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Early planning and strong partnerships enable community pharmacies to manage the surge in vaccines and treatments during flu, COVID-19, and RSV seasons.

Q&A: Preparing Community Pharmacies for Respiratory Disease Season

Videos

Community pharmacies can play a key role in addressing health-related social needs, but success requires overcoming different challenges.

Overcoming Barriers to Social Needs Care Integration in Pharmacies

Pharmacists leverage socioeconomic insights to combat health disparities, enhancing access to medications and public health services in underserved communities.

Community Pharmacies Help to Improve Access to Health Care

Samantha Picking, PharmD, senior director of immunizations at Walgreens, discussed how pharmacists have emerged as the ideal providers to manage vaccine administration.

Q&A: Pharmacists’ Role as the Most Accessible Vaccine Providers

Drug Topics connects pharmacists across retail, health system, and specialty practice with clinical updates, pharmacy trends, and regulatory news.

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California pharmacist Afrouz Nikmanesh recently filed a class-action lawsuit against Walmart, alleging the retail giant cheated her and her colleagues out of work breaks and overtime pay.

Why I filed a class action lawsuit against Walmart

journal explores issues within pharmacy, from the impact advocacy can have in community pharmacies to staffing shortages across multiple sectors within pharmacy. This month’s issue also explored the importance of disease awareness months and how they are opportunities to maximize valued care. Check out a preview of this month’s issue here.

download the PDF of the Total Pharmacy August 2024 issue here

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See what’s trending in pharmacy with a preview of the Total Pharmacy August issue.

Total Pharmacy

In This Issue: Total Pharmacy August 2024

Combining sodium glucose co-transporter 2 inhibitors (SGLT2is) with glucagon-like peptide-1 receptor agonists (GLP-1RAs) may offer additional protection against cardiovascular and kidney disease in patients with type 2 diabetes (T2D), according to the results of a new meta-analysis published in 

 and presented at the 61st European Renal Association Congress in Stockholm, Sweden.

Separately, SGLT2is and GLP-1RAs have demonstrated cardiovascular benefits. However, little clinical literature has focused on outcomes associated with using the medicines together. Due to the growing prevalence of GLP-1RAs in the 

 and obesity landscape, accelerated by an increasing number of indications for the agent class, this is a crucial area for further study.

The SGLT2 Inhibitor Meta-analysis Cardio-Renal Trialists’ Consortium (SMART-C) is the largest assessment of outcomes for the combined therapeutic use of SGLT2is and GLP-1RAs. The study gathered data from 12 large-scale, placebo-controlled trials of SGLT2is involving 73,238 patients with diabetes. Of these, 3065 were already receiving GLP-1RAs.

Overall, SGLT2is lowered the risk of major adverse cardiovascular events by 11% and hospitalization for heart failure or cardiovascular death by 23% compared to placebo. Notably, this benefit was seen regardless of whether patients were also taking GLP-1RAs.

When used together with GLP-1RAs, SGLT2is reduced the risk of chronic kidney disease progression by 33% and slowed the annual loss of kidney function by nearly 60%.

The study found no additional safety concerns when SGLT2is were used in combination with GLP-1RAs.

Study Reveals Robust Benefits of Semaglutide in Protecting Against Kidney, CV Events in Patients With T2D

Current meta-analysis results build off positive results of the landmark FLOW trial (

). Published earlier in May, results of the international, double-blind, randomized, placebo-controlled phase 3 trial spotlighted semaglutide’s effectiveness in lowering the risk of kidney failure, decelerating worsening kidney function, and protecting against the risk of cardiovascular events and death, in patients with T2D.

“SGLT2 inhibitors have clear protective effects against heart failure and chronic kidney disease, while GLP-1 receptor agonists can reduce the risk of heart attack, stroke, and also kidney disease—as recently demonstrated in the landmark FLOW trial,” said Brendon Neuen, lead author, clinical associate professor, senior research fellow at The George Institute for Global Health, and director of kidney trials at Sydney’s Royal North Shore Hospital, in a news release.

 “Our findings support using this combination to further improve outcomes in patients with type 2 diabetes who meet guideline recommendations for both therapies.”

Elevated glucose from diabetes can damage blood vessels in the heart and kidneys, increasing the risk of 

 and kidney disease. In fact, diabetes is the most common cause of chronic kidney disease.

Moreover, estimates predicting that T2D prevalence will more than double in the next 30 years, surpassing 1 billion global cases by 2050, further strengthen the need for research into diabetes care.

 According to Neuen in an interview with 

 conducted over email, the current study offers valuable insights for developing global treatment strategies for the condition.

"These findings, which represent the largest and most comprehensive evaluation of the combined use of SGLT2i and GLP-1RA, provides the clearest evidence yet that combined use of both medicines can further reduce cardiovascular and kidney disease," said Neuen. "We anticipate that these findings will inform how people with diabetes are treated worldwide, including influencing major clinical practice guidelines.

Although current results suggest that using SGLT2is and GLP-1RAs in tandem may offer robust protection against cardiovascular and kidney disease, further research is needed to fully understand the long-term effects of the combination therapy.

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1. Apperloo E, Neuen BL et al. Efficacy and safety of sodium glucose co-transporter 2 inhibitors with and without glucagon-like peptide-1 receptor agonists: A SMART-C collaborative meta-analysis of randomised controlled trials. 

. 2024. doi: 10.1016/S2213-8587(24)00183-9

2. Massaro L. Study reveals robust benefits of semaglutide in protecting against kidney, CV events in patients with T2D. 

https://www.drugtopics.com/view/study-reveals-robust-benefits-of-semaglutide-in-protecting-against-kidney-cv-events-in-patients-with-t2d

3. Combining popular diabetes drugs offers complementary heart and kidney benefits. News release. The George Institute for Global Health. July 9, 2024. Accessed July 10, 2024. 

https://www.georgeinstitute.org/media-releases/combining-popular-diabetes-drugs-offers-complementary-heart-and-kidney-benefits

4. Mayo Clinic Staff. Chronic kidney disease. Fact sheet. Accessed July 8, 2024. 

https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521

5. Klein HE. Diabetes prevalence expected to double globally by 2050. 

https://www.ajmc.com/view/diabetes-prevalence-expected-to-double-globally-by-2050

When used together, sodium glucose co-transporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) were able to lower the risk of major adverse cardiovascular events and kidney disease by 11% and 33%, respectively.

Clinical

SGLT2i, GLP-1RA Combination Therapy Offers Robust Protection Against Cardiovascular, Kidney Disease

In an era of evolving health care delivery, community pharmacies are emerging as critical access points for patient care, with point-of-care testing (POCT) positioned to revolutionize pharmacy services. In a Pharmacist View video program, Duane Jones, BSPharm, regional pharmacy supervisor and clinical program director at Harps Food Stores, discussed the pharmacist’s role in POCT.

“We are the only profession that can see everything, all the prescriptions that people have, and how we deal with those patients and relationships we have with them,” Jones said in the program. “We can actually close those care gaps by creating a point-of-care testing program in your pharmacies. It will offer you that destination point.”

The current health care landscape presents a critical challenge that demands innovative solutions. With more than half the population struggling to access adequate medical care, community pharmacies are emerging as unexpected heroes in the health care delivery system. These local health care hubs serve patients an average of 33 times annually compared with physicians at 3 visits annually, positioning pharmacists among the most accessible health care providers.

The geographical disparities in health care access are particularly stark in rural and urban health care deserts. In many communities, pharmacies are the sole health care touchpoint, bridging critical gaps in medical service delivery.

“There are so many people in need today, not just in rural America, but also in urban areas, just navigating to get through crowds and very densely populated areas,” Jones said. “There are health care deserts, but there are pharmacies there, and even with our pharmacies, we’re in some towns where we’re the only pharmacy in town, and oftentimes, we’re the only health care provider in town.”

Traditionally, concerns existed about POCT potentially disrupting physician-pharmacist relationships. However, emerging evidence suggests a more collaborative approach, with pharmacists becoming critical partners in comprehensive patient care. By providing immediate testing and treatment, pharmacies can fill crucial health care gaps, especially in these areas with limited medical access.

Health care providers increasingly recognize pharmacies as valuable partners in comprehensive care delivery. Jones highlighted case studies where pharmacies provide critical services, such as rapid testing and treatment, complementing rather than competing with traditional medical practices. This approach transforms pharmacists from medication dispensers to integral health care providers.

Technological, Operational, and Marketing Considerations

Effective POCT implementation demands strategic technological and operational planning. Pharmacies must integrate existing pharmacy management systems, develop efficient billing processes, create staff training templates, and leverage technology to streamline services. This technological evolution requires a strategic approach that balances innovation with practical implementation. Modern POCT capabilities have expanded dramatically, encompassing a wide range of diagnostic services. From COVID-19 testing and influenza screenings to hemoglobin A

 monitoring and cholesterol testing, pharmacies can offer a comprehensive suite of diagnostic services.

Successful implementation requires strategic marketing approaches. Pharmacies are developing informational brochures, utilizing social media platforms, creating targeted bag-stuffer campaigns, and leveraging word-of-mouth referrals. Research indicated that POCT patients are typically aged 18 to 44 years, with approximately one-third lacking primary care physicians. According to Jones, this presents pharmacies with a significant opportunity to attract and retain new patient populations.

The Centers for Medicare & Medicaid Services is driving a fundamental shift toward value-based care by 2030, positioning pharmacies as crucial health care partners. The financial implications extend beyond immediate revenue generation. By positioning themselves as comprehensive health care providers, pharmacies can develop long-term relationships with patients and insurance providers. The ability to offer immediate, accessible testing and treatment represents a significant value proposition in an increasingly complex health care ecosystem.

The financial landscape of pharmacy services is undergoing a significant transformation, with POCT emerging as a potentially game-changing revenue stream. Traditional pharmacy models have struggled with thin profit margins, typically around 2% per prescription, according to Jones. POCT offers a compelling alternative, with pharmacies able to charge approximately $90 per screening test, equivalent to the revenue generated from filling approximately 90 prescriptions.

“To make that same $90, you’re going to have to fill 90 prescriptions,” Jones said. “Now, if I can spend 15 to 20 minutes and do a point-of-care test for a patient, make a difference in their life, actually get positive feedback, and make that money, I would rather do that than try to fill 90 prescriptions in 15 to 20 minutes.”

This economic model represents more than just a financial opportunity; it is a fundamental reimagining of pharmacy’s value proposition. By diversifying services beyond medication dispensing, pharmacies can create more meaningful patient interactions while addressing their own economic sustainability. The potential for POCT to exceed immunization revenues signals a profound shift in how pharmacies can generate revenue and provide value to their communities.

We are the only profession that can see everything, all the prescriptions that people have, and how we deal with those patients and the relationship we have with them. — Duane Jones, BSPharm

“When we started our point-of-care testing in Arkansas, the law was silent, so it didn’t say whether we could or could not do point-of-care testing,” Jones said. Now 48 states allow pharmacists to perform POCT, with critical requirements including obtaining a Clinical Laboratory Improvement Amendments waiver, checking local regulatory requirements, and developing comprehensive testing protocols. Successful implementation requires a holistic approach to pharmacy operations, including staff training, workflow optimization, and technological integration. Pharmacies must invest in creating robust systems that seamlessly incorporate POCT into their existing service models, ensuring regulatory adherence and operational efficiency.

Pharmacies must navigate several challenges, including overcoming initial resistance to change, learning complex medical billing processes, investing in staff training, and developing efficient workflow models. Successful implementation requires proactive legislative engagement, including collaborating with state pharmacy associations, building relationships with local legislators, and demonstrating the value of expanded pharmacy services. This advocacy is crucial in creating a supportive regulatory environment that enables pharmacies to fully realize their potential as comprehensive health care providers.

Pharmacies considering POCT should carefully assess their capabilities, research local regulations, develop comprehensive staff training programs, explore testing options, begin credentialing processes, and create strategic implementation plans. POCT offers community pharmacies a transformative pathway to improve patient care, generate new revenue, expand clinical services, and establish themselves as essential health care providers.

As health care evolves, pharmacies that embrace innovation, invest in staff development, and prioritize patient access will be best positioned to thrive in an increasingly complex medical landscape. 

“The future of pharmacy is not just about dispensing medications but about becoming an integral, accessible, and proactive health care partner for communities across the nation,” Jones said.

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With more than half the population struggling to access medical care, community pharmacies are emerging as unexpected heroes in the health care delivery system.

Pharmacists Emerge as Access Points for Patient Care in Evolving Health Care Industry

Cross-training pharmacy staff as CHWs enables pharmacies to address patients’ social needs effectively and sustainably, improving engagement and health outcomes.

Strategies for Integrating Community Health Workers into the Pharmacy 

Health-related social needs (HRSNs) such as food insecurity, housing instability, and transportation barriers significantly impact health outcomes. Community pharmacies, with their accessibility and trusted relationships, are well positioned to integrate HRSN screening and referral services into patient care.

Community health workers (CHWs) are trusted members of their communities who live, work, and interact alongside the people they serve. Many pharmacy staff—pharmacists, technicians, clerks, and delivery drivers—share these same qualities, often working in the same neighborhoods for years. This connection makes pharmacies a natural fit for CHW integration.

Cross-training pharmacy staff as CHWs builds on their health care expertise while adding skills in effective communication, resource navigation, and referral coordination. Training typically includes two phases: formal CHW certification, often over several days, and ongoing training to address real-world challenges, share best practices, and adapt to emerging needs. Leadership support is also key, both at the pharmacy level and through broader networks.

According to a recent study, embedding CHWs within pharmacies improves patient engagement, increases referral uptake, and can achieve high resolution rates for identified social needs.

 Programs have succeeded in both urban and rural settings, and cross-training CHWs within pharmacies has proven both effective and financially sustainable. Integrating HRSN programs into pharmacy workflows represents a viable and scalable approach, particularly with supportive policies and reimbursement mechanisms in place.

By equipping pharmacy teams to address HRSNs, community pharmacies can bridge the gap between clinical care and social support, ultimately improving health outcomes and strengthening the communities they serve.

® recently sat down with Christopher Daly, PharmD, MBA, BCACP, clinical associate professor at the University at Buffalo, and David Jacobs, PharmD, PhD, associate professor at the University at Buffalo, who were authors on the study, to discuss how community pharmacy staff can be effectively cross-trained as community health workers to support patients with unmet social needs.

Are you ready to elevate your pharmacy practice? Sign up today for our

and get the latest drug information, industry trends, and patient care tips straight to your inbox.

1. Daly CJ, Iqbal DN, Chen E, et al. Implementing a Community Health Worker Model to Address Health-Related Social Needs in a Community Pharmacy Network: A Pragmatic Evaluation. 2025. 

Exposure to social media content related to e-cigarettes and cannabis was associated with increased use of either or both products among adolescent patients, according to data from a study published in 

 To prevent further substance use among younger patients, researchers suggest improving social media guidelines as well as the policies regarding marketing for e-cigarettes and cannabis.

“Nicotine e-cigarettes (hereafter, e-cigarettes) and cannabis products are among the most commonly used substances by adolescents in the US,” the authors of the study wrote. “In 2024, 3.5% of middle school and 7.8% of high school students reported current (past-month) e-cigarette use, whereas 8.3% of 8th graders and 29% of 12th graders reported using cannabis in the past year, 2023.”

The dual use of cannabis and e-cigarettes has been rising at an alarming rate among American youth. Aside from the aforementioned statistics, at least 1.63 million high school and middle school students are currently using e-cigarettes. Of these students, 87.6% use flavored e-cigarettes, and 26.3% use them every single day.

Social Media Significantly Influences Attitudes, Behaviors Toward Skin Health

On the other hand, reports on cannabis use in adolescent patients have shown opposite trends. According to Florida Atlantic University, adolescent cannabis use decreased from 23.1% to 15.8% from 2011 to 2021.

 Although these statistics on cannabis use spanned 88,183 surveyed individuals, recent trends in social media use and the uncaptured cannabis use trends since 2021 may reveal varied evidence.

The Pew Research Center provided statistics regarding social media use among adolescents, showing that 35% of individuals aged 13 to 17 years use one of the top social media apps “almost constantly.”

 Previous evidence has shown that e-cigarette and cannabis content on social media was associated with increased use of each product among adolescents.

To expand upon the evidence of social media, cannabis, and e-cigarette use in this population, researchers conducted 2 separate surveys for high school students in California.

“We conducted 2 studies among California adolescents to examine associations of exposure to e-cigarette and cannabis social media content with use of e-cigarettes, cannabis, or both,” the authors continued.

 “On the basis of prior research [findings], we hypothesized that exposure to posts from friends, microinfluencers, or celebrities, but not from brands or unknown sources, would be associated with past-month e-cigarette, cannabis, or dual use.”

They conducted a longitudinal survey for baseline statistics in 2021 and 2022. Then, in the fall of 2023, researchers conducted a cross-sectional survey among the same population. The first study focused on overall exposure to e-cigarette and/or cannabis social media content, and the second study was geared toward content from specific sources such as friends, celebrities, microinfluencers, e-cigarette and/or cannabis brands, or unknown sources.

Researchers explore whether or not exposure to e-cigarette or cannabis content on social media leads to increased use among adolescents.

Afrouz Nikmanesh, PharmD

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