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Culturally competent approaches in addressing hypertension control disparities in African Americans: The pharmacist's perspective 解决非裔美国人高血压控制差异的文化适应方法:药剂师的视角。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-08-17 DOI: 10.1016/j.japh.2024.102217
Nana Entsuah-Boateng, Michelle Phuong Nguyen, Parmis Khatibi, Connie Abdo

In the United States, cardiovascular disease (CVD) is the leading cause of death. Despite advancements in the identification of risk factors and management of CVD leading to improved mortality over the years, disparities in outcomes persist among racial/ethnic groups. In this commentary, we discuss the multifaceted nature of this issue, including structural barriers and historical injustices that lead to healthcare mistrust. Emphasizing culturally appropriate approaches, we explore the pharmacist's role in providing culturally competent care and propose policy recommendations to improve disparities in blood pressure outcomes. The paper underscores the importance of collaborative efforts among healthcare providers, policymakers, and communities to address this critical public health challenge.

在美国,心血管疾病(CVD)是导致死亡的主要原因。尽管多年来在心血管疾病的风险因素识别和管理方面取得了进步,从而改善了死亡率,但种族/族裔群体之间在治疗结果上的差距依然存在。在这篇评论中,我们讨论了这一问题的多面性,包括导致医疗不信任的结构性障碍和历史性不公正。在强调文化适宜性方法的同时,我们探讨了药剂师在提供文化适宜性护理中的作用,并提出了改善血压结果差异的政策建议。本文强调了医疗服务提供者、政策制定者和社区通力合作以应对这一重大公共卫生挑战的重要性。
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引用次数: 0
Standardizing a transitions of care pharmacist workflow for tobacco cessation efforts 为戒烟工作规范过渡护理药剂师工作流程。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-08-05 DOI: 10.1016/j.japh.2024.102203
Rachel C. Moehlenbrock, Amanda K. Kuszmaul, Kimber L. Woodrum, Brittany V. Wyatt

Background

Smoking is the leading cause of preventable disease, disability, and death. Pharmacists can aid in smoking cessation through pharmacotherapy recommendations, patient counseling, and follow-up.

Objective

Describe a standardized transitions of care (TOC) pharmacist workflow for patients' tobacco cessation efforts at hospital discharge and to secondarily evaluate patient participation, impact on cessation outcomes, and pharmacist effort to provide the service.

Practice description

TOC pharmacists provide medication optimization and education to patients admitted to and discharged from Norton Healthcare hospitals. Medication optimization for tobacco cessation occurs through a provider recommendation or by utilizing the Kentucky Board of Pharmacy–authorized protocol.

Practice innovation

A standardized workflow was created for TOC pharmacists to identify patients who use tobacco, assess patients’ current tobacco use and willingness to quit, select appropriate pharmacotherapy, document, and follow up after discharge.

Evaluation methods

A retrospective descriptive study was performed for adult patients assessed by TOC pharmacists for tobacco cessation between November 2021 and April 2022, with follow-up visits completed through December 2022.

Results

The pharmacists assessed 357 patients and 252 (70.6%) stated they were interested in tobacco cessation. Of those interested, 117 patients (46.4%) indicated they were interested in receiving follow-up from TOC pharmacists and refills from a Norton pharmacy. Of the 117 patients interested in follow-up, 73 patients (62.4%) completed at least 1 follow-up visit with the TOC pharmacist. At the last completed follow-up visit, 26 patients (35.6%) reported complete tobacco cessation. Of the 47 patients who did not have complete cessation, they reported using 39% less tobacco on average compared with their initial assessment at hospital discharge. The mean time spent by TOC pharmacists using this workflow was 13.5 minutes per follow-up visit.

Conclusions

This project formalized a standardized and sustainable TOC pharmacist workflow that demonstrated a positive impact on tobacco cessation efforts for participating patients.

目标:该项目旨在描述标准化的护理过渡(TOC)药剂师工作流程,为出院患者提供戒烟服务,其次评估患者的参与度、对戒烟效果的影响以及药剂师提供该服务所需的努力:TOC药剂师为诺顿医疗集团医院的入院和出院患者提供药物优化和教育服务。戒烟用药优化是通过向医疗服务提供者提出建议,或通过肯塔基州药学委员会授权的方案启动药物治疗:实践创新:为TOC药剂师创建了标准化工作流程,以识别吸烟患者、评估患者目前的烟草使用情况和戒烟意愿、选择适当的药物治疗、记录并在患者出院后对其进行随访:对2021年11月至2022年4月期间接受TOC药剂师戒烟评估的成年患者进行回顾性描述研究,并在2022年12月前完成随访:在该试点项目中,共有 357 名患者接受了评估,其中 252 人(70.6%)表示对戒烟感兴趣。其中,117 名(46.4%)患者表示有兴趣参与该项目,并接受 TOC 药剂师的随访和诺顿药房的补药。在这 117 名有兴趣接受随访的患者中,73 名(62.4%)患者至少完成了一次 TOC 药剂师的随访。在最后一次完成的随访中,有 26 名(35.6%)患者表示已完全戒烟。在47名未完全戒烟的患者中,他们报告的烟草使用量与出院时的初步评估结果相比平均减少了39%。TOC药剂师使用该工作流程的平均时间为每次随访13.5分钟:该项目正式确立了标准化、可持续的 TOC 药剂师工作流程,对参与患者的戒烟工作产生了积极影响。
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引用次数: 0
Changing the conversation: Empowering community pharmacists to address pneumococcal vaccine hesitancy 改变对话:让社区药剂师有能力解决肺炎球菌疫苗接种犹豫不决的问题。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-08-03 DOI: 10.1016/j.japh.2024.102202
Darius Ramrattan , Danielle Nagy , Dean Eurich, Christine Hughes, Darren Lau, Scot Simpson

Background

Although pneumococcal vaccine is recommended for everyone 65 years of age and older, only 58% of Canadians in this age group have been vaccinated, well below the Public Health Agency of Canada’s target of 80%. To improve uptake, a stepped-wedge cluster randomized trial testing the effectiveness of a community pharmacist intervention was developed.

Objective

This prespecified sub-study aimed to uncover and quantify factors contributing to vaccine hesitancy by exploring the nature of patient-pharmacist conversations about pneumococcal vaccine.

Methods

Beginning each month (April– August 2023), participating pharmacies were randomly selected to receive an education package designed to enhance pharmacists’ knowledge, skills, and abilities in promoting pneumococcal vaccination. Pharmacists provided usual care (control stage) until they received the educational package and transitioned to the intervention stage. Weekly scorecards tracked patient-pharmacist conversations about pneumococcal vaccination. Chi-squared tests compared time taken for each conversation and patient-reported reason(s) for refusal between control and intervention stages.

Results

Thirteen pharmacies from across Alberta were included in the analysis, reporting 656 patient-pharmacist conversations (control stage n = 271, intervention stage n = 385). Time taken for pneumococcal vaccine conversations decreased after pharmacies received the education package (65% of conversations resulting in vaccination took <20 minutes in the control stage, compared to 88% in the intervention stage (P = 0.004)). The most common patient-reported reason for refusal, needing more time to think about the vaccine, remained similar between stages (P = 0.23). However, during the intervention stage, fewer patients refused vaccination due to lack of time to receive it today (P = 0.016) and perceived lack of benefit (P = 0.035), but more patients refused vaccination due to cost barriers (P = 0.026).

Conclusion

The education provided in this study changed the reasons for refusing vaccines, suggesting the nature of patient-pharmacist conversations became more efficient and informed. Similar interventions could be adopted across Canada and the United States to help combat vaccine hesitancy.

背景:虽然建议 65 岁及以上的老人都接种肺炎球菌疫苗,但只有 58% 的这个年龄段的加拿大人接种了疫苗,远远低于加拿大公共卫生局设定的 80% 的目标。为了提高接种率,我们开展了一项阶梯式分组随机试验,测试社区药剂师干预措施的有效性:这项预先指定的子研究旨在通过探索患者与药剂师之间关于肺炎球菌疫苗的对话性质,发现并量化导致疫苗接种犹豫的因素:从每个月开始(2023 年 4 月至 8 月),参与研究的药房被随机选中接受旨在提高药剂师促进肺炎球菌疫苗接种的知识、技能和能力的教育包。药剂师提供常规护理(对照阶段),直到他们接受教育包并过渡到干预阶段。每周记分卡跟踪患者与药剂师关于肺炎球菌疫苗接种的对话。通过卡方检验比较了对照阶段和干预阶段每次谈话所花费的时间以及患者报告的拒绝原因:来自艾伯塔省各地的 13 家药房参与了分析,共报告了 656 次患者与药剂师对话(控制阶段 n=271,干预阶段 n=385)。药房接受教育包后,肺炎球菌疫苗接种谈话所需的时间缩短了(65% 的谈话导致了疫苗接种):本研究中提供的教育改变了拒绝接种疫苗的原因,表明患者与药剂师对话的性质变得更加有效和知情。类似的干预措施可在加拿大和美国各地采用,以帮助消除疫苗接种犹豫。
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引用次数: 0
Establishing mental health friendly pharmacies to assist in the early identification and support of older adults at risk of depression: The EMPATHISE pilot study 建立心理健康友好药房,协助早期识别和支持有抑郁风险的老年成人:EMPATHISE 试点研究。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-08-02 DOI: 10.1016/j.japh.2024.102199
Duha N. Gide, Sarira El-Den, Lisa Kouladjian O’Donnell, Kevin Ou, Simone Diamandis, Natasa Gisev, Claire L. O’Reilly

Background

Late-life depression (LLD) often goes underdiagnosed and undertreated. Community pharmacists are one of the most accessible and trusted healthcare professionals (HCPs) and may play a significant role in LLD screening.

Objective

This study aimed to develop and pilot a pharmacist-delivered depression screening and referral service for older adults (≥65 years) at risk of depression, within community pharmacy.

Methods

Community pharmacists across New South Wales, Australia, were recruited to participate in a prospective pilot study. Pharmacists/pharmacy staff received specialized training before recruiting and screening patients aged ≥65 years using the Geriatric Depression Scale-15 (GDS-15). Patients scoring ≥6 were referred to another HCP, e.g., general practitioner, and followed-up by the pharmacist 1-week postscreening. Patients were also followed-up by a research team member 6-weeks postscreening to explore outcomes of the screening. Semi-structured interviews with pharmacists and patients were undertaken following completion of the pilot study to explore their experiences delivering/receiving the screening service. A thematic inductive analysis approach was used to analyze interview data.

Results

A total of 39 community pharmacies participated in this study. In total, 113 participants attended the training sessions. Pharmacists screened 15 patients from 8 pharmacies, of which 67% were female. Two thirds of patients (67%) received a GDS-15 score of ≥6, indicating possible depression and requiring referral. Pharmacists referred 80% of patients to another HCP. One patient was diagnosed with depression and commenced antidepressant therapy. Five patients and 6 pharmacists participated in semi-structured interviews. Barriers to screening included lack of time and mental illness stigma. Facilitators included pharmacist-patient relationships and training.

Conclusion

Pharmacist-delivered LLD screening was found to be acceptable by both pharmacists and patients, with pharmacists reporting training improved their comfort and confidence with depression screening. These pilot study findings may inform future work into service delivery models to support early identification and treatment of LLD.

背景:晚年抑郁症(LLD)往往得不到充分诊断和治疗。社区药剂师是最容易获得和最值得信赖的医疗保健专业人员(HCP)之一,可在晚年抑郁症筛查中发挥重要作用:本研究旨在社区药房内为有抑郁症风险的老年人(≥65 岁)开发和试点由药剂师提供的抑郁症筛查和转介服务:方法:在澳大利亚新南威尔士州招募社区药剂师参与前瞻性试点研究。药剂师/药房工作人员在招募≥65岁的患者并使用老年抑郁量表-15(GDS-15)对其进行筛查之前接受了专门培训。得分≥6分的患者会被转诊至其他保健医生(如全科医生),并在筛查后一周由药剂师进行随访。研究小组成员还在筛查后 6 周对患者进行随访,以了解筛查结果。试点研究结束后,对药剂师和患者进行了半结构式访谈,以探讨他们提供/接受筛查服务的经验。采用主题归纳分析法对访谈数据进行分析:共有 39 家社区药房参与了这项研究。共有 113 人参加了培训课程。药剂师筛查了来自 8 家药房的 15 名患者,其中 67% 为女性。三分之二的患者(67%)的 GDS-15 得分≥6,表明可能患有抑郁症,需要转诊。药剂师将 80% 的患者转诊至其他保健医生。一名患者被诊断为抑郁症,并开始接受抗抑郁治疗。五名患者和六名药剂师参加了半结构化访谈。筛查的障碍包括缺乏时间和对精神疾病的偏见。促进因素包括药剂师与患者之间的关系和培训:药剂师和患者均可接受由药剂师提供的 LLD 筛查,药剂师称培训提高了他们对抑郁症筛查的舒适度和信心。这些试点研究结果可为今后研究支持早期识别和治疗 LLD 的服务提供模式提供参考。
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引用次数: 0
Assessment of PrEP and PEP furnishing in San Francisco Bay Area pharmacies: An observational cross-sectional study 对旧金山湾区药房提供的 PrEP 和 PEP 进行评估;一项观察性横断面研究。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-08-02 DOI: 10.1016/j.japh.2024.102201
Grace Herron, Ashley Leong, Keya Patel, Keanna Rasekhi, Dorie E. Apollonio

Background

Over 1 million people in the United States are infected with human immunodeficiency virus (HIV). As of 2021, pharmacists in California can prescribe PrEP and PEP without establishing a collaborative practice agreement in an effort to reduce HIV transmission. However, in 2021 less than 3% of independent pharmacies in the San Francisco Bay Area did so. To our knowledge, there has been no follow-up research assessing potential changes in pre-exposure prophylaxis/postexposure prophylaxis (PrEP/PEP) furnishing rates in the region.

Objective

Assess the extent of PrEP/PEP furnishing in San Francisco Bay Area pharmacies 3 years after policy implementation.

Methods

We conducted an observational, cross-sectional study to identify independent community and mail-order pharmacies furnishing PrEP/PEP in the nine-county San Francisco Bay Area in 2024. Furnishing pharmacies were identified via phone calls and the findings were validated with in-person visits. We also identified the number of retail chain pharmacies furnishing PrEP/PEP in San Francisco County.

Results

We contacted 202 independent community and mail order pharmacies in the nine-county San Francisco Bay Area by telephone; of these, 16 reported furnishing PEP/PrEP and all confirmed their ability to furnish when visited in person. We contacted 67 retail chain pharmacies in San Francisco County; of these, 11 pharmacies reported furnishing PrEP/PEP (10 Safeway; 1 Walgreens).

Conclusions

More pharmacies furnished PrEP/PEP in the 9-county San Francisco Bay Area in 2024 (8%) than in 2021 (3%); in addition, one retail chain pharmacy had instituted a furnishing protocol. However, furnishing rates remained low. Past research suggests that advertising and the development of furnishing protocols may help increase furnishing and increase medication access.

背景:美国有 100 多万人感染了人类免疫缺陷病毒(HIV)。从 2021 年起,加利福尼亚州的药剂师可以在不签订合作协议的情况下开具 PrEP 和 PEP 处方,以减少 HIV 传播。然而,在 2021 年,旧金山湾区只有不到 3% 的独立药店这样做了。据我们所知,还没有后续研究对该地区 PrEP/PEP 提供率的潜在变化进行评估:评估政策实施 3 年后旧金山湾区药房提供 PrEP/PEP 的情况:我们开展了一项观察性横断面研究,以确定 2024 年旧金山湾区 9 个县中提供 PrEP/PEP 的独立社区药房和邮购药房。我们通过电话确定了提供药房,并通过亲自访问对结果进行了验证。我们还确定了旧金山县提供 PrEP/PEP 的零售连锁药店数量:我们通过电话联系了旧金山湾区 9 个县的 202 家独立社区药房和邮购药房;其中 16 家药房报告提供 PEP/PrEP 服务,所有药房在接受亲自访问时均确认能够提供服务。我们联系了旧金山县的 67 家零售连锁药店;其中 11 家药店报告提供 PrEP/PrEP (10 家 Safeway;1 家 Walgreens):结论:2024 年,旧金山湾区 9 个县中提供 PrEP/PEP 的药店数量(8%)多于 2021 年(3%);此外,一家零售连锁药店制定了提供协议。然而,提供率仍然很低。过去的研究表明,广告宣传和制定提供协议可能有助于提高提供率并增加药物的可及性。
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引用次数: 0
Primary care team member’s perceptions of credentialed and privileged clinic pharmacists and impact on clinic workload in a pediatric primary care network 在儿科初级保健网络中,初级保健团队成员对有资质和有特权的诊所药剂师的看法以及对诊所工作量的影响。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-08-02 DOI: 10.1016/j.japh.2024.102200
Cheryl A. Maslouski, Sonya J. Sebastian, Addie Brown, Mahmoud Abdel-Rasoul, Anna Gehres

Background

Pharmacists provide increased access to care, vaccinations, and medication management for patients. Credentialing and privileging of pharmacists allow pharmacists to practice at the top of their licenses and elevate pharmacy practice.

Objective

The primary objective of this study was to assess the perception of health care team members of credentialed and privileged pharmacists working in a pediatric primary care network (PCN) before and after implementation of pharmacist privileges. The secondary objective was to determine team members’ perceptions on the amount of time spent refilling medications, resolving medication access issues, and ordering vaccines before and after implementation of pharmacist privileges.

Methods

This was a prospective pre-post study using surveys to capture health care team members’ perceptions of credentialed and privileged ambulatory care pharmacists. Surveyed participants included attending physicians, advanced practice nurses, registered nurses, licensed practical nurses, medical assistants, and patient care assistants. Summary statistics are reported as frequencies and percentages. Statistical analysis was conducted using SAS version 9.4.

Results

Fifty-eight preprivileging and 56 postprivileging surveys were distributed. The return rate was 79.3% (n = 46) for preprivileging and 80.4% (n = 45) for postprivileging surveys. More than 90% of respondents had a favorable perception of credentialed and privileged pharmacists in the clinic. There was a significant difference in the perception of the amount of time spent on medication access issues after pharmacist privileges were implemented (P = 0.0296).

Conclusion

Credentialed and privileged pharmacists in a pediatric PCN are viewed favorably by clinic team members and can have a positive impact on clinic workload.
背景:药剂师为患者提供更多的医疗服务、疫苗接种和药物管理。药剂师的资格认证和特权授予使药剂师能够在其执照的最高级别执业,并提升药学实践水平:本研究的主要目的是评估医疗团队成员在实施药剂师特权前后对在儿科初级医疗网络工作的认证药剂师和特权药剂师的看法。次要目标是确定团队成员在实施药剂师特权前后对重新配药、解决用药问题和订购疫苗所花费时间的看法:这是一项前瞻性的事前事中研究,通过调查了解医疗团队成员对有资格证书和特权的非住院医疗药剂师的看法。参与调查的人员包括主治医生、高级执业护士、注册护士、执业护士、医疗助理和患者护理助理。汇总统计以频率和百分比的形式报告。统计分析使用 SAS 9.4 版进行:共发放了 58 份筛选前调查问卷和 56 份筛选后调查问卷。筛选前调查的回收率为 79.3%(46 人),筛选后调查的回收率为 80.4%(45 人)。超过 90% 的受访者对诊所中的持证药剂师和特权药剂师有好感。在实施药剂师特权后,受访者对药剂师在用药问题上所花费时间的看法存在明显差异(p = 0.0296):结论:儿科初级保健网络中获得资格认证和特权的药剂师受到诊所团队成员的好评,并能对诊所的工作量产生积极影响。
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引用次数: 0
Comparing English- and Spanish-Reading Patients' Comprehension of the Drug Facts Label for a New Over-The-Counter Oral Contraceptive. 比较阅读英语和西班牙语的患者对新型非处方口服避孕药药品说明书标签的理解。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-08-01 DOI: 10.1016/j.japh.2024.102197
Aishwarya G Venkatachalam, Brock T Davis, Michelle A Adgalanis, Gicella Garcia, Ashley H Meredith

Background: Health literacy is known to impact health outcomes in a multitude of ways and is impacted by language barriers. Lower health literacy is also associated with higher rates of unintended pregnancies. A progestin-only oral hormonal contraception product, norgestrel (Opill-Perrigo), was approved for over-the-counter (OTC) use in the United States in July 2023.

Objective: (s): The objective was to utilize a knowledge assessment survey to determine participants' comprehension of norgestrel from its drug facts label and compare the comprehension between primarily English- and Spanish-reading participants.

Methods: A 7-item knowledge assessment was developed and distributed to English and Spanish readers at one site within a network of federally qualified health centers. English-reading participants completed the English survey alongside use of an English copy of norgestrel's drug facts label. Spanish-reading participants completed the Spanish survey and were randomized in a 1:1 fashion to either receive an English or Spanish copy of norgestrel's drug facts label.

Results: The English-reading/English label (E/E) group had a higher level of comprehension of norgestrel's drug facts label compared to the Spanish-reading/English label (S/E) or Spanish-reading/Spanish label (S/S) groups.

Conclusion: Differences exist in OTC label comprehension for norgestrel based on primary language able to be read. Advocacy for OTC labels to be readily available in languages other than English is imperative to mitigate unintended pregnancies associated with lower levels of health literacy.

背景:众所周知,健康素养以多种方式影响健康结果,并受到语言障碍的影响。较低的健康素养也与较高的意外怀孕率有关。一种纯孕激素口服荷尔蒙避孕产品诺孕酮(Opill-Perrigo)于2023年7月获准在美国非处方药(OTC)中使用:方法: 在联邦合格医疗中心网络内的一个站点,开发并向英语和西班牙语读者分发了 7 个项目的知识评估。阅读英语的参与者在完成英语调查的同时,还使用了一份诺孕瑞药物说明书的英文副本。阅读西班牙文的参与者完成西班牙文调查,并以 1:1 的方式随机选择接受英文版或西班牙文版的诺孕瑞药物说明书标签:结果:英文阅读/英文标签组(E/E)与西班牙文阅读/英文标签组(S/E)或西班牙文阅读/西班牙文标签组(S/S)相比,对诺孕素药品说明书标签的理解程度更高:结论:诺孕酮的非处方药标签理解能力存在差异,主要取决于能阅读的语言。为了减少因健康知识水平较低而导致的意外怀孕,必须倡导非处方药标签使用英语以外的语言。
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引用次数: 0
Exploring perspectives on vaccinations delivered in complementary nonclinical settings and by nonphysician health professionals: A qualitative interview study 探索对在非临床辅助环境下由非医生医护人员提供疫苗接种的看法:定性访谈研究。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-30 DOI: 10.1016/j.japh.2024.102193
Amanda L. Eiden, Claire Cagle, Kaitlyn Esselman, Richard Murphy, Erik Muther, Suepattra G. May, Rozanne Wilson, Alexandra Bhatti

Background

Although vaccines are an effective solution for preventing infectious disease, some vaccination rates remain below national targets, creating a need to increase vaccination access and uptake. A potential solution to improve vaccination rates is the implementation of policies that allow for more convenient vaccination access, such as the expansion of vaccination delivery by nonphysician healthcare providers (NPHPs) outside of traditional clinical settings.

Objective

To understand perspectives on vaccine administration at complementary sites (such as pharmacies, mobile clinics, and pop-up clinics) by NPHPs, and the barriers surrounding administration.

Methods

We performed interviews with healthcare providers and vaccination policy experts to elicit perspectives on including vaccination program scope, facilitators and barriers to NPHPs administering vaccines, and recommendations for improvement of vaccine administration. Eligible participants were required to either work directly in vaccination administration or work in vaccination policy.

Results

Thirty-eight participants completed interviews. Participants reported that U.S. individuals have a positive view of vaccination at complementary sites and by NPHPs, especially since the COVID-19 pandemic, where vaccination was often performed by NPHPs at complementary sites. Concerns expressed by participants included language barriers, out-of-pocket costs, and mistrust among marginalized communities. Participants described the complexity of state and local regulations, particularly scope of practice laws, as a barrier to implementation of NPHP vaccination programs at complementary sites.

Conclusion

NPHPs and vaccination advocates report that complementary sites represent a potentially important step to ensuring broader, more equitable vaccination service in the United States.

目的了解非医生医疗保健提供者(NPHPs)在辅助场所(如药房、流动诊所和临时诊所)接种疫苗的情况,以及接种疫苗的相关政策/障碍:我们对医疗保健提供者 (HCP) 和疫苗接种政策专家进行了访谈,以了解他们对疫苗接种计划范围、非医师医疗保健提供者接种疫苗的促进因素和障碍以及改进疫苗接种的建议等方面的看法。符合条件的参与者必须直接从事疫苗接种管理工作或从事疫苗接种政策工作:38 位参与者完成了访谈。参与者报告说,美国人对在补充接种点接种疫苗和由国家专业保健人员接种疫苗持积极态度,尤其是自 COVID-19 大流行以来,疫苗接种通常由国家专业保健人员在补充接种点进行。与会者表达的担忧包括语言障碍、自付费用以及边缘化社区的不信任。与会者认为,州和地方法规的复杂性,尤其是执业范围法,是在补充点实施 NPHP 疫苗接种计划的障碍:NPHP 和疫苗接种倡导者称,补充站点是确保美国更广泛、更公平的疫苗接种服务的重要一步。
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引用次数: 0
Expanding public health initiatives through community pharmacies and student pharmacists: A programmatic case study 通过社区药房和学生药剂师扩大公共卫生倡议:项目案例研究。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-23 DOI: 10.1016/j.japh.2024.102191
Sophia M.C. Herbert, Bonnie Falcione, Megan Hutar, Melissa McGivney, Joni C. Carroll

Background

Community pharmacies are critical to the public health infrastructure in the United States and provide reliable information for public health concerns. Public health agencies curate educational materials that community pharmacy teams can disseminate. Student pharmacists participate in experiential learning at community pharmacies which could be utilized for dissemination of these resources.

Objectives

The objectives of this project were to (1) design a model for dissemination of public health information at community pharmacies; and (2) evaluate both the dissemination model’s reach within communities and student pharmacist learnings from engagement in the model.

Methods

We engaged student pharmacists in a model to disseminate information at community pharmacies for 2 Centers for Disease Control and Prevention initiatives about Opioid Use Disorder Anti-Stigma and Antibiotic Stewardship Education. The number of pharmacies and student pharmacists who participated from 2021 from 2023 was retrospectively reviewed to demonstrate programmatic reach. A retrospective text mining of student assignments was conducted to evaluate student experiences. Descriptive statistics were used to report quantitative data. An inductive, rapid content analysis was completed for qualitative data.

Results

Across 3 years, 333 student pharmacists participated. Students reached 121 community pharmacies, 139 practicing pharmacist preceptors, and over 2000 patients with education and resources. Eleven student learning points emerged from the qualitative analysis. These included learnings around opioid use disorder and antibiotic stewardship. Students also acknowledged that there are public health needs present in communities and that community pharmacy teams are well-positioned to address these needs.

Conclusion

Engaging student pharmacists to distribute curated information from public health authorities, both to pharmacist preceptors and patients at community pharmacies, is one way to educate future pharmacists, pharmacy teams, and communities on public health priorities. Pharmacies can serve as key venues in communities for dissemination of reliable public health information.

背景:社区药房对美国的公共卫生基础设施至关重要,可为公共卫生问题提供可靠的信息。公共卫生机构策划了社区药房团队可以传播的教育材料。学生药剂师参与了社区药房的体验式学习,这些药房可用于传播这些资源:本项目的目标是(1) 设计一种在社区药房传播公共卫生信息的模式;(2) 评估该传播模式在社区内的覆盖范围以及学生药剂师在参与该模式中学到的知识:方法: 我们让学生药剂师参与到社区药房的信息传播模式中,以宣传美国疾病控制和预防中心的两项倡议:阿片类药物使用障碍反羞辱和抗生素管理教育。对 2021-2023 年期间参与活动的药房和学生药剂师的数量进行了回顾性审查,以证明活动的覆盖范围。对学生作业进行了回顾性文本挖掘,以评估学生的体验。描述性统计用于报告定量数据。对定性数据进行了归纳式快速内容分析:结果:在三年中,共有 333 名学生药剂师参与其中。学生向 121 家社区药房、139 名执业药剂师实习生和 2000 多名患者提供了教育和资源。定性分析得出了 11 个学生学习要点。其中包括与阿片类药物使用障碍和抗生素管理有关的学习内容。学生们还认识到,社区存在公共卫生需求,而社区药学团队完全有能力满足这些需求:让学生药剂师参与向社区药房的药剂师实习生和患者分发公共卫生机构提供的经过整理的信息,是对未来的药剂师、药房团队和社区进行公共卫生优先事项教育的一种方式。药房可以作为社区传播可靠公共卫生信息的重要场所。
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引用次数: 0
The community pharmacist as an independent prescriber: A scoping review 社区药剂师作为独立处方者:范围界定审查。
IF 2.5 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-07-22 DOI: 10.1016/j.japh.2024.102192
Arthur Piraux, Dylan Bonnan, Aline Ramond-Roquin, Sébastien Faure

Background

Due to the shortage of professionals and the ever-increasing need for and demand for appointments, consultation with physicians is becoming increasingly difficult, and delays are increasing. To limit this issue, several countries have experimented with different models of independent prescribing through pharmacies.

Aim

This study aimed to analyze the contribution of independent prescribing by community pharmacists in primary care using a micro, meso, and macrolevel framework.

Method

This was a scoping review of 3 different databases: Medline, Scopus, and Embase. The search (all databases) was executed on May 14, 2024. To be selected for the review, articles needed to be published after 2000, written in English or French, and focused on independent prescribing by community pharmacists. The articles had to investigate the pharmacist-independent prescribing (PIP) efficacy, effectiveness, or efficiency. Only original research was included. The bibliographies of the included papers were reviewed for additional studies. The articles were imported into Covidence to perform the review.

Results

The search yielded 2802 articles, and 1062 remained after removing duplicates. Finally, 13 studies were included in the scoping review. As an independent prescriber, the community pharmacist can improve patient access to primary care, reducing treatment delays (microlevel). In addition, patient safety is maintained, and patients’ quality of life is increased. Giving the community pharmacist an extra role helps reduce the workload on physicians, and thus facilitates access to care (mesolevel). The PIP model seems to be cost-effective for society and avoid medical consultations (macrolevel).

Conclusion

This review highlights the potential value and relevance of pharmacist-independent prescribers. Minor ailment services were frequently described, but PIP has also been implemented for chronic conditions. The benefits to society are felt at all levels: micro, meso, and macro. Its effectiveness and efficacy have been established, but additional studies are needed, particularly on its efficiency.

背景:由于专业人员短缺,预约需求不断增加,向医生咨询变得越来越困难,延误也越来越多。目的:本研究旨在利用微观、中观和宏观框架,分析社区药剂师独立开具处方在初级保健中的贡献:本研究对三个不同的数据库进行了范围界定:Medline、Scopus 和 Embase。搜索(所有数据库)于 2024 年 5 月 14 日完成。文章必须发表于 2000 年之后,用英语或法语撰写,并以社区药剂师的独立处方为主题。文章必须调查药剂师独立处方 (PIP) 的功效、效果或效率。文章只包括原创性研究。我们还查阅了所收录论文的参考书目,以了解其他研究。这些文章被导入 Covidence 进行审查:结果:搜索结果为2802篇文章,去除重复文章后剩余1062篇。最后,13 项研究被纳入范围审查。作为独立处方者,社区药剂师可以改善患者获得初级医疗服务的机会,减少治疗延误(微观层面)。此外,还能维护患者安全,提高患者生活质量。让社区药剂师发挥额外作用,有助于减轻医生的工作量,从而方便患者获得医疗服务(中观层面)。PIP 模式似乎对社会具有成本效益,并可避免医疗咨询(宏观层面):本综述强调了药剂师独立处方的潜在价值和相关性。轻微疾病服务经常被提及,但 PIP 也被用于慢性疾病。社会效益体现在各个层面:微观、中观和宏观。PIP 的有效性和效力已经得到证实,但还需要进行更多的研究,特别是关于其效率的研究。
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引用次数: 0
期刊
Journal of the American Pharmacists Association
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