Journal of the American Pharmacists Association最新文献

{"title":"Characterization of kratom use and knowledge at a rural, Oregon community health center","authors":"Kerri (Raven) Cauldron,&nbsp;Natalea Suchy,&nbsp;Adriane N. Irwin","doi":"10.1016/j.japh.2024.102138","DOIUrl":"10.1016/j.japh.2024.102138","url":null,"abstract":"<div><h3>Background</h3><p>Kratom is an herbal supplement that has drawn attention for its use in the self-treatment of opioid withdrawal, and its widespread availability with minimal restrictions. Past Web-based research has attempted to determine patterns and trends of use, but generalizability to underserved populations is unclear.</p></div><div><h3>Objective</h3><p>The purpose of this study was to characterize behavior related to kratom, attitudes toward kratom, and knowledge of kratom in a rural, underserved population.</p></div><div><h3>Methods</h3><p>We developed, refined, and administered a cross-sectional, 36-item survey to examine use, attitudes, and knowledge of kratom. We recruited participants and administered the survey alongside medical office appointments between January and April 2023. Data were summarized using descriptive statistics.</p></div><div><h3>Results</h3><p>A convenient sample of 186 patients (of the 907-patient clinic panel) were invited to participate and 150 returned the survey. Most patients were female (52.0%) and white (86.6%), and approximately half had an income below the federal poverty level (48.5%). Seventeen participants reported previous experience with kratom use, with one actively using kratom. The most commonly reported reasons for use were pain (47.1%) and mental health (41.2%). Kratom knowledge was low regardless of kratom use history, with most respondents correctly answering between 1 and 3 questions (n = 71 of 86; 82.3%) of the 5 knowledge-focused items.</p></div><div><h3>Conclusion</h3><p>Results suggest that although active kratom use is uncommon in this Oregon population, 1 in 10 surveyed had used kratom. Regardless of past use, respondents had limited knowledge of kratom. Future research should focus on understanding trends in kratom use behaviors in underserved populations, addressing patient knowledge gaps, and evaluating patient safety and health equity implications.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201234","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}

{"title":"Medicare medication therapy Management: Beneficiary characteristics and utilization patterns in a national CMS Medicare fee-for-service sample (2013 to 2016)","authors":"Ximena Oyarzún-González,&nbsp;Erin L. Abner,&nbsp;Patricia Freeman,&nbsp;Anna Kucharska-Newton,&nbsp;David W. Fardo,&nbsp;Daniela C. Moga","doi":"10.1016/j.japh.2024.102140","DOIUrl":"10.1016/j.japh.2024.102140","url":null,"abstract":"<div><h3>Background</h3><p>The Medicare Medication Therapy Management (MTM) program has been available to eligible Medicare Part D beneficiaries since 2006, but research regarding program utilization and characterization is limited.</p></div><div><h3>Objective</h3><p>To describe enrollee and MTM program characteristics in a national sample of Medicare fee-for-service (FFS) beneficiaries (2013 to 2016).</p></div><div><h3>Methods</h3><p>Using a 5% random sample of Medicare FFS beneficiaries, we conducted a descriptive time series analysis to examine annual MTM enrollment and describe the type of MTM criteria at enrollment (Center for Medicare and Medicaid Services [CMS] vs. expanded). We investigated the offer of Comprehensive Medication Review (CMR) along with CMR receipt status, and delivery characteristics, as well as frequencies of Target Medication Reviews (TMRs).</p></div><div><h3>Result</h3><p>Beneficiaries who met CMS enrollment criteria, compared to those eligible under expanded criteria, were significantly older, more likely to be of white race, more likely to be female, and had a significantly higher number of comorbidities. Of those meeting CMS criteria, the proportion receiving TMR increased from 95% in 2013% to 98.1% in 2016, and over 97% were offered a CMR. Although the proportion of beneficiaries offered a CMR was stable over the study period, the proportion who received a CMR increased from 17% in 2013% to 35.4% in 2016. Telephone CMR delivery was the most common method used (87.8% to 89.1% of CMRs over the study period). Over 95% of the CMRs were delivered by a pharmacist.</p></div><div><h3>Conclusion</h3><p>During the years 2013 to 2016, enrollment in the MTM program increased, as did the proportion of enrollees receiving TMRs and CMRs. However, uptake remained low and the main factors driving participation remain unclear. Significant differences in demographic characteristics between beneficiaries enrolled under the CMS MTM enrollment criteria and the expanded criteria suggest the need to further investigate the optimal provision of such programs.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1544319124001602/pdfft?md5=e789500eb47b6ec4fbdd1def2bdf12f9&pid=1-s2.0-S1544319124001602-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201239","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}

{"title":"Such a time as this","authors":"Valerie Prince PharmD, BCPS, FAPhA","doi":"10.1016/j.japh.2024.102133","DOIUrl":"10.1016/j.japh.2024.102133","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201241","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}

{"title":"2024 Pharmacy Quality Alliance (PQA) Annual Meeting, May 14-16, 2024, Baltimore, MD","authors":"","doi":"10.1016/j.japh.2024.102074","DOIUrl":"https://doi.org/10.1016/j.japh.2024.102074","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141164546","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}

{"title":"The journey of a young Afghan girl and her career path as a palliative care pharmacist","authors":"Rabia Samady Atayee","doi":"10.1016/j.japh.2024.102132","DOIUrl":"10.1016/j.japh.2024.102132","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141140882","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}

{"title":"Pharmacists’ awareness and confidence in performing Pharmacists’ Patient Care Process–related activities","authors":"Marwa Noureldin,&nbsp;Brittany Melton","doi":"10.1016/j.japh.2024.102129","DOIUrl":"10.1016/j.japh.2024.102129","url":null,"abstract":"<div><h3>Background</h3><p>The Pharmacists’ Patient Care Process (PPCP) is a 5-step approach for patient-centered evidence-based pharmaceutical care. The PPCP was developed by the Joint Commission of Pharmacy Practitioners in 2014; however, little is known about PPCP terminology and process uptake across the profession.</p></div><div><h3>Objectives</h3><p>This study aimed to explore practicing pharmacists’ awareness of and confidence in performing PPCP-related activities in various practice settings.</p></div><div><h3>Methods</h3><p>This is a cross-sectional observational study of practicing pharmacists using a multiphase quantitative survey research design. A previously validated instrument, the PPCP Self-Efficacy Scale, was revised and distributed. The 28-item instrument addressed activities mapped to each of the 5 PPCP components (Collect, Assess, Plan, Implement, and Follow-Up). The survey was distributed via Qualtrics to an IQVIA pharmacist e-mail listserv in 2021 and to pharmacist state license rosters containing e-mail addresses in 2022.</p></div><div><h3>Results</h3><p>A total 853 practicing pharmacists completed the survey. Most participants identified as female (62.5%) and white (74.6%). Almost 60% of participants reported practicing for 16 or more years. Forty-four percent practiced in a community pharmacy setting, whereas 23.6% and 15.4% practiced in a health-system setting and ambulatory care setting, respectively. Sixty-two percent indicated they had no previous knowledge of the PPCP, and 12.5% were unsure. Overall participants had relatively high self-efficacy mean scores for each of the PPCP components. Participants working in an ambulatory care setting had the highest mean self-efficacy scores across all PPCP components (<em>P</em> &lt; 0.05). Participants who were affiliated with a college or school of pharmacy (e.g., faculty, preceptor) had higher mean self-efficacy scores than participants who were not affiliated (<em>P</em> &lt; 0.01).</p></div><div><h3>Conclusion</h3><p>Most of practicing pharmacists are unaware of PPCP terminology. Their confidence in performing tasks associated with PPCP components is relatively high and varies based on PPCP component and practice setting.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141137773","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}

{"title":"Racial and ethnic inequities in spatial access to pharmacies: A geographic information system analysis","authors":"Giovanni Appolon,&nbsp;Shangbin Tang,&nbsp;Nico Gabriel,&nbsp;Jasmine Morales,&nbsp;Lucas A. Berenbrok,&nbsp;Andrea Z. LaCroix,&nbsp;Jingchuan Guo,&nbsp;Walter S. Mathis,&nbsp;Inmaculada Hernandez","doi":"10.1016/j.japh.2024.102131","DOIUrl":"10.1016/j.japh.2024.102131","url":null,"abstract":"<div><h3>Background</h3><p>Pharmacy accessibility is crucial for equity in health care access because community pharmacists may reach individuals who do not have access to other health care providers.</p></div><div><h3>Objective</h3><p>The objective of this study was to determine whether spatial access to pharmacies differs among racial/ethnic groups across the rural-urban continuum.</p></div><div><h3>Methods</h3><p>We obtained a 30% random sample of the Research Triangle Institute synthetic population, sampled at the census block level. For each individual, we defined optimal pharmacy access as having a driving distance ≤2 miles to the closest pharmacy in urban counties, ≤5 miles in suburban counties, and ≤10 miles in rural counties. We used a logistic regression model to measure the association between race/ethnicity and pharmacy access, while controlling for racial/ethnic composition of the census tract, area deprivation index, income, age, gender, and U.S. region. The model included an interaction between race/ethnicity and urbanicity to evaluate whether racial/ethnic inequities differed across the rural-urban continuum.</p></div><div><h3>Results</h3><p>The sample included 90,749,446 individuals of whom 80.6% had optimal pharmacy access. Racial/ethnic inequities in pharmacy access differed across the rural-urban continuum (<em>P</em> value for interaction= &lt;0.0001). In rural areas, Black (OR 0.87; 95% CI 0.86-0.87), Hispanic (OR 0.80; 95% CI 0.79-0.80), and indigenous (OR 0.47; 95% CI 0.47-0.48) individuals had lower odds of optimal pharmacy access, than White individuals. Hispanic (OR 0.96; 95% CI 0.96-0.97) and Indigenous individuals (OR 0.75; 95% CI 0.75-0.76) had lower odds of optimal pharmacy access compared to White individuals in suburban areas. In Western states, Asian had lower odds of optimal pharmacy access in suburban (OR 0.88; 95% CI 0.86-0.90) and rural areas (OR 0.91; 95% CI 0.87-0.95) compared to White individuals.</p></div><div><h3>Conclusions</h3><p>Racial/ethnic inequities in spatial access to community pharmacies vary between urban and rural communities. Underrepresented racial/ethnic groups have significantly lower pharmacy access in rural and some suburban areas, but not in urban areas.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141130808","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}

{"title":"All In. Together","authors":"Alex C. Varkey","doi":"10.1016/j.japh.2024.102125","DOIUrl":"10.1016/j.japh.2024.102125","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088545","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}

{"title":"Pen needle use patterns in an insured population with diabetes: U.S. retrospective claims analysis","authors":"Laura Lupton,&nbsp;Xiaowu Sun,&nbsp;Pasha Javadi,&nbsp;Jennifer D. Goldman,&nbsp;Susan Cornell,&nbsp;Joaquim Fernandes,&nbsp;Sudha Kishorekumar,&nbsp;Andrew Thach,&nbsp;Ray Sieradzan","doi":"10.1016/j.japh.2024.102124","DOIUrl":"10.1016/j.japh.2024.102124","url":null,"abstract":"<div><h3>Background</h3><p>People with diabetes who inject insulin with pen devices may reuse the pen needles (PNs), a practice that can cause PN tip deformity, breakage, and contamination, and that is associated with lipohypertrophy and injection-related pain.</p></div><div><h3>Objective</h3><p>This retrospective study aimed to estimate the extent of PN reuse among people with diabetes in 2 insured populations in the United States.</p></div><div><h3>Methods</h3><p>Using claims data for Commercial Fully Insured (CFI) and Medicare Advantage (MA) populations from 1-Oct-2018 to 31-Dec-2022, we identified adults with type 1 or type 2 diabetes (T1D/T2D) who had ≥ 1 claim for PNs and ≥ 2 claims for insulin from 1-Jan-2019 to 31-Dec-2021, with continuous medical/pharmacy eligibility for 3 months before first claim and 1 year after (follow-up). Those receiving hospice or palliative care or using mail order prescriptions were excluded. We compared actual annual fill rate of PNs with expected fill rate (assuming single use) according to prescribed insulin regimen. Whether the annual actual-to-expected ratio for PN numbers equaled 1 was evaluated using sign tests with 2-sided <em>P</em> values.</p></div><div><h3>Results</h3><p>Median annual actual-to-expected ratios ranged from 0.41 (T1D basal+prandial cohort) to 0.82 (T2D basal cohort; all <em>P</em> &lt; 0.001) in the CFI population (N = 10,854), and from 0.55 (TID basal + prandial) to 1.10 (T2D basal and basal + prandial; <em>P</em> = 0.382-&lt; 0.001) in the MA population (N = 32,495); medians were 0.34 and 0.55 for 4 expected T2D basal + prandial injections/day in CFI and MA populations, respectively (<em>P</em> &lt; 0.001). Annual actual-to-expected ratios were &lt; 1 for 62% and 47% of CFI and MA populations, respectively. An estimated 2%-27% and 0%-17%, respectively, depending on insulin regimen, had inadequate supplies of PNs suggesting that PNs could have been used ≥ 5 times.</p></div><div><h3>Conclusion</h3><p>These findings highlight the need for educating people with diabetes about reasons for avoiding PN reuse and the key role that pharmacists can play in providing this information and adequate supplies of PNs.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1544319124001444/pdfft?md5=cdada9b6004302e9f1da9a4695c6da44&pid=1-s2.0-S1544319124001444-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960467","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}

{"title":"Analyzing override patterns in profiled automated dispensing cabinets at a tertiary care hospital in Saudi Arabia","authors":"Esam Mohamed Said,&nbsp;Imraan Joosub,&nbsp;Moustafa M. Elashkar,&nbsp;Khaled F. Albusaysi,&nbsp;Khalid Refi","doi":"10.1016/j.japh.2024.102123","DOIUrl":"10.1016/j.japh.2024.102123","url":null,"abstract":"<div><h3>Background</h3><p>Inappropriate automated dispensing cabinet (ADC) overrides pose a significant risk to patient safety. Bypassing pharmacist review during these overrides removes a vital safety check, leaving nurses to review complex medication orders alone. This can lead to overlooking incorrect orders and significantly increasing the potential for medication errors. While Institute for Safe Medication Practices (ISMP) guidelines promote profiled ADCs and safe override practices, there is no national standard for acceptable override rates.</p></div><div><h3>Objectives</h3><p>Assessing the appropriateness of ADC overrides of profiled ADCs at a tertiary hospital in Saudi Arabia in accordance with ISMP guidelines (third core safety process).</p></div><div><h3>Methods</h3><p>This retrospective observational study reviewed all override transactions for 13 profiled ADCs over a 3-month period, from 1 October 2022 until 31 December 2022. The target override rate was set at no more than 5%. After applying exclusions, the relevant data fields were extracted from electronic records of 2 integrated systems: the Omnicell dashboard and the BESTCare hospital information system. The study assessed whether the override transactions complying with the standard elements required for appropriate ADC overrides in accordance with ISMP recommendations and hospital regulations.</p></div><div><h3>Results</h3><p>Six hundred sixty-four override transactions from profiled ADCs were reviewed and evaluated. Although the overall override limit for profiled ADCs was met (1.9%), multiple inappropriate override practices were revealed. These inappropriate practices are missing physician orders (33.7%), undocumented verbal orders (31.5%), nonurgent physician orders (11%), missing (8.4%) or delayed (33.7%) administration records, and unrecognized override errors (5.3%). Only 3 (0.5%) met all the standard elements required for ADC overrides.</p></div><div><h3>Conclusion</h3><p>The target override threshold of 5% is inadequate to demonstrate sufficient adherence to the standard elements of appropriate overrides or effectively prevent medication errors. Consequently, a significantly lower target threshold override limit, well below 5%, should be considered, especially with 24-hour pharmacy services and fully integrated computerized physician order entry with ADC system. A multidisciplinary override surveillance team is considered essential.</p></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913288","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}