Expertise Of Pharmacists Research Articles

Medication therapy management: The evolution of clinical pharmacy services in U.S. Community‐Based Pharmacy Practice—An opinion of the community‐based practice and research network of the American College of Clinical Pharmacy

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

Leveraging regulatory pharmacist expertise to develop a framework for drug repurposing in underserved areas of the USA

The United States continues to grapple with healthcare access disparities, particularly in underserved regions. Regulatory pharmacists, with their unique expertise in pharmaceutical laws, drug development, and safety regulations, can play a vital role in drug repurposing efforts. This paper proposes a framework for utilising regulatory pharmacist expertise to develop drug repurposing strategies to meet unmet medical needs in underserved areas. We explore the regulatory hurdles, the necessity for collaborative efforts between healthcare professionals, and the potential for drug repurposing to improve healthcare outcomes in rural and socioeconomically disadvantaged communities.

Current Situation for Pharmacists in Japanese Veterinary Medicine: Exploring the Pharmaceutical Needs and Challenges of Veterinary Staff to Facilitate Collaborative Veterinary Care.

While veterinary pharmacy is common overseas, it has yet to gain traction in Japan. To clarify the actual situation in Japan, two surveys were conducted, targeting 4017 facilities (2000 pharmacies/drug stores, 2000 veterinary medical facilities, and 17 university-affiliated veterinary hospitals). We received 324 responses from pharmacy staff and 217 from veterinary hospital staff. Pharmacists were involved in drug therapy for companion animals either via direct discussion with veterinarians or by referrals for prescriptions from veterinarians (11 respondents). Veterinary staff and pharmacists showed a disparity regarding pharmacists' involvement in companion animal healthcare. Veterinary staff wanted pharmacists to provide pharmaceutical guidance, perform audits, supply drug information, and prepare drugs. Strong demand (72.2% of the veterinary staff) existed for consultations with pharmacists regarding medication issues. Veterinary medicine has evolved to meet the demand for the advanced care of companion animals. Veterinary staff have diverse and substantial requests for pharmacists. Integrating the expertise of both veterinary staff and pharmacists may facilitate a team-based approach to veterinary medicine and improve the quality of care for companion animals. Tailoring approaches to suit Japan's unique circumstances and creating a conducive environment for effective communication between pharmacists and veterinary staff are pivotal for advancing veterinary pharmacy in Japan.

Act for the future of community pharmacy

Community pharmacies serve as a vital gateway to primary care and public health, offering face-to-face pharmacist expert care to assure safe and effective medication use. However, they are disappearing at an alarming rate, with 20%-30% of all community pharmacy locations projected to close within the next year. The objective of this commentary is to highlight the critical need for systemic reforms and collective action within our profession to address the unique challenges faced by community pharmacies, ensuring their sustainability and continued role in providing essential health care services for patients. Key issues and evidence are provided to help pharmacy professionals better articulate why pharmacy closures are happening now and how we can work toward a transformed future. Pharmacy closures stem from an unsustainable business model characterized by declining reimbursement for prescription medications, opaque and anticompetitive pricing practices of pharmacy benefit managers, and limited reimbursement for clinical services. Among these challenges, our profession has the opportunity to create a future for community pharmacy where every person has local access to pharmacist expert care and medications through sustainable, integrated community pharmacy practice. Our profession must embrace community pharmacy teams’ role in patient care, champion opportunities to integrate community pharmacists and their support staff as members of the health care team, and advocate for payment transparency and transformation. Creating this future will take all pharmacists and all pharmacy professionals.

Exploring stakeholder perceptions of implementing a pharmacist-led anticoagulation clinic in primary care settings: a cross-sectional study.

Anticoagulation therapy is crucial for managing various cardiovascular and thrombotic conditions; however, optimal delivery remains challenging in primary care. Pharmacist-led anticoagulation services have emerged as a potential strategy for enhancing patient care and outcomes in such settings. Understanding the perspectives of key stakeholders is critical for successful implementation. This study aimed to explore the perceptions of key stakeholders involved in the implementation of pharmacist-led anticoagulation clinics in primary care settings. A cross-sectional study was conducted using structured, pilot-tested questionnaires between August and October 2023. Patients receiving warfarin, pharmacists, and physicians working across various primary healthcare centres were invited to complete an online survey. Each group of stakeholders had individualised questionnaires to assess their perceptions and expectations with regard to developing pharmacist-led anticoagulation clinics in primary care. Descriptive statistics were used to analyze the data. The response rates for the survey were 29.4% for physicians, 10.4% for patients, and 48.6% for pharmacists. Participants expressed positive perceptions toward pharmacist-led anticoagulation clinics, acknowledging benefits such as improved access to care, enhanced medication management, and increased patient education. The respondents expressed confidence in the expertise and skills of pharmacists in this role. However, healthcare providers strongly agree that pharmacists should receive additional training specific to anticoagulation management. Establishing standardised protocols and fostering interprofessional collaboration were identified as the main facilitators for practical implementation. Broad support exists for pharmacist-led anticoagulation clinics in primary care, though additional pharmacist training and accountability concerns need to be addressed for successful implementation.

Managing medications for patients with cancer and chronic conditions: It's time for collaboration between primary care and oncology pharmacists.

To provide a rationale for a collaborative care model involving oncology and primary care pharmacists to improve the coordination of care of medications for cancer patients with multiple chronic conditions. A review of selected literature and the authors' own research was used. Studies illustrating the gaps in care for medications and pharmacists' roles in oncology and primary care settings from PubMed were reviewed. There has been a substantial increase in the development and utilization of oral anticancer agents (OAAs). Although OAAs offer convenience and flexibility, they also introduce challenges related to medication adherence, monitoring, and managing side effects. Up to 17.5% of patients experience moderate to severe symptoms from OAAs and about 30% report less than excellent medication adherence. Further, studies showed that 30% to 53% of adult cancer patients have at least one chronic condition that complicates their treatment plan due to the need for medications, increasing the risk of drug interactions, side effects, and non-adherence. The Primary Care Oncology Model (PCOM) incorporates both primary care and oncology pharmacists with comprehensive medication review and patient-reported outcome measure, respectively, to enhance medication appropriateness and effectiveness, and improve overall patient experience. Implementing PCOM may improve the medication management of patients taking OAAs for active cancer treatment and chronic medications for their multiple chronic conditions. This collaborative approach can transform patient care by leveraging the expertise of both primary care and oncology pharmacists.

Impact of Pharmacist Expertise on Acceptance Rates in a Comprehensive E-Consult Program within a Large Academic Health System.

Background: Although electronic consults (e-consults) are utilized in healthcare systems by medical professionals, use of e-consults by pharmacy remains novel outside of niche disease states. Additional research is required to fill literature gaps to assist in optimizing the pharmacist's role in e-consult programs. Objective: This study aimed to assess the impact of pharmacist expertise on e-consult outcomes. Methods: This study was a retrospective review of all pharmacy e-consults completed by pharmacists at a large academic health system between March 1st, 2020, and August 31st, 2022. This was deemed quality improvement and did not require Institutional Review Board approval. E-consults were identified using a report. Key data collection points included e-consult disease state, ordering provider, pharmacists' specialty, and recommendation result. The primary outcome was the difference in acceptance rates of expert versus non-expert pharmacist recommendations. Secondary outcomes included the overall implementation rate, implementation rate over time, acceptance rate between provider types, time to implementation, and pharmacist response time. Acceptance rates were compared between expert/non-expert dichotomy via Pearson chi-square test. Results: A total of 375 e-consults met inclusion criteria and spanned 19 unique disease states. The three most common included diabetes mellitus (27.0%), pain management (13.1%), and mental health (11.0%). Nearly 60% of e-consults were in a disease with an expert. The provider acceptance rate was higher when e-consults were completed by an expert versus non-expert (62.6% versus 39.6% respectively, p = 0.002). The overall implementation rate was 51.8%. Physicians (MD/DOs) accepted the pharmacist's recommendations 55.6% of the time, advanced practice registered nurses (APRNs) 64.7%, physician assistants (PAs) 100.0%, and other professionals 25.0% (p = 0.033). Mean time to recommendation implementation was 16.5 days (SD = 29.4 days). Mean time to pharmacist response was 1.1 days (SD = 1.4 days). Conclusions: Comprehensive e-consult programs are more successful when integrating expert pharmacists.

Assessing Public Awareness, Utilization and Satisfaction with Community Pharmacy Services.

The Saudi Community pharmacy sector has been changing towards patient-centred care rather than depending solely on dispensing medications. Accordingly, pharmacies can now provide many services that they previously could not offer. The aims of this study were to identify all pharmacy services provided in a community setting and to assess public awareness and utilization of and satisfaction with these services. This was a cross-sectional study in which the authors first purposively visited community pharmacies to identify the services offered. Pharmacists were asked about pharmacy services currently provided to community. Fieldnotes were used to document pharmacists' responses. After identifying pharmacy services, a questionnaire was desgined and reviewed by experts in the field, piloted and approved by the Ethics Committee at King Faisal University, then disseminated via Google Forms. The satisfaction level with pharmacy services was assessed using a five-point Likert scale. Data were collected from 24 January 2023 to 2 March 2023. Eighteen community pharmacies offering 17 different services were visited across Alahsa Governorate. The number of participants who completed the questionnaire was 350. Of those (232 [66.3%]) were female, and the majority of the sample (80.5%) were younger than 40 years old. The majority of the participants were unaware of pharmacy services. Out of 17 services, six received a score of 50% or higher regarding participant awareness. The most utilized services were the medication dispensing service "Wasfaty" (250 [71.4%]), medication counselling provided by pharmacists (232 [66.3%]) and minor ailment service (231 [66%]). The overall satisfaction score for pharmacy services was 87.2%. The majority of the participants were unaware of the full range of available pharmacy services. There is a potential for community pharmacists to fill the capacity gap in the healthcare system since, overall, the participants rated the pharmacies' clinical services as satisfactory. Commissioners of pharmacy services may consider extending the scope of community pharmacies to include services that best utilize the expertise of clinical pharmacists.

Forty-three Years of Dedicated Efforts in Advancing Pharmacist Expertise: Aspiring to Become a Pharmacist and Cultivate Pharmacists Proficient in Recommending Prescription Medicines to Doctors

When I graduated from university, my aim was to become a pharmacist capable of recommending prescription medicines to doctors and teaching others to do the same. To achieve this goal, I developed comprehensive curricula incorporating progressive educational tools such as problem-based learning and small group discussions. Subsequently, the effectiveness of these tools and curricula was evaluated, and the findings of these assessments were published in various peer-reviewed journal articles. Consequently, a body of evidence on the most effective ways to recommend prescription medicines to doctors was gradually established. This paper aims to summarize this comprehensive body of research spanning over 43 years, with the objective of highlighting the valuable insights gained thus far, identifying the best practice techniques, and exploring potential avenues for future research.

Council of Europe Resolution on the Implementation of Pharmaceutical Care-A Step Forward in Enhancing the Appropriate Use of Medicines and Patient-Centred Care.

Pharmaceutical care was proposed to address morbidity and mortality associated with medicine-related problems. It utilises the pharmacist's expertise in medicines, their relationship with the patient and cooperation with other healthcare professionals to optimise the use of medicines. The European Directorate for the Quality of Medicines & HealthCare (EDQM), part of the Council of Europe, found significant variation in the acceptance of pharmaceutical care and in the implementation of pharmaceutical care in Europe. A multidisciplinary group was established to draft a statement of principles and recommendations concerning pharmaceutical care. Through face-to-face meetings, circulation of draft texts and informal consultation with stakeholders, the group produced a resolution. On 11 March 2020, the resolution was adopted by the Committee of Ministers of the Council of Europe. It explains pharmaceutical care and illustrates pharmacists' contribution to medicine optimisation in different care settings. Pharmaceutical care's value to health services and its place in health policy were emphasised by addressing the risks and harms from suboptimal use of medicines. Pharmaceutical care can improve medicine use, promote rational use of healthcare resources and reduce inequalities in healthcare by realigning the roles and responsibilities of pharmacists and healthcare professionals. EDQM will promote and advocate for the implementation of pharmaceutical care by enacting practice Resolution CM/Res(2020)3.

Evaluation of a psychiatric pharmacist consultation service in a multispecialty outpatient clinic

AbstractBackgroundIntegrated care programs provide both medical and mental health care in clinical settings. Psychiatric pharmacists play a key role in optimizing patient care when integrated into a healthcare team. This project describes the implementation and trends of a psychiatric pharmacist consultation service in a multispecialty outpatient through an integrated behavioral healthcare model.MethodsThis is a retrospective study analyzing a psychiatric pharmacist consultation service at an academic multispecialty outpatient clinic. Eligible patients were aged ≥17 years and seen by the psychiatric pharmacist between June 1, 2019 and June 30, 2022. Patient demographics, reasons for referral, and pharmacist interventions were collected. Patient outcomes on depression, anxiety, and diabetes were also explored. Descriptive statistics were used to quantify information.ResultsA total of 572 encounters were identified. Of those, 285 (49.8%) represented unique patients. Over the 36‐month period, an average of 16 consults were conducted per month. Anxiety and depressive disorders, pain syndromes, and adult attention‐deficit/hyperactivity disorder were the most common diagnoses listed as reasons for consultation. An average of five recommendations or interventions were provided by the psychiatric pharmacist at each initial consultation. Anxiety and depression symptom scores, as well as hemoglobin A1c (HbA1c) values, were lower following pharmacist consultation.ConclusionPsychiatric pharmacists can serve a unique role at multispecialty clinics by providing consultation for patients with psychiatric conditions, chronic pain, medical conditions, and polypharmacy. This study demonstrates the successful utilization of such a service and suggests a psychiatric pharmacist's expertise contributes to improved depression, anxiety, and glycemic outcomes. The multispecialty outpatient setting represents an opportunity to further explore growth for psychiatric pharmacists and the impact these services have on patient outcomes.

Considering the Professionalism of Pharmacists from a Viewpoint of "Regulatory Science"

Regulatory science underpins scientific regulations, including reflection papers, guidelines, and administrative notices, and is closely related to the quality assurance (QA) of pharmaceuticals, foods, and chemicals in our living environment. Historically, QA has been considered the basis of pharmaceutical science. Therefore, the Pharmaceutical and Medical Device Law specifies that pharmacists, as marketing directors of pharmaceutical products, are responsible for their QA. Furthermore, a pharmacist is responsible for the QA of foods and environmental chemicals by several laws; for example, as a food sanitation supervisor or an environmental sanitation training officer. This suggests that the professional expertise of pharmacists is expected in medical care where pharmaceuticals are used and in other fields associated with QA. Thus, I consider that the professionalism of a pharmacist is guided by spiritual concepts with a pragmatic attitude and conformance to these expectations.

Analyzing pharmacist representation in public-facing health media: Insights and implications

BackgroundDespite the importance of marketing for community pharmacies, evidence on its effectiveness in influencing consumer behavior and the added value for pharmacies remains limited. This study explores the representation of pharmacists in consumer-facing print media used for consumer marketing. ObjectiveThe aim of this study is to analyze professional representation, especially of community pharmacists alongside other health professionals, in health-related public-facing print media, and to explore and further develop the use of novel, consumer facing data sources in a healthcare research context. MethodsAn exploratory qualitative content analysis of a sample of issues from a leading consumer-facing healthcare print magazine was conducted. Of 565 extracted text passages, 328 were retained for analysis and coded using a coding scheme focused on described professional role, type of content, depth of voice, and demographics. ResultsPhysicians (42 %) and researchers (19 %) were the largest professional groups to be directly cited in print media texts while pharmacists provided 14 % of all direct quotations. Nurses were identified as sources in 1 % of texts. Male professionals were quoted almost twice as frequently as their female counterparts. Images accompanying texts were more gender balanced but did not reflect workforce demographics. ConclusionThe comparative lack of pharmacist representation in marketing print magazines suggests a missed opportunity both as a marketing tool and for educating the public about community pharmacist expertise. There is a need to harness the potential of print media, especially those financed by and distributed in community pharmacies, to improve public perception and visibility of pharmacists, and to inform the public about the evolving roles of pharmacists in the healthcare ecosystem. Further research should explore pharmacist representations in different types of news media to better understand the impacts on public perception of pharmacists internationally.

커뮤니티 케어에서 방문약료 경험에 관한 사례 연구

As our society enters an aging society, community care is emerging to enable the elderly to spend the rest of their lives in their own neighborhoods. This is a case study of pharmacists who provided home-based pharmaceutical services as part of the leading community care programs in Jeonju and Cheonan city. By interviewing pharmacists who provided home-based pharmaceutical services, we identified the status of pharmaceutical services in community care based on their experiences. Cheonan city has provided pharmaceutical services for poly-pharmacy users, visiting them three to four times a year, and most of the initial recipients have been retained. Jeonju city has provided three types of pharmaceutical services: medication counseling, medication counseling during the transition period after discharge, and medication counseling for diabetics. Both medication counseling and the discharge transition period service were provided twice per patient. The services provided were medication reorganization and medication counseling. The pharmacist thought that they had a better understanding of the senior and could focus on patient care. They had difficulty in preparing for the service in advance due to inadequate records of medication history, and medication reconciliation, and needed various contents to increase patient interest and pharmacist expertise. In order for the visiting pharmacy program to operate more effectively in community care in the future, it is necessary to increase the effectiveness of visiting pharmacy program by establishing an information-sharing platform and developing and disseminating various visiting pharmacy program.

Patients' attitudes towards using a question prompt list in community pharmacies

ObjectiveTo explore patients’ usage rate and perceived usefulness and benefits of a question prompt list (QPL) when collecting prescribed medication in community pharmacies. MethodsData were collected in Swedish pharmacies using questionnaires and semi-structured interviews with patients. The Technology Acceptance Model (TAM) was used, and the outcomes were usage rate, factors impacting on use, and perceived ease of use, usefulness, and benefits of self-reported question-asking and self-perceived medication knowledge. Descriptive statistics and group comparisons were performed, and qualitative data were analyzed thematically with the TAM. ResultsOut of 145 patients filling out the questionnaire, 72 (50.0%) reported they had used the QPL. Patients with new prescriptions and non-native Swedish speakers used the QPL more often (p = 0.03; p = 0.009, respectively). The QPL was quick to read (86.3%) and easy to understand (91.4%). Forty percent stated that they asked more questions, and self-reported users scored higher on self-perceived medication knowledge. In the interviews (n = 14), the QPL was described as an eye-opener as to what one could ask the pharmacist. ConclusionsPatients were willing to use a QPL in community pharmacies. Practice implicationsA QPL in pharmacies might improve patients' engagement medication knowledge, as well as showcase the expertise of pharmacists.

Implementation and evaluation of a shared care model between oncologists and pharmacists for breast cancer patients at a Canadian regional ambulatory cancer centre.

The introduction of CDK 4/6 inhibitors for breast cancer patients has contributed to increased ambulatory patient visits for oncologists. The Medication Assessment by Pharmacist program aims to evaluate the impact of oncology pharmacists performing medication assessment follow-up visits. Breast cancer patients on a CDK 4/6 inhibitor deemed suitable by their oncologist for pharmacist assessment could be booked for a pharmacist medication assessment appointment at alternate treatment cycles. Between February 2019 to November 2021, 29 of 128 patients (22.7%) were selected for 46 total Medication Assessment by Pharmacist visits resulting in 920 min of clinic time savings for physicians. There were similar rates of adhering to provincial protocols for scheduling visits (99% vs. 96%, p = 0.12) and monitoring investigations (98% vs. 98%, p = 0.96) between those enrolled in Medication Assessment by Pharmacist or not. Surveys completed by medical oncologists and pharmacists demonstrated that nine of nine oncologists felt Medication Assessment by Pharmacist reduced workload and wanted Medication Assessment by Pharmacist expanded to additional oncology drugs. Pharmacist-completed surveys revealed that nine of nine pharmacists felt Medication Assessment by Pharmacist increased job satisfaction, and allowed further application of clinical skills. All agreed that patients were receptive to meeting with pharmacists. According to survey results, 33% of oncologists versus 100% of pharmacists routinely asked about medication adherence, new medications or supplements. Integrating pharmacists into a shared care model reduces ambulatory patient visits for oncologists without deviating from provincial protocol guidelines for monitoring and visits for patients on CDK 4/6 inhibitors. Leveraging the medication expertise of pharmacists also increases the frequency of addressing medication adherence and concurrent therapies. Medication Assessment by Pharmacist may be an effective strategy in alleviating projected shortages of oncology providers.

Expert Consensus on the Nephrotoxic Potential of 195 Medications in the Non-intensive Care Setting: A Modified Delphi Method.

Nephrotoxin exposure is significantly associated with acute kidney injury (AKI) development. A standardized list of nephrotoxic medications to surveil and their perceived nephrotoxic potential (NxP) does not exist for non-critically ill patients. This study generated consensus on the nephrotoxic effect of 195 medications used in the non-intensive care setting. Potentially nephrotoxic medications were identified through a comprehensive literature search, and 29 participants with nephrology or pharmacist expertise were identified. The primary outcome was NxP by consensus. Participants rated each drug on a scale of 0-3 (not nephrotoxic to definite nephrotoxicity). Group consensus was met if ≥ 75% of responses were one single rating or a combination of two consecutive ratings. If ≥ 50% of responses indicated "unknown" or not used in the non-intensive care setting, the medication was removed for consideration. Medications not meeting consensus for a given round were included in the subsequent round(s). A total of 191 medications were identified in the literature, with 4 medications added after the first round from participants' recommendations. NxP index rating consensus after three rounds was: 14 (7.2%) no NxP in almost all situations (rating 0); 62 (31.8%) unlikely/possibly nephrotoxic (rating 0.5); 21 (10.8%) possibly nephrotoxic (rating 1); 49 (25.1%) possibly/probably nephrotoxic (rating 1.5); 2 (1.0%) probably nephrotoxic (rating 2); 8 (4.1%) probably/definite nephrotoxic (rating 2.5); 0 (0.0%) definitely nephrotoxic (rating 3); and 39 (20.0%) medications were removed from consideration. NxP index rating provides clinical consensus on perceived nephrotoxic medications in the non-intensive care setting and homogeneity for future clinical evaluations and research.

169 COPD Care for Patients in Rural Clinics: A Mixed Methods Evaluation

OBJECTIVES/GOALS: To assess barriers and recommendations for improving delivery of care for chronic obstructive pulmonary disease (COPD) in rural clinics, we assessed COPD care metrics and obtained perspectives of primary care providers (PCPs) who practice in rural clinics. METHODS/STUDY POPULATION: Quantitative retrospective analysis of patients with COPD using VA data. We included patients whose primary care clinic is located in a rural VA Midwest Health Care Network (HCN) facility and quantified binary measures for receipt of: spirometry, pulmonary specialty care, and optimal inhaler therapy (regimen with LAMA or LABA monotherapy) Qualitative semi-structured individual interviews of PCPs (physicians, nurse practitioners, and physician assistants) whose clinics are located in a rural VA Midwest HCN facility. We elicited perceived barriers to and recommendations for receiving spirometry, pulmonary specialty care, and optimal inhaler therapy from PCPs. RESULTS/ANTICIPATED RESULTS: 6,350 rural patients had a new diagnosis of COPD in 2016-2019. 48.4% had spirometry, 14.4% had pulmonary encounters, and among patients who were prescribed long-acting inhaler therapy, 48.8% received optimal inhaler regimens. Rural PCPs (n=14) highlighted lack of access to spirometry, pulmonary specialty care, and clinic staff support in local clinics and suggested: 1) leveraging the expertise of pharmacists in COPD management and 2) improving access to resources, including use of telehealth technologies. DISCUSSION/SIGNIFICANCE: Less than 50% of rural COPD patients received recommended diagnostic testing and therapy. Resource limitations in rural clinics were the main barrier. The main recommendation was to leverage pharmacists’ expertise in COPD care. These findings provide a pathway forward to improving rural COPD care.

Item development for patient-centered care preferences using a three-archetype heuristic: An exploratory study

BackgroundPatient-centered care is at the center of the Pharmacists' Patient Care Process; however, little is known about patient-centered care preferences and expectations for pharmacist care. ObjectiveTo develop and test items exploring the applicability of a proposed three-archetype heuristic for patient-centered care preferences and expectations in pharmacist care in a population of older adults using community pharmacies that provided enhanced and integrated services. MethodsThis was an exploratory analysis of a cross-sectional survey developed and distributed by postal mail to 17 Medicare-eligible patients at five Community Pharmacy Enhanced Service Network (CPESN) pharmacies in Iowa between November 2021 and January 2022. A total of 15 Likert-type archetype survey items were developed with an item developed for each of five constructs (Nature of Relationship and Locus of Control, Care Customization, Care Longevity, Intent of Communication, and Source of Value) for three archetypes (“Partner,” “Client,” and “Customer”).Items were grouped by archetype to yield three, five-item scales, intended to reflect each archetype. Cronbach alphas (α) were calculated for each scale, measuring internal consistency. K-means clustering with silhouette analysis was performed using a group of archetype items with high internal consistency to identify clusters. Kruskal Wallis and Fisher's exact tests used to determine statistical significance for response means and frequencies between clusters, when appropriate. ResultsIn total, 17 participants completed the survey (100% response rate). Cronbach alphas for the five-item scales reflecting “Partner,” “Client,” and “Customer” archetypes were 0.66, 0.33, and − 0.03, respectively. K-means clustering identified two clusters, labeled: “Independent Partner” and “Collaborative Partner.” There were significant (p-value <0.05) differences between clusters for four of the 15 Likert-type items, suggesting the “Independent Partner” more autonomous, seek pharmacist expertise less frequently, and value pharmacist collaboration less compared to the “Collaborative Partner.” ConclusionsThe items comprising the “Partner” archetype scale had a reasonably strong level of internal consistency. Older adults may desire highly tailored, co-created experience created from long-standing relationships with a particular pharmacist.

Pharmacist-led smoking cessation programs: A comprehensive review of effectiveness, implementation models, and future directions

Pharmacist-led smoking cessation programs have emerged as effective interventions in addressing the global tobacco epidemic, leveraging the accessibility and expertise of pharmacists to provide tailored behavioral counseling, pharmacological support, and follow-up care. This review examines the effectiveness of these programs, highlighting their ability to achieve higher quit rates, improved patient satisfaction, and cost-effectiveness compared to traditional methods. Various implementation models, including those in community pharmacies, hospital settings, and telehealth platforms, are explored, along with the challenges of scaling these interventions, such as limited awareness, training gaps, and inadequate reimbursement. Future directions emphasize innovations in digital tools, personalized medicine, artificial intelligence, and policy and funding support to enhance program reach and sustainability. Recommendations are provided for pharmacists, healthcare systems, and policymakers to address barriers, expand access, and foster collaboration, ultimately integrating pharmacist-led smoking cessation into mainstream healthcare as a critical strategy for tobacco control.