交 RxChange 申请的时间长于从申请到回复的时间，两者之间存在显著的统计学差异（中位数为 1.57 天 vs 0.27 天，P 值 < 0.05）：本研究强调了药剂师使用 RxChange 与电子处方进行干预，以改善患者护理和用药安全。它强调了改进 RxChange 信息内容的必要性，以及 RxChange 信息在改善药物使用方面的有效性数据。

{"title":"Pharmacist initiated interventions using RxChange message communication with prescribers for electronic prescriptions: A retrospective descriptive study","authors":"","doi":"10.1016/j.japh.2024.102188","DOIUrl":"10.1016/j.japh.2024.102188","url":null,"abstract":"<div><h3>Background</h3><p>RxChange messages improve patient medication management by enhancing pharmacist-prescriber communication, but their usage patterns in the United States are not well-documented.</p></div><div><h3>Objective</h3><p>To determine intervention characteristics by pharmacists and prescribers using RxChange messages.</p></div><div><h3>Methods</h3><p>A retrospective analysis of electronic prescription and RxChange messages from 2022 to 2023, using data from Surescripts, LLC, was conducted. This included NewRx messages and RxChange Responses, categorized by 7 RxChange use cases and Anatomical Therapeutic Chemical level 4 medication classes. Descriptive statistics and nonparametric tests were used for statistical analysis.</p></div><div><h3>Results</h3><p>The study analyzed 1,361,528 RxChange messages. Therapeutic interchange was the predominant use case (76.14%). Direct approvals accounted for 10.44% of requests, approvals with changes for 42.55%, and denials for 47.01%. Script clarification had the highest approval rate (64.21%), while prior authorization faced the most frequent denials (73.38%). The top denial reason was \"Request addressed through alternate methods such as phone or fax (41.50%).” The most frequent drug classes observed in the data were selective beta-2 adrenoreceptor agonists, extended-spectrum penicillins, selective serotonin reuptake inhibitors, and glucagon-like peptide 1 analogues. Time from new e-prescription issuance to RxChange request submission was longer than from request to response, with a significant statistical difference (median 1.57 vs 0.27 days, <em>P</em>-value < 0.05).</p></div><div><h3>Conclusion</h3><p>This study highlights interventions pharmacists make using RxChange with electronic prescriptions to improve patient care and medication safety. It underlined the need for improved RxChange message content and data on the effectiveness of RxChange messages in improving medication use.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728053","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

Pharmacist roles in the medication use Process: Qualitative analysis of stakeholder perceptions 药剂师在药物使用过程中的作用：利益相关者看法的定性分析。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-07-14 DOI: 10.1016/j.japh.2024.102186

Background

Pharmacist roles in the Medication Use Process (MUP) have advanced along with new healthcare delivery models and interprofessional collaborative practice. It is unclear whether stakeholder perceptions of pharmacist roles have evolved simultaneously.

Objectives

Examine patient, pharmacist, and physician perceptions of pharmacist roles in the MUP.

Methods

This institutional review board-approved study used a cross-sectional design with Qualtrics panels of patients, pharmacists, and physicians. Role Theory was used as a framework to develop 12-item surveys to study pharmacist role perceptions in the MUP: prescribing, transcribing, dispensing, administration, and monitoring. Content analysis was performed on the responses to open-ended questions.

Results

From 1004 patients, a total of 7217 comments were obtained on 9 questions (740-1004 comments), resulting in an average of 802 comments per question or 0.8 comments per question per respondent (CQR). Similarly, 1620 comments from 205 pharmacists on 11 questions (121-205 comments) averaged 0.72 CQR; and 1561 comments from 200 physicians on 11 questions (136-200 comments) equated to 0.74 CQR. Content analysis revealed recurring themes across the stakeholders: “pharmacists,” “physicians,” “insurance,” “technology,” “collaboration,” “time,” “communication,” and “patient’s responsibility.” Some role congruence was seen regarding pharmacist roles by all 3 stakeholders; noting pharmacist roles in improving all steps of the MUP, except transcribing. Pharmacists highlighted professional challenges such as staffing issues, burnout, and competing demands; which were not acknowledged by patients and physicians indicating the need to increase awareness.

Conclusion

This study showed increased visibility and awareness of pharmacist roles in the MUP by all stakeholders, compared to previous research showing pharmacist roles limited to dispensing. Known barriers to pharmacy practice such as lack of provider status and reimbursement were not reported by any of the stakeholders in this study. There is a need to continuously inform stakeholders about pharmacists’ expanding roles in the MUP through advocacy and marketing.

背景：药剂师在药物使用过程（MUP）中的角色随着新的医疗保健服务模式和跨专业合作实践的发展而不断进步。目前尚不清楚利益相关者对药剂师角色的看法是否也在同步发展：研究患者、药剂师和医生对药剂师在 MUP 中角色的看法：这项经 IRB 批准的研究采用横断面设计，通过 Qualtrics 小组对患者、药剂师和医生进行调查。以角色理论为框架，开发了 12 个项目的调查问卷，研究药剂师在医保中的角色认知：处方、转录、配药、管理和监控。对开放式问题的回答进行了内容分析：在 1004 名患者中，共有 7217 人对 9 个问题发表了意见（740-1004 条意见），平均每个问题有 802 条意见，即每个受访者对每个问题发表 0.8 条意见（CQR）。同样，205 名药剂师就 11 个问题（121-205 条评论）发表了 1620 条评论，平均每条评论的 CQR 为 0.72；200 名医生就 11 个问题（136-200 条评论）发表了 1561 条评论，平均每条评论的 CQR 为 0.74。内容分析揭示了利益相关者之间反复出现的主题："药剂师"、"医生"、"保险"、"技术"、"合作"、"时间"、"沟通 "和 "患者责任"。所有 3 位利益相关者都认为药剂师的角色具有一定的一致性；他们注意到药剂师在改进 MUP 所有步骤（除转录外）中的作用。药剂师强调了职业挑战，如人员配备问题、职业倦怠和相互竞争的需求；而患者和医生并未认识到这一点，这表明有必要提高对药剂师的认识：这项研究表明，与以往研究显示药剂师的作用仅限于配药相比，所有利益相关者对药剂师在医保中的作用都有了更多的了解和认识。在这项研究中，所有利益相关者都没有提到药剂师执业的已知障碍，如缺乏提供者地位和报销问题。有必要通过宣传和营销，不断向利益相关者介绍药剂师在医保中不断扩大的作用。

{"title":"Pharmacist roles in the medication use Process: Qualitative analysis of stakeholder perceptions","authors":"","doi":"10.1016/j.japh.2024.102186","DOIUrl":"10.1016/j.japh.2024.102186","url":null,"abstract":"<div><h3>Background</h3><p>Pharmacist roles in the Medication Use Process (MUP) have advanced along with new healthcare delivery models and interprofessional collaborative practice. It is unclear whether stakeholder perceptions of pharmacist roles have evolved simultaneously.</p></div><div><h3>Objectives</h3><p>Examine patient, pharmacist, and physician perceptions of pharmacist roles in the MUP.</p></div><div><h3>Methods</h3><p>This institutional review board-approved study used a cross-sectional design with Qualtrics panels of patients, pharmacists, and physicians. Role Theory was used as a framework to develop 12-item surveys to study pharmacist role perceptions in the MUP: prescribing, transcribing, dispensing, administration, and monitoring. Content analysis was performed on the responses to open-ended questions.</p></div><div><h3>Results</h3><p>From 1004 patients, a total of 7217 comments were obtained on 9 questions (740-1004 comments), resulting in an average of 802 comments per question or 0.8 comments per question per respondent (CQR). Similarly, 1620 comments from 205 pharmacists on 11 questions (121-205 comments) averaged 0.72 CQR; and 1561 comments from 200 physicians on 11 questions (136-200 comments) equated to 0.74 CQR. Content analysis revealed recurring themes across the stakeholders: “pharmacists,” “physicians,” “insurance,” “technology,” “collaboration,” “time,” “communication,” and “patient’s responsibility.” Some role congruence was seen regarding pharmacist roles by all 3 stakeholders; noting pharmacist roles in improving all steps of the MUP, except <em>transcribing</em>. Pharmacists highlighted professional challenges such as staffing issues, burnout, and competing demands; which were not acknowledged by patients and physicians indicating the need to increase awareness.</p></div><div><h3>Conclusion</h3><p>This study showed increased visibility and awareness of pharmacist roles in the MUP by all stakeholders, compared to previous research showing pharmacist roles limited to dispensing. Known barriers to pharmacy practice such as lack of provider status and reimbursement were not reported by any of the stakeholders in this study. There is a need to continuously inform stakeholders about pharmacists’ expanding roles in the MUP through advocacy and marketing.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1544319124002061/pdfft?md5=76605327120622d4e76ef7a316cca0b1&pid=1-s2.0-S1544319124002061-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604412","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

Trust in information sources during the COVID-19 pandemic and its association with vaccine trust among a sample of Hispanic adults 在 COVID-19 大流行期间对信息来源的信任及其与西语裔成年人对疫苗信任的关系。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-07-10 DOI: 10.1016/j.japh.2024.102184

Background

Public response to the COVID-19 pandemic has underscored the importance of trust, particularly among minority populations. Several factors might affect vaccine safety trust, including source trustworthiness. Using data from the Puerto Rico Community Engagement Alliance, we assessed the association between trust in information sources and the COVID-19 vaccine in a sample of Hispanic adults.

Methods

A cross-sectional survey-based study was conducted from November 2021 to March 2022. Participants were telephone-interviewed to assess sociodemographic, clinical, and COVID-19-related variables. Vaccine trust was assessed by how confident respondents were regarding COVID-19 vaccine safety. Trust in COVID-19 information sources was assessed by asking respondents how much they trusted selected sources of information to provide accurate information about COVID-19, including the US and Puerto Rico governments, Centers for Disease Control and Prevention (CDC), health care professionals, and traditional media (television/radio/newspaper/internet). Logistic regression models estimated the odds ratio (OR, 95% CI) of COVID-19 vaccine trust based on trust in information sources.

Results

A total of 200 adults aged ≥21 years completed the telephone interview. While most of the study sample (97.5%) had been inoculated with at least 1 dose of the COVID-19 vaccine, 86% trusted in the COVID-19 vaccine’s safety. After adjusting for age and sex, participants who attested greater trust in their health care professionals (odds ratio [OR] = 1.99, 95% confidence interval [CI] = 0.71, 5.62), the US government (OR = 2.44, 95% CI = 0.69, 8.68), and the CDC (OR = 8.18, 95% CI = 2.97, 22.57) reported increased vaccine trust as compared to those not having great confidence in these entities.

Conclusion

These findings support that trust in information provided by the CDC is positively associated with COVID-19 vaccine trust. Acknowledging predictors of trust regarding COVID-19 vaccination could help address factors that affect vaccine confidence. In turn, it strengthens COVID-19 prevention efforts, benefiting common welfare, reducing health disparities, and aiding underserved populations.

背景：公众对 COVID-19 大流行的反应凸显了信任的重要性，尤其是在少数民族人群中。有几个因素可能会影响疫苗安全信任度，包括信息来源的可信度。利用波多黎各社区参与联盟（Puerto Rico Community Engagement Alliance）的数据，我们对西班牙裔成人样本中信息来源的信任度与 COVID-19 疫苗之间的关联进行了评估：方法：我们于 2021 年 11 月至 2022 年 3 月开展了一项基于横断面调查的研究。参与者接受了电话访谈，以评估社会人口学、临床和 COVID-19 相关变量。根据受访者对 COVID-19 疫苗安全性的信心程度来评估疫苗信任度。对 COVID-19 信息来源信任度的评估是通过询问受访者对所选信息来源（包括美国和波多黎各政府、疾病控制和预防中心 (CDC)、医疗保健专业人员和传统媒体（电视/广播/报纸/互联网））提供有关 COVID-19 的准确信息的信任程度来进行的。逻辑回归模型根据对信息来源的信任度估算出 COVID-19 疫苗信任度的几率比（OR，95% CI）：共有 200 名年龄≥21 岁的成年人完成了电话访谈。研究样本中的大多数人（97.5%）至少接种过一剂 COVID-19 疫苗，86%的人对 COVID-19 疫苗的安全性表示信任。在对年龄和性别进行调整后，与那些对医疗保健专业人员（OR=1.99，95% CI=0.71，5.62）、美国政府（OR=2.44，95% CI=0.69，8.68）和美国疾病预防控制中心（OR=8.18，95% CI=2.97，22.57）不太信任的人相比，那些对这些机构更信任的人对疫苗的信任度有所提高：这些研究结果表明，对疾病预防控制中心提供的信息的信任度与 COVID-19 疫苗信任度呈正相关。了解 COVID-19 疫苗接种信任度的预测因素有助于解决影响疫苗信任度的因素。反过来，它还能加强 COVID-19 的预防工作，造福大众，减少健康差异，并为得不到充分服务的人群提供帮助。

{"title":"Trust in information sources during the COVID-19 pandemic and its association with vaccine trust among a sample of Hispanic adults","authors":"","doi":"10.1016/j.japh.2024.102184","DOIUrl":"10.1016/j.japh.2024.102184","url":null,"abstract":"<div><h3>Background</h3><p>Public response to the COVID-19 pandemic has underscored the importance of trust, particularly among minority populations. Several factors might affect vaccine safety trust, including source trustworthiness. Using data from the Puerto Rico Community Engagement Alliance, we assessed the association between trust in information sources and the COVID-19 vaccine in a sample of Hispanic adults.</p></div><div><h3>Methods</h3><p>A cross-sectional survey-based study was conducted from November 2021 to March 2022. Participants were telephone-interviewed to assess sociodemographic, clinical, and COVID-19-related variables. Vaccine trust was assessed by how confident respondents were regarding COVID-19 vaccine safety. Trust in COVID-19 information sources was assessed by asking respondents how much they trusted selected sources of information to provide accurate information about COVID-19, including the US and Puerto Rico governments, Centers for Disease Control and Prevention (CDC), health care professionals, and traditional media (television/radio/newspaper/internet). Logistic regression models estimated the odds ratio (OR, 95% CI) of COVID-19 vaccine trust based on trust in information sources.</p></div><div><h3>Results</h3><p>A total of 200 adults aged ≥21 years completed the telephone interview. While most of the study sample (97.5%) had been inoculated with at least 1 dose of the COVID-19 vaccine, 86% trusted in the COVID-19 vaccine’s safety. After adjusting for age and sex, participants who attested greater trust in their health care professionals (odds ratio [OR] = 1.99, 95% confidence interval [CI] = 0.71, 5.62), the US government (OR = 2.44, 95% CI = 0.69, 8.68), and the CDC (OR = 8.18, 95% CI = 2.97, 22.57) reported increased vaccine trust as compared to those not having great confidence in these entities.</p></div><div><h3>Conclusion</h3><p>These findings support that trust in information provided by the CDC is positively associated with COVID-19 vaccine trust. Acknowledging predictors of trust regarding COVID-19 vaccination could help address factors that affect vaccine confidence. In turn, it strengthens COVID-19 prevention efforts, benefiting common welfare, reducing health disparities, and aiding underserved populations.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591871","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

Suppressed thyroid stimulating hormone levels after initiation of a subcutaneous glucagon-like peptide-1 receptor agonist in a post-thyroidectomy patient managed with levothyroxine case report. 甲状腺切除术后使用左甲状腺素治疗的患者在开始使用皮下注射胰高血糖素样肽-1受体激动剂后促甲状腺激素水平受到抑制的病例报告。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-07-09 DOI: 10.1016/j.japh.2024.102185

Lauren Wilcox, Elizabeth Van Dril

Objectives: Glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy has demonstrated an increased risk of thyroid C-cell hyperplasia and C-cell tumors in rodents. Due to this risk, a boxed warning for this drug class exists for people with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2. There is a lack of data regarding any possible effect of GLP-1 RA therapy on serum thyroid levels. The objective of this case report is to describe a case of suppressed thyroid stimulating hormone levels after initiation of a subcutaneous semaglutide in a post-total thyroidectomy patient managed with levothyroxine in order to highlight the need for closer monitoring of these patients and further research in this area.

Case summary: The patient described in the case underwent a total thyroidectomy in 2015 with stable thyroid hormone replacement requirements with levothyroxine for 5 years until the initiation and titration of subcutaneous semaglutide. The reduction in thyroid stimulating hormone (TSH) after starting GLP-1 RA therapy necessitated a 25 percent dose reduction of levothyroxine from her original dose.

Practice implications: This patient experienced suppressed TSH levels following initiation and titration of subcutaneous semaglutide. The etiology of these changes may be related to the direct effects of GLP-1 RA therapy on TSH levels, changes in absorption related to delayed gastric emptying rates, secondary to GLP-1 RA-associated weight loss, or a combination of these proposed mechanisms. It may be prudent to exercise more frequent monitoring of medications that require weight-based dosing and those with a narrow therapeutic index when initiating and titrating GLP-1 RA-based therapies and is an area of potential study.

目的：胰高血糖素样肽-1受体激动剂（GLP-1 RA）疗法已在啮齿类动物中证实会增加甲状腺C细胞增生和C细胞肿瘤的风险。由于存在这种风险，该类药物对有甲状腺髓样癌或多发性内分泌肿瘤综合征2型个人或家族史的人发出了盒装警告。关于GLP-1 RA疗法对血清甲状腺水平可能产生的影响，目前还缺乏相关数据。本病例报告旨在描述一例使用左甲状腺素治疗的甲状腺全切除术后患者在开始皮下注射赛马鲁肽后促甲状腺激素水平受到抑制的病例，以强调对这些患者进行更密切监测的必要性以及在这一领域开展进一步研究的必要性。病例摘要：病例中描述的患者于2015年接受了甲状腺全切除术，5年来一直使用左甲状腺素稳定地补充甲状腺激素，直到开始使用并滴定皮下注射的塞马鲁肽。在开始接受 GLP-1 RA 治疗后，促甲状腺激素（TSH）有所下降，因此有必要将左甲状腺素的剂量从原来的剂量减少 25%：该患者在开始使用和滴定皮下注射塞马鲁肽后，促甲状腺激素水平受到抑制。这些变化的病因可能与 GLP-1 RA 治疗对 TSH 水平的直接影响、与胃排空率延迟有关的吸收变化、继发于 GLP-1 RA 相关的体重减轻或这些机制的组合有关。在开始和滴定基于 GLP-1 RA 的疗法时，对需要根据体重给药的药物和治疗指数较窄的药物进行更频繁的监测可能是明智之举，这也是一个潜在的研究领域。

{"title":"Suppressed thyroid stimulating hormone levels after initiation of a subcutaneous glucagon-like peptide-1 receptor agonist in a post-thyroidectomy patient managed with levothyroxine case report.","authors":"Lauren Wilcox, Elizabeth Van Dril","doi":"10.1016/j.japh.2024.102185","DOIUrl":"https://doi.org/10.1016/j.japh.2024.102185","url":null,"abstract":"<p><strong>Objectives: </strong>Glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy has demonstrated an increased risk of thyroid C-cell hyperplasia and C-cell tumors in rodents. Due to this risk, a boxed warning for this drug class exists for people with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2. There is a lack of data regarding any possible effect of GLP-1 RA therapy on serum thyroid levels. The objective of this case report is to describe a case of suppressed thyroid stimulating hormone levels after initiation of a subcutaneous semaglutide in a post-total thyroidectomy patient managed with levothyroxine in order to highlight the need for closer monitoring of these patients and further research in this area.</p><p><strong>Case summary: </strong>The patient described in the case underwent a total thyroidectomy in 2015 with stable thyroid hormone replacement requirements with levothyroxine for 5 years until the initiation and titration of subcutaneous semaglutide. The reduction in thyroid stimulating hormone (TSH) after starting GLP-1 RA therapy necessitated a 25 percent dose reduction of levothyroxine from her original dose.</p><p><strong>Practice implications: </strong>This patient experienced suppressed TSH levels following initiation and titration of subcutaneous semaglutide. The etiology of these changes may be related to the direct effects of GLP-1 RA therapy on TSH levels, changes in absorption related to delayed gastric emptying rates, secondary to GLP-1 RA-associated weight loss, or a combination of these proposed mechanisms. It may be prudent to exercise more frequent monitoring of medications that require weight-based dosing and those with a narrow therapeutic index when initiating and titrating GLP-1 RA-based therapies and is an area of potential study.</p>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591870","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

Polypharmacy among adults with asthma in the United States, 2005-2020 2005-2020 年美国成人哮喘患者的多重用药情况。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-07-02 DOI: 10.1016/j.japh.2024.102154

Background

Asthma is a chronic disease that often requires medication for control. Polypharmacy remains a major issue to medication adherence; however, its evidence among patients with asthma is limited.

Objectives

To evaluate the prevalence and determinants of polypharmacy and its associations with asthma control among adults with asthma in the United States.

Methods

Data from the 2005-2020 National Health and Nutrition Examination Survey were used to estimate the weighted prevalence of polypharmacy. Selected variables, including demographics, comorbidities, prescription medications, and asthma-related adverse events, were extracted from the National Health and Nutrition Examination Survey. Multivariable logistic regression was conducted to identify factors associated with polypharmacy. Another two sets of multivariable logistic regression models were employed to further assess the association between polypharmacy and asthma-related adverse events: one for asthma attacks and the other for asthma-related emergency department visits.

Results

From 2005 to 2020, polypharmacy prevalence was 34.3% and 14.1% among adults with and without asthma, respectively. Characteristics, including older age (P < 0.01), non-Hispanic blacks (P < 0.01), health insurance coverage (P < 0.01), number of health care visits (P < 0.01), and multiple comorbidities (P < 0.01), were associated with polypharmacy. Polypharmacy was associated with increased risks of having asthma attacks (odds ratio, 1.38; 95% CI, 1.08-1.76) and asthma-related emergency department visits (odds ratio, 1.46; 95% CI, 1.09-1.94) among adults with asthma. Among patients taking at least one asthma medication, risks of asthma attacks, and asthma-related emergency department visits did not differ between those with and without polypharmacy.

Conclusion

Approximately one in three adults with asthma experienced polypharmacy in the United States. Disparities existed in several characteristics, highlighting the necessity for appropriate care and policies among vulnerable populations. Further validation on the impact of polypharmacy on asthma control is required.

背景：哮喘是一种慢性疾病，通常需要药物控制。多药合用仍然是影响用药依从性的一个主要问题；然而，其在哮喘患者中的证据却很有限：目的：评估美国成人哮喘患者中多药治疗的发生率、决定因素及其与哮喘控制的关系：方法：利用 2005-2020 年美国国家健康与营养调查（NHANES）的数据来估算多种药物的加权使用率。从 NHANES 中提取了部分变量，包括人口统计学、合并症、处方药和哮喘相关不良事件。进行了多变量逻辑回归，以确定与多重用药相关的因素。另外还采用了两组多变量逻辑回归模型来进一步评估多种药物治疗与哮喘相关不良事件之间的关系：一组是哮喘发作，另一组是哮喘相关急诊就诊：从 2005 年到 2020 年，在患有哮喘和未患有哮喘的成年人中，使用多种药物的比例分别为 34.3% 和 14.1%。包括年龄较大（PConclusion：在美国，大约每三名哮喘成人中就有一人使用多种药物。在一些特征方面存在差异，这凸显了为弱势群体提供适当护理和政策的必要性。需要进一步验证多种药物治疗对哮喘控制的影响。

{"title":"Polypharmacy among adults with asthma in the United States, 2005-2020","authors":"","doi":"10.1016/j.japh.2024.102154","DOIUrl":"10.1016/j.japh.2024.102154","url":null,"abstract":"<div><h3>Background</h3><p>Asthma is a chronic disease that often requires medication for control. Polypharmacy remains a major issue to medication adherence; however, its evidence among patients with asthma is limited.</p></div><div><h3>Objectives</h3><p>To evaluate the prevalence and determinants of polypharmacy and its associations with asthma control among adults with asthma in the United States.</p></div><div><h3>Methods</h3><p>Data from the 2005-2020 National Health and Nutrition Examination Survey were used to estimate the weighted prevalence of polypharmacy. Selected variables, including demographics, comorbidities, prescription medications, and asthma-related adverse events, were extracted from the National Health and Nutrition Examination Survey. Multivariable logistic regression was conducted to identify factors associated with polypharmacy. Another two sets of multivariable logistic regression models were employed to further assess the association between polypharmacy and asthma-related adverse events: one for asthma attacks and the other for asthma-related emergency department visits.</p></div><div><h3>Results</h3><p>From 2005 to 2020, polypharmacy prevalence was 34.3% and 14.1% among adults with and without asthma, respectively. Characteristics, including older age (<em>P</em> < 0.01), non-Hispanic blacks (<em>P</em> < 0.01), health insurance coverage (<em>P</em> < 0.01), number of health care visits (<em>P</em> < 0.01), and multiple comorbidities (<em>P</em> < 0.01), were associated with polypharmacy. Polypharmacy was associated with increased risks of having asthma attacks (odds ratio, 1.38; 95% CI, 1.08-1.76) and asthma-related emergency department visits (odds ratio, 1.46; 95% CI, 1.09-1.94) among adults with asthma. Among patients taking at least one asthma medication, risks of asthma attacks, and asthma-related emergency department visits did not differ between those with and without polypharmacy.</p></div><div><h3>Conclusion</h3><p>Approximately one in three adults with asthma experienced polypharmacy in the United States. Disparities existed in several characteristics, highlighting the necessity for appropriate care and policies among vulnerable populations. Further validation on the impact of polypharmacy on asthma control is required.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535795","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

Implementation of a North Dakota opioid misuse and overdose prevention program in West Virginia 在西弗吉尼亚州实施北达科他州阿片类药物滥用和过量预防计划。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-07-02 DOI: 10.1016/j.japh.2024.102152

Background

Pharmacy has an important role in combating the opioid epidemic. However, there is a need for more consistency of programs and evidence-based practices across the country.

Objectives

To describe how an evidence-based opioid misuse and overdose prevention program that originated in North Dakota was implemented in West Virginia and to compare program results between the two states including pharmacist interventions and patient screening for opioid misuse and overdose.

Practice description

This advancement in practice took place in participating North Dakota and West Virginia community pharmacies.

Practice innovation

An evidence-based program that originated in North Dakota was implemented in West Virginia. The details of this collaboration are outlined in this manuscript.

Evaluation methods

Program screening and pharmacist intervention data were collected using DocStation, an online pharmacy patient management platform.

Results

Thirty-four pharmacies in West Virginia implemented the program. Between April 2022 and September 2023, a total of 34 West Virginia pharmacies conducted 449 documented screenings compared to 12,105 screenings by 81 pharmacies in North Dakota over the same time. There were differences between the states with regard to the proportion of individuals screened as high-risk for opioid use disorder and individuals at risk of accidental opioid overdose likely attributable to different demographics.

Conclusion

An opioid misuse and prevention program was successfully implemented in two states, which can serve as a model to implement similar programs in other pharmacies across the United States.

背景：药学在抗击阿片类药物流行方面发挥着重要作用。然而，全国各地的计划和循证实践需要更加一致：描述如何在西弗吉尼亚州实施一项源自北达科他州的阿片类药物滥用和过量预防循证计划，并比较两个州的计划成果，包括药剂师干预和阿片类药物滥用和过量患者筛查：实践创新：实践创新：在西弗吉尼亚州实施了一项源自北达科他州的循证计划。本手稿概述了这一合作的细节：评估方法：使用在线药房患者管理平台 DocStation 收集项目筛选和药剂师干预数据：结果：西弗吉尼亚州的 34 家药房实施了该计划。2022 年 4 月至 2023 年 9 月期间，西弗吉尼亚州共有 34 家药房进行了 449 次有记录的筛查，而同期北达科他州有 81 家药房进行了 12105 次筛查。各州被筛查为阿片类药物滥用高风险人群和意外阿片类药物过量风险人群的比例存在差异，这可能是由于人口统计学特征不同所致：两个州成功实施了阿片类药物滥用和预防计划，可作为在全美其他药店实施类似计划的典范。

{"title":"Implementation of a North Dakota opioid misuse and overdose prevention program in West Virginia","authors":"","doi":"10.1016/j.japh.2024.102152","DOIUrl":"10.1016/j.japh.2024.102152","url":null,"abstract":"<div><h3>Background</h3><p>Pharmacy has an important role in combating the opioid epidemic. However, there is a need for more consistency of programs and evidence-based practices across the country.</p></div><div><h3>Objectives</h3><p>To describe how an evidence-based opioid misuse and overdose prevention program that originated in North Dakota was implemented in West Virginia and to compare program results between the two states including pharmacist interventions and patient screening for opioid misuse and overdose.</p></div><div><h3>Practice description</h3><p>This advancement in practice took place in participating North Dakota and West Virginia community pharmacies.</p></div><div><h3>Practice innovation</h3><p>An evidence-based program that originated in North Dakota was implemented in West Virginia. The details of this collaboration are outlined in this manuscript.</p></div><div><h3>Evaluation methods</h3><p>Program screening and pharmacist intervention data were collected using DocStation, an online pharmacy patient management platform.</p></div><div><h3>Results</h3><p>Thirty-four pharmacies in West Virginia implemented the program. Between April 2022 and September 2023, a total of 34 West Virginia pharmacies conducted 449 documented screenings compared to 12,105 screenings by 81 pharmacies in North Dakota over the same time. There were differences between the states with regard to the proportion of individuals screened as high-risk for opioid use disorder and individuals at risk of accidental opioid overdose likely attributable to different demographics.</p></div><div><h3>Conclusion</h3><p>An opioid misuse and prevention program was successfully implemented in two states, which can serve as a model to implement similar programs in other pharmacies across the United States.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535794","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

Actions of the 2024 American Pharmacists Association House of Delegates, Orlando, FL, March 22 – 25, 2024 2024 年美国药剂师协会代表大会行动，佛罗里达州奥兰多，2024 年 3 月 22 - 25 日

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-07-01 DOI: 10.1016/j.japh.2024.102117

引用次数: 0

Cover 封面

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-07-01 DOI: 10.1016/j.japh.2024.102229

引用次数: 0

When PharmDs pursue a PhD 药学博士攻读博士学位的情况