The global rise in opioid-related harms has impacted the United States severely. Current efforts to manage the opioid crisis have prompted a re-evaluation of many of the existing roles in the healthcare system, in order to maximize their individual effects on reducing opioid-associated morbidity and preventing overdose deaths. As one of the most accessible healthcare professionals in the US, pharmacists are well-positioned to participate in such activities. Historically, US pharmacists have had a limited role in the surveillance and treatment of substance use disorders. This narrative review explores the literature describing novel programs designed to capitalize on the role of the community pharmacist in helping to reduce opioid-related harms, as well as evaluations of existing practices already in place in the US and elsewhere around the world. Specific approaches examined include strategies to facilitate pharmacist monitoring for problematic opioid use, to increase pharmacy-based harm reduction efforts (including naloxone distribution and needle exchange programs), and to involve community pharmacists in the dispensation of opioid agonist therapy (OAT). Each of these activities present a potential means to further engage pharmacists in the identification and treatment of opioid use disorders (OUDs). Through a careful examination of these approaches, we hope that new strategies can be adopted to leverage the unique role of the community pharmacist to help reduce opioid-related harms in the US.

/pdf/leveraging-the-role-of-community-pharmacists-in-the-4z0d4ohpru.pdf

Leveraging the role of community pharmacists in the prevention, surveillance, and treatment of opioid use disorders.

Pharmacists’ roles in provision of family planning products is expanding in the United States (U.S.). This article details established as well as emerging roles for U.S. pharmacists in the provision of contraception. These include helping patients develop reproductive life plans; dispensing prescription contraceptive products and counseling patients; assisting and educating patients with non-prescription contraceptive products, including emergency contraception; participating in collaborative practice agreements; administering contraception products; and making referrals and developing partnerships. The provision of contraception in the U.S. is dynamic, and pharmacists should continue to be aware of changes that will impact them professionally. As approximately 45% of pregnancies in the U.S. are unintended, through these roles pharmacists can impact an important public health priority.
Conflict of Interest
We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties
 
Type: Idea Paper

https://pubs.lib.umn.edu/index.php/innovations/article/download/458/452

Pharmacists’ Provision of Contraception: Established and Emerging Roles

There are multiple opportunities for community pharmacists to take on greater roles in the delivery of preconception care and contraceptive services, and pharmacists have indicated interest in developing and expanding such services. Therefore, the objective of this review is to summarize published literature related to community pharmacists' provision of preconception care and contraceptive interventions to help guide related service development and raise awareness about potential opportunities to further expand and integrate such services into practice. Two searches were performed on February 5, 2019 of Medline, Academic Search Complete, and the International Pharmaceutical Abstracts databases from database inception to December 31, 2018. The first search utilized the terms [([contraception or birth control or family planning or contraceptive] OR contraception education OR contraceptives OR contraceptive access) AND ([pharmacists or pharmacist] OR pharmacy OR community pharmacy OR community pharmacist)]; the second search utilized the terms [(preconception OR preconception care OR preconception counseling OR preconception health OR [“preconception care” or “pre‐pregnancy care” or “prepregnancy care”]) AND ([pharmacists or pharmacist] OR pharmacy OR community pharmacy OR community pharmacist)]. Inclusion criteria for the review were articles written in English describing a community pharmacist‐delivered service in the United States. Six articles detailed community pharmacists' roles in contraception, including prescribing hormonal and emergency contraception and administration of injectable contraception. Each study found high rates of patient uptake and satisfaction with these services. One article detailed community pharmacists' provision of preconception care services; again, there was rapid uptake of the service. These articles together highlighted the logistical ease, economic viability, and patient acceptance of such services. Opportunities to expand and integrate these services exist. Published data show that community pharmacists have demonstrated provision of contraceptive and preconception care services in the US, and opportunities exist to grow these programs.

Preconception care and contraception services: Opportunities for community pharmacists

Long-acting injectable antipsychotics (LAIAs) have demonstrated positive outcomes for people with serious mental illnesses. They are underused, and access to LAIAs can be challenging. Pharmacies could serve as suitable environments for LAIA injection by pharmacists. To map and characterize the literature regarding the administration of LAIAs by pharmacists, a scoping review was conducted. Electronic-database searches (e.g., PsycINFO, Ovid Medline, Scopus, and Embase) and others including ProQuest Dissertations & Theses Global and Google, were conducted. Citation lists and cited-reference searches were completed. Zotero was used as the reference-management database. Covidence was used for overall review management. Two authors independently screened articles and performed full-text abstractions. From all sources, 292 studies were imported, and 124 duplicates were removed. After screening, 13 studies were included for abstraction. Most articles were published in the US since 2010. Seven studies used database and survey methods, with adherence and patient satisfaction as the main patient-outcomes assessed. Reporting of pharmacists’ and patients’ perspectives surrounding LAIA administration was minimal and largely anecdotal. Financial analyses for services were also limited. The published literature surrounding pharmacist administration of LAIAs is limited, providing little-to-no guidance for the development and implementation of this service by others.

/pdf/pharmacist-administration-of-long-acting-injectable-22td0xxp.pdf

Pharmacist Administration of Long-Acting Injectable Antipsychotics to Community-Dwelling Patients: A Scoping Review

Mishra, Pragya, M.S., Purdue University, December 2014. Pharmacist Collaborative Drug Therapy Management in U.S. hospitals. Major Professor: Joseph Thomas III. The objectives for this study were to 1) assess the current extent, scope and perceptions of CDTM in U.S. hospitals, 2) determine the associations between hospital characteristics, pharmacy director characteristics, and perceptions of CDTM, 3) investigate hospitals' short-term and long-term plans regarding CDTM, and 4) identify pharmacy directors' views about the major facilitators and barriers for CDTM in hospitals A self-administered written survey was mailed to a national random sample of hospitals stratified by state. Pharmacy directors indicated whether any pharmacists were engaged in CDTM, what CDTM activities were permitted, and in what treatment categories CDTM was permitted. Demographic data was also collected on both pharmacy director characteristics as well as hospital characteristics. All respondents were asked to indicate their views of CDTM in terms of support for CDTM, financial impact of CDTM, strategic impact of CDTM and effect of CDTM regulations on practice, on a 5-point Likert-type scale, where 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, and 5 = strongly agree. The respondents also indicated their plans for expanding CDTM in their hospitals on a 5-point Likert-type scale, where 1 = large decrease, 2 = slight decrease, 3 = no change, 4 = slight increase, and 5 = large increase. All respondents were asked in open-ended questions to indicate what they perceived to be the greatest barrier to CDTM and the greatest facilitator of CDTM. Logistic regression

/pdf/pharmacist-collaborative-drug-therapy-management-in-u-s-1jhkvv48s0.pdf

Pharmacist collaborative drug therapy management in U.S. hospitals

Purpose Privileges for administering nonvaccine injectable medications among pharmacists in the United States were assessed.

Methods An e-mail inquiry on specific protocols for the administration of injectables was sent to the state boards of pharmacy (BOPs) for all 50 states and the District of Columbia that had a valid e-mail address listed on the National Association of Boards of Pharmacy website. Respondents were encouraged to include in their response a link to state regulations so that information from the BOP laws on privileges for administering injectables could be closely reviewed. State guidelines were reviewed online for all BOPs that did not respond to the first e-mail in order to complete the study. A follow-up e-mail was sent only to those respondents whose states granted pharmacists privileges for administering nonvaccine injectables in order to clarify the specific drugs allowed to be injected by pharmacists.

Results Responses received included either links to state regulations or explicit statements of the rules regarding pharmacists' injectable privileges. A total of 21 states currently grant pharmacists articulate written information or rules pertaining to the privilege of administering nonvaccine injectable products. Authority is provided through collaborative practice agreements for most states. Products administered by pharmacists vary by state.

Conclusion Pharmacists in 21 states were found to have privileges for administering injectable medications other than vaccines. Pharmacists were authorized to administer these drugs through completion of training approved by the Accreditation Council for Pharmacy Education, collaborative practice agreements, valid prescription orders, board certification, or other broad privileges as specified in state regulations.

Am J Health-Syst Pharm. 2012; 69:2002-5

Injectable administration privileges among pharmacists in the United States.

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Injectable administration privileges among pharmacists in the United States.