首页 > 最新文献
paperpass

JAPhA Practice Innovations最新文献

英文 中文
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":"148661377","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 provider satisfaction with the role of clinical pharmacists delivering chronic care management services within an accountable care organization 评估提供者对临床药剂师在负责任的护理组织中提供慢性护理管理服务的角色的满意度
Pub Date : 2026-07-01 Epub Date: 2026-02-05 DOI: 10.1016/j.japhpi.2026.100100
Courtney Whitfield, Anna Baird, Ashley Abode, Macary Weck Marciniak, Laura A. Rhodes

Background

Chronic care management (CCM) involves coordinating comprehensive care for patients with multiple chronic conditions and focuses on addressing medical, functional, and psychosocial needs. This project describes an independent pharmacy that has delivered clinical services with a local accountable care organization (ACO). This collaboration has enabled clinical pharmacists to enhance patient care through medication expertise and patient relationships. Pharmacists facilitate communication with patients and care managers by remotely accessing electronic health records while providing the service. CCM services include reviewing medications and potential interactions, overseeing patient self-management of medications, and managing transitions of care.

Objective

This project aimed to assess provider perspectives on the role of the clinical pharmacist within the CCM model, access to a clinical pharmacist, and satisfaction with disease state impact and changes of care recommended by clinical pharmacists within an ACO.

Methods

A prospective, cross-sectional electronic survey was distributed to 32 ACO providers with pharmacists on their CCM teams. A 19-item survey captured provider perspectives on pharmacist contributions to CCM components. The survey was open for 30 days, with anonymized responses analyzed using descriptive statistics. Ranked responses were analyzed by generating a mean rank for each answer option, then ordered from low to high.

Results

Ten surveys were returned (response rate 31%). Most respondents were 46-65 years of age (n = 7, 70%) and physicians (n = 10, 100%), with 15+ years of practice experience (n = 8, 80%). The most impactful clinical pharmacy services were comprehensive medication reviews (mean, 2.7) and medication reconciliations (mean, 3.0). The top 5 disease states that clinical pharmacists affected were diabetes (mean, 2.7), atherosclerotic cardiovascular disease (mean, 3.9), chronic kidney disease (mean, 4.5), chronic obstructive pulmonary disease (mean, 5.4), and hypertension (mean, 6.0).

Conclusion

Providers expressed support for pharmacist-led services in CCM, highlighting pharmacists’ ability to enhance medication management, patient safety, and chronic disease outcomes.
慢性护理管理(chronic care management, CCM)涉及对多种慢性疾病患者的协调综合护理,重点关注医疗、功能和社会心理需求。本项目描述了一家独立的药房,该药房与当地负责任的护理组织(ACO)一起提供临床服务。这种合作使临床药剂师能够通过药物专业知识和患者关系加强患者护理。药剂师在提供服务的同时,通过远程访问电子健康记录,促进了与患者和护理管理人员的沟通。CCM服务包括审查药物和潜在的相互作用,监督患者对药物的自我管理,以及管理护理的过渡。目的:本项目旨在评估医疗服务提供者对临床药师在CCM模式中的作用、获得临床药师的机会以及对ACO中临床药师推荐的疾病状态影响和护理变化的满意度。方法采用前瞻性、横断面电子调查的方法,对32家有CCM团队药师的ACO供应商进行调查。一项19项调查捕获了提供者对药剂师对CCM组件的贡献的观点。该调查开放30天,使用描述性统计对匿名回复进行分析。通过为每个答案选项生成平均排名,然后从低到高排序来分析排名的回答。结果共回收问卷10份,回复率31%。大多数受访者为46-65岁(n = 7, 70%)和医生(n = 10, 100%),具有15年以上的执业经验(n = 8, 80%)。影响最大的临床药学服务是综合用药回顾(平均2.7)和用药调解(平均3.0)。临床药师影响的疾病状态前5位分别是糖尿病(平均2.7)、动脉粥样硬化性心血管疾病(平均3.9)、慢性肾病(平均4.5)、慢性阻塞性肺疾病(平均5.4)和高血压(平均6.0)。结论提供方对药师主导的CCM服务表示支持,强调药师加强用药管理、患者安全和慢性病转归的能力。
{"title":"Evaluating provider satisfaction with the role of clinical pharmacists delivering chronic care management services within an accountable care organization","authors":"Courtney Whitfield,&nbsp;Anna Baird,&nbsp;Ashley Abode,&nbsp;Macary Weck Marciniak,&nbsp;Laura A. Rhodes","doi":"10.1016/j.japhpi.2026.100100","DOIUrl":"10.1016/j.japhpi.2026.100100","url":null,"abstract":"<div><h3>Background</h3><div>Chronic care management (CCM) involves coordinating comprehensive care for patients with multiple chronic conditions and focuses on addressing medical, functional, and psychosocial needs. This project describes an independent pharmacy that has delivered clinical services with a local accountable care organization (ACO). This collaboration has enabled clinical pharmacists to enhance patient care through medication expertise and patient relationships. Pharmacists facilitate communication with patients and care managers by remotely accessing electronic health records while providing the service. CCM services include reviewing medications and potential interactions, overseeing patient self-management of medications, and managing transitions of care.</div></div><div><h3>Objective</h3><div>This project aimed to assess provider perspectives on the role of the clinical pharmacist within the CCM model, access to a clinical pharmacist, and satisfaction with disease state impact and changes of care recommended by clinical pharmacists within an ACO.</div></div><div><h3>Methods</h3><div>A prospective, cross-sectional electronic survey was distributed to 32 ACO providers with pharmacists on their CCM teams. A 19-item survey captured provider perspectives on pharmacist contributions to CCM components. The survey was open for 30 days, with anonymized responses analyzed using descriptive statistics. Ranked responses were analyzed by generating a mean rank for each answer option, then ordered from low to high.</div></div><div><h3>Results</h3><div>Ten surveys were returned (response rate 31%). Most respondents were 46-65 years of age (n = 7, 70%) and physicians (n = 10, 100%), with 15+ years of practice experience (n = 8, 80%). The most impactful clinical pharmacy services were comprehensive medication reviews (mean, 2.7) and medication reconciliations (mean, 3.0). The top 5 disease states that clinical pharmacists affected were diabetes (mean, 2.7), atherosclerotic cardiovascular disease (mean, 3.9), chronic kidney disease (mean, 4.5), chronic obstructive pulmonary disease (mean, 5.4), and hypertension (mean, 6.0).</div></div><div><h3>Conclusion</h3><div>Providers expressed support for pharmacist-led services in CCM, highlighting pharmacists’ ability to enhance medication management, patient safety, and chronic disease outcomes.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100100"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661452","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
College student attitudes and perceptions toward opioid overdose and harm reduction at a large, public university 一所大型公立大学的大学生对阿片类药物过量和减少危害的态度和看法
Pub Date : 2026-07-01 Epub Date: 2025-12-26 DOI: 10.1016/j.japhpi.2025.100090
Kaileigh D. Yen, Alexis Shook, Macary Weck Marciniak, Laura A. Rhodes

Background

The number of college-aged students using illicit drugs has increased, alongside cases of polysubstance use and the addition of illegally manufactured fentanyl into other substances. Harm reduction strategies have been implemented to reduce overdose encounters. Literature has focused on college students’ knowledge of these topics; however, evidence is lacking regarding student attitudes toward opioid overdose risk and harm reduction tools and their perceptions and knowledge regarding access to those tools.

Objective

This study aimed to assess (1) student attitudes regarding opioid overdose and harm reduction and (2) perception and knowledge of access to these services at a public university.

Methods

This survey was conducted by an on-campus pharmacy at a large university in the southern United States. A 32-item survey was developed in Qualtrics and distributed using Listservs and e-mail groups and by posting flyers around campus. Those 18+ years and students enrolled at the university were included. The survey included 3 sections: (1) perceptions and attitudes, (2) supplemental questions, and (3) demographics. The survey remained open for 30 days. Results were analyzed using descriptive statistics.

Results

A total of 196 surveys were included. Most respondents were unlikely or very unlikely to obtain naloxone for themselves (n = 113, 58%); however, almost three-quarters (n = 136, 70%) indicated that they were very likely or likely to recommend obtaining naloxone to a friend. Of 174 comments provided, 64 (38%) mentioned a lack of knowledge of resources and 26 (18%) cited stigma as a barrier. Most respondents (n = 141, 72%) were unaware that naloxone is available free of charge from on-campus pharmacies.

Conclusion

Many college-aged students agreed that there is a risk of overdose on campus, a lack of knowledge about harm reduction tools, and a need to increase access to these tools. Students’ attitudes toward the need for harm reduction tools highlight a need for expanded education in this population.
使用非法药物的大学生人数有所增加,同时还有多种物质使用和在其他物质中添加非法制造的芬太尼的情况。已实施减少危害战略,以减少过量接触。文献关注的是大学生对这些话题的认识;然而,缺乏证据表明学生对阿片类药物过量风险和减少伤害工具的态度以及他们对获得这些工具的看法和知识。目的本研究旨在评估(1)公立大学学生对阿片类药物过量和减少危害的态度;(2)获得这些服务的认知和知识。方法本调查由美国南部一所大型大学的校园药房进行。Qualtrics开发了一项包含32个项目的调查,并通过Listservs和电子邮件组以及在校园里张贴传单的方式进行分发。包括18岁以上的学生和在校学生。调查包括3个部分:(1)看法和态度,(2)补充问题,(3)人口统计。调查持续了30天。结果采用描述性统计进行分析。结果共纳入调查196份。大多数受访者不太可能或非常不可能为自己获得纳洛酮(n = 113, 58%);然而,几乎四分之三(n = 136,70%)的人表示,他们很可能或很可能向朋友推荐服用纳洛酮。在提供的174条评论中,64条(38%)提到缺乏对资源的了解,26条(18%)认为耻辱是一个障碍。大多数受访者(n = 141, 72%)不知道纳洛酮可以从校园药房免费获得。结论许多大学生认为校园存在过量用药风险,缺乏减少危害工具的知识,需要增加获得这些工具的机会。学生对需要减少伤害工具的态度突出了在这一人群中扩大教育的必要性。
{"title":"College student attitudes and perceptions toward opioid overdose and harm reduction at a large, public university","authors":"Kaileigh D. Yen,&nbsp;Alexis Shook,&nbsp;Macary Weck Marciniak,&nbsp;Laura A. Rhodes","doi":"10.1016/j.japhpi.2025.100090","DOIUrl":"10.1016/j.japhpi.2025.100090","url":null,"abstract":"<div><h3>Background</h3><div>The number of college-aged students using illicit drugs has increased, alongside cases of polysubstance use and the addition of illegally manufactured fentanyl into other substances. Harm reduction strategies have been implemented to reduce overdose encounters. Literature has focused on college students’ knowledge of these topics; however, evidence is lacking regarding student attitudes toward opioid overdose risk and harm reduction tools and their perceptions and knowledge regarding access to those tools.</div></div><div><h3>Objective</h3><div>This study aimed to assess (1) student attitudes regarding opioid overdose and harm reduction and (2) perception and knowledge of access to these services at a public university.</div></div><div><h3>Methods</h3><div>This survey was conducted by an on-campus pharmacy at a large university in the southern United States. A 32-item survey was developed in Qualtrics and distributed using Listservs and e-mail groups and by posting flyers around campus. Those 18+ years and students enrolled at the university were included. The survey included 3 sections: (1) perceptions and attitudes, (2) supplemental questions, and (3) demographics. The survey remained open for 30 days. Results were analyzed using descriptive statistics.</div></div><div><h3>Results</h3><div>A total of 196 surveys were included. Most respondents were unlikely or very unlikely to obtain naloxone for themselves (n = 113, 58%); however, almost three-quarters (n = 136, 70%) indicated that they were very likely or likely to recommend obtaining naloxone to a friend. Of 174 comments provided, 64 (38%) mentioned a lack of knowledge of resources and 26 (18%) cited stigma as a barrier. Most respondents (n = 141, 72%) were unaware that naloxone is available free of charge from on-campus pharmacies.</div></div><div><h3>Conclusion</h3><div>Many college-aged students agreed that there is a risk of overdose on campus, a lack of knowledge about harm reduction tools, and a need to increase access to these tools. Students’ attitudes toward the need for harm reduction tools highlight a need for expanded education in this population.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100090"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661454","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。
{"title":"Enhancing timely access to medication changes: The role of ambulatory care pharmacists in overcoming transitions of care challenges","authors":"Alison N. Van Dyke,&nbsp;Karen S. Williams,&nbsp;Jessica Carswell,&nbsp;Keith M. Hughes Jr","doi":"10.1016/j.japhpi.2026.100110","DOIUrl":"10.1016/j.japhpi.2026.100110","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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; <em>P</em> = 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; <em>P</em> &lt; 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%, <em>P</em> &lt; 0.001), and more frequent barriers, such as inadequate discharge education.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100110"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661476","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 COPD outcomes: RPM, pulse oximetry, and direct billable clinical services 改善COPD结果:RPM、脉搏血氧测定和直接计费临床服务
Pub Date : 2026-07-01 Epub Date: 2026-02-13 DOI: 10.1016/j.japhpi.2026.100104
Rachel Carter, Blair Lykins, Ryan Cooper, Abigail Leonhard, Clark Kebodeaux

Background

Chronic obstructive pulmonary disease (COPD) is currently 1 of the top 3 causes of death worldwide. A decrease in peripheral oxygen saturation (SpO2) can be a strong indicator of a COPD exacerbation. Pharmacists are well positioned to monitor SpO2 trends and changes in baseline symptoms and provide counseling on proper inhaler technique to prevent exacerbations, especially in the outpatient setting.

Objectives

This pilot study aimed to (1) determine the exacerbation rate of COPD after enrollment in a pharmacist-led remote patient monitoring (RPM) program that used a Bluetooth pulse oximeter to measure SpO2 and (2) assess the impact of pharmacist-led RPM for COPD on adherence with maintenance inhaler therapy, smoking cessation, immunization uptake, and patient satisfaction.

Methods

Patients completed a pre- and postintervention survey at the beginning and end of the 90-day study period. While enrolled, patients were contacted on a weekly basis to discuss SpO2 readings, changes in baseline COPD symptoms, inhaler adherence and technique, upcoming appointments, vaccine eligibility, and smoking cessation when applicable. If SpO2 was less than or equal to 92%, an effort was made to reach the patient immediately.

Results

A total of 14 patients were enrolled, and 13 completed the pre- and postintervention survey. The median difference in average SpO2 change over 90 days was an increase of 0.10%. Overall, 7 patients demonstrated promising trends in average SpO2. Uptake of the influenza; tetanus, diphtheria, and pertussis; respiratory syncytial virus; and pneumococcal vaccines increased during the study period. There was also an increase in patient-reported satisfaction with COPD education and treatment.

Conclusion

Enrollment in a pharmacist-led RPM program for COPD suggests an improvement in average SpO2, adherence with guideline-recommended therapy, immunization uptake, and patient satisfaction.
背景:慢性阻塞性肺疾病(COPD)目前是全球三大死亡原因之一。外周氧饱和度(SpO2)的降低可能是COPD加重的一个强有力的指标。药剂师可以很好地监测SpO2趋势和基线症状的变化,并提供有关适当吸入器技术的咨询,以防止病情恶化,特别是在门诊情况下。本初步研究旨在(1)确定参加药师主导的远程患者监测(RPM)项目后COPD的加重率,该项目使用蓝牙脉搏血氧仪测量SpO2;(2)评估药师主导的RPM对COPD患者坚持使用维持性吸入器治疗、戒烟、免疫接种和患者满意度的影响。在为期90天的研究开始和结束时,患者完成了干预前和干预后的调查。在入组期间,每周与患者联系,讨论SpO2读数、基线COPD症状的变化、吸入器依从性和技术、即将进行的预约、疫苗接种资格和戒烟(如适用)。如果SpO2小于或等于92%,则应立即与患者联系。结果共纳入14例患者,其中13例完成干预前后调查。90天平均SpO2变化的中位数差异增加了0.10%。总体而言,7例患者的平均SpO2表现出有希望的趋势。感染流感;破伤风、白喉和百日咳;呼吸道合胞病毒;在研究期间,肺炎球菌疫苗的数量有所增加。患者报告的COPD教育和治疗满意度也有所增加。结论:参加药剂师主导的COPD RPM项目表明,平均SpO2、指南推荐治疗的依从性、免疫摄取和患者满意度均有改善。
{"title":"Enhancing COPD outcomes: RPM, pulse oximetry, and direct billable clinical services","authors":"Rachel Carter,&nbsp;Blair Lykins,&nbsp;Ryan Cooper,&nbsp;Abigail Leonhard,&nbsp;Clark Kebodeaux","doi":"10.1016/j.japhpi.2026.100104","DOIUrl":"10.1016/j.japhpi.2026.100104","url":null,"abstract":"<div><h3>Background</h3><div>Chronic obstructive pulmonary disease (COPD) is currently 1 of the top 3 causes of death worldwide. A decrease in peripheral oxygen saturation (SpO<sub>2</sub>) can be a strong indicator of a COPD exacerbation. Pharmacists are well positioned to monitor SpO<sub>2</sub> trends and changes in baseline symptoms and provide counseling on proper inhaler technique to prevent exacerbations, especially in the outpatient setting.</div></div><div><h3>Objectives</h3><div>This pilot study aimed to (1) determine the exacerbation rate of COPD after enrollment in a pharmacist-led remote patient monitoring (RPM) program that used a Bluetooth pulse oximeter to measure SpO<sub>2</sub> and (2) assess the impact of pharmacist-led RPM for COPD on adherence with maintenance inhaler therapy, smoking cessation, immunization uptake, and patient satisfaction.</div></div><div><h3>Methods</h3><div>Patients completed a pre- and postintervention survey at the beginning and end of the 90-day study period. While enrolled, patients were contacted on a weekly basis to discuss SpO<sub>2</sub> readings, changes in baseline COPD symptoms, inhaler adherence and technique, upcoming appointments, vaccine eligibility, and smoking cessation when applicable. If SpO<sub>2</sub> was less than or equal to 92%, an effort was made to reach the patient immediately.</div></div><div><h3>Results</h3><div>A total of 14 patients were enrolled, and 13 completed the pre- and postintervention survey. The median difference in average SpO<sub>2</sub> change over 90 days was an increase of 0.10%. Overall, 7 patients demonstrated promising trends in average SpO<sub>2</sub>. Uptake of the influenza; tetanus, diphtheria, and pertussis; respiratory syncytial virus; and pneumococcal vaccines increased during the study period. There was also an increase in patient-reported satisfaction with COPD education and treatment.</div></div><div><h3>Conclusion</h3><div>Enrollment in a pharmacist-led RPM program for COPD suggests an improvement in average SpO<sub>2</sub>, adherence with guideline-recommended therapy, immunization uptake, and patient satisfaction.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100104"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661478","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
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。
{"title":"Advancing food-is-medicine: A pilot of pharmacist-facilitated dietitian scheduling","authors":"Jackie Tan,&nbsp;Kimberly Johnson,&nbsp;Amy Bailey,&nbsp;Kellie J. Goodlet","doi":"10.1016/j.japhpi.2026.100096","DOIUrl":"10.1016/j.japhpi.2026.100096","url":null,"abstract":"<div><h3>Background</h3><div>“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.</div></div><div><h3>Objective</h3><div>This study aimed to explore the feasibility of community pharmacist-facilitated dietitian appointments.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100096"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661500","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
Awareness and perceptions of community pharmacist–provided clinical services among Illinois health professional students 伊利诺伊州卫生专业学生对社区药剂师提供临床服务的认识和看法
Pub Date : 2026-07-01 Epub Date: 2026-07-07 DOI: 10.1016/j.japhpi.2026.100116
Joseph Shen, Chandni Clough, Christina J. Cross, Rachel Russell, Jeffrey Hamper, Beatrice Drambarean

Background

The scope of practice and clinical responsibilities of community pharmacists have expanded over time but are not widely used. This cross-sectional study provides a quantitative assessment of how widely known clinical services provided at community pharmacies are to students of health care professions with prescriptive authority.

Objective

To determine health professional students’ awareness of and support for the clinical services that community pharmacists are permitted to perform under the Illinois Pharmacy Practice Act.

Methods

An online survey was conducted with students at accredited Illinois programs for physicians, nurse practitioners, and physician assistants. Participants answered questions regarding their awareness of available community pharmacist–provided clinical services and their support for patients using these services.

Results

Less than 40% of respondents reported having some awareness of services beyond vaccinations. Mean and median scores for support for services were above the positive response level, with maximum median scores in most subgroups. Except for the administration of long-acting medications, more than 80% of respondents reported that they support or strongly support patients using services from a community pharmacist. Most comparisons of differences between subgroups were not statistically significant.

Conclusion

Health care professional students are largely unaware of community pharmacist–provided clinical services but strongly support patients using them, suggesting trust and a willingness to delegate responsibilities to them. There are opportunities for educating students on the evolving capabilities of community pharmacists and potentially shifting how community pharmacists provide patient care. Future improvements to interprofessional education and experiental learning should address potential concerns about patient safety and outcomes.
社区药剂师的执业范围和临床责任随着时间的推移而扩大,但并未得到广泛应用。这项横断面研究提供了一个定量评估,以了解社区药房提供的广为人知的临床服务对具有规定权威的卫生保健专业学生的影响。目的了解卫生专业学生对《伊利诺斯州药学实践法》规定的社区药师临床服务的认知和支持情况。方法对伊利诺斯州认可的医师、执业护士和医师助理课程的学生进行在线调查。参与者回答了有关他们对社区药剂师提供的临床服务的认识以及他们对使用这些服务的患者的支持的问题。结果不到40%的应答者报告对疫苗接种以外的服务有一定的了解。对服务支持的平均和中位数得分高于积极反应水平,大多数亚组的中位数得分最高。除了长效药物的管理,超过80%的受访者报告说,他们支持或强烈支持患者使用社区药剂师的服务。大多数亚组间比较差异无统计学意义。结论卫生保健专业学生对社区药剂师提供的临床服务基本不了解,但对患者使用社区药剂师提供的临床服务表示强烈支持,表明对社区药剂师的信任并愿意将责任委托给他们。有机会教育学生了解社区药剂师不断发展的能力,并有可能改变社区药剂师提供患者护理的方式。未来对跨专业教育和实验学习的改进应解决对患者安全和结果的潜在担忧。
{"title":"Awareness and perceptions of community pharmacist–provided clinical services among Illinois health professional students","authors":"Joseph Shen,&nbsp;Chandni Clough,&nbsp;Christina J. Cross,&nbsp;Rachel Russell,&nbsp;Jeffrey Hamper,&nbsp;Beatrice Drambarean","doi":"10.1016/j.japhpi.2026.100116","DOIUrl":"10.1016/j.japhpi.2026.100116","url":null,"abstract":"<div><h3>Background</h3><div>The scope of practice and clinical responsibilities of community pharmacists have expanded over time but are not widely used. This cross-sectional study provides a quantitative assessment of how widely known clinical services provided at community pharmacies are to students of health care professions with prescriptive authority.</div></div><div><h3>Objective</h3><div>To determine health professional students’ awareness of and support for the clinical services that community pharmacists are permitted to perform under the Illinois Pharmacy Practice Act.</div></div><div><h3>Methods</h3><div>An online survey was conducted with students at accredited Illinois programs for physicians, nurse practitioners, and physician assistants. Participants answered questions regarding their awareness of available community pharmacist–provided clinical services and their support for patients using these services.</div></div><div><h3>Results</h3><div>Less than 40% of respondents reported having some awareness of services beyond vaccinations. Mean and median scores for support for services were above the positive response level, with maximum median scores in most subgroups. Except for the administration of long-acting medications, more than 80% of respondents reported that they support or strongly support patients using services from a community pharmacist. Most comparisons of differences between subgroups were not statistically significant.</div></div><div><h3>Conclusion</h3><div>Health care professional students are largely unaware of community pharmacist–provided clinical services but strongly support patients using them, suggesting trust and a willingness to delegate responsibilities to them. There are opportunities for educating students on the evolving capabilities of community pharmacists and potentially shifting how community pharmacists provide patient care. Future improvements to interprofessional education and experiental learning should address potential concerns about patient safety and outcomes.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100116"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661266","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
Awareness and perceptions of community pharmacist–provided clinical services among Illinois health professional students 伊利诺伊州卫生专业学生对社区药剂师提供临床服务的认识和看法
Pub Date : 2026-07-01 Epub Date: 2026-07-07 DOI: 10.1016/j.japhpi.2026.100116
Joseph Shen, Chandni Clough, Christina J. Cross, Rachel Russell, Jeffrey Hamper, Beatrice Drambarean

Background

The scope of practice and clinical responsibilities of community pharmacists have expanded over time but are not widely used. This cross-sectional study provides a quantitative assessment of how widely known clinical services provided at community pharmacies are to students of health care professions with prescriptive authority.

Objective

To determine health professional students’ awareness of and support for the clinical services that community pharmacists are permitted to perform under the Illinois Pharmacy Practice Act.

Methods

An online survey was conducted with students at accredited Illinois programs for physicians, nurse practitioners, and physician assistants. Participants answered questions regarding their awareness of available community pharmacist–provided clinical services and their support for patients using these services.

Results

Less than 40% of respondents reported having some awareness of services beyond vaccinations. Mean and median scores for support for services were above the positive response level, with maximum median scores in most subgroups. Except for the administration of long-acting medications, more than 80% of respondents reported that they support or strongly support patients using services from a community pharmacist. Most comparisons of differences between subgroups were not statistically significant.

Conclusion

Health care professional students are largely unaware of community pharmacist–provided clinical services but strongly support patients using them, suggesting trust and a willingness to delegate responsibilities to them. There are opportunities for educating students on the evolving capabilities of community pharmacists and potentially shifting how community pharmacists provide patient care. Future improvements to interprofessional education and experiental learning should address potential concerns about patient safety and outcomes.
社区药剂师的执业范围和临床责任随着时间的推移而扩大,但并未得到广泛应用。这项横断面研究提供了一个定量评估,以了解社区药房提供的广为人知的临床服务对具有规定权威的卫生保健专业学生的影响。目的了解卫生专业学生对《伊利诺斯州药学实践法》规定的社区药师临床服务的认知和支持情况。方法对伊利诺斯州认可的医师、执业护士和医师助理课程的学生进行在线调查。参与者回答了有关他们对社区药剂师提供的临床服务的认识以及他们对使用这些服务的患者的支持的问题。结果不到40%的应答者报告对疫苗接种以外的服务有一定的了解。对服务支持的平均和中位数得分高于积极反应水平,大多数亚组的中位数得分最高。除了长效药物的管理,超过80%的受访者报告说,他们支持或强烈支持患者使用社区药剂师的服务。大多数亚组间比较差异无统计学意义。结论卫生保健专业学生对社区药剂师提供的临床服务基本不了解,但对患者使用社区药剂师提供的临床服务表示强烈支持,表明对社区药剂师的信任并愿意将责任委托给他们。有机会教育学生了解社区药剂师不断发展的能力,并有可能改变社区药剂师提供患者护理的方式。未来对跨专业教育和实验学习的改进应解决对患者安全和结果的潜在担忧。
{"title":"Awareness and perceptions of community pharmacist–provided clinical services among Illinois health professional students","authors":"Joseph Shen,&nbsp;Chandni Clough,&nbsp;Christina J. Cross,&nbsp;Rachel Russell,&nbsp;Jeffrey Hamper,&nbsp;Beatrice Drambarean","doi":"10.1016/j.japhpi.2026.100116","DOIUrl":"10.1016/j.japhpi.2026.100116","url":null,"abstract":"<div><h3>Background</h3><div>The scope of practice and clinical responsibilities of community pharmacists have expanded over time but are not widely used. This cross-sectional study provides a quantitative assessment of how widely known clinical services provided at community pharmacies are to students of health care professions with prescriptive authority.</div></div><div><h3>Objective</h3><div>To determine health professional students’ awareness of and support for the clinical services that community pharmacists are permitted to perform under the Illinois Pharmacy Practice Act.</div></div><div><h3>Methods</h3><div>An online survey was conducted with students at accredited Illinois programs for physicians, nurse practitioners, and physician assistants. Participants answered questions regarding their awareness of available community pharmacist–provided clinical services and their support for patients using these services.</div></div><div><h3>Results</h3><div>Less than 40% of respondents reported having some awareness of services beyond vaccinations. Mean and median scores for support for services were above the positive response level, with maximum median scores in most subgroups. Except for the administration of long-acting medications, more than 80% of respondents reported that they support or strongly support patients using services from a community pharmacist. Most comparisons of differences between subgroups were not statistically significant.</div></div><div><h3>Conclusion</h3><div>Health care professional students are largely unaware of community pharmacist–provided clinical services but strongly support patients using them, suggesting trust and a willingness to delegate responsibilities to them. There are opportunities for educating students on the evolving capabilities of community pharmacists and potentially shifting how community pharmacists provide patient care. Future improvements to interprofessional education and experiental learning should address potential concerns about patient safety and outcomes.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100116"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661331","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
Impact of a pharmacist-led weight management service in patients with metabolic dysfunction–associated steatotic liver disease at outpatient clinics on the United States–Mexico border 药剂师主导的体重管理服务对美国-墨西哥边境门诊代谢功能障碍相关脂肪变性肝病患者的影响
Pub Date : 2026-07-01 Epub Date: 2025-11-08 DOI: 10.1016/j.japhpi.2025.100082
Royce Li, Liliana Lunares, Karem E. Lambeth, Valerie M. Alvarado, Jacquelyn P. Navarrete, Bruno Hernandez Bizouarn, Alaa K. Abdelhakiem

Background

Metabolic dysfunction–associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease, affects up to 30% of adults in the United States and is associated with an increased risk of cardiovascular disease, cancer, and end-stage liver disease. The University Medical Center (UMC) of El Paso consists of 6 community health clinics along the United States–Mexico border in El Paso, TX, serving a unique population addressing multiple conditions including MASLD.

Objective

This study aimed to investigate the efficacy of a pharmacist-led weight management service in patients with MASLD at an outpatient clinic on the United States–Mexico border.

Methods

Clinical pharmacists at UMC conducted a cohort study to assess the impact of pharmacist-led weight management on patients with MASLD. The primary outcomes were the improvement of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and FibroScan controlled attenuation parameter (CAP) scores. The secondary outcomes of this study were the decrease in weight, body mass index, and hemoglobin A1C.

Results

Of 669 chart reviews, 86 participants met the inclusion criteria. There was a statistically significant overall decrease in AST levels over a 7-month study period (P < 0.001). However, both primary care providers (PCPs) and clinical pharmacist health care teams experienced similar reductions in AST, with a mean decrease of 13 units/liter and 8 units/liter, respectively (PCP vs. clinical pharmacist, P = 0.382). ALT levels also decreased significantly over the 7-month period (P < 0.001), with a significant reduction observed in the clinical pharmacists compared with PCPs (13 vs. 6 units/liter, P = 0.023). Owing to incomplete data, analysis of FibroScan CAP scores was not performed. The results demonstrate that pharmacist involvement in MASLD care is associated with potential improvements in metabolic and hepatic parameters.

Conclusion

Both AST and ALT levels showed statistically significant reductions over a 7-month period. The significant decline in AST (P < 0.001) across both groups suggests general hepatic improvement.
代谢功能障碍相关脂肪变性肝病(MASLD),以前称为非酒精性脂肪性肝病,在美国影响高达30%的成年人,并与心血管疾病、癌症和终末期肝病的风险增加相关。埃尔帕索大学医学中心(UMC)由德克萨斯州埃尔帕索美国-墨西哥边境的6个社区卫生诊所组成,为包括MASLD在内的多种疾病的独特人群提供服务。目的:本研究旨在探讨在美国-墨西哥边境的一家门诊诊所,药剂师主导的体重管理服务对MASLD患者的疗效。方法UMC临床药师进行了一项队列研究,评估药师主导的体重管理对MASLD患者的影响。主要结果是天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)和纤维扫描控制衰减参数(CAP)评分的改善。该研究的次要结果是体重、体重指数和血红蛋白A1C的下降。结果669例患者中,86例符合纳入标准。在7个月的研究期间,AST水平总体下降具有统计学意义(P < 0.001)。然而,初级保健提供者(PCP)和临床药师卫生保健团队都经历了类似的AST降低,平均分别降低了13单位/升和8单位/升(PCP与临床药师,P = 0.382)。ALT水平在7个月期间也显著下降(P < 0.001),与pcp相比,临床药师的ALT水平显著降低(13比6单位/升,P = 0.023)。由于数据不完整,未对FibroScan CAP评分进行分析。结果表明,药剂师参与MASLD护理与代谢和肝脏参数的潜在改善有关。结论AST和ALT水平在7个月内均有显著降低。两组间AST显著下降(P < 0.001)表明肝脏总体改善。
{"title":"Impact of a pharmacist-led weight management service in patients with metabolic dysfunction–associated steatotic liver disease at outpatient clinics on the United States–Mexico border","authors":"Royce Li,&nbsp;Liliana Lunares,&nbsp;Karem E. Lambeth,&nbsp;Valerie M. Alvarado,&nbsp;Jacquelyn P. Navarrete,&nbsp;Bruno Hernandez Bizouarn,&nbsp;Alaa K. Abdelhakiem","doi":"10.1016/j.japhpi.2025.100082","DOIUrl":"10.1016/j.japhpi.2025.100082","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic dysfunction–associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease, affects up to 30% of adults in the United States and is associated with an increased risk of cardiovascular disease, cancer, and end-stage liver disease. The University Medical Center (UMC) of El Paso consists of 6 community health clinics along the United States–Mexico border in El Paso, TX, serving a unique population addressing multiple conditions including MASLD.</div></div><div><h3>Objective</h3><div>This study aimed to investigate the efficacy of a pharmacist-led weight management service in patients with MASLD at an outpatient clinic on the United States–Mexico border.</div></div><div><h3>Methods</h3><div>Clinical pharmacists at UMC conducted a cohort study to assess the impact of pharmacist-led weight management on patients with MASLD. The primary outcomes were the improvement of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and FibroScan controlled attenuation parameter (CAP) scores. The secondary outcomes of this study were the decrease in weight, body mass index, and hemoglobin A1C.</div></div><div><h3>Results</h3><div>Of 669 chart reviews, 86 participants met the inclusion criteria. There was a statistically significant overall decrease in AST levels over a 7-month study period (<em>P</em> &lt; 0.001). However, both primary care providers (PCPs) and clinical pharmacist health care teams experienced similar reductions in AST, with a mean decrease of 13 units/liter and 8 units/liter, respectively (PCP vs. clinical pharmacist, <em>P</em> = 0.382). ALT levels also decreased significantly over the 7-month period (<em>P</em> &lt; 0.001), with a significant reduction observed in the clinical pharmacists compared with PCPs (13 vs. 6 units/liter, <em>P</em> = 0.023). Owing to incomplete data, analysis of FibroScan CAP scores was not performed. The results demonstrate that pharmacist involvement in MASLD care is associated with potential improvements in metabolic and hepatic parameters.</div></div><div><h3>Conclusion</h3><div>Both AST and ALT levels showed statistically significant reductions over a 7-month period. The significant decline in AST (<em>P</em> &lt; 0.001) across both groups suggests general hepatic improvement.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100082"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661373","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 effectiveness of patient-pharmacist communication during medication counseling in Texas community pharmacies 评估德克萨斯州社区药房药物咨询过程中患者与药师沟通的有效性
Pub Date : 2026-07-01 Epub Date: 2026-03-02 DOI: 10.1016/j.japhpi.2026.100106
Kendall McKenzie, Amanda R. Stallings, Elizabeth Unni

Background

Pharmacists, especially those in community settings, are well-positioned to reinforce medication understanding at the point of counseling, yet it remains unclear whether patients truly retain this information. There is a lack of understanding regarding the concordance between what pharmacists communicate and what patients perceive or recall.

Objective

To evaluate communication concordance between pharmacists and patients during counseling in community pharmacy settings.

Methods

A cross-sectional survey was conducted with 87 pharmacist–patient dyads across three Texas grocery store pharmacies. Both parties completed a five-item survey, including four closed-ended and one open-ended item. Concordance rates and demographic correlations were analyzed.

Results

Closed-ended item concordance was high (97.7%–100%), indicating strong agreement on structured counseling topics. Open-ended responses showed only 37.93% concordance, suggesting variability in perceived key takeaways. Patient age had a mild positive correlation with concordance (r = 0.324), while gender, ethnicity, insurance, and health literacy had no meaningful associations.

Conclusion

While pharmacists reliably deliver key medication information, discrepancies in open-ended recall point to a need for enhancing patient engagement and confirming understanding.
背景药剂师,尤其是社区药剂师,在咨询时可以很好地加强对药物的理解,但患者是否真正记住了这些信息仍不清楚。关于药剂师沟通和患者感知或回忆之间的一致性缺乏理解。目的评价社区药房咨询过程中药师与患者的沟通协调性。方法采用横断面调查方法,对德克萨斯州三家杂货店药房的87对药师-患者进行调查。双方完成了五项调查,其中四个是封闭式的,一个是开放式的。分析了一致性率和人口统计学相关性。结果封闭式项目一致性高(97.7% ~ 100%),表明对结构化咨询主题的一致性较强。开放式回答显示只有37.93%的一致性,这表明在感知到的关键要点上存在差异。患者年龄与一致性有轻度正相关(r = 0.324),而性别、种族、保险和健康素养无显著相关。结论在药师可靠地提供关键用药信息的同时,开放式回忆的差异表明需要加强患者的参与和确认理解。
{"title":"Assessing the effectiveness of patient-pharmacist communication during medication counseling in Texas community pharmacies","authors":"Kendall McKenzie,&nbsp;Amanda R. Stallings,&nbsp;Elizabeth Unni","doi":"10.1016/j.japhpi.2026.100106","DOIUrl":"10.1016/j.japhpi.2026.100106","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacists, especially those in community settings, are well-positioned to reinforce medication understanding at the point of counseling, yet it remains unclear whether patients truly retain this information. There is a lack of understanding regarding the concordance between what pharmacists communicate and what patients perceive or recall.</div></div><div><h3>Objective</h3><div>To evaluate communication concordance between pharmacists and patients during counseling in community pharmacy settings.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted with 87 pharmacist–patient dyads across three Texas grocery store pharmacies. Both parties completed a five-item survey, including four closed-ended and one open-ended item. Concordance rates and demographic correlations were analyzed.</div></div><div><h3>Results</h3><div>Closed-ended item concordance was high (97.7%–100%), indicating strong agreement on structured counseling topics. Open-ended responses showed only 37.93% concordance, suggesting variability in perceived key takeaways. Patient age had a mild positive correlation with concordance (r = 0.324), while gender, ethnicity, insurance, and health literacy had no meaningful associations.</div></div><div><h3>Conclusion</h3><div>While pharmacists reliably deliver key medication information, discrepancies in open-ended recall point to a need for enhancing patient engagement and confirming understanding.</div></div>","PeriodicalId":100737,"journal":{"name":"JAPhA Practice Innovations","volume":"3 3","pages":"Article 100106"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661389","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