Journal of the American Pharmacists Association

Publisher: American Pharmacists Association

Description

The Journal of the American Pharmacists Association, the official peer-reviewed journal of the American Pharmacists Association, provides members with articles and columns on pharmaceutical care, drug therapy, diseases and other health issues, trends in pharmacy practice and therapeutics, informed opinion, and original research.

  • Impact factor
    0.00
  • 5-year impact
    0.00
  • Cited half-life
    0.00
  • Immediacy index
    0.00
  • Eigenfactor
    0.00
  • Article influence
    0.00
  • Website
    Journal of the American Pharmacists Association: JAPhA website
  • Other titles
    Journal of the American Pharmacists Association (1996: Online), Journal of the American Pharmacists Association, JAPhA
  • ISSN
    1544-3450
  • OCLC
    52032194
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publications in this journal

  • [show abstract] [hide abstract]
    ABSTRACT: OBJECTIVE To assess Spanish-speaking patients' satisfaction with their clinical pharmacists' communication skills and demonstration of cultural sensitivity, while controlling for patients' sociodemographic, clinical, and communication factors, as well as pharmacist factors, and to identify clinical pharmacists' cultural factors that are important to Spanish-speaking patients. DESIGN Cross-sectional study. SETTING Central Texas during August 2011 to May 2012. PARTICIPANTS Spanish-speaking patients of federally qualified health centers (FQHCs). MAIN OUTCOME MEASURE(S) A Spanish-translated survey assessed Spanish-speaking patients' satisfaction with their clinical pharmacists' communication skills and demonstration of cultural sensitivity. RESULTS Spanish-speaking patients (N = 101) reported overall satisfaction with their clinical pharmacists' communication skills and cultural sensitivity. Patients also indicated that pharmacists' cultural rapport (e.g., ability to speak Spanish, respectfulness) was generally important to Spanish speakers. Multiple linear regression analyses showed that cultural rapport was significantly related to satisfaction with pharmacists' communication skills and demonstration of cultural sensitivity. CONCLUSION Overall, patients were satisfied with pharmacists' communication skills and cultural sensitivity. Patient satisfaction initiatives that include cultural rapport should be developed for pharmacists who provide care to Spanish-speaking patients with limited English proficiency.
    Journal of the American Pharmacists Association 03/2014; 54(2):121-9.
  • [show abstract] [hide abstract]
    ABSTRACT: OBJECTIVE To measure the impact of student pharmacists' consultation on participant knowledge and attitudes about influenza and tetanus-diphtheria-acellular pertussis (Tdap) vaccines. DESIGN Pre- and post-consultation surveys. SETTING Free health care service and immunization clinics in Vallejo and Martinez, CA. PARTICIPANTS Children and adults 13 years of age or older. INTERVENTION A convenience sample of participants completed a preintervention survey (PrIs) on basic vaccine knowledge and attitudes. Student pharmacists then delivered the intervention, which consisted of a 5-minute consultation on vaccines. A postintervention (PoIs) survey was administered immediately after the intervention. MAIN OUTCOME MEASURES Cumulative scores for eight knowledge-based questions and four attitude-based questions. RESULTS 198 participants completed both PrIs and PoIs. Compared with the PrI scores, the PoI scores showed significant improvement in basic vaccine knowledge and attitudes toward receiving vaccinations. Participants also were more likely to view pharmacists as a source of information about vaccines after the intervention. Student pharmacists administered 109 total vaccinations during the study, including 68 influenza vaccinations and 41 Tdap vaccinations. CONCLUSION A short, 5-minute consultation by a student pharmacist may increase vaccination rates and help serve as a vehicle to change the public's view of vaccines as well as pharmacists and their role in primary and preventive care.
    Journal of the American Pharmacists Association 03/2014; 54(2):130-7.
  • [show abstract] [hide abstract]
    ABSTRACT: OBJECTIVE To determine the feasibility of implementing a pharmacogenomics service in a community pharmacy. SETTING A single community pharmacy that is part of a regional chain known for offering innovative pharmacy services. PRACTICE DESCRIPTION Community pharmacists at the project site routinely provide clinical pharmacy services, including medication therapy management, immunizations, point-of-care testing, blood pressure monitoring, and diabetes education. PRACTICE INNOVATION The implementation of a pharmacogenomic testing and interpretation service for the liver isoenzyme cytochrome P450 2C19. PARTICIPANTS 18 patients taking clopidogrel, a drug metabolized by CYP2C19. MAIN OUTCOME MEASURES Rate of patient participation, rate of prescriber acceptance of pharmacist recommendation, time to perform genetic testing service, and number of claims submitted to and paid by insurance. RESULTS Of 41 patients taking clopidogrel and meeting project criteria, 18 (43.9%) enrolled and completed testing and interpretation of pharmacogenomic results. The mean time pharmacists spent completing all stages of the project with each participant was 76.6 minutes. The mean time to complete participation in the project (time between person's first and second visit) was 30.1 days. Nine patients had wild-type alleles, and pharmacists recommended continuation of therapy as ordered. Genetic variants were found in the other nine patients, and all pharmacist recommendations for modifications in therapy were ultimately accepted by prescribers. Overall, 17 patients consented to filing of reimbursement claims with their insurers. Five were not able to be billed due to submission difficulties. Of the remaining 12, none was paid. CONCLUSION A pharmacogenomics service can be an extension of medication therapy management services in a community pharmacy. Prescribers are receptive to having community pharmacists conduct pharmacogenomics testing, but reimbursement is a challenge.
    Journal of the American Pharmacists Association 03/2014; 54(2):172-80.
  • [show abstract] [hide abstract]
    ABSTRACT: OBJECTIVE To characterize students' views and opinions of professionalism on popular social media sites and compare responses about social media behavior among students in different groups. DESIGN Cross-sectional survey. SETTING Four colleges of pharmacy in midwestern United States. PARTICIPANTS 516 graduating student pharmacists. INTERVENTIONS Online survey with open-ended questions. MAIN OUTCOME MEASURES Qualitative analysis of responses and themes. RESULTS A total of 212 student pharmacists completed surveys (41% response rate). Mean (± SD) age was 25.2 ± 4.6 years, and 72% of respondents were women. Major overarching themes identified in the qualitative analysis were separation of personal and professional lives, how accountability for actions should vary by severity, and the extent of representation of the students' character on social media. CONCLUSION Identified themes provided important insights into the ways in which student pharmacists view social media and use this widely accessible means of personal communication.
    Journal of the American Pharmacists Association 03/2014; 54(2):138-43.
  • Journal of the American Pharmacists Association 03/2014; 54(2):208.
  • Journal of the American Pharmacists Association 03/2014; 54(2):102-20.
  • Journal of the American Pharmacists Association 03/2014; 54(2):202-7.
  • Journal of the American Pharmacists Association 03/2014; 54(2):198-201.
  • [show abstract] [hide abstract]
    ABSTRACT: OBJECTIVES To identify opportunities to perform point-of-care (POC) testing and/or screening for infectious diseases in community pharmacies, provide an overview of such tests and how they are used in current practice, discuss how the Clinical Laboratory Improvement Amendments of 1988 (CLIA) affect pharmacists performing POC testing, and identify and discuss barriers and provide recommendations for those wanting to establish POC testing for infectious diseases services in community pharmacies. DATA SOURCES PubMed and Google Scholar were searched from November 2012 through May 2013 and encompassed the years 2000 and beyond for the narrative review section of this article using the search terms rapid diagnostic tests, POC testing and infectious diseases, pharmacy services, CLIA waiver, and collaborative drug therapy management. All state boards of pharmacy in the United States were contacted and their regulatory and legislative websites accessed in 2012 and January 2013 to review relevant pharmacy practice laws. DATA SYNTHESIS POC testing for infectious diseases represents a significant opportunity to expand services in community pharmacies. Pharmacist education and training are addressing knowledge deficits in good laboratory practices and test performance and interpretation. Federal regulations do not define the qualifications for those who perform CLIA-waived tests, yet few pharmacists perform such services. Fewer than 20% of states address POC testing in their statutes and regulations governing pharmacy. CONCLUSION POC testing for infectious diseases could benefit patients and society and represents an opportunity to expand pharmacy services in community pharmacies. Existing barriers to the implementation of such services in community pharmacies, including deficits in pharmacist training and education along with state regulatory and legislative variance and vagueness in statutes governing pharmacy, are not insurmountable.
    Journal of the American Pharmacists Association 03/2014; 54(2):163-71.
  • [show abstract] [hide abstract]
    ABSTRACT: OBJECTIVE To describe physicians' knowledge, patients' adherence, and perceptions of both regarding mealtime-related dosing directions for proton-pump inhibitors (PPIs). DESIGN Chart review and survey of patients and physicians. SETTING United States, with data collected between January and July 2011. PARTICIPANTS Patients being treated for gastroesophageal reflux disease (GERD) with PPIs and their prescribing physicians. MAIN OUTCOME MEASURES Patient- and physician-reported perception of PPI mealtime-related directions as important/inconvenient (seven-point Likert scale; 7 = very important/very inconvenient); physician-reported knowledge of PPI mealtime-related dosing directions based on whether the agent is labeled to be taken 30-60 minutes before eating (DIR-esomeprazole magnesium [Nexium-AstraZeneca], lansoprazole, and omeprazole) or labeled to be taken regardless of meals (NoDIR-dexlansoprazole [Dexilant-Takeda], rabeprazole, and pantoprazole); and patient-reported PPI mealtime-related directions received and adherence to directions. RESULTS Physicians (n = 262) recruited 501 patients who had been prescribed PPIs (262 DIR/239 NoDIR; mean age 51 years, 37% men, 56% nonerosive GERD [29% undocumented]). Across PPIs, physicians frequently reported incorrect directions or "did not know directions" (29% for esomeprazole to 69% for pantoprazole). While 98% of patients reported receiving directions from their physicians and 55% from their pharmacists, only 65% of DIR patients and 18% of NoDIR received directions consistent with product labeling. Physicians perceived greater inconvenience than patients (4.4 vs. 1.6, P < 0.001) and greater importance (5.2 vs. 4.5, P < 0.001) of mealtime-related directions. Overall, 81% of patients reported taking their PPI as directed. CONCLUSION While this patient cohort was adherent to directions given, physicians' directions were often inconsistent with product labeling. Understanding physician and patient knowledge gaps may be critical to ensuring patients receive appropriate directions, improving patient adherence to specific dosing instructions, attaining positive therapy outcomes, and identifying opportunities for pharmacist-led interventions.
    Journal of the American Pharmacists Association 03/2014; 54(2):144-53.
  • [show abstract] [hide abstract]
    ABSTRACT: Objective To identify a pathway forward for practicing pharmacists in supporting public health initiatives by applying the five core competencies of public health.Summary The pharmacist is well positioned to improve population health. Until now, increased impact of pharmacists has been based on the expansion of patient services rather than guided by a population approach to health. To increase their effectiveness and breadth of impact, pharmacists would benefit from applying the five core competencies of public health (social and behavioral science, health policy and administration, epidemiology, biostatistics, and environmental health sciences) to the practice of pharmacy. This article aims to explain how each of the core competencies applies to pharmacy practice and how pharmacists might apply public health skills in a more specific manner.Conclusion With increased clarity of the role of public health, and mastery of the five core competencies of public health, pharmacists can make unique and valuable contributions to the health of the public.
    Journal of the American Pharmacists Association 02/2014;
  • [show abstract] [hide abstract]
    ABSTRACT: OBJECTIVES To describe sodium-related knowledge and self-reported behaviors in adults with hypertension and assess the association between knowledge and behaviors and blood pressure levels in this population. METHODS Using convenience sampling of patients with hypertension, an oral cross-sectional survey was administered by student pharmacists in 45 community pharmacies in Alabama and Florida in May to July 2012. After survey questions were administered, patients' blood pressures were measured. Data were tested for significance at alpha < 0.05 using bivariate analyses of independent and dependent variables (systolic/diastolic blood pressure [SBP/DBP]) and parallel linear regression of significant independent variables. RESULTS The majority of the 664 patients surveyed were women (59.3%) and white (75.2%). Most resided in urban areas (81.5%). The mean SBP/DBP was 133.3 (SD = 15.7)/81.7 (SD = 9.1) mg Hg. Most participants recognized the relationship between salt intake and high blood pressure (91.1%) and stroke (78.0%). A small percentage of patients reported that they always look for sodium content on food products (15.0%) and always buy low-sodium products (10.6%). Patients with lower knowledge scores (B = -0.01, P < 0.001) and those who were advised to cut down on salt (B = 0.02, P = 0.037) had higher SBP levels when controlled for gender, race, and awareness of their blood pressure goals. In regression analysis, lower knowledge scores were associated with increased DBP levels (B = -0.52, P = 0.014) when controlled for gender and race. CONCLUSION Many patients were not aware of salt in processed food and did not always look for sodium content on nutritional labels. Pharmacists should address dietary salt when interacting with patients with hypertension.
    Journal of the American Pharmacists Association 02/2014;
  • [show abstract] [hide abstract]
    ABSTRACT: OBJECTIVE To assess the association between unhealthy lifestyle-related behaviors in patients and the pharmacist's professional obligation for providing care. DESIGN Repeated measures ANOVA was used to examine the effect of severity of lifestyle disease on professional obligation. SETTING Four live continuing education programs on law and management conducted in the state of Florida. PARTICIPANTS 488 Florida pharmacists were surveyed with 65% completing the survey. MAIN OUTCOME MEASURES Pharmacists' opinions based on lifestyle-related diseases classified as follows: low lifestyle-related disease (low LD): nonsmoker with asthma who is adherent with asthma medications; moderate (mod) LD: nonsmoker with asthma who is nonadherent with asthma medications; high LD: smoker with asthma who is adherent with asthma medications. RESULTS The difference between the scales for measuring professional obligation for low and mod LD was significant, with pharmacists reporting greater professional obligation for low versus mod LD. The difference between professional obligation for low and high LD was significant, with pharmacists reporting greater professional obligation for low than high LD. The difference between professional obligation for mod and high LD was significant, with pharmacists reporting a higher professional obligation for mod than high LD. CONCLUSION The differences in professional obligation between the three patient scenarios were small but statistically significant. The findings suggest that certain patient behaviors, such as smoking or medication nonadherence, can have a negative effect on pharmacists' sense of professional obligation to the patient.
    Journal of the American Pharmacists Association 02/2014;
  • [show abstract] [hide abstract]
    ABSTRACT: OBJECTIVES To evaluate the incidence of medication discrepancies in electronic health record (EHR) medication lists in an outpatient family medicine clinic where clinical pharmacists perform medication reconciliation, to classify and resolve the discrepancies, to identify the most common medication classes involved, and to assess the clinical importance of the discrepancies. METHODS This research was conducted at Bethesda Family Medicine Clinic in St. Paul, MN, with data collected from February 2009 to February 2010. To be included, patients had to be 18 years or older and have at least 10 medications listed in the EHR. The clinical pharmacist saw each patient before the physician, reviewed the medication list with the patient, and made corrections to the EHR medication list. When possible, comprehensive medication management (CMM) also was conducted. RESULTS During 1 year, 327 patients were seen for medication reconciliation. A total of 2,167 discrepancies were identified and resolved, with a mean (±SD) of 6.6 ± 4.5 total discrepancies and 3.4 ± 3.2 clinically important discrepancies per patient. The range of total discrepancies per patient was 0 to 26. The most common discrepancy category was "patient not taking medication on list" (54.1%). Overall, the source of the discrepancy usually was the patient, but it varied according to discrepancy category. The most common medication classes involved were pain medications, gastrointestinal medications, and topical medications. Of the 2,167 discrepancies, 51.1% were determined to be clinically important by the pharmacist. The pharmacist conducted CMM in 48% of patients. CONCLUSION Outpatient medication reconciliation by a pharmacist identified and resolved a large number of medication discrepancies and improved the accuracy of EHR medication lists. Because more than 50% of the discrepancies were thought to be clinically important, improving the accuracy of medication lists could affect patient care.
    Journal of the American Pharmacists Association 02/2014;
  • [show abstract] [hide abstract]
    ABSTRACT: OBJECTIVE To report an atypical case of Guillain-Barré syndrome (GBS) after administration of the 2012-13 influenza vaccine. SETTING Urban tertiary hospital. PATIENT DESCRIPTION An 81-year-old man was admitted to the hospital after he began experiencing numbness and tingling in both feet that began ascending toward the waistline. The patient complained of intense neuropathic pain in his lower extremities and eventually lost the deep tendon reflexes in his ankles. CASE SUMMARY In addition to clinical manifestations of GBS, electromyography revealed a sensorimotor, polyneuropathy, predominantly axonal, with prolonged F-waves in all nerves tested. A lumbar puncture revealed clear and colorless cerebrospinal fluid with an elevated protein level of 66 mg/dL (reference, 15-60 mg/dL) despite the lack of a normal cell count, which indicates albuminocytologic dissociation. Based on these findings, the patient met Brighton level 3 diagnostic certainty and was diagnosed with GBS. MAIN OUTCOMES MEASURE Signs and symptoms of GBS. RESULTS On day 5 of hospitalization, intravenous immunoglobulin 0.4 mg/kg/d was initiated for 5 days in combination with gabapentin 100 mg at bedtime for neuropathic pain. After completing treatment, the patient experienced progressively improved sensation in his extremities and was discharged. CONCLUSION This is a rare report of GBS lacking albuminocytologic dissociation after an older patient received the 2012-13 influenza vaccine.
    Journal of the American Pharmacists Association 02/2014;
  • Journal of the American Pharmacists Association 01/2014; 54(1):88-90.
  • [show abstract] [hide abstract]
    ABSTRACT: OBJECTIVES To enhance public access to prophylaxis for Lyme disease following an identified Ixodes scapularis tick bite through pharmacist-initiated antibiotic therapy and to assess patient satisfaction with the pharmacy-based service provided. SETTING Independent community pharmacy in Charlestown, RI, from May to October 2012. PRACTICE DESCRIPTION Under a collaborative practice agreement, trained pharmacists at an independent pharmacy identified patients eligible for postexposure antibiotic prophylaxis following attachment and removal of an I. scapularis tick (commonly known as a deer tick) and dispensed two 100 mg tablets of doxycycline. Patients were included if they were 18 years or older, provided informed consent, had an estimated time of tick attachment of 36 hours or more, had the tick removed within 72 hours of visit, denied contraindications to doxycycline therapy, and reported telephone access for follow-up. Patients enrolled in the study protocol were given counseling related to doxycycline, signs and symptoms of Lyme disease, and future tick prevention strategies. PRACTICE INNOVATION Pharmacist initiation of doxycycline prophylaxis has not been described in the literature previously. Successful pharmacist initiation of antibiotic prophylaxis may have broader implications for states with endemic Lyme disease or other infectious disease public health concerns. MAIN OUTCOME MEASURES Patient self-reported adverse outcomes and satisfaction with the pharmacy-based service. RESULTS Eight patients enrolled in the study and completed the follow-up survey. The results indicated a high level of satisfaction with the pharmacy services provided, with no reports of the subsequent development of Lyme disease symptoms or major adverse events. CONCLUSION The project has expanded to three community pharmacy sites in southern Rhode Island based on this experience. Similar pharmacy-based collaborative practice models should be considered in highly endemic Lyme disease areas.
    Journal of the American Pharmacists Association 01/2014; 54(1):69-73.
  • Journal of the American Pharmacists Association 01/2014; 54(1):7.
  • Journal of the American Pharmacists Association 01/2014; 54(1):96.
  • [show abstract] [hide abstract]
    ABSTRACT: OBJECTIVE To provide a model that enables health systems and pharmacy benefit managers to provide medications reliably and test for reliability and validity in the analysis of adherence to drug therapy of chronic disease. SUMMARY The quantifiable model described here can be used in conjunction with behavioral designs of drug adherence assessments. The model identifies variables that can be reproduced and expanded across the management of chronic diseases with drug therapy. By creating a reorder point system for reordering medications, the model uses a methodology commonly seen in operations research. The design includes a safety stock of medication and current supply of medication, which increases the likelihood that patients will have a continuous supply of medications, thereby positively affecting adherence by removing barriers. CONCLUSION This method identifies an adherence model that quantifies variables related to recommendations from health care providers; it can assist health care and service delivery systems in making decisions that influence adherence based on the expected order cycle days and the expected daily quantity of medication administered. This model addresses the possession of medication as a barrier to adherence.
    Journal of the American Pharmacists Association 01/2014; 54(1):63-8.

Related Journals