Pharmacy Sites Research Articles

Evaluating the sustained effectiveness of a novel pharmacy-based intervention to reduce older adult misuse of over-the-counter medications: A case for non-significance.

Misuse of over-the-counter (OTC) medications by older adults (age 65+) can comprise Drug-Age, Drug-Drug, Drug-Disease, and Drug-Label types. Pharmacies in the United States are prevalent sources of OTCs and are an apt setting to address OTC misuse. Senior Safe™ is a pharmacy-system redesign for preventing older adult OTC misuse. The redesign uses signage to designate high-risk OTCs and safer products for older adult use, as well as prompting older adults to engage with pharmacy staff around medication safety issue. This study compared misuse in pharmacies with initial Senior Safe implementation (Immediate Effects group) to pharmacies with Senior Safe after 3 months (Sustained Effects group). A non-equivalent group design, involving older adults recruited from matched and randomly-allocated pharmacy sites within a health system, compared the Immediate Effects (n=83) and Sustained Effects (n=65) groups. All participants were recruited outside the pharmacy and were given hypothetical symptom scenarios from which to choose (i.e., cough/cold/allergy, pain, or sleep). Participants were then asked to select an OTC to treat that symptom, and explain their OTC use at symptom onset and if symptoms persisted/worsened. Participants' reported OTC use was evaluated for each misuse type. Multivariate modeling estimated differences in misuse between the Immediate and Sustained Effects groups. No significant differences emerged between Immediate and Sustained Effect groups for any misuse type for which statistical modeling was conducted. Drug-Age misuse was statistically less likely for sleep products (OR=0.170, p=.005) and for adults aged 85+ when compared to the 65-74 and 75-84 age categories (OR=3.979, p=.053; OR=6.900, p=.031, respectively). These non-significant results suggest that the intervention effect was maintained at three months. Overall, then, misuse reductions occurring immediately after intervention implementation did not significantly increase after three months. System buy-in, including assessing costs to implement and maintain Senior Safe, is critical to promote broader adoption.

Students’ Engagement in Learning Nursing Pharmacotherapeutics: A Self-reported Volunteer Experience

Hands-on experiential learning within a clinical setting and the integration and translation of theoretical knowledge to practice have been explored as pedagogical methods to enhance nursing education. This study reports nursing students’ self-assessment of volunteer learning experience at hospitals and community pharmacies to enhance nursing pharmacologic knowledge. The study quantitatively evaluated the self-reported assessment of nursing students at hospital and community pharmacies in Belize using a convenient sampling technique. Forty-six nursing students spent 48 hours at assigned community and hospital pharmacies under the supervision of a licensed pharmacist. Self-assessment questionnaires and the grades from preceptors were analysed and reported. Students described a positive experience with high mean scores indicating self-reported learning of new medications, drug side effects, labelling of drugs, dispensing prescriptions, patients’ assessment, communication and experience working alongside interprofessional healthcare team members. This study shows that undergraduate nursing students can benefit from volunteer learning at community and hospital-based pharmacies to enhance hands-on learning of pharmacotherapeutics knowledge. Daily interactions with pharmacists, medications and patients complemented students’ learning of medications and skills acquisition. Nursing educators should explore nonconventional pedagogical approaches, such as pharmacy clinical sites, to complement students’ pharmacologic learning.

Screening and referral programs for diabetes and cardiovascular disease: Can community pharmacists bridge the care gap?

Background and ObjectivesHeart disease and diabetes are leading causes of death in the U.S., with timely screening, referrals, and education being critical for effective treatment. The Community-based Valued-driven Care Initiative (CVCI) aimed to develop, implement, and evaluate the feasibility of delivering patient-centered care interventions for high priority disease states in community pharmacies. This article focuses specifically on two of the selected interventions, both of which were screening and referral (S&R) programs for the prevention and treatment of cardiovascular disease (CVD) and diabetes (DM) respectively. This exploratory evaluation was designed as an effectiveness-implementation hybrid Type II study. Its objectives were to assess both implementation and preliminary program effectiveness using mixed data. MethodsFifteen community pharmacies opted to implement one of the two programs over a 12-month period. Implementation feasibility involved examining program adoption rates by sites and patients; acceptability, appropriateness, feasibility, and intent to sustain use survey scores; and pharmacists' interviews. Program effectiveness was based on patient referral rates, physician follow-up communication rates, and perceived outcomes, collected via patient logs, surveys, and interviews. ResultsTwo of the 15 sites discontinued participation, yielding an 87 % adoption rate. Patient adoption varied based on contact and screening rates, due to differences in patient recruitment, staffing, and workflow. Pharmacist acceptability, compatibility, and feasibility remained high throughout implementation; however, only three pharmacy sites planned on continuing offering the programs. All at-risk patients were appropriately referred based on screening results, with 65 % having their screening results communicated to their primary healthcare providers. The programs were perceived as beneficial, increasing pharmacists' knowledge and motivation, enhancing relationships with patients, and producing an impact on patients'' health. DiscussionResults highlight the implementation feasibility and preliminary outcomes of delivering DM and CVD S&R programs in community pharmacies. However, despite these positive results, most pharmacies did not intend to continue the programs, underscoring the continued need for sustainable clinical services models in non-traditional settings. Success with broader implementation will require a paradigm shift in support of community pharmacists as clinical care extenders.

Identifying legitimate websites selling medicines in South Africa

Background: The online sale of medicines has skyrocketed globally, where medicines are purchased in the comfort and privacy of one’s own home. However, there are an increasing number of illegal websites selling counterfeit and falsified medicines.Aim: The aim of this study was to review the information and medicines sold online through pharmacy websites in South Africa (SA) and their compliance with local legislation.Setting: The study setting comprised online pharmacy websites in SA.Methods: This quantitative descriptive study used a purposeful questionnaire based on the South African Pharmacy Council inspection questionnaire for pharmacies operating websites. Websites claiming to be an online pharmacy in SA were included.Results: There were 25 websites reviewed, which claimed to be online pharmacies. Majority (n = 22) were found to be legal websites, operated by a registered community pharmacy and required a prescription for the purchase of prescription only medicines. Few websites complied with legislation such as displaying the Y number (n = 5) and name of the responsible pharmacist (n = 10). The remaining three websites were not linked to physical pharmacies, none complied with legislation and supplied medicines without a prescription.Conclusion: Although the online sale of medicines is regulated in SA, not all websites complied with legislation. The study highlighted the importance of monitoring websites claiming to be online pharmacies and their compliance with legislation.Contribution: Four stakeholders, consumers; pharmacy websites; regulators and healthcare providers, were identified and their role outlined in promoting the safe online purchasing of medicines.

Fair Balance of Prescription Drug Information on Legitimate and Illegitimate Online Pharmacy Websites.

Patients require important information when prescribed medications. For example, the U.S. Food and Drug Administration (FDA) requires that promotional information includes a fair balance of risks and benefits. This study evaluates how well legitimate online pharmacies (LOPs) and illegitimate online pharmacies (IOPs) comply with the spirit of the FDA's fair balance guidelines by examining the extent and equivalence of risk and benefit information on their websites. This study analyzed the content of 307 online pharmacy websites. Most (90.3%) communicated drug benefits, while 84.7% provided risks. Both risk and benefit information was moderately extensive. Presentation of risks and benefits differed between online pharmacy types. Compared to LOPs, IOPs were more likely to present risk information but also exaggerate benefits. Four in ten online pharmacies presented a fair balance of risks and benefits. However, LOPs (47.4%) were more likely to present a fair balance than IOPs (36.5%). Interestingly, IOPs were more likely to disclose instructions for use and overdose information than LOPs. These findings underscore the need for regulatory guidelines to encourage online pharmacies to present a fair balance of benefit and risk information. Also, pharmacists should develop online approaches to better fulfill their professional responsibility as drug information providers while maintaining their integrity and objectivity.

Pharmacist certification of drug therapy modification: A survey of pharmacist‐reported practices, facilitators, and barriers in Georgia

AbstractIntroductionCollaborative drug therapy management (CDTM) allows pharmacists to assess patients, administer medications, manage and adjust medication regimens, and order laboratory tests within a defined protocol. Pharmacist CDTM may aid in preventative care and chronic condition management.ObjectivesThe primary objectives were to identify CDTM services provided by pharmacists in the state of Georgia, examine factors associated with the provision of CDTM services, and identify barriers and facilitators to CDTM service provision. The secondary objective was to assess differences in CDTM practice between pharmacists who completed a Registered Pharmacist (R.Ph.)/Doctor of Pharmacy (Pharm.D.), postgraduate year one (PGY1), or postgraduate year two (PGY2) residency.MethodsUsing the Dilman method, this cross‐sectional study invited all 134 CDTM‐licensed pharmacists in Georgia to complete a 30‐min electronic survey. Data included demographics, training, services offered, disease states managed, and perceptions regarding CDTM implementation. Descriptive statistics, Welchs analysis of variance (ANOVA), and chi‐square were conducted using SPSS v28.ResultsA total of 36 (26.9%) pharmacists completed the survey. Participants offered a median of three CDTM services. A majority offered medication therapy management (86.1%) and chronic care management (66.7%). A majority offered services for diabetes (58.3%), hyperlipidemia (55.6%), and hypertension (55.6%). There were differences in the mean ranked number of CDTM services offered between R.Ph./Pharm.D. and PGY2 groups (−11.667, p = 0.019), and the mean ranked number of disease states covered between R.Ph./Pharm.D. and PGY1 (−10.990, p = 0.029) and R.Ph./Pharm.D. and PGY2 (−12.640, p = 0.010, adjusted p‐value) groups. Reported CDTM facilitators were job requirements, expanding patient care, job satisfaction/personal advancement, and expanding professional practice. Reported challenges were continuing education, clinical/interprofessional concerns, administration issues with the board of pharmacy or individual practice site, and regulations differing from other states.ConclusionOf those with CDTM licensure, a majority offer medication therapy management and chronic care management services covering diabetes, hypertension, and hyperlipidemia. Postgraduate training may help prepare pharmacists to engage in CDTM services.

Analyzing third-party data leaks on online pharmacy websites

PurposeWith digitalization, using essential digital services such as online services has become increasingly common. These services process sensitive health related data, such as customers’ prescription medicine orders, which makes ensuring stringent data privacy crucial. The current study examines third parties such as analytics services on Finnish pharmacy websites and investigates the nature and contents of data leaks on these websites.MethodsWe perform an extensive network traffic analysis to reveal data leaks among 163 Finnish online pharmacies. We also study a set of privacy policies of these online pharmacies, and provide a legal analysis regarding the interpretation of the concept of data concerning health in the context of online pharmacies.ResultsOur findings reveal serious data leaks among Finnish online pharmacies. We found 145 pharmacies had third-party services on their websites and only 18 did not. Out of all 163 online pharmacies, 57 (35.0 %) leaked a specific prescription medicine name connected with identifying personal data on the customer. We argue that the information concerning purchases on the prescription medicines should be interpreted as data concerning health to ensure efficient protection of customers’ right to data protection and privacy.ConclusionsWe hope that these concerning results will serve as a wake-up call for the developers and maintainers of online pharmacies and other web services processing sensitive data. Any third-party services incorporated into websites processing sensitive personal data should be closely inspected in terms of data leaks, or preferably not used at all.

Health equity in COVID-19 testing among patients of a large national pharmacy chain.

Several social determinants of health and other structural factors drive racial and ethnic disparities in COVID-19 risk, morbidity, and mortality. Public-private collaborations with community pharmacies have been successful in expanding access to COVID-19 testing and reaching historically underserved communities. The objectives of this study were to describe individuals who sought testing for COVID-19 at a national community pharmacy chain and to understand potential racial and ethnic inequities in testing access, positivity, and infection with emerging variants of concern. We conducted a cross-sectional study of individuals aged ≥18 who were tested for COVID-19 (SARS-CoV-2) at a Walgreens pharmacy or Walgreen-affiliated mass testing site between May 1, 2021 and February 28, 2022. Positivity was defined as the proportion of positive tests among all administered tests. A geographically balanced random subset of positive tests underwent whole genome sequencing to identify specific viral variants (alpha, delta, and omicron). Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) to compare the likelihood of testing positive and testing positive with an emerging variant of concern across race and ethnicity groups. A total of 18,576,360 tests were analyzed (16.0% tests were positive for COVID-19; 59.5% of tests were from White individuals and 13.1% were from Black individuals). American Indian or Alaska Native (OR = 1.12; 95%CI = 1.10-1.13), Hispanic or Latino (1.20; 95%CI = 1.120, 1.21), and Black (1.12; 95%CI = 1.12, 1.13) individuals were more likely to test positive for COVID-19 compared to White individuals. Non-White individuals were also more likely to test positive for emerging variants of concern (e.g., Black individuals were 3.34 (95%CI = 3.14-3.56) times more likely to test positive for omicron compared to White individuals during the transition period from delta to omicron). Using a national database of testing data, we found racial and ethnic differences in the likelihood of testing positive for COVID-19 and testing positive for emerging viral strains. These results demonstrate the feasibility of public-private collaborations with local pharmacies and pharmacy chains to support pandemic response and reach harder to reach populations with important health services.

Exploring the medicine cost of managing Diabetes Mellitus in Nepal: A cross-sectional analysis of oral hypoglycaemic medications.

Diabetes Mellitus is a significant global public health burden. Although medication adherence is an inevitable consideration in managing and curing the disease, medication price is the major barrier to patients in Nepal, like any other low- and middle-income countries. Prescribing in brand-name inhibits the possibility of accessing cost-effective generic alternatives in Nepal. This study aimed to explore and examine price variations among the oral hypoglycaemic medicines (OHMs) available in the country and their distribution in various medicine-related characteristics. A cross-sectional study was conducted using a convenient sample of five tertiary care hospital pharmacies in Kathmandu, publicly accessible online pharmacy websites, and a government database to list the OHMs available in Nepal. The study determined price variations and statistically tested the association between these variations and the characteristics of the medicines. Fourteen OHMs were available as 57 generic medicine items with different formulations in Nepal. The maximum of 484.82% of price variation was found. Fourteen, fifteen and eighteen OHMs have variations of over 100%, more than 10 rupees and no price change, respectively. Except for Dipeptidyl Peptidase-IV (DPP-4) Inhibitors and Thiazolidinediones (TZDs), all other categories of OHMs have >100% of price variation in medicine items. Although Nepal itself produces most of the available OHMs, the available OHMs have price variations. Most fixed dose combinations showed no reduction in cost compared to their component medicine's mean price. This study presented and discussed the price variation scenario of OHMs with their medicine-related characteristics to develop and implement effective drug policies and programs that can address medication price-related issues to ensure access to OHMs without placing an economic burden on patients.

Development of an Environmental Audit Tool for Hospital Pharmacy.

Health care contributes significantly to greenhouse gas emissions, and pharmacy departments have many opportunities to reduce their emissions. To describe the development and implementation of an environmental audit tool for hospital pharmacy departments. A pharmacy environmental audit tool was developed by modifying a generic workplace audit tool to include pharmacy-specific content. The audit tool contained 22 categories, with scoring on a 4-point scale (from 0 to 3). Members of a volunteer committee completed the audit by observing practice areas. The lowest-scoring categories were then prioritized for action. Overall, the 4 main pharmacy sites in Regina, Saskatchewan, scored 23/66 (35%). Areas of strength identified in the audit included reuse of packaging materials, carpooling, and paperless meetings. Areas for improvement prioritized by the committee included paper use, plastic use, and recycling. The pharmacy environmental audit tool described here can facilitate reflection on current practice, benchmarking, and goal setting. Pharmacy professionals have a role in leading change for the benefit of planetary health.

Understanding the Information Needs of Pharmacy Staff Using CancelRx: A Qualitative Study of the Use of Prescription E-cancellation

BackgroundAlthough electronic prescription cancellation such as via CancelRx can facilitate critical communication between prescribers and pharmacy staff about discontinued medications, there is little work that explores whether CancelRx meets the needs of pharmacy staff users. ObjectiveThis study leverages qualitative interviews with pharmacy staff to address the following question: When medication changes are made by a prescriber using CancelRx, what information is needed by pharmacy staff to make correct and effective decisions in their roles in medication management? MethodsWe conducted an inductive thematic analysis of interviews with 11 pharmacy staff members (pharmacists and pharmacy technicians) across three outpatient community pharmacy sites within an academic health care system. ResultsThree information needs themes were consistently identified by both pharmacists and pharmacy technicians: prescriber intent when initiating the CancelRx, clinical rationale for the medication change, and intended medication regimen. Notably, both pharmacists and pharmacy technicians often reported seeking multiple information needs not fully addressed by CancelRx in the electronic health record (EHR) to achieve the shared goals of correct dispensing of medications and supporting patient self-management. ConclusionsOur qualitative analysis reveals that outpatient community pharmacy staff in an academic health care system often seek additional information from the (EHR) following medication changes communicated by CancelRx to meet their information needs. Ideally, the prescriber would provide sufficient information through CancelRx to automatically identify all discontinued prescriptions. These limitations highlight the need for design features that support routine communication of needed information at the time of a medication change, such as structured data elements.

Preparing community pharmacy teams for health information exchange (HIE)

BackgroundHealth information exchanges (HIEs) facilitate health care professionals’ electronic sharing of patient information across different organizations. When community pharmacists have access to HIE, they can further contribute to improved patient outcomes. However, several implementation challenges are noted, which impede sustained pharmacist access to HIE. To our knowledge, no bidirectional HIE interface design and pharmacy team-informed implementation process has been documented. In response, our research team designed and developed an HIE interface prototype for use specifically by community pharmacy teams to access local HIE data through their pharmacy dispensing software. ObjectivesTo 1) identify barriers, facilitators, and recommendations for using HIE data in community pharmacies and 2) create a curated list of resources addressing identified implementation needs to aid future implementation of a fully functional, bidirectional HIE interface by community pharmacy teams. MethodsPharmacists, pharmacy technicians, and patients from three pharmacy sites within the Community Pharmacy Enhanced Services Network of Indiana participated in individual semi-structured interviews. Interview questions were mapped to select constructs across all domains of the Consolidated Framework for Implementation Research. Interview transcripts were deductively coded. A subset of participants participated in Evidence-Based Quality Improvement sessions to iteratively update planned resource items needed to support future HIE implementation. ResultsWe interviewed 23 total participants: 8 pharmacists, 8 pharmacy technicians, and 7 patients. Five facilitators, four barriers, and two recommendations were identified. These were further characterized into four key implementation needs: instruction on how to use HIE; guidance on workflow and team roles; resources that are patient-facing; and resources that are provider-facing, resulting in 16 planned implementation resources. ConclusionOur study provides the first-of-its-kind list of pharmacy team-informed resources to facilitate sustainability and scalability of HIE implementation in community pharmacies.

Community Pharmacists expand access to cognitive function assessments with Cognivue Clarity™ device

AbstractBackgroundMost initial cognitive assessments are performed by primary care physicians (PCPs). With the growing senior population reaching the age of increased risk for Alzheimer’s (65 yrs), coupled with the projected shortage of up to 48,000 PCPs by 2034 (IHS Market Ltd. AAMC;2021), use of pharmacy‐based cognitive assessments can greatly expand access. Pharmacists are more accessible than PCPs (Tsuyuki et al. 2018) and are among the most trusted healthcare professionals.MethodMember pharmacies of CPESN USA were selected to conduct standardized cognitive function tests using the Cognivue Clarity® device. Study participants were ≥65 yrs and had the ability to complete a survey about their cognitive screening history and PCP contact information. Site education and training were conducted by the Avant Institute and Cognivue. Sites were surveyed following data collection. Study was funded by the Davos Alzheimer’s Collaborative and occurred August 2022 ‐ December 2022.ResultNineteen CPESN pharmacy sites from 13 states, 10 within medically underserved or rural areas, submitted 425 eCare plans that were eligible for analysis. Less than 16% (67/425) patients reported having a previous cognitive assessment, with 81% (343/425) reporting this was their first cognitive assessment, and the remainder reported unknown. Approximately 73% (312/425) of patients had Cognivue clinical overall scores outside the normal range and were referred to their PCP. Site surveys post‐data collection showed that >83% and >72% of pharmacies rated ease of use of the Cognivue Clarity device, and education and training, to be an extremely significant or significant contributor to study success, respectively.ConclusionPharmacists are often overlooked as a vital link to assessing the cognitive health of seniors. With two FDA‐cleared immunotherapies available, it is critical that seniors are aware of their cognitive status so they can seek research studies, further evaluations, and/or medications. This study showed that with training and use of Cognitive Clarity, pharmacists can easily provide seniors with an objective cognitive function assessment. Accordingly, widespread implementation of pharmacy‐based computerized cognitive testing could greatly expand access to meet the brain health needs of the growing senior population.

Use of Social Media and Websites by students of Pharmacy

Background: Social media sites are widespread among both young and older adults for purpose of networking, sharing, and marketing. They are a way for individuals to connect with others and share similar interests and values. The purpose of our study was to evaluate social media use among pharmacy students at distance campus sites to determine student preferences for ways in which social media can be used within the pharmacy curriculum. Aim: This study aimed to investigate the professional use of social media, databases, and applications by pharmacy college students. Methods: A survey questionnaire was used to collect data from pharmacy college students by using Google forms. Findings: The survey was collected from 200 responses (108 male & 92 female) from pharmacy college students. Conclusion: According to the survey in this study, the pharmacy students are knowing social media, pharmacy websites, pharmacy apps, and databases. Pharmacy college student needs to expand the use of social media for professional development most preferably to obtain information regarding continuing education opportunities through these pharmacy websites, pharmacy apps, and database.

Adapting a community pharmacy intervention to improve medication safety

BackgroundCommunity pharmacies are an ideal location to address challenges of over-the-counter medication safety, yet many successful interventions are only tested in a few pharmacies without expansion, creating unrealized opportunities to improve patient care on a larger scale. Scaling up to numerous pharmacies can be challenging because each community pharmacy has unique needs and layouts and requires individualized adaptation. ObjectivesThis paper reports techniques for (a) adapting a community pharmacy intervention to fit the unique physical layout and patient needs of health system pharmacy sites without increasing staff workload, (b) identifying strategies to gather feedback on adaptations from stakeholders, and (c) developing materials to share with pharmacy champions for them to independently implement and sustain the intervention in their organization. Practice descriptionThe study team collaborated with Aurora Pharmacy, Inc to develop an intervention designed to increase awareness of safe over-the-counter medication use for older adults. Practice innovationSenior Safe, a community pharmacy-based intervention, was designed, implemented, and tested using the Exploration, Preparation, Implementation, and Sustainment implementation framework. Evaluation methodsSenior Safe was adapted through pilot testing and a randomized control trial. Feedback was collected from key stakeholders, including pharmacy staff, older adults, and a research advisory group. ResultsA finalized version of Senior Safe, as well as an implementation package, was provided to Aurora Pharmacy to integrate into all 63 sites. ConclusionThis multiphase study illustrated that refining an intervention is possible and welcomed by pharmacy staff, but it requires time, resources, and funds to create an impactful, sustainable community pharmacy intervention.

Usage of Web Scraping in the Pharmaceutical Sector

INTRODUCTION: Web scraping is a technique that provides organizations with the ability to analyse large amounts of information and gather new information. 
 OBJECTIVES: Find a group that is a health check, a full body test, a blood test, and so on. In this way, the pharmaceutical industry should consider how to improve information, information storage, information retrieval, and capture. For example, the healthcare system may decide to standardize the assessment of speech and allow information to be shared across organizations to improve treatment outcomes in web scraping applications.
 METHODS: Web scraping is based on the pharmaceutical industry. From here, we get information about pharmacies, such as drug names in different categories or drug sales. However, we are dealing with diseases and common medicines. Using this information, we can find the most common viruses. There are many factors to consider when creating a junk website for the pharmaceutical industry, such as drug names, tablet categories, and syrups found in the pharmaceutical industry.
 RESULTS: As is clearly visible from the output, there are columns for drug names, manufacturers, drug types, and prices. This is the information we get from a website called Net meds, a pharmacy site. With the help of this information, we learn which drugs are most needed, and then we can find the most common diseases today.
 CONCLUSION: The results of this web scraping can be very useful and powerful. However, the industry's success in web scraping and data extraction techniques depends on the availability of clean chemical data.

A-178 Reduced Hemolysis with a Novel Capillary Collection System as Compared With Conventional Capillary Collection Devices

Abstract Background Capillary blood collection is often cumbersome and lacks consistency in the applied pressure during squeezing of the finger. This may result in poor sample quality (i.e., hemolysis and dilution of the sample with interstitial fluid). Standardizing the capillary collection process and thereby making it less technique dependent can enable diagnostic blood testing to be performed in non-traditional settings (e.g., retail pharmacy). A novel capillary blood collection system has been developed to help standardize the process and may enable blood sampling by non-traditional healthcare workers (e.g., pharmacists, pharmacy technicians). Multiple studies were performed to evaluate the performance of this capillary blood collection system on sample quality in comparison with currently marketed capillary and venous blood collection devices. Sample quality was assessed by visual observation of hemolysis and by quantitative assessment of Plasma Free Hemoglobin (PFH). Methods Participants were enrolled at three sites representative of the intended use environment (i.e., retail pharmacy site or patient service center). Phlebotomists performed venipuncture using a currently marketed venous comparator and conventional capillary collection using a capillary comparator. Capillary collection was also performed using the novel capillary device in the same subjects by targeted trained healthcare workers (e.g., retail pharmacists, pharmacy technicians). Blood was collected using each method (venous and two capillary–conventional and novel capillary devices) into serum separator tubes from the same subject within the same timeframe. Data from the studies were pooled in a meta-analysis to assess device performance across multiple studies. Visual assessment of hemolysis was performed post centrifugation using a rating scale (0 = None, 1 = Trace, 2 = Moderate, 3 = Gross). For PFH measurement, a cut-off of >50 mg/dL was selected, as hemolysis interference may be observed at these levels in highly sensitive analytes. Results When compared with the venous comparator, the incidences of hemolysis, as assessed by visual hemolysis and PFH measurements, were higher with capillary collections. However, the incidences were significantly lower with the novel capillary collection system than with the capillary comparator. The overall incidence of visual hemolysis was significantly lower for the new capillary device when compared to the capillary comparator (“None” rating of 94% vs 64.5%). The frequency of trace, moderate and gross hemolysis was also less in the new capillary device when compared to the capillary comparator (4.4% vs 23.2%, 1.2% vs 9.8%, 0.4% vs 2.5%, respectively). For the quantitative measurement of PFH as an indicator of hemolysis, a similar trend was observed. The mean PFH value in the new capillary device was significantly lower than in the capillary comparator (29.87 vs 55.18), and the frequency of PFH >50 mg/dL was also significantly lower in the new capillary device than in the capillary comparator (11.7% vs 42.0%). Conclusions Improved sample quality was demonstrated with a novel capillary blood collection system, as the incidences of hemolysis, as measured visually and quantitatively as PFH measurement, were significantly lower than in conventional capillary blood collection devices. Consequently, this may result in fewer rejected samples in the lab than conventional capillary methods and help meet the demands for more convenient, patient-centric healthcare services.

Public Commitment to Diversity, Equity, Inclusion Displayed on US Schools and Colleges of Pharmacy Websites

Public Commitment to Diversity, Equity, Inclusion Displayed on US Schools and Colleges of Pharmacy Websites

COVID-19 host genetic risk study conducted at community pharmacies: Implications for public health, research and pharmacists’ scope of practice

Community pharmacists serve a large, diverse population of patients, resulting in the potential to utilize community pharmacies as recruitment sites for clinical research. Beyond traditional roles as one of the most accessible health care professionals in the US healthcare system, pharmacists have played a major role in the response to the COVID-19 pandemic, administering hundreds of thousands of vaccines and tests. However, less emphasis is placed on the ability to leverage community pharmacies as research-focused partners for clinical studies. In this study, we demonstrate the feasibility and workflow of recruiting study participants from community pharmacies and confirm genetic markers of COVID-19 susceptibility. Specific genetic markers include those associated with COVID-19 infection risk (ACE2, TMEM27, and RAVER1), difficulty breathing (NOTCH4), and hospitalization (OAS3). In addition, collaboration with a clinical laboratory allowed for a more seamless consenting process without substantial training needs or workflow disruption at the community pharmacy site. The COVID-19 pandemic has demonstrated that the expansion of pharmacists’ scope of practice is a key factor in managing the population health crisis; this study demonstrates that pharmacies can also advance clinical research studies by serving as sites for patient recruitment from a large, diverse, and ambulatory study population.

Flip the Pharmacy’s impact on comprehensive medication management performance

BackgroundClinically integrated networks of community pharmacies are expanding partnerships with health care payers for sustainable provision of patient care services. The Pennsylvania Pharmacists Care Network (PPCN), a part of CPESN USA, launched its first payer program in 2017 with a Medicaid managed care organization for comprehensive medication management (CMM). Some PPCN pharmacy teams have participated in Flip the Pharmacy, a national practice transformation initiative. ObjectivesThis study aimed to determine whether pharmacy participation in Flip the Pharmacy was associated with a greater rate of CMM encounters than in nonparticipating pharmacies within a statewide clinically integrated network. MethodsThis project was a retrospective quantitative study. CMM encounter data including total number of encounters and total number of eligible members were extracted from monthly reports. Generalized estimating equations were used to assess the association between Flip the Pharmacy participation and CMM encounter rates. ResultsOf 103 pharmacies that participated in the CMM program in 2019 and 2020, 77.7% of pharmacies (n = 80) were included in analyses. Of these, 31.3% (n = 25) participated in Flip the Pharmacy. Overall, 80 pharmacies documented 8460 patient encounters through the CMM program. On average, pharmacies participating in Flip the Pharmacy recorded 1.67 times the rate of encounters compared with non-Flip the Pharmacy pharmacies (95% CI 1.10–2.54), controlling for single versus multiple pharmacy sites and weekend hours. On average, pharmacies participating in Flip the Pharmacy recorded 1.18 times the rate of initial encounters (95% CI 0.84–1.59) and 2.06 times the rate of follow-up encounters (95% CI 1.22–3.48) compared with non-Flip the Pharmacy pharmacies. ConclusionParticipation in Flip the Pharmacy in Pennsylvania was associated with greater engagement and completion of encounters within a payer program for CMM. Continued practice transformation efforts are needed to ensure the sustainability of community pharmacy practice as it continues to expand into payment for patient care services.