Recently, California (CA) pharmacists’ scope of practice has expanded to include independently prescribing self-administered hormonal contraceptives, nicotine replacement therapy medications, travel health medications, routine vaccinations, naloxone hydrochloride, and HIV preexposure and postexposure prophylaxis. However, previous reports indicate that practicing within this expanded scope has remained limited. Therefore, a 26-item, web-based survey was emailed to CA community pharmacists to assess pharmacists’ knowledge, intent, and barriers to prescribing and billing for these patient care services. A total of 216 chain, supermarket-based, independent, mass merchant, and health-system outpatient pharmacists were included. The primary services provided and medications prescribed are for vaccinations and naloxone. Most pharmacists agree that engagement in and implementation of new strategies to enhance patients’ access to care is important. Common barriers include patient unawareness of pharmacist-provided services, lack of payment for services, and difficulty incorporating services within pharmacy workflow. Pharmacists are confident in their ability to provide patient care services but are less knowledgeable and confident about billing for them. Enhancing promotion of pharmacist-provided services to patients, developing strategies to efficiently incorporate them into the workflow, and payment models can help overcome barriers to providing these services.
Introduction Long‐acting injectable antipsychotic (LAIA) medications can improve medication adherence in patients with schizophrenia and bipolar disorder due to their 1‐ to 3‐month administration schedules. Objectives The primary objective of this study was to examine the effect of a pharmacist‐administered LAIA service in a supermarket‐based community pharmacy on medication adherence rates. Methods In this descriptive study, service data from July 1, 2017 through February 28, 2018 were obtained from a national chain pharmacy. The study population included all patients utilizing the pharmacist‐administered LAIA service who received one of the following LAIA medications during the study period: aripiprazole, aripiprazole lauroxil, paliperidone palmitate, and risperidone. Patients under the age of 18 and those who received fewer than two pharmacist administrations of the same medication were excluded. Medication adherence was measured using the proportion of days covered (PDC) with ≥80% being considered adherent. Logistic regression analysis was performed to identify factors that affected PDC. Results A total of 78% (500/641) of patients enrolled in the service were determined to be adherent to their LAIA. Statistically significant differences were found between PDC rates based on medication selection. Using aripiprazole (Abilify Maintena) as a reference, patients on paliperidone palmitate (Invega Sustenna), paliperidone palmitate (Invega Trinza), and risperidone (Risperdal Consta) were 2.1 (95% CI 1.3‐3.3, P < .002), 4.4 (95% CI 1.8‐11.2, P < .002), and 4.3 (95% CI 1.6‐11.8, P < .004) times more likely to have a PDC ≥80%, respectively. Conclusion A majority of patients (78%) enrolled in a community pharmacy‐based service in which pharmacists‐administered LAIA medications were shown to be adherent to their medication. Specific LAIA medications were found to be associated with greater medication adherence. Findings from this study will provide insight into effective means of care delivery for other community‐based specialty pharmacy programs.
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