Journal of the American College of Clinical Pharmacy : JACCP最新文献

Pharmacists in all settings are continually expanding their roles and responsibilities and advocating for the profession. Pharmacists, as medication experts, are trained to identify and resolve medication therapy problems. The act of providing clinical pharmacist expertise is not tied to a specific practice setting, but rather is the mindset in which a pharmacist approaches patient-centered practice. In community-based pharmacy settings, pharmacists have been providing clinical services for years through Medication Therapy Management (MTM) and other enhanced services which prioritize quality care. This manuscript will outline the history of the pharmacist's role in managing patients utilizing MTM, present evidence of positive patient care outcomes from pharmacist-led services in the community-based setting, and provide recommendations for United States payers to acknowledge and increase payment for pharmacist-led services. This paper represents the opinion of the Community-Based Practice and Research Network of the American College of Clinical Pharmacy (ACCP) in the United States. It does not necessarily represent an official ACCP commentary, guideline, or statement of policy or position.

Cognitive impairment affects around 19% of community-dwelling older adults in the United States. Pharmacists can play a significant role in identifying and deprescribing cognitive-impairing medications through cognitive-focused medication reviews or as part of comprehensive medication management. Multiple tools exist to help pharmacists and other practitioners identify these medications, yet a comprehensive description of these tools has not been undertaken. We searched EBSCO MEDLINE, PubMed, EMBASE, CINAHL, and PsycInfo from inception to August 4, 2023, using search terms relative to medications and cognition. Studies were included if they detailed a tool to assess the cognitive burden of a medication regimen. Abstracts and full texts were screened independently and in duplicate. Any disagreements at the level of full-text screening were resolved by consensus. Eligible studies underwent data extraction by two authors independently and in duplicate using a data extraction form. Our search identified 13 126 articles of which only four tools were initially included. Additionally, we identified seven articles from the reference lists of excluded review articles for a final inclusion count of 11 tools. Articles were published between 2001 and 2017. Nine of 11 tools (82%) were focused solely on anticholinergic medications, while only one tool indicated a clinically relevant cutoff value and alternative medication recommendations. While there are many tools to assess the cognitive burden from medications, many are limited by the development date, focus on anticholinergic medications, or lack clinically useful information. Further research is needed to develop more comprehensive, up-to-date, and readily implementable tools that clinical pharmacists can utilize to assess medication-induced cognitive risks. Such as tool could be applied by pharmacists in many settings to optimize medication use and improve patient outcomes.

Responding to the changing landscape of health care is a critical responsibility of the American College of Clinical Pharmacy (ACCP). Aligned with its mission of extending the frontiers of clinical pharmacy, ACCP is committed to embracing diversity and inclusion as a core value. Creating a comprehensive organizational strategy reflecting the College's authentic endeavors to embrace the tasks required is an ongoing effort. ACCP is embracing an inclusive vision whereby all members can feel welcomed, valued, respected, and heard. Belief that the journey will bring diverse voices, leadership, and understanding for all clinical pharmacists sustains the College's motivation toward this goal. In this commentary, we, as past presidents of ACCP, are learning the challenges related to this endeavor and systematically addressing each issue. Each ACCP member is an essential partner as the College strives toward being an inclusive organizational home for all clinical pharmacists. This commentary summarizes the rationale for this work and the alignment of ACCP's efforts with its core values. We must remain firm in our belief that inclusive clinical pharmacy leaders can recognize diversity and equity gaps, mobilize as advocates to amplify underrepresented voices, and transform hope into action for future generations.

Type 2 diabetes (T2D) affects over 38 million Americans, leading to significant health complications and substantial healthcare costs. Novel antidiabetic medications, such as SGLT2 inhibitors and GLP-1 receptor agonists, have shown promise in improving glycemic control and reducing cardiovascular risks. However, their underuse, particularly among minority populations, remains a concern. This review examines the impact of structural factors, including socioeconomic determinants and historical practices like redlining, on the utilization of new antidiabetic agents. Disparities in T2D outcomes are driven by inadequate access to care and neighborhood characteristics. Addressing these issues requires comprehensive strategies, including the integration of pharmacist support to enhance medication adherence and overall T2D management. Understanding the influence of structural racism on healthcare disparities is crucial for improving access and outcomes for all patients.