BACKGROUND: Treating multiple myeloma is complex, and providing supportive care through an interdisciplinary approach is essential.
OBJECTIVE: To report and synthesize pharmacists\' clinical activities and impact on the care of patients with multiple myeloma.
METHODS: This was a scoping review that followed the PRISMA-ScR reporting recommendations. A search was conducted in PubMed, Embase, Web of Science, Scopus, and LILACS from the inception of the database until January 10th, 2024. Papers that reported pharmacists\' clinical activities in the care of patients with multiple myeloma were included. Descriptive Elements of Pharmacist Intervention Characterization Tool (DEPICT) version 2 was used to characterize the pharmacists\' clinical activities. The results are presented as a narrative and tabular synthesis.
RESULTS: A total of 2885 records were identified, 10 of which met the inclusion criteria. Pharmacists\' clinical activities related to \'direct patient care\' (n = 8) and \'medication counseling, education, and training\' (n = 7) were the most cited. Most were provided for patients (n = 8), by one-on-one contact (n = 9), and through face-to-face communication method (n = 8), with patient counseling being the main action taken by pharmacists (n = 7). Materials that supported pharmacists\' actions were cited in five studies. Integrating pharmacists into interdisciplinary teams led to improved process, clinical, humanistic, and economic outcomes.
CONCLUSIONS: This scoping review emphasizes pharmacists\' clinical activities in improving the care of patients with multiple myeloma. There is a need to develop studies with patient-reported outcomes and comprehensive reporting of pharmacists\' clinical activities to ensure reproducibility and effective implementation in clinical practice.

UNASSIGNED: The appointment-based model (ABM) is a pharmacy service to improve medication-related health outcomes. ABM involves medication synchronization and medication review, plus other services such as medication reconciliation, medication therapy management, vaccine administration, and multimedication packaging. ABM can improve medication adherence, but the economic impact is unknown.
UNASSIGNED: To assess the effect of a national pharmacy chain\'s ABM program for Medicare Advantage beneficiaries on total cost of care (TCOC).
UNASSIGNED: This study analyzed administrative claims data from April 7, 2017, through February 29, 2020, for Medicare Advantage beneficiaries with Part D using a propensity score-matched cohort design. The national pharmacy chain provided a list of ABM participants. Eligibility criteria for the ABM and control (non-ABM) groups included age 65 years or older on the index date (initial participation, ABM; random fill date, control) and continuous enrollment from at least 6 months pre-index (baseline) date through at least 6 months post-index (follow-up) date. Medical inflation-adjusted (2020) TCOC was calculated as the sum of all health care spending from Medicare Advantage beneficiaries with Part D plan and patient paid amounts, standardized to per patient per month (PPPM), during the follow-up period. Secondary outcomes included medication adherence calculated across prevalent maintenance therapeutic classes using proportion of days covered (PDC).
UNASSIGNED: Each group contained 5,225 patients with balanced characteristics after matching: 64% female, 73% White, mean age 75 years, mean Quan-Charlson comorbidity index score 0.9, and hypertension and dyslipidemia, each >65%. Median baseline all-cause PPPM health care costs in the ABM and control groups, respectively, were $517 and $548 ($221 and $234 medical, $135 and $164 pharmacy). Baseline PDC of at least 80% was 83% in the ABM group and, similarly, 84% in the control group. The mean (SD) follow-up was 604 (155) days for the ABM group and 598 (151) days for the control group. During the follow-up period, the median PPPM TCOC for the ABM group was $656 and was $723 for the control group (P = 0.011). Median pharmacy costs were also significantly less in the ABM group ($161 vs $193, P < 0.001), whereas median medical costs were $328 in the ABM group and $358 among controls (P = 0.254). More patients in the ABM group were adherent during follow-up, with 84% achieving PDC of at least 80% vs 82% among controls (P = 0.009).
UNASSIGNED: The ABM program was associated with significantly lower follow-up median total costs (medical and pharmacy), driven primarily by pharmacy costs. More patients were adherent in the ABM program. Payers and pharmacies can use this evidence to assess ABM programs for their members.

The purpose of this study was to identify patient outcomes after pharmacist interventions in the home health care context using pharmaceutical care records accumulated during daily operations. We focused on 591 cases at Nakajima Pharmacy from April 2020 to December 2021, where dispensing fees were charged to prevent duplication of medication and unnecessary interactions of home patients (excluding those related to adjustment of ongoing medications). The study investigated the content and background of prescription changes, the follow-up rate, and patient outcomes. The most common circumstances that led to pharmacist intervention for homebound patients were symptom occurrence (uncontrolled symptom, new symptom, drug adverse event). Of the patients for whom pharmacist intervention was provided for symptoms, 72.8% received follow-up according to the pharmaceutical care records. Furthermore, 59.2% of patients with follow-up showed an improvement of their symptoms. In addition, many patients had their medications discontinued or the dosage reduced by the pharmacist despite stable symptoms. More than 90% of these patients showed no change in symptoms. Besides interventions associated with the occurrence of symptoms, many interventions related to medication adherence were found to result from the patient\'s physical condition, such as poor swallowing function. The results suggest that tracking pharmacy drug histories may help pharmacists to better understand the need for follow-up implementation and the changes in patient outcomes after interventions.

BACKGROUND: Comprehensive medication management (CMM) programs optimize the effectiveness and safety of patients\' medication regimens, but CMM may be underutilized. Whether healthcare claims data can identify patients appropriate for CMM is not well-studied.
OBJECTIVE: Determine the face validity of a claims-based algorithm to prioritize patients who likely need CMM.
METHODS: We used claims data to construct patient-level markers of \"regimen complexity\" and \"high-risk for adverse effects,\" which were combined to define four categories of claims-based CMM-need (very likely, likely, unlikely, very unlikely) among 180 patient records. Three clinicians independently reviewed each record to assess CMM need. We assessed concordance between the claims-based and clinician-review CMM need by calculating percent agreement as well as kappa statistic.
RESULTS: Most records identified as \'very likely\' (90%) by claims-based markers were identified by clinician-reviewers as needing CMM. Few records within the \'very unlikely\' group (5%) were identified by clinician-reviewers as needing CMM. Interrater agreement between CMM-based algorithm and clinician review was moderate in strength (kappa = 0.6, p < 0.001).
CONCLUSIONS: Claims-based pharmacy measures may offer a valid approach to prioritize patients into CMM-need groups. Further testing of this algorithm is needed prior to implementation in clinic settings.

BACKGROUND: Effective management of cancer pain critically depends on timely medication administration and adherence to precise medication guidelines. In the context of limited time and a busy healthcare environment, tailoring the optimal medication schedule for each patient with cancer pain presents a significant challenge for physicians and clinical pharmacists.
METHODS: To address this challenge, we conducted a comprehensive analysis of healthcare professionals\' needs in guiding cancer pain medication. By developing core features based on key user needs and continuously updating them, we have created the Universal Medication Schedule System (UMSS). We invited 20 physicians and pharmacists specializing in oncology or cancer pain to trial the system and assessed UMSS usage through distributed questionnaires.
RESULTS: We identified five key needs of healthcare professionals in cancer pain medication guidance. Based on these needs, we (1) constructed a comprehensive drug information database, including basic information for 1135 drugs, 130,590 drug interaction data entries, and 1409 individual medication timing constraints, and (2) developed a web-based system that provides essential reference information such as drug interactions and dietary restrictions. It can create medication schedules and provide medication education tailored to the patient\'s daily routine. Participating evaluators unanimously agreed (100%) that the system aids in accurately assessing the risks of polypharmacy and quickly scheduling medication regimens.
CONCLUSIONS: UMSS, by offering personalized medication schedule support, assists healthcare professionals in better managing patients\' medication treatment plans. However, further improvements are needed in the automation of database updates and maintenance, as well as in integrating it with electronic health records.

OBJECTIVE: Aim: To investigate the influence of socio-economic factors on the state of pharmaceutical provision of patients with cardiovascular diseases.
METHODS: Materials and Methods: To achieve the goal of the research, scientific publications posted in Ukrainian information and scientific databases (NRAT, OUCI) and scientometric databases Scopus, Web of Science, PubMed, MedLine, BMJ, Embase were used. The analysis of international and domestic legal documents was carried out, the sites of global international organizations, the sites of cardiology societies and Ukrainian statistical data bases were researched. The methods of content analysis, synthesis, systematization, and generalization were used.
CONCLUSIONS: Conclusions: As a result of the study, socio-economic factors that af f ect the state of pharmaceutical provision of patients with CVD (in particular, CAD) were determined. In this study, among the specif i ed socio-economic factors, the need to update the regulatory and legal security of the pharmaceutical care process attracts the most of attention. The positive impact of the use of modern drug pharmacotherapy for coronary artery disease on the budget of the health care system in clinical practice proposed by the ESC was determined.

BACKGROUND: The final prescription check is a mandatory but time-consuming process in Dutch community pharmacies. A safer dispensing process may have made the final prescription check obsolete.
OBJECTIVE: To describe the final prescription check in Dutch community pharmacies and explore pharmacists\' attitudes towards changing this.
METHODS: A cross-sectional survey among Dutch community pharmacists. The online questionnaire was based on literature and previous qualitative research, piloted in three pharmacies, and took 10 min to complete. Results were analysed descriptively.
RESULTS: A total of 409 pharmacists participated. They saw the final prescription check as an important quality assurance of the dispensing process. Nevertheless, most pharmacists agreed that the final prescription check could be optimized as they thought that the time invested outweighed the benefits. Automation of the dispensing process, only checking selected high-risk prescriptions, and more in-process checks could reduce the need for an extensive final prescription check, rather than delegating the task to assistants. To implement changes, most pharmacists felt current dispensing guidelines needed to be adapted.
CONCLUSIONS: There was a widespread consensus that optimizing the final prescription check could enhance efficiency and allow more time for person-centred care. Most pharmacists expressed a preference for updated guidelines before implementing such changes.

Although disparities and inequities in health status and access to health care services have long existed in our nation, the COVID-19 pandemic cast a bright spotlight on them. Communities of color and socioeconomically disadvantaged populations were disproportionally affected by the pandemic. These same populations suffer from higher prevalences of chronic illnesses, which puts them at greater risk for poor outcomes associated with SARS-CoV-2. At long last, in the wake of the pandemic, the health care community began to acknowledge improving health equity as a public health imperative. In a November 2020 JMCP Viewpoints article, Dr Stephen Kogut of the University of Rhode Island College of Pharmacy presented an insightful analysis of disparities in medication use (DMU) and offered 4 suggestions on how the managed care pharmacy community can help eliminate DMU. This Viewpoints article assesses what progress has been made in addressing those imperatives and proposes further steps that should be taken. Although the managed care pharmacy community has broadly acknowledged the existence of DMU and taken steps to mitigate them, there is much work to do in examining and improving benefit design and coverage policies; collecting and reporting data on race and ethnicity and DMU; incorporating the perspectives of patients, including those representing minority populations, in benefit design and coverage policies; and addressing the challenges associated with traditional cost-sharing models. The entire managed care pharmacy community, including AMCP and other membership organizations, must remain steadfast in its efforts to improve health equity and eliminate DMU.

This article provides a summary of Viewpoint and Research articles responding to the 2020 Journal of Managed Care + Specialty Pharmacy Call to Action to address racial and social inequities in medication use. We find great heterogeneity in terms of topic, clinical condition examined, and health disparity addressed. Common recommendations across Viewpoint articles include the need to increase racial and ethnic diversity in clinical trial participants, the need to address drug affordability and health insurance literacy, and the need to incentivize providers and plans to participate in diversity initiatives, such as the better capture of information on social determinants of health (SDOH) in claims data to be able to address SDOH needs. Across research articles, we also find a large range of approaches and study designs, spanning from randomized controlled trials to surveys to observational studies. These articles identify disparities in which minoritized beneficiaries are shown to be less likely to receive medications and vaccines, as well as less likely to be adherent to medications, across a variety of conditions. Finally, we discuss Healthy People 2030 as a potential framework for future health disparity researchers.

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