Journal of the American Pharmacists Association最新文献

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Availability of and attitudes toward harm reduction services: A rural pharmacy perspective. 减低伤害服务的可用性和态度：农村药房的视角。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-11-16 DOI: 10.1016/j.japh.2024.102291

Grace Marley, Erin Blythe, Salisa Westrick, Delesha M Carpenter

Background: There's limited information available about the range of harm reduction (HR) services provided by rural pharmacies.

Objective: This study's objectives are to describe the types of HR services offered by rural pharmacies and examine pharmacists' attitudes and willingness to offer those services.

Methods: A cross-sectional online survey was sent to pharmacists who are members of a practice-based research network for rural community pharmacies. Pharmacists reported the frequency to which their pharmacy engage in as well as their willingness to offer the following HR services: naloxone dispensing; buprenorphine dispensing; point of care testing for human immunodeficiency virus (HIV) and Hepatitis C (HCV); and nonprescription syringe (NPS) sales. Also, pharmacists' knowledge and willingness to sell drug test strips and attitudes toward people who inject drugs (PWIDs) were assessed. Descriptive statistics were calculated.

Results: A total of 61 pharmacists completed the survey (completion rate = 45.2%). Most reported dispensing naloxone 2-3 times per month (90.2%), and a third dispensed buprenorphine daily (32.8%). Only one pharmacy offered HIV testing, and none offered HCV testing. Most pharmacies (65.6%) had a policy regarding the sale of NPS, with 21.3% reporting they never dispense nonprescription syringes. Many pharmacists were willing to sell fentanyl test strips (67.2%) and xylazine test strips (50.8%). Pharmacists' most negative attitudes related to believing PWID customers make other customers feel uncomfortable and that providers keep patients on buprenorphine for too long.

Conclusion: Many rural community pharmacists engage in HR services and are willing to offer more. However, stigmatizing attitudes highlight the need for pharmacy-focused HR training to reduce stigma and increase knowledge.

背景：关于农村药店提供的减低伤害（HR）服务范围的信息很有限：本研究的目的是描述农村药店提供的减低危害服务的类型，并考察药剂师提供这些服务的态度和意愿：我们向农村社区药房实践研究网络成员中的药剂师发送了一份横断面在线调查。药剂师报告了其药房提供以下人力资源服务的频率和意愿：纳洛酮配药；丁丙诺啡配药；人体免疫缺陷病毒（HIV）和丙型肝炎（HCV）的护理点检测；以及非处方注射器（NPS）销售。此外，还评估了药剂师销售药物试纸的知识和意愿以及对注射吸毒者（PWID）的态度。结果共有 61 名药剂师完成了调查（完成率= 45.2%）。大多数药剂师表示每月发放纳洛酮 2-3 次（90.2%），三分之一的药剂师每天发放丁丙诺啡（32.8%）。只有一家药房提供 HIV 检测，没有一家药房提供 HCV 检测。大多数药房（65.6%）都制定了有关销售非处方药的政策，其中 21.3% 的药房表示他们从不配发非处方药注射器。许多药剂师愿意销售芬太尼试纸（67.2%）和异丙嗪试纸（50.8%）。药剂师最消极的态度是认为感染艾滋病病毒者的顾客会让其他顾客感到不舒服，以及服务提供者让患者服用丁丙诺啡的时间过长：许多农村社区药剂师从事人力资源服务，并愿意提供更多服务。结论：许多农村社区药剂师参与了人力资源服务，并愿意提供更多服务。然而，鄙视态度突出表明，需要开展以药剂学为重点的人力资源培训，以减少鄙视并增加知识。

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引用次数: 0

Pharmacy 2050: A new clinical and patient experience 药房 2050：全新的临床和患者体验。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

Pub Date : 2024-11-08 DOI: 10.1016/j.japh.2024.102290

George Bernard Van Antwerp Jr.

With the changing demographics of the U.S. population and evolving shift in urban design, the physical experience at the community level will change how health care is delivered. This will allow for more personalized and localized care complemented by digital technologies and smart devices over the next 25 years. At the same time, the evolution of clinical research with prevention, vaccinations, 3-dimensional printing, drone delivery, clustered interspaced short palindromic repeats, and implantables, will change the pharmaceutical landscape.

Pharmacists and pharmacies have an opportunity to evolve with these changes making their role an integral part of the care team, but it is important that regulations and reimbursement also change. By 2050, pharmacists may play very different roles from clinical specialists to digital coaches and use data, artificial intelligence, and technology to help drive outcomes whereas robots and technology automate many of their current repetitive tasks.

随着美国人口结构的变化和城市设计的发展，社区层面的实际体验将改变医疗服务的提供方式。这将在未来 25 年内实现更加个性化和本地化的医疗服务，并辅以数字技术和智能设备。同时，临床研究与预防、疫苗接种、3D 打印、无人机投递、CRISPR 和植入式设备的发展将改变制药业的格局。药剂师和药房有机会随着这些变化而发展，使自己的角色成为医疗团队中不可或缺的一部分，但重要的是法规和报销也要发生变化。到 2050 年，药剂师可能会扮演非常不同的角色，从临床专家到数字教练，并利用数据、人工智能和技术来帮助推动治疗效果，同时机器人和技术将他们目前的许多重复性任务自动化。

引用次数: 0

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

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

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

Rebecca M. Lahrman

引用次数: 0

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

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

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

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

Background

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

Objective

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

Methods

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

Results

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

Conclusion

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

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

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引用次数: 0

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

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

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

Diana D. Martínez-Nava BA, BS

引用次数: 0

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

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

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

Heather A. Johnson PharmD, BCACP

引用次数: 0

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

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

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

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

引用次数: 0

Cover 封面

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

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

引用次数: 0

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

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

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

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

Background

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

Objectives

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

Methods

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

Results

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

Conclusion

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

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

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引用次数: 0

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

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association

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

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

Background

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

Objective

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

Methods

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

Results

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

Conclusion

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

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

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