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

{"title":"Comprehensive Medication Reviews for Adults With Intellectual or Developmental Disabilities","authors":"Steven R. Erickson,&nbsp;Ariana Nigoghosian,&nbsp;Brianna Marzolf,&nbsp;Beatrice Palazzolo,&nbsp;Dawn Michael,&nbsp;Muhammad Othman,&nbsp;Michael M. McKee","doi":"10.1002/jac5.70120","DOIUrl":"https://doi.org/10.1002/jac5.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>People with intellectual or developmental disabilities face an elevated risk of adverse medication and health outcomes due to polypharmacy, medication interactions, and adherence issues. This study's objective was to assess the feasibility of virtual and in-home comprehensive medication reviews (CMRs) to identify and, when necessary, intervene on medication-related problems (MRPs) among patients with intellectual or developmental disabilities (IDD) residing in community group homes and to assess the caregivers' satisfaction with the CMRs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with IDD taking 5 or more medications were detected by using the health system's data warehouse. CMR steps included meeting with the patient and caregiver, assessing for MRP using the American Pharmacist Association/National Association of Chain Drug Stores framework, and providing a summary report for the patient/caregiver/prescriber. The report was reviewed with the caregiver 2 weeks after the initial CMR visit and sent to the prescriber. Outcomes measured included changes in the number of medications in patients' regimens, the number of MRPs identified, and a description of the MRPs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-nine patients with IDD received the CMR intervention. A median and interquartile range (IQR) of 4 (3.0, 4.0) MRPs were identified for each patient. The most common MRPs were inaccurate medication list in the medical record (<i>n</i> = 21), duplication of therapy (<i>n</i> = 13), no indication for medication use documented (<i>n</i> = 8), and a potential problem present but not treated (<i>n</i> = 7). There was a statistically significant difference in the median number of medications prior to and after CMR (<i>p</i> = 0.046), which decreased from 16 (12, 19) to 14.5 (10.8, 18.3). Caregivers were highly satisfied with the CMR process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These results support the feasibility of conducting CMR both virtually and in-home. Implementation of a CMR program on a larger scale and conducting outcomes assessment are the next steps, with the goal to ensure safe and effective use of their medications by patients who have IDD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 11","pages":"1161-1166"},"PeriodicalIF":1.5,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://accpjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.70120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145493713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capabilities of Large Language Models in Detecting and Managing Drug Interactions During Medication Reviews: Potential Implications as A Digital Assistant for Pragmatic Pharmacy Practice in Thailand","authors":"Nuntapong Boonrit,&nbsp;Achiraya Thaweechai,&nbsp;Bussabong Kessarin,&nbsp;Warit Ruanglertboon","doi":"10.1002/jac5.70115","DOIUrl":"https://doi.org/10.1002/jac5.70115","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The emerging capabilities of large language models (LLMs) have drawn increasing attention across various fields, including pharmacy practice in Thailand. Given the extensive number of available medications and the complex, often perplexing prescribing patterns, medication review remains a critical responsibility for pharmacists. This study explored the potential role of LLMs in supporting the medication review process within the Thai health care context, specifically focusing on their ability to detect drug interactions (DIs) and suggest context-sensitive management strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ten clinical vignettes were constructed, each depicting a patient with a specific drug regimen seeking assistance from a pharmacist. These cases were tailored to reflect the Thai context and represent commonly encountered DIs in Thailand. Each vignette was submitted to a set of LLMs—ChatGPT-4, ChatGPT-4o, ChatGPT-4o mini, Gemini 1.5, Claude 3.5, Microsoft Copilot, and Alisa 3.0—in both English and Thai. Evaluation metrics were developed and validated using the Index of Item-Objective Congruence. Two independent evaluators assessed all responses, and inter-rater reliability was measured using weighted Cohen's <i>κ</i>. LLM performance was scored based on percentage ranges, and cumulative scores were reported across evaluation domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The weighted Cohen's <i>κ</i> values across six domains—(A) ability to identify DIs, (B) completeness, (C) clarity, (D) citation reliability, (E) usefulness, and (F) ability to assess harm—exceeded 0.6, indicating substantial inter-rater agreement. All LLMs showed clinically acceptable performance in both languages. Citation reliability was limited in Alisa 3.0 and Gemini 1.5, while ChatGPT-4o demonstrated the most consistent and well-rounded performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The selected LLMs demonstrated their potential as capable digital assistants in medication reviews, although some models require further improvement and careful consideration when applied in real-world settings. Nevertheless, human oversight remains essential; when used in parallel, LLMs and health professionals can work synergistically to enhance patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 11","pages":"1117-1128"},"PeriodicalIF":1.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145493691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tipping the Scales: Strategies to Improve Anti-Obesity Medication Access and Affordability","authors":"Anne M. Komé,&nbsp;Amanda R. Boykin,&nbsp;Alayah C. Johnson-Jennings,&nbsp;Andrea D. Coviello","doi":"10.1002/jac5.70118","DOIUrl":"https://doi.org/10.1002/jac5.70118","url":null,"abstract":"<div>\u0000 \u0000 <p>Despite soaring demand and prescribing rates, access to anti-obesity medications (AOM) remains unbalanced due to high manufacturer costs, inadequate insurance coverage, intermittent shortages, and lack of provider knowledge in overcoming medication access barriers. Pharmacists are uniquely positioned to bridge care gaps for people with obesity by facilitating medication management, identifying drug interactions, counseling on lifestyle modification and adverse effects, and providing more frequent follow-up. Further, pharmacists can use their expertise to assist with AOM access, affordability, and therapeutic interchange. This article highlights the challenges routinely encountered in chronic weight management while offering practical pearls for pharmacists about insurance coverage, prior authorizations, current affordability initiatives, navigating shortages, and the importance of education and advocacy for people living with obesity.</p>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 11","pages":"1187-1193"},"PeriodicalIF":1.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145493690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Consensus Recommendations for the Integration of Critical Care Pharmacists on Intensive Care Unit Teams: Endorsed by the American Association of Critical-Care Nurses, American College of Clinical Pharmacy, American Society of Health-System Pharmacists, Institute for Safe Medication Practices, and Society of Critical Care Medicine”","authors":"John Carr,&nbsp;Dustin Orvin","doi":"10.1002/jac5.70117","DOIUrl":"https://doi.org/10.1002/jac5.70117","url":null,"abstract":"","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 10","pages":"1101-1102"},"PeriodicalIF":1.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145248547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Comment on “Consensus Recommendations for the Integration of Critical Care Pharmacists on Intensive Care Unit Teams: Endorsed by the American Association of Critical-Care Nurses, American College of Clinical Pharmacy, American Society of Health-System Pharmacists, Institute for Safe Medication Practices, and Society of Critical Care Medicine”","authors":"Mojdeh S. Heavner,&nbsp;Jason J. Heavner,&nbsp;Brian Murray,&nbsp;Andrea Sikora","doi":"10.1002/jac5.70116","DOIUrl":"https://doi.org/10.1002/jac5.70116","url":null,"abstract":"","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 10","pages":"1103-1104"},"PeriodicalIF":1.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145248772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Framework for Oncology Pharmacist-Led Parenteral Anticancer Therapy Patient Education: The Opinion of the American College of Clinical Pharmacy Hematology/Oncology Practice and Research Network","authors":"Erin Hickey Zacholski,&nbsp;Jack Dierckes,&nbsp;David Hartnett-Quach,&nbsp;Cady Noda,&nbsp;Amanda Sharps,&nbsp;Olivia White,&nbsp;Kyle Zacholski,&nbsp;Shawn P. Griffin","doi":"10.1002/jac5.70114","DOIUrl":"https://doi.org/10.1002/jac5.70114","url":null,"abstract":"<p>Educating patients and caregivers on anticancer therapy is central to oncology pharmacy practice. As anticancer regimens become more complex, oncology pharmacists need a structured framework that ensures vital information is communicated and personalized to each patient. Though existing organizational guidelines, largely written for nurses, and standards for oral oncolytic therapy counseling provide valuable insight, a dedicated guideline for oncology pharmacists regarding the delivery of patient education for parenteral and combination anticancer therapies is largely bereft. This review addresses that gap, presenting a pharmacist-led model that encompasses the pre-visit assessment, preparation, step-by-step delivery of the teaching session, and practical considerations for maximizing patient understanding and safety.</p><p>This narrative review summarizes evidence for effective patient education on parenteral anticancer therapies. The authors propose a structured framework for oncology pharmacist-led patient education on parenteral anticancer therapies that combines pharmacotherapy knowledge and the application of patient-centered care.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 11","pages":"1202-1214"},"PeriodicalIF":1.5,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://accpjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145493725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PSAP in JACCP Case Series: Hypertension","authors":"Andrew Y. Hwang,&nbsp;Christina H. Sherrill","doi":"10.1002/jac5.70102","DOIUrl":"10.1002/jac5.70102","url":null,"abstract":"","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 9","pages":"962-963"},"PeriodicalIF":1.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PSAP in JACCP Recorded Webcast: Behavioral Approaches to Optimize Patient Engagement in a Healthy Lifestyle","authors":"Lauren M. Hynicka,&nbsp;Richard J. Rovelli","doi":"10.1002/jac5.70101","DOIUrl":"10.1002/jac5.70101","url":null,"abstract":"","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 9","pages":"964-965"},"PeriodicalIF":1.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pharmacist's Role in the Use of Incretin-Based Therapies for Weight Management: An Opinion of the Endocrine and Metabolism Practice and Research Network of the American College of Clinical Pharmacy","authors":"Sara Lingow,&nbsp;Nicholas Carris,&nbsp;Jennifer Clements,&nbsp;Lindsay Courtney,&nbsp;Abby Lennon,&nbsp;Christina H. Sherrill,&nbsp;Elizabeth Van Dril","doi":"10.1002/jac5.70111","DOIUrl":"https://doi.org/10.1002/jac5.70111","url":null,"abstract":"<p>The popularity of incretin-based therapies has increased substantially over the past several years due to their clinically significant efficacy for weight loss and positive impact on weight-related comorbid conditions, yet, few clinical practice guidelines for the management of overweight and obesity have been updated to incorporate these agents. The increased demand for incretin-based therapies for weight management has revealed barriers to their implementation related to cost, availability, and emerging safety concerns. This opinion paper aims to briefly review the available literature on the current role of incretin-based therapy for chronic weight management in persons with overweight or obesity and provide recommendations for clinical pharmacists utilizing these agents. The intent of this opinion paper is to discuss the benefits and risks of incretin-based therapy for weight management, review approaches for clinical pharmacists to overcome barriers to their implementation, and address ongoing questions related to their use. Finally, the authors suggest an approach to the management of people with overweight or obesity with incretin-based therapy using the Pharmacists' Patient Care Process along with actions clinical pharmacists can take to ensure best practices with these agents.</p>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 10","pages":"1078-1093"},"PeriodicalIF":1.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://accpjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jac5.70111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145248770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Community Pharmacists on Reducing Opioid and Alcohol Co-Use: A Pilot Randomized Control Trial of a Medication Therapy Management Intervention","authors":"Kenneth C. Hohmeier,&nbsp;Grace Broussard,&nbsp;Melissa Tyszko,&nbsp;Kelly Barland,&nbsp;Kristi Carlston,&nbsp;Yingjia Wei,&nbsp;Craig Field,&nbsp;Adam J. Gordon,&nbsp;Alina Cernasev,&nbsp;Gerald Cochran","doi":"10.1002/jac5.70113","DOIUrl":"https://doi.org/10.1002/jac5.70113","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Concurrent use of opioids and alcohol can result in respiratory depression, overdose, and death. Prior research has shown that 20%–30% of patients receiving opioid medications in community pharmacies engage in high-risk drinking. We adapted a medication therapy management-based intervention to address co-use and tested its feasibility, acceptability, and preliminary efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This pilot study enrolled adult, English-speaking community pharmacy patients dispensed opioids who reported current drinking. Participants were randomized to standard medication counseling (SMC) or alcohol-targeted brief intervention-medication therapy management (ABI-MTM). ABI-MTM included two pharmacist-delivered sessions focused on reviewing medications/interactions, motivating participants to discontinue co-use, and providing a written action plan. We assessed enrollment, retention, intervention delivery, satisfaction, drinks per drinking day (DDD), and daily morphine milligram equivalent (MME) at baseline, 2, and 3 months. Outcomes were analyzed using descriptive statistics and generalized linear mixed modeling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We enrolled 44 patients (110% of target; 22 per group). No significant differences were found in age (mean = 55.8), sex (female = 65.9%), race (White = 95.5%), education (&gt; high school = 95.5%), or health insurance status (insured = 95.5%). Consent and retention rates exceeded 90%, session delivery was ≥ 95%, and ABI-MTM satisfaction ranged from 79% to 89%. At 3 months, 59.1% of ABI-MTM participants versus 45.5% of SMC achieved ≥ 30% reduction in DDD and/or daily MME. Mixed models showed ABI-MTM recipients had 2.10 (95% confidence interval = 0.34–12.95) higher odds of achieving this reduction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ABI-MTM demonstrated feasibility, acceptability, and preliminary efficacy. A fully powered trial is warranted to evaluate broader implementation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73966,"journal":{"name":"Journal of the American College of Clinical Pharmacy : JACCP","volume":"8 10","pages":"991-1002"},"PeriodicalIF":1.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145248593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}