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Advancing food-is-medicine: A pilot of pharmacist-facilitated dietitian scheduling 推进食物即药物:药剂师促进营养师调度的试点
Pub Date : 2026-07-01 Epub Date: 2026-01-29 DOI: 10.1016/j.japhpi.2026.100096
Jackie Tan, Kimberly Johnson, Amy Bailey, Kellie J. Goodlet

Background

“Food-is-medicine” (FIM) is an emerging health care model that integrates nutrition into chronic disease management. The accessibility of community pharmacists makes them well positioned to identify and refer eligible patients to dietitian services, yet these collaborations and associated patient perceptions remain underexplored in current practice.

Objective

This study aimed to explore the feasibility of community pharmacist-facilitated dietitian appointments.

Methods

A large pharmacy chain piloted an initiative allowing pharmacists in 1 regional division to directly schedule patients for virtual appointments with their nutrition team. A pharmacist contacted English-speaking adult patients with diabetes or hypertension by telephone between December 2024 and April 2025 and offered to schedule them with a dietitian. Patients who accepted direct scheduling were invited to complete a voluntary survey on their experience.

Results

The pharmacist reached 172 of 336 eligible patients (51.2%) across 110 pharmacy sites. After speaking with the pharmacist, 26 patients (15.1%) expressed interest in dietitian services and 8 (4.7%) were directly scheduled. Reasons for declining an appointment included not having insurance information readily available, requesting contact at a later time, or scheduling conflicts. Among patients who were directly scheduled, 50% attended their appointment. The most common reason for nonattendance was scheduling conflicts. Survey responses indicated overall favorable impressions of both the scheduling process and the dietitian service, including observed minor health improvements such as weight loss. Respondents recognized both pharmacists and dietitians as playing an important role in supporting the management of their chronic conditions.

Conclusion

The results of this pilot study support the hypothesis that community pharmacists can facilitate access to nutrition-focused care and highlight an actionable opportunity to integrate community pharmacists into FIM initiatives. Future research should focus on optimizing referral workflows and addressing patient barriers to increase engagement with dietitian services and develop sustainable and scalable models for broader implementation.
“食物即药物”(Food-is-medicine, FIM)是一种将营养纳入慢性病管理的新兴卫生保健模式。社区药剂师的可及性使他们能够很好地识别和推荐符合条件的患者到营养师服务,然而这些合作和相关的患者感知在当前的实践中仍未得到充分的探索。目的探讨社区药师预约营养师的可行性。方法一家大型连锁药店试行了一项举措,允许1个区域部门的药剂师直接安排患者与他们的营养团队进行虚拟预约。一位药剂师在2024年12月至2025年4月期间通过电话联系了说英语的成年糖尿病或高血压患者,并提出安排他们与营养师会面。接受直接调度的患者被邀请完成一项关于他们经历的自愿调查。结果110个药房336例符合条件的患者中,药师达到172例,占51.2%。在与药剂师交谈后,26名患者(15.1%)表示对营养师服务感兴趣,8名患者(4.7%)被直接安排。拒绝预约的原因包括没有现成的保险信息,要求在以后的时间联系,或者安排冲突。在直接预约的患者中,50%的人参加了他们的预约。缺席的最常见原因是日程冲突。调查结果表明,人们对日程安排过程和营养师服务的总体印象都很好,包括观察到的轻微健康改善,如体重减轻。受访者承认药剂师和营养师在支持其慢性病管理方面发挥着重要作用。结论本试点研究的结果支持了社区药师可以促进获得以营养为重点的护理的假设,并突出了将社区药师纳入FIM倡议的可行机会。未来的研究应侧重于优化转诊工作流程和解决患者障碍,以增加对营养师服务的参与,并为更广泛的实施开发可持续和可扩展的模型。
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引用次数: 0
Blood pressure reduction in glucagon-like peptide-1 receptor agonist users in a family medicine clinic 在家庭医学诊所使用胰高血糖素样肽-1受体激动剂降低血压
Pub Date : 2026-07-01 Epub Date: 2025-11-08 DOI: 10.1016/j.japhpi.2025.100083
Julia Mesawich, Tiffaney Threatt, David Mercer

Background

Hypertension remains increasingly prevalent, affecting an estimated 45.4% of adults in the United States (Ostchega et al., 2017-2018; National Center for Health Statistics, 2020). It is a common comorbidity in individuals with both type 2 diabetes mellitus (T2DM) and obesity. Incretin-based therapies, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs), are an effective treatment for T2DM and obesity. Although some meta-analyses have shown that patients on GLP-1 RAs experience modest blood pressure lowering, there have not been any studies that look at this as a primary end point.

Objective

This study aimed to determine the blood pressure–lowering effect of GLP-1 RAs on systolic and diastolic blood pressure in adults within 1 year of initiation.

Methods

This study was single center, observational, and retrospective. Patients were identified for inclusion if they were prescribed a GLP-1 RA between December 1, 2020, and June 1, 2021. GLP-1 RA use was defined as at least 2 prescriptions for the same GLP-1 RA, authorized on different dates. Clinic-measured blood pressures from baseline to 1 year after the initiation of GLP-1 RA therapy were collected.

Results

A total of 77 participants were evaluated for change in blood pressure from baseline to 1 year after GLP-1 RA initiation. Most participants were prescribed semaglutide injection (33.77%) or dulaglutide injection (36.36%). For the primary outcome, there was a statistically significant change in systolic blood pressure from baseline to 1 year after initiation of GLP-1 RA therapy. There was no statistically significant change in diastolic blood pressure.

Conclusion

From baseline to 1 year, GLP-1 receptor agonists lowered blood pressure with statistical significance. Therefore, in someone with hypertension and another compelling indication, GLP-1 RAs may be a good option for comprehensive management of comorbidities.
背景:高血压仍然越来越普遍,影响了美国约45.4%的成年人(Ostchega等人,2017-2018;国家卫生统计中心,2020)。它是2型糖尿病(T2DM)和肥胖患者的常见合并症。以肠促胰岛素为基础的治疗,包括胰高血糖素样肽-1受体激动剂(GLP-1 RAs),是治疗2型糖尿病和肥胖的有效方法。尽管一些荟萃分析表明,GLP-1 RAs治疗的患者血压有适度降低,但还没有任何研究将其作为主要终点。目的本研究旨在确定GLP-1 RAs对成人1年内收缩压和舒张压的降血压作用。方法采用单中心、观察性、回顾性研究。如果患者在2020年12月1日至2021年6月1日期间服用GLP-1 RA,则确定纳入研究。GLP-1 RA的使用定义为同一种GLP-1 RA的至少2种处方,在不同的日期获得批准。收集从基线到开始GLP-1 RA治疗后1年的临床测量血压。结果共有77名参与者在GLP-1 RA开始治疗后1年内的血压变化进行了评估。大多数参与者开的是西马鲁肽注射液(33.77%)或杜拉鲁肽注射液(36.36%)。对于主要结局,在GLP-1 RA治疗开始1年后,收缩压从基线到1年后有统计学意义的变化。舒张压没有统计学上的显著变化。结论从基线到1年,GLP-1受体激动剂降低血压具有统计学意义。因此,对于患有高血压和其他令人信服的适应症的患者,GLP-1 RAs可能是综合治疗合并症的良好选择。
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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
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引用次数: 0
Psychosocial factors influencing community pharmacist’s intention to counsel on medication-induced genitourinary adverse effects 影响社区药师药物性泌尿生殖系统不良反应咨询意向的社会心理因素
Pub Date : 2026-07-01 Epub Date: 2026-05-25 DOI: 10.1016/j.japhpi.2026.100117
Emma Brusio, Deanna Tran, Hyunuk Seung, Eric Kim, Tiffany Taliaferro-Roberts, Victoria Bulkin

Background

Pharmacist-led counseling is an important service that has been associated with improved clinical outcomes, increased quality of life, drug knowledge, and patient satisfaction.2 Effective patient education that produces patient understanding of medication-induced adverse effects has shown to improve medication adherence.8 To date, there are no studies regarding factors influencing community pharmacists’ intention to counsel on medication-induced genitourinary adverse effects (GAEs).

Objectives

The objectives of this study were to determine psychosocial and workflow factors that may influence a community pharmacist’s intention to counsel patients on medication-induced genitourinary adverse effects.

Methods

This study was an anonymous, online survey distributed to community pharmacists focusing on their intention to counsel patients on medication-induced GAEs. Inclusion criteria were licensed community pharmacists employed at Albertsons community pharmacies, primarily working with patients, aged 18 years or older, and able to read and write English. Survey items used the Theory of Planned Behavior (TPB) framework to assess factors such as attitudes, subjective norms, and perceived behavioral control and included demographic questions and ranking of workflow influences. Descriptive statistics were used to summarize survey data.

Results

Out of 276 survey respondents, 242 individuals provided usable responses. The majority of respondents agreed that both patients and providers expect them to provide counseling on GAEs (∼55%), although fewer respondents (∼48%) felt that patients are comfortable discussing these issues. Pharmacists who counseled more frequently reported significantly greater comfort discussing GAEs across age and gender differences.

Conclusion

Most Albertsons pharmacists were willing and comfortable discussing medication-induced GAEs with patients. Additional training may support consistent counseling in the presence of external workflow challenges.
背景药剂师主导的咨询是一项重要的服务,与改善临床结果,提高生活质量,药物知识和患者满意度有关有效的患者教育,使患者了解药物引起的不良反应,已被证明可以提高服药依从性到目前为止,还没有关于影响社区药师对药物性泌尿生殖系统不良反应(GAEs)进行咨询意愿的因素的研究。目的本研究的目的是确定可能影响社区药剂师就药物引起的泌尿生殖系统不良反应向患者提供咨询的心理社会因素和工作流程因素。方法本研究是一项匿名的在线调查,调查对象是社区药剂师,主要关注他们对药物性GAEs患者的咨询意向。纳入标准是在Albertsons社区药房工作的有执照的社区药剂师,主要与18岁或以上的患者一起工作,能够读写英语。调查项目使用计划行为理论(TPB)框架来评估诸如态度、主观规范和感知行为控制等因素,并包括人口统计问题和工作流影响排名。采用描述性统计对调查数据进行汇总。结果276名调查对象中,242人提供了可用的回答。大多数受访者同意,患者和提供者都希望他们提供GAEs咨询(约55%),尽管较少的受访者(约48%)认为患者愿意讨论这些问题。经常提供咨询服务的药剂师报告说,在讨论游戏时,他们更能跨越年龄和性别差异。结论大多数艾伯森的药师愿意且愿意与患者讨论药物性GAEs。额外的培训可以在外部工作流程挑战的情况下支持一致的咨询。
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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":"148661319","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
Psychosocial factors influencing community pharmacist’s intention to counsel on medication-induced genitourinary adverse effects 影响社区药师药物性泌尿生殖系统不良反应咨询意向的社会心理因素
Pub Date : 2026-07-01 Epub Date: 2026-05-25 DOI: 10.1016/j.japhpi.2026.100117
Emma Brusio, Deanna Tran, Hyunuk Seung, Eric Kim, Tiffany Taliaferro-Roberts, Victoria Bulkin

Background

Pharmacist-led counseling is an important service that has been associated with improved clinical outcomes, increased quality of life, drug knowledge, and patient satisfaction.2 Effective patient education that produces patient understanding of medication-induced adverse effects has shown to improve medication adherence.8 To date, there are no studies regarding factors influencing community pharmacists’ intention to counsel on medication-induced genitourinary adverse effects (GAEs).

Objectives

The objectives of this study were to determine psychosocial and workflow factors that may influence a community pharmacist’s intention to counsel patients on medication-induced genitourinary adverse effects.

Methods

This study was an anonymous, online survey distributed to community pharmacists focusing on their intention to counsel patients on medication-induced GAEs. Inclusion criteria were licensed community pharmacists employed at Albertsons community pharmacies, primarily working with patients, aged 18 years or older, and able to read and write English. Survey items used the Theory of Planned Behavior (TPB) framework to assess factors such as attitudes, subjective norms, and perceived behavioral control and included demographic questions and ranking of workflow influences. Descriptive statistics were used to summarize survey data.

Results

Out of 276 survey respondents, 242 individuals provided usable responses. The majority of respondents agreed that both patients and providers expect them to provide counseling on GAEs (∼55%), although fewer respondents (∼48%) felt that patients are comfortable discussing these issues. Pharmacists who counseled more frequently reported significantly greater comfort discussing GAEs across age and gender differences.

Conclusion

Most Albertsons pharmacists were willing and comfortable discussing medication-induced GAEs with patients. Additional training may support consistent counseling in the presence of external workflow challenges.
背景药剂师主导的咨询是一项重要的服务,与改善临床结果,提高生活质量,药物知识和患者满意度有关有效的患者教育,使患者了解药物引起的不良反应,已被证明可以提高服药依从性到目前为止,还没有关于影响社区药师对药物性泌尿生殖系统不良反应(GAEs)进行咨询意愿的因素的研究。目的本研究的目的是确定可能影响社区药剂师就药物引起的泌尿生殖系统不良反应向患者提供咨询的心理社会因素和工作流程因素。方法本研究是一项匿名的在线调查,调查对象是社区药剂师,主要关注他们对药物性GAEs患者的咨询意向。纳入标准是在Albertsons社区药房工作的有执照的社区药剂师,主要与18岁或以上的患者一起工作,能够读写英语。调查项目使用计划行为理论(TPB)框架来评估诸如态度、主观规范和感知行为控制等因素,并包括人口统计问题和工作流影响排名。采用描述性统计对调查数据进行汇总。结果276名调查对象中,242人提供了可用的回答。大多数受访者同意,患者和提供者都希望他们提供GAEs咨询(约55%),尽管较少的受访者(约48%)认为患者愿意讨论这些问题。经常提供咨询服务的药剂师报告说,在讨论游戏时,他们更能跨越年龄和性别差异。结论大多数艾伯森的药师愿意且愿意与患者讨论药物性GAEs。额外的培训可以在外部工作流程挑战的情况下支持一致的咨询。
{"title":"Psychosocial factors influencing community pharmacist’s intention to counsel on medication-induced genitourinary adverse effects","authors":"Emma Brusio,&nbsp;Deanna Tran,&nbsp;Hyunuk Seung,&nbsp;Eric Kim,&nbsp;Tiffany Taliaferro-Roberts,&nbsp;Victoria Bulkin","doi":"10.1016/j.japhpi.2026.100117","DOIUrl":"10.1016/j.japhpi.2026.100117","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacist-led counseling is an important service that has been associated with improved clinical outcomes, increased quality of life, drug knowledge, and patient satisfaction.<span><span><sup>2</sup></span></span> Effective patient education that produces patient understanding of medication-induced adverse effects has shown to improve medication adherence.<span><span><sup>8</sup></span></span> To date, there are no studies regarding factors influencing community pharmacists’ intention to counsel on medication-induced genitourinary adverse effects (GAEs).</div></div><div><h3>Objectives</h3><div>The objectives of this study were to determine psychosocial and workflow factors that may influence a community pharmacist’s intention to counsel patients on medication-induced genitourinary adverse effects.</div></div><div><h3>Methods</h3><div>This study was an anonymous, online survey distributed to community pharmacists focusing on their intention to counsel patients on medication-induced GAEs. Inclusion criteria were licensed community pharmacists employed at Albertsons community pharmacies, primarily working with patients, aged 18 years or older, and able to read and write English. Survey items used the Theory of Planned Behavior (TPB) framework to assess factors such as attitudes, subjective norms, and perceived behavioral control and included demographic questions and ranking of workflow influences. Descriptive statistics were used to summarize survey data.</div></div><div><h3>Results</h3><div>Out of 276 survey respondents, 242 individuals provided usable responses. The majority of respondents agreed that both patients and providers expect them to provide counseling on GAEs (∼55%), although fewer respondents (∼48%) felt that patients are comfortable discussing these issues. Pharmacists who counseled more frequently reported significantly greater comfort discussing GAEs across age and gender differences.</div></div><div><h3>Conclusion</h3><div>Most Albertsons pharmacists were willing and comfortable discussing medication-induced GAEs with patients. Additional training may support consistent counseling in the presence of external workflow challenges.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100117"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661332","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":"148661390","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 lipid targets: A cross-sectional general internal medicine patient evaluation for optimal lipid-lowering outcomes 评估脂质目标:对最佳降脂结果的横断面普通内科患者评估
Pub Date : 2026-07-01 Epub Date: 2025-11-28 DOI: 10.1016/j.japhpi.2025.100086
David Keister ((Robbie) III), Sarah Lorenzen, Marilee Clemons, Sarah Aldrich Renner, Brian Tasma

Background

In 2022, heart disease and stroke caused nearly 875,000 deaths in the United States, with $216 billion in health care costs and $147 billion in lost productivity. Preventing and managing atherosclerotic cardiovascular disease (ASCVD) are crucial.

Objectives

This study evaluates the integration of lower low-density lipoprotein cholesterol (LDL-C) targets from the 2022 American College of Cardiology (ACC) and 2023 American Diabetes Association (ADA) guidelines into practice.

Methods

This retrospective chart review investigated adult patients with ASCVD receiving lipid-lowering therapy (LLT) seen at an internal medicine clinic between January 1 and July 31, 2023. LDL-C targets were assigned per the 2022 ACC and the 2023 ADA guidelines. The primary end point was assigned LDL-C target achievement. Secondary end points included analyzing whether LLT was assessed for efficacy, provider identification of LDL-C targets, and target-directed interventions. Data were analyzed using quantitative and qualitative statistics.

Results

Of 375 screened patients, 319 were included. Overall, 265 (83%) had a lipid panel drawn within a year of their provider visit, with 222 (70%) from January 1, 2023, or later. Only 91 (29%) met their assigned LDL-C target, leaving 228 (71%) suboptimally treated. Among these, only 18 (8%) had a provider-identified LDL-C target, with 11 of these targets (61%) being inappropriate. Providers intervened to improve lipid control in only 23 of the 228 patients (10%) not meeting their LDL-C target.

Conclusions

Most primary care patients (71%) did not meet newer LDL-C targets, highlighting gaps in guideline adoption. These findings will guide clinic pharmacists in enhancing practices and addressing patient care gaps.
2022年,心脏病和中风在美国造成近87.5万人死亡,造成2160亿美元的医疗费用和1470亿美元的生产力损失。预防和控制动脉粥样硬化性心血管疾病(ASCVD)至关重要。本研究评估了2022年美国心脏病学会(ACC)和2023年美国糖尿病协会(ADA)指南中较低低密度脂蛋白胆固醇(LDL-C)目标在实践中的整合。方法回顾性分析2023年1月1日至7月31日在内科门诊接受降脂治疗(LLT)的成年ASCVD患者。LDL-C目标是根据2022 ACC和2023 ADA指南指定的。主要终点为LDL-C达标。次要终点包括分析是否评估了LLT的疗效,提供者对LDL-C靶点的识别,以及目标导向的干预措施。数据分析采用定量和定性统计。结果375例筛查患者中,319例纳入。总体而言,265名(83%)患者在就诊一年内进行了血脂检查,222名(70%)患者在2023年1月1日或之后进行了血脂检查。只有91例(29%)达到了指定的LDL-C目标,其余228例(71%)治疗不理想。其中,只有18个(8%)有提供者确定的LDL-C目标,其中11个(61%)目标不合适。在228名未达到LDL-C目标的患者中,只有23名(10%)的提供者进行了干预以改善脂质控制。大多数初级保健患者(71%)没有达到新的LDL-C目标,这突出了指南采用的差距。这些发现将指导临床药师加强实践和解决病人护理差距。
{"title":"Assessing lipid targets: A cross-sectional general internal medicine patient evaluation for optimal lipid-lowering outcomes","authors":"David Keister ((Robbie) III),&nbsp;Sarah Lorenzen,&nbsp;Marilee Clemons,&nbsp;Sarah Aldrich Renner,&nbsp;Brian Tasma","doi":"10.1016/j.japhpi.2025.100086","DOIUrl":"10.1016/j.japhpi.2025.100086","url":null,"abstract":"<div><h3>Background</h3><div>In 2022, heart disease and stroke caused nearly 875,000 deaths in the United States, with $216 billion in health care costs and $147 billion in lost productivity. Preventing and managing atherosclerotic cardiovascular disease (ASCVD) are crucial.</div></div><div><h3>Objectives</h3><div>This study evaluates the integration of lower low-density lipoprotein cholesterol (LDL-C) targets from the 2022 American College of Cardiology (ACC) and 2023 American Diabetes Association (ADA) guidelines into practice.</div></div><div><h3>Methods</h3><div>This retrospective chart review investigated adult patients with ASCVD receiving lipid-lowering therapy (LLT) seen at an internal medicine clinic between January 1 and July 31, 2023. LDL-C targets were assigned per the 2022 ACC and the 2023 ADA guidelines. The primary end point was assigned LDL-C target achievement. Secondary end points included analyzing whether LLT was assessed for efficacy, provider identification of LDL-C targets, and target-directed interventions. Data were analyzed using quantitative and qualitative statistics.</div></div><div><h3>Results</h3><div>Of 375 screened patients, 319 were included. Overall, 265 (83%) had a lipid panel drawn within a year of their provider visit, with 222 (70%) from January 1, 2023, or later. Only 91 (29%) met their assigned LDL-C target, leaving 228 (71%) suboptimally treated. Among these, only 18 (8%) had a provider-identified LDL-C target, with 11 of these targets (61%) being inappropriate. Providers intervened to improve lipid control in only 23 of the 228 patients (10%) not meeting their LDL-C target.</div></div><div><h3>Conclusions</h3><div>Most primary care patients (71%) did not meet newer LDL-C targets, highlighting gaps in guideline adoption. These findings will guide clinic pharmacists in enhancing practices and addressing patient care gaps.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100086"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661393","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
Enhancing timely access to medication changes: The role of ambulatory care pharmacists in overcoming transitions of care challenges 加强及时获得药物变化:门诊护理药师在克服护理挑战的转变中的作用
Pub Date : 2026-07-01 Epub Date: 2026-04-01 DOI: 10.1016/j.japhpi.2026.100110
Alison N. Van Dyke, Karen S. Williams, Jessica Carswell, Keith M. Hughes Jr

Background

Transitions of care are high-risk periods marked by frequent medication-related problems. Up to 80% of patients discharged from hospitals and 98% of older adults experience medication discrepancies. These lapses, often because of delayed refills or fragmented coordination, contribute to unplanned healthcare encounters, increased costs, and provider strain. Pharmacists in ambulatory care settings can mitigate these by improving medication access continuity.

Objective

To evaluate the impact of medication access gaps on time for the first unplanned healthcare encounter among patients discharged with chronic maintenance prescription medication changes.

Methods

A retrospective cohort study of patients discharged from two hospital sites between June 1, 2023 and May 31, 2024, with changes to chronic maintenance prescription medication. Eligible patients were ≥18 years of age, discharged to home, and followed up with a system-affiliated primary care provider. Patients were categorized as having a “medication gap” if they experienced any lapse in medication coverage because of delayed refills or required intervention. Patients with “no medication gap” maintained continuous medication access, with timely refills coordinated at follow-up.

Results

Among 104 patients, those with a medication gap had a significantly shorter time to first unplanned healthcare encounter (adjusted HR, 1.61; 95% CI, 1.09–2.39; P = 0.017) and were nearly four times more likely to experience a medication-related encounter (IPTW-adjusted HR, 3.76; 95% CI, 2.00–7.06; P < 0.001). Patients with a medication gap were associated with more days without medication, lower refill rates at follow-up (26.9% vs. 61.5%, P < 0.001), and more frequent barriers, such as inadequate discharge education.

Conclusions

Medication access gaps following discharge were associated with earlier and more frequent unplanned healthcare encounters. These findings highlight the need for pharmacist involvement in post-discharge medication management to reduce preventable healthcare use and improve care transitions.
背景:护理过渡期是高危期,其特点是药物相关问题频繁出现。高达80%的出院患者和98%的老年人都有用药不一致的经历。这些失误通常是由于延迟补充或分散的协调,导致计划外的医疗保健遭遇、成本增加和提供者压力。门诊护理机构的药剂师可以通过改善药物获取的连续性来减轻这些问题。目的评价药物获取缺口对慢性维持性处方用药改变出院患者首次计划外就诊时间的影响。方法回顾性队列研究2023年6月1日至2024年5月31日两所医院出院的慢性维持性处方药物变化患者。符合条件的患者年龄≥18岁,出院回家,并与系统附属的初级保健提供者进行随访。患者被归类为有“药物缺口”,如果他们经历了任何失效的药物覆盖,因为延迟补充或需要干预。“无用药缺口”的患者保持持续用药,并在随访中协调及时补充。结果在104名患者中,有药物间隔的患者到第一次计划外医疗保健就诊的时间明显更短(调整后的风险比,1.61;95% CI, 1.09-2.39; P = 0.017),并且经历药物相关就诊的可能性几乎是四倍(iptw调整后的风险比,3.76;95% CI, 2.00-7.06; P < 0.001)。有药物缺口的患者没有药物治疗的天数更长,随访时补药率较低(26.9%对61.5%,P < 0.001),以及更常见的障碍,如出院教育不足。结论出院后药物获取缺口与更早和更频繁的计划外医疗保健遭遇有关。这些发现强调了药剂师参与出院后用药管理的必要性,以减少可预防的医疗保健使用并改善护理过渡。
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引用次数: 0
Assessing lipid targets: A cross-sectional general internal medicine patient evaluation for optimal lipid-lowering outcomes 评估脂质目标:对最佳降脂结果的横断面普通内科患者评估
Pub Date : 2026-07-01 Epub Date: 2025-11-28 DOI: 10.1016/j.japhpi.2025.100086
David Keister ((Robbie) III), Sarah Lorenzen, Marilee Clemons, Sarah Aldrich Renner, Brian Tasma

Background

In 2022, heart disease and stroke caused nearly 875,000 deaths in the United States, with $216 billion in health care costs and $147 billion in lost productivity. Preventing and managing atherosclerotic cardiovascular disease (ASCVD) are crucial.

Objectives

This study evaluates the integration of lower low-density lipoprotein cholesterol (LDL-C) targets from the 2022 American College of Cardiology (ACC) and 2023 American Diabetes Association (ADA) guidelines into practice.

Methods

This retrospective chart review investigated adult patients with ASCVD receiving lipid-lowering therapy (LLT) seen at an internal medicine clinic between January 1 and July 31, 2023. LDL-C targets were assigned per the 2022 ACC and the 2023 ADA guidelines. The primary end point was assigned LDL-C target achievement. Secondary end points included analyzing whether LLT was assessed for efficacy, provider identification of LDL-C targets, and target-directed interventions. Data were analyzed using quantitative and qualitative statistics.

Results

Of 375 screened patients, 319 were included. Overall, 265 (83%) had a lipid panel drawn within a year of their provider visit, with 222 (70%) from January 1, 2023, or later. Only 91 (29%) met their assigned LDL-C target, leaving 228 (71%) suboptimally treated. Among these, only 18 (8%) had a provider-identified LDL-C target, with 11 of these targets (61%) being inappropriate. Providers intervened to improve lipid control in only 23 of the 228 patients (10%) not meeting their LDL-C target.

Conclusions

Most primary care patients (71%) did not meet newer LDL-C targets, highlighting gaps in guideline adoption. These findings will guide clinic pharmacists in enhancing practices and addressing patient care gaps.
2022年,心脏病和中风在美国造成近87.5万人死亡,造成2160亿美元的医疗费用和1470亿美元的生产力损失。预防和控制动脉粥样硬化性心血管疾病(ASCVD)至关重要。本研究评估了2022年美国心脏病学会(ACC)和2023年美国糖尿病协会(ADA)指南中较低低密度脂蛋白胆固醇(LDL-C)目标在实践中的整合。方法回顾性分析2023年1月1日至7月31日在内科门诊接受降脂治疗(LLT)的成年ASCVD患者。LDL-C目标是根据2022 ACC和2023 ADA指南指定的。主要终点为LDL-C达标。次要终点包括分析是否评估了LLT的疗效,提供者对LDL-C靶点的识别,以及目标导向的干预措施。数据分析采用定量和定性统计。结果375例筛查患者中,319例纳入。总体而言,265名(83%)患者在就诊一年内进行了血脂检查,222名(70%)患者在2023年1月1日或之后进行了血脂检查。只有91例(29%)达到了指定的LDL-C目标,其余228例(71%)治疗不理想。其中,只有18个(8%)有提供者确定的LDL-C目标,其中11个(61%)目标不合适。在228名未达到LDL-C目标的患者中,只有23名(10%)的提供者进行了干预以改善脂质控制。大多数初级保健患者(71%)没有达到新的LDL-C目标,这突出了指南采用的差距。这些发现将指导临床药师加强实践和解决病人护理差距。
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引用次数: 0
期刊
JAPhA Practice Innovations
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