首页 > 最新文献
paperpass

JAPhA Practice Innovations最新文献

英文 中文
Evaluating patient perceived effectiveness, safety, and satisfaction with a pharmacist-led clinical wound care service 评估患者对药剂师主导的临床伤口护理服务的有效性、安全性和满意度
Pub Date : 2026-07-01 Epub Date: 2026-04-15 DOI: 10.1016/j.japhpi.2026.100112
Victoria Pinkovsky, Traci Poole, Angela Hagan

Background

Chronic wounds are associated with morbidity, reduced quality of life, and high healthcare costs. Topical antibiotics offer localized therapy, and community pharmacists can support patients through individualized therapy, education, and antimicrobial stewardship.

Objectives

To evaluate patient-reported outcomes on effectiveness, safety, and satisfaction with a pharmacist-led wound care service providing topical antibiotic therapy.

Methods

This cross-sectional survey study encompassed adults who had received pharmacist-recommended topical therapy in the preceding 90 days. Participants completed an anonymous Likert-scale survey assessing perceived therapy effectiveness, safety, and satisfaction using positively worded statements. Responses were recorded on a 5-point scale (1 = strongly agree to 5 = strongly disagree). Descriptive statistics summarized demographics and survey responses. Because satisfaction and effectiveness were assessed using Likert-scale items treated as continuous interval data, one-sample t-tests compared mean scores with the neutral midpoint (3) to determine whether patient perceptions differed significantly from neutrality. Chi-square goodness-of-fit tests evaluated categorical safety outcomes by comparing observed response distributions to an expected equal distribution across response categories. Internal consistency of the patient survey was assessed using Cronbach’s alpha.

Results

Of the 231 patients who were administered the survey, 94 met eligibility criteria and completed the survey to termination (40.69% response). Patients reported high perceived effectiveness in wound healing (mean = 1.69), smell (mean = 1.79), size (mean = 1.84), drainage (mean = 1.98), and pain (mean = 2.07) (all P < 0.001). Safety data showed 17.02% (P < 0.001) experienced application-site pain; 58.51% (P < 0.005) had earlier systemic antibiotics. Satisfaction was high across communication (mean = 1.44), verbal (mean = 1.51) and written instructions (mean = 1.56), application (mean = 1.67), and affordability (mean = 1.82) (all P < 0.001).

Conclusion

Pharmacist-recommended topical therapy for chronic, treatment-resistant wounds was associated with high satisfaction and perceived effectiveness, with few adverse events.
背景:慢性伤口与发病率、生活质量下降和高医疗费用有关。局部抗生素提供局部治疗,社区药剂师可以通过个体化治疗、教育和抗菌药物管理来支持患者。目的评价以药剂师为主导的伤口护理服务提供局部抗生素治疗的有效性、安全性和满意度。方法本横断面调查研究包括在过去90天内接受过药剂师推荐的局部治疗的成年人。参与者完成了一个匿名李克特量表调查评估感知治疗的有效性,安全性和满意度使用积极的措辞陈述。回答以5分制进行记录(1 =非常同意,5 =非常不同意)。描述性统计总结了人口统计和调查结果。由于满意度和有效性是使用李克特量表项目作为连续间隔数据进行评估的,单样本t检验将平均得分与中性中点(3)进行比较,以确定患者的感知是否与中性有显著差异。卡方拟合优度检验通过比较观察到的反应分布与反应类别之间的预期均匀分布来评估分类安全性结果。采用Cronbach 's alpha评估患者调查的内部一致性。结果在接受调查的231例患者中,94例符合资格标准并完成调查至终止(40.69%的应答)。患者报告在伤口愈合(平均= 1.69)、气味(平均= 1.79)、大小(平均= 1.84)、引流(平均= 1.98)和疼痛(平均= 2.07)方面的感知效果较高(均P <; 0.001)。安全性数据显示,17.02% (P < 0.001)的患者出现应用部位疼痛;58.51% (P < 0.005)患者有早期全身性抗生素。满意度在沟通(平均= 1.44),口头(平均= 1.51)和书面说明(平均= 1.56),应用(平均= 1.67)和负担能力(平均= 1.82)(均P <; 0.001)方面都很高。结论药师推荐的局部治疗对慢性难治性创面有较高的满意度和疗效,不良事件较少。
{"title":"Evaluating patient perceived effectiveness, safety, and satisfaction with a pharmacist-led clinical wound care service","authors":"Victoria Pinkovsky,&nbsp;Traci Poole,&nbsp;Angela Hagan","doi":"10.1016/j.japhpi.2026.100112","DOIUrl":"10.1016/j.japhpi.2026.100112","url":null,"abstract":"<div><h3>Background</h3><div>Chronic wounds are associated with morbidity, reduced quality of life, and high healthcare costs. Topical antibiotics offer localized therapy, and community pharmacists can support patients through individualized therapy, education, and antimicrobial stewardship.</div></div><div><h3>Objectives</h3><div>To evaluate patient-reported outcomes on effectiveness, safety, and satisfaction with a pharmacist-led wound care service providing topical antibiotic therapy.</div></div><div><h3>Methods</h3><div>This cross-sectional survey study encompassed adults who had received pharmacist-recommended topical therapy in the preceding 90 days. Participants completed an anonymous Likert-scale survey assessing perceived therapy effectiveness, safety, and satisfaction using positively worded statements. Responses were recorded on a 5-point scale (1 = strongly agree to 5 = strongly disagree). Descriptive statistics summarized demographics and survey responses. Because satisfaction and effectiveness were assessed using Likert-scale items treated as continuous interval data, one-sample t-tests compared mean scores with the neutral midpoint (3) to determine whether patient perceptions differed significantly from neutrality. Chi-square goodness-of-fit tests evaluated categorical safety outcomes by comparing observed response distributions to an expected equal distribution across response categories. Internal consistency of the patient survey was assessed using Cronbach’s alpha.</div></div><div><h3>Results</h3><div>Of the 231 patients who were administered the survey, 94 met eligibility criteria and completed the survey to termination (40.69% response). Patients reported high perceived effectiveness in wound healing (mean = 1.69), smell (mean = 1.79), size (mean = 1.84), drainage (mean = 1.98), and pain (mean = 2.07) (all <em>P</em> &lt; 0.001). Safety data showed 17.02% (<em>P</em> &lt; 0.001) experienced application-site pain; 58.51% (<em>P</em> &lt; 0.005) had earlier systemic antibiotics. Satisfaction was high across communication (mean = 1.44), verbal (mean = 1.51) and written instructions (mean = 1.56), application (mean = 1.67), and affordability (mean = 1.82) (all <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Pharmacist-recommended topical therapy for chronic, treatment-resistant wounds was associated with high satisfaction and perceived effectiveness, with few adverse events.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100112"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661321","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}
引用次数: 0
Clinical impact of GLP-1 and GIP/GLP-1 agonist access barriers in primary care 初级保健中GLP-1和GIP/GLP-1激动剂获取障碍的临床影响
Pub Date : 2026-07-01 Epub Date: 2025-11-07 DOI: 10.1016/j.japhpi.2025.100081
Alexandra Cochran, Laura Schalliol, Holly Lowe, Savannah Owen, Gabriella V. Rosellini

Background

Access to glucagon-like peptide-1 (GLP-1) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonists is frequently limited by medication shortages, insurance restrictions, and financial barriers. These medications are critical tools for glycemic control and weight management in patients with type 2 diabetes mellitus (T2DM). However, there is limited research on the clinical consequences of access barriers for these therapies.

Objectives

This study aimed to evaluate the impact of such barriers on hemoglobin A1c (HbA1c), weight, and body mass index (BMI) and examine how medication regimens are adjusted in response.

Methods

A retrospective cohort analysis was performed in a primary care setting. Adults with T2DM who were prescribed liraglutide, semaglutide, dulaglutide, exenatide, or tirzepatide between January 1, 2022, and July 31, 2024, were included. Patients were categorized based on exposure or no exposure to an access barrier. Access barriers were defined via a retrospective chart review.

Results

The primary outcome was the change in HbA1c. Patients with access barriers experienced a smaller reduction in HbA1c than those without (−0.42% vs. −0.75%, P = 0.2128). Secondary outcomes included changes in weight (−1.91 kg vs. −2.13 kg, P = 0.7022) and BMI (−0.7 vs. −0.75, P = 0.812). Common interventions that were performed by the clinic staff included providing medication samples and initiating alternative therapies such as insulin or sodium-glucose cotransporter 2 inhibitors during the delay period.

Conclusion

Although the study was underpowered to detect statistically significant differences, patients with documented access barriers had smaller reductions in HbA1c, weight, and BMI than those with uninterrupted therapy. These findings highlight the need for proactive strategies. Pharmacists can support patients by initiating alternative medications, providing medication samples if available, and developing clinic-wide protocols to manage shortages. Further research is needed to evaluate the long-term effects of interrupted GLP-1/GIP therapy owing to access barriers.
胰高血糖素样肽-1 (GLP-1)和双葡萄糖依赖性胰岛素性多肽(GIP)/GLP-1受体激动剂的获得经常受到药物短缺、保险限制和财务障碍的限制。这些药物是2型糖尿病(T2DM)患者血糖控制和体重管理的关键工具。然而,对这些疗法的获取障碍的临床后果的研究有限。本研究旨在评估这些屏障对血红蛋白A1c (HbA1c)、体重和体重指数(BMI)的影响,并研究如何调整药物治疗方案。方法回顾性队列分析在初级保健机构进行。纳入了2022年1月1日至2024年7月31日期间服用利拉鲁肽、西马鲁肽、杜拉鲁肽、艾塞那肽或替西帕肽的2型糖尿病成人患者。患者根据是否暴露于通道屏障进行分类。通过回顾性图表审查确定准入障碍。结果主要终点为HbA1c的变化。有通道障碍的患者的HbA1c降低幅度小于无通道障碍的患者(- 0.42% vs - 0.75%, P = 0.2128)。次要结局包括体重(- 1.91 kg对- 2.13 kg, P = 0.7022)和BMI(- 0.7对- 0.75,P = 0.812)的变化。临床工作人员进行的常见干预措施包括提供药物样本,并在延迟期间启动胰岛素或钠-葡萄糖共转运蛋白2抑制剂等替代疗法。结论:尽管该研究不足以发现统计学上的显著差异,但有记录的通道障碍患者的HbA1c、体重和BMI的降低幅度小于不间断治疗的患者。这些发现强调了采取主动战略的必要性。药剂师可以通过启动替代药物、提供可用的药物样本以及制定全诊所范围的方案来管理短缺来支持患者。由于进入障碍,需要进一步的研究来评估中断GLP-1/GIP治疗的长期效果。
{"title":"Clinical impact of GLP-1 and GIP/GLP-1 agonist access barriers in primary care","authors":"Alexandra Cochran,&nbsp;Laura Schalliol,&nbsp;Holly Lowe,&nbsp;Savannah Owen,&nbsp;Gabriella V. Rosellini","doi":"10.1016/j.japhpi.2025.100081","DOIUrl":"10.1016/j.japhpi.2025.100081","url":null,"abstract":"<div><h3>Background</h3><div>Access to glucagon-like peptide-1 (GLP-1) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonists is frequently limited by medication shortages, insurance restrictions, and financial barriers. These medications are critical tools for glycemic control and weight management in patients with type 2 diabetes mellitus (T2DM). However, there is limited research on the clinical consequences of access barriers for these therapies.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the impact of such barriers on hemoglobin A1c (HbA1c), weight, and body mass index (BMI) and examine how medication regimens are adjusted in response.</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis was performed in a primary care setting. Adults with T2DM who were prescribed liraglutide, semaglutide, dulaglutide, exenatide, or tirzepatide between January 1, 2022, and July 31, 2024, were included. Patients were categorized based on exposure or no exposure to an access barrier. Access barriers were defined via a retrospective chart review.</div></div><div><h3>Results</h3><div>The primary outcome was the change in HbA1c. Patients with access barriers experienced a smaller reduction in HbA1c than those without (−0.42% vs. −0.75%, <em>P</em> = 0.2128). Secondary outcomes included changes in weight (−1.91 kg vs. −2.13 kg, <em>P</em> = 0.7022) and BMI (−0.7 vs. −0.75, <em>P</em> = 0.812). Common interventions that were performed by the clinic staff included providing medication samples and initiating alternative therapies such as insulin or sodium-glucose cotransporter 2 inhibitors during the delay period.</div></div><div><h3>Conclusion</h3><div>Although the study was underpowered to detect statistically significant differences, patients with documented access barriers had smaller reductions in HbA1c, weight, and BMI than those with uninterrupted therapy. These findings highlight the need for proactive strategies. Pharmacists can support patients by initiating alternative medications, providing medication samples if available, and developing clinic-wide protocols to manage shortages. Further research is needed to evaluate the long-term effects of interrupted GLP-1/GIP therapy owing to access barriers.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100081"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661370","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}
引用次数: 0
Evaluation of community pharmacy outreach events to promote screening for human immunodeficiency virus 评价促进人类免疫缺陷病毒筛查的社区药房外展活动
Pub Date : 2026-07-01 Epub Date: 2026-03-12 DOI: 10.1016/j.japhpi.2026.100107
Destanie Truman, Robert Nichols, Stevie Veach, Enas M. Yehya, Matthew Witry

Background

Human immunodeficiency virus (HIV) remains a prominent public health concern, with approximately 1.2 million individuals in the U.S. living with HIV and 13% unaware of their status. Community pharmacists are positioned to engage in HIV screening and education.

Objectives

The study aimed to (1) assess perceptions of HIV risk, HIV related knowledge, and public attitudes toward community pharmacist-provided HIV testing and (2) evaluate pharmacists offering HIV testing at community events.

Methods

A cross-sectional survey was administered to adults attending 3 community events where pharmacists were present to provide HIV education and testing. Participants completed an anonymous 16-item electronic survey via a quick-response code covering demographics, perceived risks, attitudes toward community pharmacist–provided HIV testing, and HIV knowledge. Descriptive statistics and multiple linear regression were used to analyze data. Impact was evaluated through the number of attendees and the number of HIV tests administered.

Results

Among 260 individuals who interacted with pharmacists, 58 completed the survey (response rate 22.3%). Most respondents were women (70.9%), aged 25-31 years, and white (76.4%). Perceived HIV risk was low, with 60% reporting that they were extremely unlikely to acquire HIV. The mean HIV knowledge score was 3.4 of 5, and 70% correctly identified Centers for Disease Control and Prevention testing recommendations. Attitudes toward pharmacist-provided HIV testing were generally positive, particularly when testing was offered at no cost. Multiple linear regression demonstrated that younger age was significantly associated with more favorable attitudes toward pharmacy-based HIV testing (P = 0.044). During the study period, 13 HIV tests were administered at community events.

Conclusion

Attendees of community outreach events were positive toward community pharmacists providing HIV education and testing. Community-based pharmacy outreach represents a promising approach to expand HIV testing access and normalize discussions around HIV prevention.
人类免疫缺陷病毒(HIV)仍然是一个突出的公共卫生问题,在美国大约有120万人感染了HIV, 13%的人不知道自己的状况。社区药剂师的定位是从事艾滋病毒筛查和教育。目的本研究旨在(1)评估公众对HIV风险的认知、HIV相关知识以及对社区药剂师提供HIV检测的态度;(2)评估药剂师在社区活动中提供HIV检测。方法对参加3次社区活动的成年人进行横断面调查,活动中有药师提供HIV教育和检测。参与者通过快速响应代码完成了一份16项匿名电子调查,调查内容包括人口统计、感知风险、对社区药剂师提供的艾滋病毒检测的态度以及艾滋病毒知识。采用描述性统计和多元线性回归对数据进行分析。通过参加人数和进行艾滋病毒检测的次数来评估影响。结果260名受访药师中,58人完成问卷调查,回复率为22.3%。大多数受访者为25-31岁的女性(70.9%)和白人(76.4%)。人们认为感染艾滋病毒的风险很低,60%的人报告说他们极不可能感染艾滋病毒。平均艾滋病毒知识得分为3.4分(满分5分),70%的人正确识别了疾病控制和预防中心的检测建议。对药剂师提供的艾滋病毒检测的态度通常是阳性的,特别是在免费提供检测的情况下。多元线性回归显示,年龄越小,对基于药物的HIV检测的态度越有利(P = 0.044)。在研究期间,在社区活动中进行了13次艾滋病毒检测。结论社区外展活动参与者对社区药师提供HIV教育和检测持积极态度。以社区为基础的药房外展是一种有希望的方法,可以扩大艾滋病毒检测的可及性,并使有关艾滋病毒预防的讨论正常化。
{"title":"Evaluation of community pharmacy outreach events to promote screening for human immunodeficiency virus","authors":"Destanie Truman,&nbsp;Robert Nichols,&nbsp;Stevie Veach,&nbsp;Enas M. Yehya,&nbsp;Matthew Witry","doi":"10.1016/j.japhpi.2026.100107","DOIUrl":"10.1016/j.japhpi.2026.100107","url":null,"abstract":"<div><h3>Background</h3><div>Human immunodeficiency virus (HIV) remains a prominent public health concern, with approximately 1.2 million individuals in the U.S. living with HIV and 13% unaware of their status. Community pharmacists are positioned to engage in HIV screening and education.</div></div><div><h3>Objectives</h3><div>The study aimed to (1) assess perceptions of HIV risk, HIV related knowledge, and public attitudes toward community pharmacist-provided HIV testing and (2) evaluate pharmacists offering HIV testing at community events.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was administered to adults attending 3 community events where pharmacists were present to provide HIV education and testing. Participants completed an anonymous 16-item electronic survey via a quick-response code covering demographics, perceived risks, attitudes toward community pharmacist–provided HIV testing, and HIV knowledge. Descriptive statistics and multiple linear regression were used to analyze data. Impact was evaluated through the number of attendees and the number of HIV tests administered.</div></div><div><h3>Results</h3><div>Among 260 individuals who interacted with pharmacists, 58 completed the survey (response rate 22.3%). Most respondents were women (70.9%), aged 25-31 years, and white (76.4%). Perceived HIV risk was low, with 60% reporting that they were extremely unlikely to acquire HIV. The mean HIV knowledge score was 3.4 of 5, and 70% correctly identified Centers for Disease Control and Prevention testing recommendations. Attitudes toward pharmacist-provided HIV testing were generally positive, particularly when testing was offered at no cost. Multiple linear regression demonstrated that younger age was significantly associated with more favorable attitudes toward pharmacy-based HIV testing (<em>P</em> = 0.044). During the study period, 13 HIV tests were administered at community events.</div></div><div><h3>Conclusion</h3><div>Attendees of community outreach events were positive toward community pharmacists providing HIV education and testing. Community-based pharmacy outreach represents a promising approach to expand HIV testing access and normalize discussions around HIV prevention.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100107"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661371","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}
引用次数: 0
Assessing the impact of certified pharmacy technicians on behavioral health care management 评估认证药房技术人员对行为保健管理的影响
Pub Date : 2026-07-01 Epub Date: 2026-02-11 DOI: 10.1016/j.japhpi.2026.100101
Alyssa A. Longenecker, Jennifer Buxton, Sarah Logue, Ashley Sloop, Evelyn Ocana, Macary Weck Marciniak, Laura A. Rhodes

Background

More than 50 million Americans experience a behavioral health illness. Adherence to prescribed medication is important for those with mental illness. Pharmacists are widely used health care providers, especially in rural areas with a limited number of mental health professionals. Owing to pharmacists’ increased duties, certified pharmacy technicians (CPhTs) can assume broader roles in patient care. Cape Fear Clinic serves rural counties wherein most patients experience a mental health illness. A CPhT intervention was implemented to assess the impact of ongoing care management after the initiation of a behavioral health medication.

Objective

The primary objective was to assess changes in Short Form Health Survey 12 (SF-12) scores after participation in a CPhT-led care management program. The secondary objectives were to assess behavioral health medication proportion of days covered (PDC) and suicidal/homicidal ideation at baseline and 12 weeks after the intervention.

Methods

Patients aged 18 years and older receiving a first-time prescription for a behavioral health medication or dose change were included. CPhTs contacted patients telephonically at enrollment and at 2, 4, 8, and 12 weeks after enrollment. Data collected at each touchpoint included SF-12 score, suicidal or homicidal ideation, and PDC. Results were analyzed using descriptive statistics.

Results

A total of 34 patients were enrolled; 9 patients (24%) completed the 12-week program. The average change in the SF-12 mental component score was +12.7 (baseline, 38.8; final, 51.5) and the SF-12 physical component score was −1.3 (baseline, 47.1; final, 45.8). Average PDC values were 71% (n = 1), 83% (n = 1), 87% (n = 1), and 100% (n = 6). Suicidal or homicidal ideation was positively reported in 7% of appointments (n = 6 of 86); 100% of positive findings (n = 6 of 6) were reported to the care team. There were 0 positive suicidal or homicidal ideation reports (0%) at program completion.

Conclusion

This CPhT-led care management service contributed to improved mental health, measured through SF-12 scores, and decreased positive suicidal ideation or homicidal ideation findings.
超过5000万美国人患有行为健康疾病。对精神病患者来说,坚持服用处方药很重要。药剂师是广泛使用的卫生保健提供者,特别是在精神卫生专业人员数量有限的农村地区。由于药剂师的职责增加,经过认证的药学技术人员(CPhTs)可以在患者护理中承担更广泛的角色。开普恐惧诊所服务于农村县,那里的大多数病人都患有精神疾病。实施CPhT干预,以评估行为健康药物治疗开始后持续护理管理的影响。目的:主要目的是评估参加cpht主导的护理管理项目后,简短健康调查12 (SF-12)得分的变化。次要目标是评估基线和干预后12周的行为健康用药天数比例(PDC)和自杀/杀人意念。方法纳入18岁及以上首次服用行为健康药物或改变剂量的患者。cpht在入组时以及入组后2、4、8和12周与患者进行电话联系。在每个接触点收集的数据包括SF-12评分、自杀或杀人意念和PDC。结果采用描述性统计进行分析。结果共纳入34例患者;9例患者(24%)完成了为期12周的计划。SF-12心理成分得分的平均变化为+12.7(基线,38.8;终值,51.5),SF-12身体成分得分的平均变化为- 1.3(基线,47.1;终值,45.8)。平均PDC值分别为71% (n = 1)、83% (n = 1)、87% (n = 1)和100% (n = 6)。7%的患者报告有自杀或杀人的念头(n = 6 / 86);100%的阳性结果(n = 6 / 6)报告给护理小组。在项目完成时,有0个阳性的自杀或杀人意念报告(0%)。结论cpht主导的护理管理服务有助于改善心理健康,通过SF-12评分测量,并减少积极的自杀意念或杀人意念。
{"title":"Assessing the impact of certified pharmacy technicians on behavioral health care management","authors":"Alyssa A. Longenecker,&nbsp;Jennifer Buxton,&nbsp;Sarah Logue,&nbsp;Ashley Sloop,&nbsp;Evelyn Ocana,&nbsp;Macary Weck Marciniak,&nbsp;Laura A. Rhodes","doi":"10.1016/j.japhpi.2026.100101","DOIUrl":"10.1016/j.japhpi.2026.100101","url":null,"abstract":"<div><h3>Background</h3><div>More than 50 million Americans experience a behavioral health illness. Adherence to prescribed medication is important for those with mental illness. Pharmacists are widely used health care providers, especially in rural areas with a limited number of mental health professionals. Owing to pharmacists’ increased duties, certified pharmacy technicians (CPhTs) can assume broader roles in patient care. Cape Fear Clinic serves rural counties wherein most patients experience a mental health illness. A CPhT intervention was implemented to assess the impact of ongoing care management after the initiation of a behavioral health medication.</div></div><div><h3>Objective</h3><div>The primary objective was to assess changes in Short Form Health Survey 12 (SF-12) scores after participation in a CPhT-led care management program. The secondary objectives were to assess behavioral health medication proportion of days covered (PDC) and suicidal/homicidal ideation at baseline and 12 weeks after the intervention.</div></div><div><h3>Methods</h3><div>Patients aged 18 years and older receiving a first-time prescription for a behavioral health medication or dose change were included. CPhTs contacted patients telephonically at enrollment and at 2, 4, 8, and 12 weeks after enrollment. Data collected at each touchpoint included SF-12 score, suicidal or homicidal ideation, and PDC. Results were analyzed using descriptive statistics.</div></div><div><h3>Results</h3><div>A total of 34 patients were enrolled; 9 patients (24%) completed the 12-week program. The average change in the SF-12 mental component score was +12.7 (baseline, 38.8; final, 51.5) and the SF-12 physical component score was −1.3 (baseline, 47.1; final, 45.8). Average PDC values were 71% (n = 1), 83% (n = 1), 87% (n = 1), and 100% (n = 6). Suicidal or homicidal ideation was positively reported in 7% of appointments (n = 6 of 86); 100% of positive findings (n = 6 of 6) were reported to the care team. There were 0 positive suicidal or homicidal ideation reports (0%) at program completion.</div></div><div><h3>Conclusion</h3><div>This CPhT-led care management service contributed to improved mental health, measured through SF-12 scores, and decreased positive suicidal ideation or homicidal ideation findings.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100101"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661386","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}
引用次数: 0
Evaluation of vitamin K on coagulopathy in patients with cirrhosis: An observational study 评价维生素K对肝硬化患者凝血功能的影响:一项观察性研究
Pub Date : 2026-07-01 Epub Date: 2026-02-06 DOI: 10.1016/j.japhpi.2026.100099
Parker Kaleo, Joshua Akinsanya, Tiffany Lyons, Drew A. Wells

Background

Cirrhosis impairs the liver’s ability to synthesize vitamin K–dependent coagulation factors, contributing to coagulopathy. Elevated international normalized ratio (INR) in these patients often prompts intravenous (I.V.) vitamin K administration, despite limited evidence supporting its efficacy.

Objectives

This study aimed to evaluate the impact of I.V. vitamin K administration on INR and identify factors that may predict response in patients with severe cirrhosis.

Methods

This single-center, retrospective, institutional review board–approved study included adult hospitalized patients with cirrhosis who received I.V. vitamin K. The primary outcome of this study was to evaluate the change in INR. Secondary analysis included the rate of bleeding events, in-hospital venous thromboembolism (VTE), and in-hospital mortality. Subgroup analysis and linear regression analysis were conducted.

Results

Among 134 patients, the median INR change from day 0 to day 3 was 0 [−0.4 to 0.2]. Bleeding events occurred in 19% of patients, in-hospital VTE in 3%, and mortality in 16%. Subgroup analysis showed a numerically greater INR reduction in patients with a baseline INR of greater than 2, but no differences based on Model for End-Stage Liver Disease scores or cirrhosis etiology. Multivariate analysis demonstrated that age older than 60 years and a decrease in INR of 0.5 from day 0 to 1 significantly predicted the overall change in INR.

Conclusion

Our research provides additional data to the existing literature, showcasing a lack of impact of I.V. vitamin K on INR in patients with cirrhosis. Notably, our study adds insight into the lack of benefit even in patients with more severe cirrhosis. Standardization of clinical practice recommendations to guide I.V. vitamin K use across the spectrum of cirrhosis is needed.
肝硬化损害肝脏合成维生素k依赖性凝血因子的能力,导致凝血功能障碍。这些患者的国际标准化比值(INR)升高常常促使静脉注射(I.V.)维生素K,尽管支持其有效性的证据有限。目的本研究旨在评估静脉注射维生素K对严重肝硬化患者INR的影响,并确定可能预测其反应的因素。方法:本研究为单中心、回顾性、机构审查委员会批准的研究,纳入了接受静脉注射维生素k的成年肝硬化住院患者。本研究的主要结果是评估INR的变化。二次分析包括出血事件、院内静脉血栓栓塞(VTE)和院内死亡率。进行亚组分析和线性回归分析。结果134例患者中,从第0天到第3天的中位INR变化为0[- 0.4至0.2]。19%的患者发生出血事件,3%的患者发生院内静脉血栓栓塞,16%的患者死亡。亚组分析显示,基线INR大于2的患者在数值上的INR降低幅度更大,但基于终末期肝病模型评分或肝硬化病因学没有差异。多因素分析表明,年龄大于60岁和INR从第0天到第1天下降0.5显著预测INR的整体变化。结论:我们的研究为现有文献提供了额外的数据,表明静脉注射维生素K对肝硬化患者INR的影响不足。值得注意的是,我们的研究增加了对即使在更严重的肝硬化患者中也缺乏益处的见解。需要标准化临床实践建议,以指导肝硬化患者静脉注射维生素K的使用。
{"title":"Evaluation of vitamin K on coagulopathy in patients with cirrhosis: An observational study","authors":"Parker Kaleo,&nbsp;Joshua Akinsanya,&nbsp;Tiffany Lyons,&nbsp;Drew A. Wells","doi":"10.1016/j.japhpi.2026.100099","DOIUrl":"10.1016/j.japhpi.2026.100099","url":null,"abstract":"<div><h3>Background</h3><div>Cirrhosis impairs the liver’s ability to synthesize vitamin K–dependent coagulation factors, contributing to coagulopathy. Elevated international normalized ratio (INR) in these patients often prompts intravenous (I.V.) vitamin K administration, despite limited evidence supporting its efficacy.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the impact of I.V. vitamin K administration on INR and identify factors that may predict response in patients with severe cirrhosis.</div></div><div><h3>Methods</h3><div>This single-center, retrospective, institutional review board–approved study included adult hospitalized patients with cirrhosis who received I.V. vitamin K. The primary outcome of this study was to evaluate the change in INR. Secondary analysis included the rate of bleeding events, in-hospital venous thromboembolism (VTE), and in-hospital mortality. Subgroup analysis and linear regression analysis were conducted.</div></div><div><h3>Results</h3><div>Among 134 patients, the median INR change from day 0 to day 3 was 0 [−0.4 to 0.2]. Bleeding events occurred in 19% of patients, in-hospital VTE in 3%, and mortality in 16%. Subgroup analysis showed a numerically greater INR reduction in patients with a baseline INR of greater than 2, but no differences based on Model for End-Stage Liver Disease scores or cirrhosis etiology. Multivariate analysis demonstrated that age older than 60 years and a decrease in INR of 0.5 from day 0 to 1 significantly predicted the overall change in INR.</div></div><div><h3>Conclusion</h3><div>Our research provides additional data to the existing literature, showcasing a lack of impact of I.V. vitamin K on INR in patients with cirrhosis. Notably, our study adds insight into the lack of benefit even in patients with more severe cirrhosis. Standardization of clinical practice recommendations to guide I.V. vitamin K use across the spectrum of cirrhosis is needed.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100099"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661391","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}
引用次数: 0
Evaluating pharmacist-directed care for eligible patients of a large community-based pharmacy chain: An analysis of dietitian referral adoption rates 评估大型社区连锁药房中合格患者的药剂师指导护理:对营养师转诊采用率的分析
Pub Date : 2026-07-01 Epub Date: 2026-03-14 DOI: 10.1016/j.japhpi.2026.100108
Avery Salcedo, Jamie Remines, Pramit Nadpara, Jean-Venable R. Goode

Background

A large community-based pharmacy chain offers medical nutrition therapy (MNT) via secure dietitian telehealth virtual calls to eligible patients under a contracted benefit plan. This service supports chronic disease management, such as diabetes and cardiovascular conditions, through remote, personalized nutrition care. However, despite evidence of clinical benefit, patient engagement with MNT services through telehealth remains low. Pharmacists are well positioned to identify eligible patients, refer them to MNT services, and conduct outreach to promote attendance.

Objective

This study aimed to evaluate the impact of pharmacist-directed care, including pharmacist-led identification of eligible patients, referral to MNT, and follow-up telephone calls, on dietitian referral adoption rates and patient engagement.

Methods

In this prospective quality improvement study, 388 adult beneficiaries enrolled in a contracted benefit plan were identified as eligible for MNT through the Diabetes and Heart Health Welcome programs. Pharmacists conducted follow-up calls to educate patients and encourage MNT scheduling. Descriptive and univariate analyses were used to summarize outcomes.

Results

Pharmacists conducted outreach telephone calls to all 388 eligible patients (100%). The most frequent call outcome was voicemail (205 of 388, 52.8%). Only 25 patients scheduled an MNT appointment (25 of 388, 6.4%), and 6 ultimately attended (6 of 388, 1.5%). Among those who declined or expressed disinterest (70 of 388, 18.0%), 10 (10 of 70, 14.3%) reported no interest in nutritional counseling, and 6 (6 of 70, 8.6%) were already receiving care from another dietitian. Cost concerns were the most frequently cited barrier (33 of 388, 8.5%). Most calls (261 of 388, 67.3%) lasted less than 1 minute.

Conclusion

Phone-based pharmacist outreach alone yielded limited patient engagement in MNT. Although pharmacist-directed referral and follow-up are feasible, they were insufficient to meaningfully increase appointment scheduling or attendance. Future efforts should incorporate multimodal outreach strategies, clearer cost and benefit communication, and personalized engagement methods to better address patient barriers and improve adoption of dietitian services.
一家大型社区连锁药房通过安全的营养师远程医疗虚拟电话向合同福利计划下的合格患者提供医疗营养治疗(MNT)。这项服务通过远程个性化营养护理支持慢性病管理,如糖尿病和心血管疾病。然而,尽管有临床效益的证据,但患者通过远程保健参与妇幼保健服务的程度仍然很低。药剂师可以很好地识别符合条件的患者,将他们转介到MNT服务,并进行外展以促进出勤率。目的本研究旨在评估药剂师指导的护理对营养师转诊采用率和患者参与度的影响,包括药剂师主导的合格患者识别、转介到MNT和随访电话。方法在这项前瞻性质量改进研究中,388名参加合同福利计划的成年受益人通过糖尿病和心脏健康欢迎计划被确定为有资格获得MNT。药剂师进行了随访电话,以教育患者并鼓励MNT计划。使用描述性和单变量分析来总结结果。结果药师对388例符合条件的患者均进行了外展电话随访(100%)。最常见的通话结果是语音信箱(388个电话中有205个,占52.8%)。只有25名患者安排了MNT预约(388人中有25人,占6.4%),最终有6名患者就诊(388人中有6人,占1.5%)。在拒绝或表示不感兴趣的人中(388人中有70人,18.0%),10人(70人中有10人,14.3%)报告对营养咨询不感兴趣,6人(70人中有6人,8.6%)已经接受了其他营养师的护理。成本问题是最常被提及的障碍(388人中有33人,占8.5%)。大多数电话(388个中的261个,67.3%)持续时间不到1分钟。结论仅以电话为基础的药师外诊对MNT的患者参与度有限。虽然药剂师指导的转诊和随访是可行的,但它们不足以有效地增加预约安排或出席率。未来的努力应包括多模式外展策略,更清晰的成本和效益沟通,以及个性化的参与方法,以更好地解决患者的障碍,提高对营养师服务的采用。
{"title":"Evaluating pharmacist-directed care for eligible patients of a large community-based pharmacy chain: An analysis of dietitian referral adoption rates","authors":"Avery Salcedo,&nbsp;Jamie Remines,&nbsp;Pramit Nadpara,&nbsp;Jean-Venable R. Goode","doi":"10.1016/j.japhpi.2026.100108","DOIUrl":"10.1016/j.japhpi.2026.100108","url":null,"abstract":"<div><h3>Background</h3><div>A large community-based pharmacy chain offers medical nutrition therapy (MNT) via secure dietitian telehealth virtual calls to eligible patients under a contracted benefit plan. This service supports chronic disease management, such as diabetes and cardiovascular conditions, through remote, personalized nutrition care. However, despite evidence of clinical benefit, patient engagement with MNT services through telehealth remains low. Pharmacists are well positioned to identify eligible patients, refer them to MNT services, and conduct outreach to promote attendance.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the impact of pharmacist-directed care, including pharmacist-led identification of eligible patients, referral to MNT, and follow-up telephone calls, on dietitian referral adoption rates and patient engagement.</div></div><div><h3>Methods</h3><div>In this prospective quality improvement study, 388 adult beneficiaries enrolled in a contracted benefit plan were identified as eligible for MNT through the Diabetes and Heart Health Welcome programs. Pharmacists conducted follow-up calls to educate patients and encourage MNT scheduling. Descriptive and univariate analyses were used to summarize outcomes.</div></div><div><h3>Results</h3><div>Pharmacists conducted outreach telephone calls to all 388 eligible patients (100%). The most frequent call outcome was voicemail (205 of 388, 52.8%). Only 25 patients scheduled an MNT appointment (25 of 388, 6.4%), and 6 ultimately attended (6 of 388, 1.5%). Among those who declined or expressed disinterest (70 of 388, 18.0%), 10 (10 of 70, 14.3%) reported no interest in nutritional counseling, and 6 (6 of 70, 8.6%) were already receiving care from another dietitian. Cost concerns were the most frequently cited barrier (33 of 388, 8.5%). Most calls (261 of 388, 67.3%) lasted less than 1 minute.</div></div><div><h3>Conclusion</h3><div>Phone-based pharmacist outreach alone yielded limited patient engagement in MNT. Although pharmacist-directed referral and follow-up are feasible, they were insufficient to meaningfully increase appointment scheduling or attendance. Future efforts should incorporate multimodal outreach strategies, clearer cost and benefit communication, and personalized engagement methods to better address patient barriers and improve adoption of dietitian services.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100108"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661479","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}
引用次数: 0
Evaluating patient willingness for influenza testing and treatment: A comparison between community-based pharmacy setting and alternative health care settings 评估患者对流感检测和治疗的意愿:社区药房设置和替代卫生保健设置之间的比较
Pub Date : 2026-07-01 Epub Date: 2026-01-14 DOI: 10.1016/j.japhpi.2026.100094
Raney Ward, Sharon S. Gatewood, Tana N. Kaefer, Pramit Nadpara, Jean-Venable R. Goode

Background

In Virginia, pharmacists are authorized to test and treat for influenza, group A streptococcus, coronavirus disease 2019, and urinary tract infections per statewide protocols.

Objectives

This study aimed to assess patients’ willingness to receive influenza test and treat services in a community-based pharmacy setting versus other health care settings, evaluate patients’ willingness to pay, identify barriers preventing use, and understand which patient demographic is best to target for marketing strategies.

Methods

A 6-month prospective convenience sample-based study was conducted using a 49-question needs assessment survey, distributed via quick response code or text link at an independent pharmacy and 3 off-site influenza vaccine clinics. The survey assessed patient perceptions of health care settings, health care access, payment preferences, and demographics. Data were analyzed using SPSS version 26. Descriptive statistics were reported, and Wilcoxon signed-rank tests were used to assess differences in patients’ likelihood of using community-based pharmacy test and treat services compared with alternative health care settings.

Results

More than 300 surveys were offered, and 25 surveys were completed. Most patients were female (76%), were Caucasian (88%), were aged 31-50 years (40%), held a graduate degree (48%), and were employed full time (56%). A statistically significant difference was observed in patients’ willingness to receive influenza test and treat services at community-based pharmacies compared with at hospitals, specialist offices, nurse practitioner–led clinics, or free clinics. Convenience was the most cited reason for choosing both pharmacies and other health care settings, followed by cost, trust, and wait times; perceived quality and urgency also influenced care decisions. A lack of awareness was the most noted barrier, followed by distance, limited weekend hours, and preference for primary providers; 96% of patients were willing to use insurance and preferred out-of-pocket costs from $0 to $25. Those most likely to use pharmacist-led test services were aged 31-50 years, retired or full-time employed, Caucasian, and female and held graduate degrees.

Conclusion

There is strong patient willingness to use test and treat services in community-based pharmacies; however, a lack of awareness needs to be addressed to increase patient engagement.
在弗吉尼亚州,药剂师有权根据全州协议检测和治疗流感、A组链球菌、2019年冠状病毒病和尿路感染。本研究旨在评估患者在社区药房与其他卫生保健机构接受流感检测和治疗服务的意愿,评估患者的支付意愿,确定阻止使用的障碍,并了解哪些患者是营销策略的最佳目标。方法采用一项包含49个问题的需求评估调查,通过快速响应代码或文本链接在一家独立药房和3家非现场流感疫苗诊所进行为期6个月的前瞻性便捷抽样研究。该调查评估了患者对医疗保健环境、医疗保健获取、支付偏好和人口统计数据的看法。数据分析采用SPSS version 26。报告了描述性统计数据,并使用Wilcoxon符号秩检验来评估患者使用社区药检和治疗服务的可能性与替代医疗保健机构的差异。结果共开展问卷调查300余份,完成问卷调查25项。大多数患者为女性(76%),高加索人(88%),年龄31-50岁(40%),拥有研究生学位(48%),全职工作(56%)。与医院、专科诊所、执业护士主导的诊所或免费诊所相比,患者在社区药房接受流感检测和治疗服务的意愿存在统计学上的显著差异。在选择药店和其他医疗机构时,方便是被提及最多的原因,其次是成本、信任和等待时间;感知到的质量和紧迫性也影响了护理决策。缺乏意识是最明显的障碍,其次是距离、周末时间有限和对主要提供者的偏好;96%的患者愿意使用保险,并希望自付费用从0美元到25美元不等。那些最有可能使用药剂师主导的测试服务的人年龄在31-50岁之间,退休或全职工作,白种人,女性,拥有研究生学位。结论社区药房患者使用检验治疗服务的意愿较强;然而,需要解决缺乏意识的问题,以增加患者的参与。
{"title":"Evaluating patient willingness for influenza testing and treatment: A comparison between community-based pharmacy setting and alternative health care settings","authors":"Raney Ward,&nbsp;Sharon S. Gatewood,&nbsp;Tana N. Kaefer,&nbsp;Pramit Nadpara,&nbsp;Jean-Venable R. Goode","doi":"10.1016/j.japhpi.2026.100094","DOIUrl":"10.1016/j.japhpi.2026.100094","url":null,"abstract":"<div><h3>Background</h3><div>In Virginia, pharmacists are authorized to test and treat for influenza, group A streptococcus, coronavirus disease 2019, and urinary tract infections per statewide protocols.</div></div><div><h3>Objectives</h3><div>This study aimed to assess patients’ willingness to receive influenza test and treat services in a community-based pharmacy setting versus other health care settings, evaluate patients’ willingness to pay, identify barriers preventing use, and understand which patient demographic is best to target for marketing strategies.</div></div><div><h3>Methods</h3><div>A 6-month prospective convenience sample-based study was conducted using a 49-question needs assessment survey, distributed via quick response code or text link at an independent pharmacy and 3 off-site influenza vaccine clinics. The survey assessed patient perceptions of health care settings, health care access, payment preferences, and demographics. Data were analyzed using SPSS version 26. Descriptive statistics were reported, and Wilcoxon signed-rank tests were used to assess differences in patients’ likelihood of using community-based pharmacy test and treat services compared with alternative health care settings.</div></div><div><h3>Results</h3><div>More than 300 surveys were offered, and 25 surveys were completed. Most patients were female (76%), were Caucasian (88%), were aged 31-50 years (40%), held a graduate degree (48%), and were employed full time (56%). A statistically significant difference was observed in patients’ willingness to receive influenza test and treat services at community-based pharmacies compared with at hospitals, specialist offices, nurse practitioner–led clinics, or free clinics. Convenience was the most cited reason for choosing both pharmacies and other health care settings, followed by cost, trust, and wait times; perceived quality and urgency also influenced care decisions. A lack of awareness was the most noted barrier, followed by distance, limited weekend hours, and preference for primary providers; 96% of patients were willing to use insurance and preferred out-of-pocket costs from $0 to $25. Those most likely to use pharmacist-led test services were aged 31-50 years, retired or full-time employed, Caucasian, and female and held graduate degrees.</div></div><div><h3>Conclusion</h3><div>There is strong patient willingness to use test and treat services in community-based pharmacies; however, a lack of awareness needs to be addressed to increase patient engagement.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100094"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661499","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}
引用次数: 0
Evaluation of SGLT2 inhibitor effects on glycemic management in hospitalized non-critically ill patients SGLT2抑制剂对住院非危重患者血糖管理效果的评价
Pub Date : 2026-07-01 Epub Date: 2026-04-01 DOI: 10.1016/j.japhpi.2026.100111
E.J. Marineau, Dennis Dubovetsky

Background

Professional society guidelines provide discordant recommendations regarding the inpatient use of sodium–glucose cotransporter 2 inhibitors (SGLT2i) for glycemic management in non-critically ill patients with type 2 diabetes mellitus (T2DM). Although the American Diabetes Association supports continuation or initiation of SGLT2i in select hospitalized patients with heart failure, the Endocrine Society recommends against routine inpatient use.

Objective

This study evaluated real-world safety and glycemic outcomes associated with SGLT2i use in non-critically ill hospitalized patients with T2DM.

Methods

This single-center, observational, retrospective cohort study included adults with established T2DM admitted to a large tertiary care hospital between August 1 and December 7, 2024. Patients receiving an SGLT2i in combination with insulin therapy were compared with patients receiving insulin therapy alone. The primary outcome was median inpatient point-of-care blood glucose. Secondary outcomes included percentage of glucose readings within the target range (100–180 mg/dL), total daily insulin, 90-day all-cause readmissions, length of stay, inpatient mortality, acute kidney injury, hypoglycemia, and ketoacidosis.

Results

A total of 150 patients were included (75 per group). Median inpatient blood glucose was lower in the SGLT2i group compared with insulin alone (165 vs. 180 mg/dL; P < 0.001). There was no difference in the percentage of glucose readings within target range. Patients receiving SGLT2i required a slightly lower median total daily insulin dose (15 vs. 16 units; P = 0.006) and had fewer 90-day all-cause readmissions (28% vs. 48%; P = 0.005). Rates of hypoglycemia, acute kidney injury, ketoacidosis, length of stay, and inpatient mortality were similar between groups.

Conclusions

In this real-world cohort of non-critically ill hospitalized patients with T2DM, SGLT2i use in combination with insulin was associated with comparable glycemic control and no increase in adverse safety outcomes. These findings support cautious continuation of SGLT2i during hospitalization in appropriately selected patients and underscore the need for prospective studies to better define inpatient use.
背景:对于非危重型2型糖尿病(T2DM)住院患者使用钠-葡萄糖共转运蛋白2抑制剂(SGLT2i)进行血糖管理,专业协会指南提供了不一致的建议。尽管美国糖尿病协会支持在住院心力衰竭患者中继续或开始使用SGLT2i,但内分泌学会建议不要在住院患者中常规使用。目的:本研究评估非危重住院T2DM患者使用SGLT2i的实际安全性和血糖结局。方法这项单中心、观察性、回顾性队列研究纳入了2024年8月1日至12月7日在一家大型三级医院住院的确诊T2DM成人患者。将接受SGLT2i联合胰岛素治疗的患者与单独接受胰岛素治疗的患者进行比较。主要终点是住院患者护理点的中位血糖。次要结局包括血糖读数在目标范围内(100-180 mg/dL)的百分比、每日总胰岛素、90天全因再入院、住院时间、住院死亡率、急性肾损伤、低血糖和酮症酸中毒。结果共纳入150例患者,每组75例。与单独使用胰岛素相比,SGLT2i组住院患者血糖中位数较低(165 vs 180 mg/dL; P < 0.001)。血糖读数在目标范围内的百分比没有差异。接受SGLT2i治疗的患者需要的每日胰岛素总剂量中位数略低(15对16单位,P = 0.006), 90天全因再入院较少(28%对48%,P = 0.005)。两组间的低血糖、急性肾损伤、酮症酸中毒、住院时间和住院死亡率相似。结论:在这个非危重住院T2DM患者的现实世界队列中,SGLT2i与胰岛素联合使用与相当的血糖控制相关,并且没有增加不良安全性结果。这些发现支持在适当选择的患者住院期间谨慎继续使用SGLT2i,并强调需要前瞻性研究来更好地定义住院患者的使用。
{"title":"Evaluation of SGLT2 inhibitor effects on glycemic management in hospitalized non-critically ill patients","authors":"E.J. Marineau,&nbsp;Dennis Dubovetsky","doi":"10.1016/j.japhpi.2026.100111","DOIUrl":"10.1016/j.japhpi.2026.100111","url":null,"abstract":"<div><h3>Background</h3><div>Professional society guidelines provide discordant recommendations regarding the inpatient use of sodium–glucose cotransporter 2 inhibitors (SGLT2i) for glycemic management in non-critically ill patients with type 2 diabetes mellitus (T2DM). Although the American Diabetes Association supports continuation or initiation of SGLT2i in select hospitalized patients with heart failure, the Endocrine Society recommends against routine inpatient use.</div></div><div><h3>Objective</h3><div>This study evaluated real-world safety and glycemic outcomes associated with SGLT2i use in non-critically ill hospitalized patients with T2DM.</div></div><div><h3>Methods</h3><div>This single-center, observational, retrospective cohort study included adults with established T2DM admitted to a large tertiary care hospital between August 1 and December 7, 2024. Patients receiving an SGLT2i in combination with insulin therapy were compared with patients receiving insulin therapy alone. The primary outcome was median inpatient point-of-care blood glucose. Secondary outcomes included percentage of glucose readings within the target range (100–180 mg/dL), total daily insulin, 90-day all-cause readmissions, length of stay, inpatient mortality, acute kidney injury, hypoglycemia, and ketoacidosis.</div></div><div><h3>Results</h3><div>A total of 150 patients were included (75 per group). Median inpatient blood glucose was lower in the SGLT2i group compared with insulin alone (165 vs. 180 mg/dL; <em>P</em> &lt; 0.001). There was no difference in the percentage of glucose readings within target range. Patients receiving SGLT2i required a slightly lower median total daily insulin dose (15 vs. 16 units; <em>P</em> = 0.006) and had fewer 90-day all-cause readmissions (28% vs. 48%; <em>P</em> = 0.005). Rates of hypoglycemia, acute kidney injury, ketoacidosis, length of stay, and inpatient mortality were similar between groups.</div></div><div><h3>Conclusions</h3><div>In this real-world cohort of non-critically ill hospitalized patients with T2DM, SGLT2i use in combination with insulin was associated with comparable glycemic control and no increase in adverse safety outcomes. These findings support cautious continuation of SGLT2i during hospitalization in appropriately selected patients and underscore the need for prospective studies to better define inpatient use.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100111"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661214","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}
引用次数: 0
Expanding impact: Resident research advancing the future of pharmacy practice 扩大影响:居民研究推进药房实践的未来
Pub Date : 2026-07-01 Epub Date: 2026-06-04 DOI: 10.1016/j.japhpi.2026.100118
Darin C. Ramsey PharmD, BCPS, BCACP
{"title":"Expanding impact: Resident research advancing the future of pharmacy practice","authors":"Darin C. Ramsey PharmD, BCPS, BCACP","doi":"10.1016/j.japhpi.2026.100118","DOIUrl":"10.1016/j.japhpi.2026.100118","url":null,"abstract":"","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100118"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661215","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}
引用次数: 0
Advanced roles for pharmacy technicians in North Carolina outpatient community-based pharmacies: A survey of pharmacists and pharmacy technicians 北卡罗莱纳州门诊社区药房药学技术人员的高级角色:药剂师和药学技术人员的调查
Pub Date : 2026-07-01 Epub Date: 2026-04-15 DOI: 10.1016/j.japhpi.2026.100113
Andria Zuhlke, Laura Russell, Macary Weck Marciniak, Traci Shell, Laura A. Rhodes

Background

Pharmacy technicians have traditionally assisted pharmacists with administrative medication dispensing tasks, but many are now being trained to serve in advanced roles supporting clinical services. However, the specific advanced tasks they perform and the benefits or barriers associated with these roles remain unclear.

Objective

To identify the roles and training methods offered by outpatient community-based pharmacies to pharmacy technicians and to identify perceived benefits and barriers for pharmacy technicians serving in advanced roles.

Methods

A cross-sectional, online survey was distributed to outpatient community-based pharmacists and pharmacy technicians in North Carolina whose sites employed at least one pharmacy technician. A 19-item investigator-developed survey explored technician roles, practice site-encouraged or supported training, and perceived benefits and barriers to pharmacy technicians in advanced roles. The survey was open for 30 days. Responses were analyzed using descriptive statistics and thematic analysis.

Results

Of 42,800 surveys distributed, 2663 were returned, and 1257 were included (pharmacists: n = 459; pharmacy technicians: n = 798). Commonly reported tasks performed were refill reminders (n = 1237, 98%), data entry (n = 1213, 96%), inventory management (n = 1203, 96%), and patient intake (n = 975, 78%). Encouraged or supported trainings at the practice site were continuing education (n = 1080, 86%), vaccine administration certificate training programs (n = 986, 78%), and cardiopulmonary resuscitation training (n = 874, 70%). Reported benefits were increased workflow efficiency (n = 645, 51%), increased personal or career satisfaction (n = 599, 48%), and increased workplace engagement (n = 555, 44%). Reported barriers were hiring shortages or high turnover (n = 591, 47%), lack of interest, engagement, or capacity (n = 574, 46%), and lack of incentive (n = 561, 45%).

Conclusion

North Carolina pharmacy technicians support pharmacists in tasks beyond medication dispensing, aided by practice site-supported training or education aligned with regulatory requirements. Findings suggest the need for solutions to address hiring shortages, a lack of interest, engagement, or capacity, and to incentivize those fulfilling advanced roles.
传统上,药学技术人员协助药剂师完成行政药物配药任务,但现在许多人正在接受培训,担任支持临床服务的高级角色。然而,他们执行的具体高级任务以及与这些角色相关的好处或障碍仍然不清楚。目的了解社区门诊药房对药学技术人员的作用和培训方法,了解药学技术人员担任高级职务的好处和障碍。方法采用横断面在线调查方法,对北卡罗莱纳州至少有一名药学技术人员的门诊社区药师和药学技术人员进行调查。一项由研究者开发的19项调查探讨了技术人员的角色、实践场所鼓励或支持的培训,以及药学技术人员在高级角色中的利益和障碍。调查为期30天。使用描述性统计和专题分析对回复进行分析。结果发放问卷42,800份,回收2663份,纳入1257份(药师459份,药学技术人员798份)。通常报告的执行任务是补充提醒(n = 1237, 98%)、数据输入(n = 1213, 96%)、库存管理(n = 1203, 96%)和患者入院(n = 975, 78%)。在实践现场鼓励或支持的培训包括继续教育(n = 1080, 86%)、疫苗管理证书培训(n = 986, 78%)和心肺复苏培训(n = 874, 70%)。报告的好处是提高了工作流程效率(n = 645, 51%),提高了个人或职业满意度(n = 599, 48%),提高了工作场所参与度(n = 5555, 44%)。报告的障碍是招聘短缺或高流动率(n = 591, 47%),缺乏兴趣、参与或能力(n = 574, 46%),以及缺乏激励(n = 561, 45%)。结论:北卡罗莱纳州的药学技术人员在实践现场支持的培训或符合法规要求的教育的帮助下,支持药剂师完成药物配药以外的任务。研究结果表明,需要解决招聘短缺、缺乏兴趣、参与或能力的问题,并激励那些履行高级角色的人。
{"title":"Advanced roles for pharmacy technicians in North Carolina outpatient community-based pharmacies: A survey of pharmacists and pharmacy technicians","authors":"Andria Zuhlke,&nbsp;Laura Russell,&nbsp;Macary Weck Marciniak,&nbsp;Traci Shell,&nbsp;Laura A. Rhodes","doi":"10.1016/j.japhpi.2026.100113","DOIUrl":"10.1016/j.japhpi.2026.100113","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacy technicians have traditionally assisted pharmacists with administrative medication dispensing tasks, but many are now being trained to serve in advanced roles supporting clinical services. However, the specific advanced tasks they perform and the benefits or barriers associated with these roles remain unclear.</div></div><div><h3>Objective</h3><div>To identify the roles and training methods offered by outpatient community-based pharmacies to pharmacy technicians and to identify perceived benefits and barriers for pharmacy technicians serving in advanced roles.</div></div><div><h3>Methods</h3><div>A cross-sectional, online survey was distributed to outpatient community-based pharmacists and pharmacy technicians in North Carolina whose sites employed at least one pharmacy technician. A 19-item investigator-developed survey explored technician roles, practice site-encouraged or supported training, and perceived benefits and barriers to pharmacy technicians in advanced roles. The survey was open for 30 days. Responses were analyzed using descriptive statistics and thematic analysis.</div></div><div><h3>Results</h3><div>Of 42,800 surveys distributed, 2663 were returned, and 1257 were included (pharmacists: n = 459; pharmacy technicians: n = 798). Commonly reported tasks performed were refill reminders (n = 1237, 98%), data entry (n = 1213, 96%), inventory management (n = 1203, 96%), and patient intake (n = 975, 78%). Encouraged or supported trainings at the practice site were continuing education (n = 1080, 86%), vaccine administration certificate training programs (n = 986, 78%), and cardiopulmonary resuscitation training (n = 874, 70%). Reported benefits were increased workflow efficiency (n = 645, 51%), increased personal or career satisfaction (n = 599, 48%), and increased workplace engagement (n = 555, 44%). Reported barriers were hiring shortages or high turnover (n = 591, 47%), lack of interest, engagement, or capacity (n = 574, 46%), and lack of incentive (n = 561, 45%).</div></div><div><h3>Conclusion</h3><div>North Carolina pharmacy technicians support pharmacists in tasks beyond medication dispensing, aided by practice site-supported training or education aligned with regulatory requirements. Findings suggest the need for solutions to address hiring shortages, a lack of interest, engagement, or capacity, and to incentivize those fulfilling advanced roles.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100113"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661320","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}
引用次数: 0
期刊
JAPhA Practice Innovations
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
﹀
mjeditor
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1