INNOVATIONS in pharmacy

Pharmacogenomic considerations in a pretransplant statin tolerant, post-transplant intolerant liver transplant patient: A case report

Michael J. Schuh — 2026-05-12

As pharmacogenomics testing is becoming more common, it can be used in more medical settings to assist in clinical decision making. This is a case study examining the implications of a patient having potentially different cytochrome P-450 enzyme phenotypes in the donor liver once transplanted. This patient tolerated statin therapy prior to liver transplantation but was intolerant to the same statin after liver transplant.

Impact of a pharmacist-led migraine group appointment program

Enav Zusman — 2026-05-12

Background: Migraine is a common and debilitating neurological disorder. While healthcare provider-led group appointments have been shown to support treatment management for a variety of medical conditions, this is the first study to describe pharmacist-led group appointments for people with migraine.

Methods: Adults with any migraine diagnosis were eligible to participate and recruited though posters and e-mail newsletters. Group appointments were facilitated by a clinical pharmacist in-person or virtually and included three sessions spanning three months. Topics covered included general migraine education, non-pharmacologic management, medications for acute and preventative treatment, and natural health products. Surveys were deployed to assess migraine attack frequency and severity and participant experience at baseline, program conclusion, and three months post-program completion. Results were analysed using quantitative and qualitative methods.

Results: Twelve participants enrolled in migraine group appointments. Upon program completion, 75% of participants felt they were better able to self-manage migraine. While migraine frequency and severity and days of missed work were numerically lower post-program completion, outcomes were not statistically significant. Participants reported high-satisfaction overall with pharmacist-led group appointments and ascribed benefits to both the education provided and support from peers with shared lived experiences.

Conclusion: Pharmacist-led group appointments were highly valued by people living with migraine and hold promise for reducing disease burden. Additional studies are required to further characterize impact on clinically relevant outcomes such as migraine attack frequency.

Ambulatory care pharmacist evaluation of drug-drug interactions with nirmatrelvir/ritonavir: Managing workload and ensuring patient safety during the COVID-19 pandemic

Abigail Pape — 2026-05-19

Background: Nirmatrelvir/ritonavir, an oral antiviral for COVID-19, was released under an Emergency Use Authorization in December 2021. Its complex drug-drug interaction (DDI) profile, combined with limited initial guidance on DDI management, created a critical need for pharmacist-led interventions to ensure safe use.

Objectives: The objective of this study was to evaluate the frequency, type, and interventions for DDIs identified by an ambulatory care pharmacist in a rural clinic during a period when comprehensive guiding literature on nirmatrelvir/ritonavir was unavailable.

Methods: A retrospective electronic medical record review was conducted at a rural South Dakota clinic for patients seen January 1 to September 12, 2022. Adult patients with confirmed COVID-19 who were assessed by the pharmacist for antiviral therapy eligibility were included. Pharmacist-identified DDIs and interventions were categorized by type, and time spent per evaluation was recorded.

Results: Of the 141 included evaluations, 103 (73.0%) had at least one DDI identified, with a total of 195 interactions across 73 drugs. Most common drug classes involved were statins, opioids, and calcium channel blockers. Multiple DDIs were found in 52 evaluations and 32 evaluations required more than one drug intervention. Time spent on evaluations averaged 35 minutes. Despite incomplete guidance, pharmacist assessments aligned with later published data.

Conclusion: In the absence of comprehensive resources, the ambulatory care pharmacist played a critical role in identifying and managing potential DDIs. This study highlights the clinical value and workload burden of pharmacists practicing in settings where DDI evaluation occurs prior to prescribing, such as this clinic-based model. These findings underscore the importance of recognizing and appropriately reimbursing pharmacist contributions within ambulatory care practices.

Differences by patient race in guideline concordant outpatient antibiotic use in adult patients in Michigan

Benjamin Pontefract — 2026-05-12

Purpose: To determine if there are significant differences in the rate of guideline concordant antibiotic use by race in adult patients in the state of Michigan.

Methods: Using the Collaboration to Harmonize Antimicrobial Registry Measures (CHARM) database, outpatient prescriptions from 6 health systems throughout the state of Michigan in 2021 were reviewed, and the 5 infectious disease diagnoses with the most antibiotic prescriptions were identified. The 2 most common races amongst patients were identified, and the differences in rates of guideline concordance were compared between them.

Results: A total of 62,070 outpatient prescriptions were identified for the 2 most common races, White and Black or African American. Of those, 43,519 outpatient prescriptions were identified for the top 5 infectious diagnoses, acute cystitis, acute sinusitis, acute pharyngitis, cellulitis, and otitis media. Antimicrobial choice concordance was higher in patients who are White (71.6% vs. 68.5%; p<0.01), while antibiotic dosing concordance was higher in patients who are Black or African American (65.9% vs 68.4%; p=0.02). Differences in antimicrobial choice concordance was primary driven by acute cystitis with more patients who are Black or African American receiving doxycycline (1.1 % vs 6.0%; p<0.01). Differences in antimicrobial dose concordance was primary driven by acute pharyngitis with fewer patients who are White receiving concordant doses of amoxicillin (45.5 % vs 64.6%; p<0.01).

Conclusion: Differences in rates of antibiotic choice and dosing concordance were seen between patients who are White and Black or African American. Further studies investigating the clinical significance of these differences are warranted.

IRB approval: This study was evaluated by the local Institutional Review Board and determined to be exempt because it did not involve human subjects research.

Effect of single doses of droperidol or haloperidol on QTc Interval

Emily Stephens — 2026-05-12

Purpose: Droperidol and haloperidol are nonselective dopamine receptor blockers with clinical indications including postoperative nausea and vomiting and agitation. One signature side effect of both medications includes electrocardiogram (EKG) changes, such as QT prolongation. This may lead to torsades de pointes (TdP), a life-threatening arrhythmia.

Objectives: The primary objective of this study is to evaluate the change in the QTc interval following a single dose of droperidol or haloperidol.

Methods: This study entailed a retrospective chart review of inpatient medical records of adult patients who received a single dose of either droperidol or haloperidol. The primary outcome measure is the presence of QT prolongation following the administration of a single dose of droperidol or haloperidol.

Results: A total of 44 patients were included in the study. Patients were included in the study irrespective of their baseline QTc interval. QTc prolongation from baseline occurred in 52% of patients who received droperidol (13/25) and 79% of patients in the haloperidol group (15/19; p=0.113). As for patients who did not have prolonged QTc intervals at baseline, 9/15 patients (60%) in the droperidol group and 5/9 (56%) of patients in the haloperidol group experienced QTc after the study medication was administered (p=1).

Conclusions: There was no significant difference in the incidence of QTc prolongation following single doses of either droperidol or haloperidol. Future studies with larger sample sizes are needed to assess the effect of droperidol and haloperidol on QTc prolongation.

Innovating opioid research with social media data: A social network analysis of Twitter conversations

Nada Alshahrani — 2026-05-12

Background: Opioid overdose deaths remain a critical public health challenge in the United States. Social media platforms have emerged as important venues for information sharing, peer support, and shaping public discourse about the opioid crisis. Twitter/X is widely used to discuss opioid use, prevention, policy, and personal experiences. However, little is known about how these conversations are structured, who the key voices are, and what topics are most shared. Few studies have used social network analysis to investigate these trends. This study aimed to uncover the structure of the opioid-related network and identify key influencers, top hashtags, and top content producers.

Methods: We used NodeXL to import, visualize, and analyze data from public Twitter/X accounts. A total of 32,745 tweets containing the keyword “opioid” were collected between December 18, 2024, and March 26, 2025.

Results: Network analysis of opioid-related conversations on Twitter/X identified 21,654 users and 32,743 interactions. The network showed low density, but clustered communities centered on the opioid crisis. Top accounts were primarily health-related, though AI-driven accounts also played a growing role in information dissemination. Key themes included fentanyl, crisis, and overdose, with hashtags such as #opioid and #fentanyl most frequent. Findings highlight both public concern and the influence of AI-driven accounts in shaping online opioid discourse.

Conclusion: Twitter/X provides key insights into the actors and narratives influencing discussions about opioids. The growing role of AI systems underscores the need for public health officials to enhance their digital presence and prioritize accurate information over misinformation.

Supporting rural health system pharmacy technicians: A qualitative evaluation of manager perspectives and engagement with a student-developed wellness website

Emily Tisler — 2026-05-19

Purpose: Pharmacy technicians in rural health systems face elevated risk of burnout, yet limited research has explored management perspectives on this issue. The objective of this study was to explore pharmacy management perceptions of technician burnout in South Dakota health systems. The secondary objective was to evaluate user engagement with a free, student-developed website containing technician-focused burnout resources.

Methods: This qualitative study used virtual focus groups with pharmacy managers from three major rural health systems to identify perceptions of technician burnout. Inductive coding was used to analyze focus group transcripts. Additionally, students designed a website based on data from South Dakota-based technicians that contained links to targeted resources. Website usage was tracked for six weeks using Google Analytics.

Results: Thirteen pharmacy managers from five hospitals participated. Themes included recognition of burnout indicators, emphasis on behavioral rather than structural solutions, and challenges in addressing technician needs. The website, organized around five technician-reported stressors, was accessed 140 times by 67 unique users. Engagement was brief (average 72 seconds per visit), with the “Inadequate Staffing” page receiving the most views.

Conclusion: Pharmacy managers are aware of technician burnout but emphasize individual-level support over system-level change. A student-developed website was modestly utilized, suggesting that passive tools may have limited standalone impact without structural reinforcement or integration into practice.

Pharmacist-led screening for social determinants of health and diabetes distress in an underserved ambulatory care population

Crystal Deas — 2026-05-19

Introduction: Social determinants of health (SDOH) significantly influence Type 2 diabetes (T2DM) outcomes but are often unaddressed in traditional care models. Diabetes-related distress (DD) also contributes to suboptimal disease control. Pharmacists in ambulatory settings are well-positioned to screen for and respond to these non-clinical barriers.

Objective: To assess the prevalence of SDOH needs and DD among patients in a pharmacist-led clinic and describe interventions provided in response.

Methods: This cross-sectional study was conducted over a seven-month period. Forty adult patients with T2DM attending in-person pharmacist-led visits were screened for SDOH and DD using validated tools. Descriptive statistics and Spearman correlations were used to analyze relationships among HbA1c, SDOH burden, and DD.

Results: The majority of patients were female (72.5%) and African American (87.5%). SDOH needs were identified in 67.5% of patients, with the most common being lack of social support (44.4%), financial strain (40.7%), and food insecurity (29.6%). Moderate to high DD (T2-DDAS CORE ≥2.0) was present in 50.0% of patients. A significant, moderate positive correlation was observed between baseline HbA1c and T2-DDAS CORE scores (Spearman ρ = 0.423, p = 0.007; R² = 0.191). Pharmacists provided a mean of 1.9 ± 0.9 interventions per patient visit, which included both routine clinical actions and screening-prompted interventions. Routine care most commonly included medication adjustment (n=23) and diabetes self-management education and support (n=19), whereas referral to community resources were the most frequent screening-prompted interventions, driven by both SDOH (n=11) and DD (n=6) findings. The mean combined time to complete both screenings was 6.45 ± 2.32 minutes.

Conclusion: Pharmacist-led screenings identified a high prevalence of unmet SDOH needs and DD. Interventions prompted by SDOH and DD screenings were feasible to implement and may support improved diabetes management.

Social media inspired visual distractions: A case study in pharmacy education

Maia Davey — 2026-05-12

Description of the Problem: Digital tools such as hybrid learning models, messaging apps, and social media are increasingly embedded in education, but often introduce distractions that can impair learning.

Statement of the Innovation: While platforms such as TikTok use continuous visual stimulation to sustain user attention, it remains unclear whether such techniques can be repurposed to support meaningful student engagement in academia.

The Innovation: This research integrated non-auditory, low-arousal visual distractions common on social media platforms, into an online pharmacy lecture with the goal of examining the impact on student attention on the lecture material and reducing external multitasking. A 50-minute recorded lecture in a first-year pharmacy course incorporated short, “oddly satisfying” video clips displayed alongside lecture slides. Twenty-eight students completed a post-lecture survey assessing their social media use and perceptions of this novel lecture format.

Critical Analysis: Findings revealed three major themes. First, most participants (~75%) reported that the visual distractions disrupted their focus rather than enhancing it, with several noting they actively avoided looking at the visual distractions. Second, while Gen Z students are often thought to be more accustomed to multi-stimulus environments, survey responses suggested that pharmacy students did not find these distractions beneficial even if familiar with similar content on social media. Third, the format primarily captured attention at a superficial level, initially drawing eyes to the screen but not for a meaningful duration. These results suggest that techniques designed to maximize engagement in purely entertainment settings do not directly translate to effective academic learning.

Next Steps: Future research should explore how attention-sustaining features of social media can be adapted for academic settings without compromising comprehension or long-term retention.

Predicting performance of pharmacy calculations assessments via an algebra-based pre-test and other variables using a logistical regression model: A pilot study

Kyle Shapcott — 2026-05-12

Objective: Pharmacy calculations are crucial for practice and licensure examinations. This study aimed to be the first to assess the external validity of the correlation between an algebra-based pre-test, previously published, and calculation assessment performances. A secondary objective was to identify variables associated with poor assessment performance.

Methods: An 18-item survey and an 18-question algebra-based pre-test were distributed to 144 first professional-year (P1) candidates on the first day of their fall 2024’s semester. This was used to characterize student-specific variables (e.g. work experience). The survey included dichotomous (yes/no) and rating (5-point Likert scale) items; the algebra-based pre-test included open-response items. Data were analyzed using linear regression and logistic regression to determine variables associated with passing (≥70%) or not passing (<70%) assessments. Pearson correlation coefficients were computed between the algebra-based pre-test and assessment performance.

Results: Ninety-one candidates (63%) completed the survey, and 139 (97%) completed the algebra-based pre-test. Variables associated with passing assessments (p<.05) included no prior work experience (adjusted odds ratio=6.6, confidence interval=1.3-34.3) and algebra-based pre-test performance >15/18 points (adjusted odds ratio=5.9, confidence interval=1.6-21.8). Algebra-based pre-test performance was moderately correlated with assessment scores (Pearson correlation coefficients: 0.47 for assessments one and two, 0.4 for assessment three).

Conclusions: The algebra-based pre-test had a comparable correlation to assessment performance to previously published results and could be a tool to identify those at risk for poor pharmacy calculation assessment performance across the academy. Future studies warrant utilization of this algebra-based pre-test to target interventions to those at high risk of poor performance on calculations content.

Pharmacy students’ perceptions of an active learning job-posting assignment and its role in career development

Clarence Moore — 2026-05-12

Introduction: Career preparation is an essential element in a student's academic journey. Pharmacy curricula are required to cover this content, however the depth and breadth of support varies widely. This study investigates the effectiveness and impact of an Active Learning Job-Posting assignment on pharmacy students’ perceptions of their career development and their interest in further career preparation activities.

Innovation: Students participated in an active learning activity during a pharmacy administration course related to career development. Anonymous, voluntary surveys were administered to 3rd-year pharmacy students following the activity. Descriptive statistics were completed.

Findings: Twenty-three students responded to the survey with 21 students (91%) reporting that the assignment encouraged them to review current real-world job postings and 18 students (78%) being open to further opportunities within the curriculum to explore and discuss the transition into the pharmacy profession.

Conclusions: Data showed that the active learning activity was received positively by students, but also highlights the need for more time on career planning and development.

Reflective Audio Note (RAN): A novel tool for enhancing reflection in pharmacy education – A case study report

Mirey Alfarah — 2026-05-12

Background: Reflection is an essential skill for pharmacists. Teaching reflection and fostering a meaningful reflective practice remains challenging in health education. Traditional written reflections are often perceived as time consuming and disconnected from learning. To address this, we designed and implemented the Reflective Audio Notes (RAN), a low-threshold, mobile based reflective assignment. RAN aimed to enhance immediacy, authenticity, and inclusivity in reflection across diverse pharmacy learning contexts.

Case Description: RAN was implemented in three courses at the University of Bergen’s integrated Master of Pharmacy program. Students recorded short reflections during or after placement and lab experiential activities. Educators provided formative feedback through either individual audio responses or group discussions. Data were collected through pre/post surveys and focus groups over two years (2021–2023).

Case Themes: Students described the RAN as a positive, engaging, and a time-efficient way to reflect. Speaking aloud felt more natural and personal than writing, helping them express emotions honestly. It deepened their understanding and helped them connect experiences to their future pharmacist roles. This format also reduced language barriers, allowing students with varying writing confidence to participate equally. When teachers responded, students felt heard and educators gained clearer insight into students’ feelings.

Impact: RAN improved student engagement, metacognition, and professional identity formation. For educators, it provided real-time insights into student learning and prompted interdisciplinary collaboration. Institutionally, RAN fostered a culture of inclusive, experiential learning and inspired broader application across health education. RAN demonstrates that effective reflective learning can be achieved through flexible, and human-centred pedagogical design

Exploring public awareness and willingness to engage in pharmacy-based sexual health services: A cross sectional survey

Josleen Albishara — 2026-05-19

Background: Pharmacists are increasingly recognized as accessible providers of sexual and reproductive health services, including sexually transmitted infection (STI) testing and education. However, public comfort discussing sexual health in pharmacy settings remains underexplored. This study aimed to assess public willingness and comfort in engaging with pharmacists and pharmacy technicians on sexual health topics.

Methods: A 22-item cross-sectional survey developed and validated by the study investigators was distributed via Qualtrics to adults aged ≥ 18 years between September and November 2024. Recruitment occurred through Wayne State University communication platforms and an external consumer email list. Survey items included multiple-choice, Likert-scale, and yes/no questions across five domains: demographics, comfort discussing sexual health with pharmacy staff, willingness to use pharmacy-based sexual health services (PBSHS) (e.g., pharmacist-performed STI testing), provider preferences, and awareness of PBSHS. Responses were analyzed using descriptive statistics.

Results: A total of 110 eligible respondents were included in the analysis (mean age 26 years; 71% female). Although 73% of participants reported being comfortable discussing sexual health topics in general, only 39% reported feeling somewhat or extremely comfortable discussing sexual health with a pharmacist. Most respondents preferred discussing sexual health with a primary care provider (64%), while only 2% preferred a pharmacist. Awareness of pharmacy-based STI testing services was limited, with 53% reporting they were unaware such services were available. Despite this, 57% indicated willingness to receive pharmacist-performed point-of-care STI testing, and 74% reported willingness to receive pharmacist follow-up counseling and treatment after testing. Willingness to discuss sexual health through telepharmacy was reported by 71% of respondents.

Conclusion: Although willingness to utilize pharmacy-based sexual health services was moderate, awareness of available services and comfort discussing sexual health with pharmacists remain limited. Increasing public awareness of pharmacist-provided services and improving communication around pharmacists’ clinical roles may enhance patient engagement with PBSHS.