BACKGROUND: Expanding access to naloxone through pharmacies is an important policy goal. Our objective was to characterize national county-level naloxone dispensing of chain versus independent pharmacies.
METHODS: The primary exposure in our longitudinal analysis was the proportion of chain pharmacies in a county, identified through the US Department of Homeland Security 2010 Infrastructure Foundation-Level Data. We defined counties as having \"higher proportion\" of chain pharmacies if at least 50% of pharmacies were large national chains. The primary outcome was quarter-year (2016Q1-2019Q2) rate of pharmacy naloxone claims per 100,000 persons from Symphony Health at the county-level. We compared the naloxone dispensing rate between county types using two-sample t-tests. We estimated the association between county-level chain pharmacy proportion and rate of naloxone claims using a linear model with year-quarter fixed effects.
RESULTS: Nearly one third of counties (n=946) were higher proportion. Higher proportion counties had a significantly higher rate of naloxone claims across the study period, in 4 of 6 urban-rural classifications, and in counties with and without naloxone access laws. The linear model confirmed that higher proportion counties had a significantly higher rate of naloxone claims, adjusting for urban/rural designation, income, population characteristics, opioid mortality rate, co-prescribing laws and naloxone access laws.
CONCLUSIONS: In this national study, we found an association between naloxone dispensing rates and the county-level proportion of chain (versus independent) pharmacies. Incentivizing naloxone dispensing through educational, regulatory, or legal efforts may improve naloxone availability and dispensing rates - particularly in counties with proportionately high numbers of independent pharmacies.

BACKGROUND: Adult smoking rates in the USA are highest in economically depressed rural Appalachia. Pharmacist-delivered tobacco cessation support that incorporates medication therapy management (such as the QuitAid intervention) is a promising approach to address this need.
METHODS: Twenty-four adult smokers recruited between September and November 2021 through an independent pharmacy in rural Appalachia were randomized in a non-blinded 2 × 2 × 2 factorial design to (1) pharmacist delivered QuitAid intervention (yes vs. no); (2) combination nicotine replacement therapy (NRT) gum + NRT patch (vs. NRT patch); and/or (3) 8 weeks of NRT (vs. standard 4 weeks). Participants received 4 weeks of NRT patch in addition to the components to which they were assigned. Participants completed baseline and 3-month follow-up assessments. Primary outcomes were feasibility of recruitment and randomization, retention, treatment adherence, and fidelity.
RESULTS: Participants were recruited in 7 weeks primarily through a referral process, commonly referred to as ask-advise-connect (61%). Participants were on average 52.4 years old, 29.2% were male and the majority were white (91.6%) and Non-Hispanic (91.7%). There was a high level of adherence to the interventions, with 85% of QuitAid sessions completed, 83.3% of the patch used, and 54.5% of gum used. Participants reported a high level of satisfaction with the program, and there was a high level of retention (92%).
CONCLUSIONS: This demonstration pilot randomized controlled study indicates that an ask-advise-connect model for connecting rural smokers to smoking cessation support and providing QuitAid for smoking cessation is feasible and acceptable among rural Appalachian smokers and independent pharmacists. Further investigation into the efficacy of a pharmacist-delivered approach for smoking cessation is needed.
BACKGROUND: The trial was retrospectively registered at ClinicalTrials.gov. Trial #: NCT05649241.

Historically, pharmacists in independent community pharmacies have been pivotal in promoting community health. During the COVID-19 pandemic, they demonstrated their commitment by advocating for vaccination and providing accessible care, particularly in underserved communities. By addressing disparities, implementing strategies like mobile clinics and community outreach, and fostering trust and engagement, independent community pharmacists played a crucial role in bridging gaps in healthcare access for vulnerable populations and mitigating the impact of the COVID-19 pandemic.

Background: In April 2020, pharmacists were added as medical providers under Idaho Medicaid in response to recent scope expansion for pharmacists and to increase beneficiaries\' access to coronavirus disease 2019 (COVID-19) testing and services. The COVID-19 pandemic prompted expedited Medicaid enrollment for pharmacists but did not address coverage of medical services provided to privately insured individuals for pharmacy-based testing services. Objective: This study aimed to describe processes used by independently owned, community-based pharmacies in Idaho to credential with private insurers and report outcomes. Methods: Relevant information and forms required to credential with the four major payers in the state of Idaho were collected. Packets were obtained via medical insurers\' websites and by direct contact. Questions that arose from community pharmacists during the submission process were collected and answered on a shared spreadsheet, and insurance representatives were contacted directly to resolve questions. Results: Eight out of 13 participating pharmacies submitted an average of three credentialing packets for their facilities. Thirty-five pharmacists also submitted an average of four credentialing packets for themselves. As of mid-May 2021, nearly 20 weeks after submission, only 67 out of 129 pharmacists had received word regarding the status of their applications. Less than half of all pharmacist applications were approved (after their first attempt). Conclusion: Efforts to support the education of both pharmacists and medical insurers may streamline the credentialing processes in the future.

UNASSIGNED: To advocate for independent pharmacy to embrace digital health as a means to improve patient outcomes and compete more strongly in an increasingly competitive business environment.
UNASSIGNED: Independent pharmacies are positioned to be at the forefront of adopting digital health tools for a variety of reasons. They often can make changes to their business model faster than a major retail chain, are often in rural locations where few other providers are located, and are already starting to offer the types of clinical services that can be greatly aided by digital health. This commentary presents the case for a change in the current model of pharmacy practice to one which embraces digital health. The role of the pharmacist would grow beyond exclusively medication management to incorporate tools such as wearable health trackers and mobile phone applications. By utilizing digital health, the pharmacist can obtain a greater amount of patient health data via an asynchronous electronic uploading process, and then use that data to further improve their ability to offer clinical services.
UNASSIGNED: Digital health is a powerful tool that should be embraced by independent pharmacy. By leveraging digital health, pharmacies can improve both accessibility and quality of care, thus providing a competitive advantage in the retail marketplace.

With approximately 300 prescriptions dispensed per day in a typical community pharmacy, several activities take place to ensure the safe dispensing of medicines. While some of these activities are common for all prescriptions, others need further activities such as prescription clarification. These activities are important to avoid any potential harm to the patient and improve medication adherence. The objective of this study was to measure the impact of these additional dispensing services in a community pharmacy by evaluating the documented patient notes. Two-hundred patients with annotations on their profiles between 1 July and 31 August 2018 were randomly selected and 322 notes were analyzed. The average number of notes per patient was 1.6. The majority of the notes were about contacting the patient/caregiver for prescription clarification (86.8%). When analyzed based on Medication Therapy Problems, 54.7% were related to adherence and 35.4% to safety. Using the cost saving estimate from the literature for each averted adverse event, these activities resulted in a minimum cost saving of $10,458. This study was able to show the positive impacts that everyday dispensing services in an independent community pharmacy have on ensuring the safe use of medication, thus potentially preventing adverse drug events and reducing health care costs.

Background Whether Chinese community pharmacists in chain pharmacies and independent pharmacies provide the same type and quality of pharmaceutical care has not been fully investigated. Objective This study aimed to investigate community pharmacists\' understanding, attitude, practice and perceived barriers of pharmaceutical care at chain pharmacies and independent pharmacies in China. Setting Community pharmacies in China. Method A questionnaire survey was conducted in 27 provinces (autonomous regions) and 4 municipality cities in China. Main outcome measure Chinese community pharmacists\' understanding, attitude, practice and perceived barriers of pharmaceutical care. Results The respondent pharmacists\' understanding of pharmaceutical care was only moderate, though they showed a positive attitude towards providing the service. The respondent pharmacists from both chain and independent pharmacies provided more basic pharmaceutical service than advanced pharmaceutical care. Regarding barriers to providing pharmaceutical care, the respondent pharmacists identified the main barriers as a lack of physical space, slow introduction of pharmacist law, lack of patient acceptance of pharmaceutical care, and lack of face-to-face communication with patients. Pharmacists at chain pharmacies had a better understanding of and attitude toward pharmaceutical care and practiced more advanced pharmaceutical care than pharmacists at independent pharmacies. Conclusion Chinese community pharmacists\' understanding and practice of pharmaceutical care in China needs improvement. Compared with pharmacists at chain pharmacies, pharmacists at independent pharmacies face more challenges in providing pharmaceutical care. Specific efforts should be made to improve pharmacist competence, increase patient acceptance and shape a better operative environment for community pharmacies, especially for independent pharmacies.

In service industries, employee salaries and wages often constitute the largest portion of the costs to the company. This is very true in the case of an independent pharmacy, which employs pharmacists and pharmacy technicians. Thus, for pharmacies to cost effectively meet the increasing demand for pharmaceuticals, it is crucial that pharmacy managers efficiently allocate the pharmacy staff\'s time.
Through a case study, this paper demonstrates the use of an Excel VBA based on a mathematical model to schedule the staff of an independent pharmacy. The whole year data was used in this study. After collection of whole year\'s data, the number of prescriptions to be filled for each day by hour of hour of the day were sourced and classified.
It is indicated that the pharmacy employees\' time could be more efficiently assigned to meet the demand of the pharmacy. The benefit of modeling the pharmacy employees at this pharmacy is based on the data (the number of total prescriptions filled on Friday in March) with the following results; 12 h shifts are covered where one employee must be between 04:00-16:00, two employees between 06:00-18:00, one employee between 07:00-19:00 and one employee between 15:00-03:00.
In this study a basic model was presented that can be used schedule pharmacy employees in an independent pharmacy and solved by Excel VBA. This model can be further extended to meet the needs of a specific pharmacy.