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Articles

Researchers explore factors influencing pharmacists' willingness to provide medication takeback services, highlighting the need for improved disposal practices and education.

Multifaceted Approach Is Necessary for Pharmacist-Led Medication Takeback 

Community pharmacists embrace mental health interventions to combat depression and anxiety in long-term condition patients, enhancing overall care and accessibility.

Pharmacists Welcome Mental Health Interventions for Long-Term Condition Patients

Laura is the vice president of content of Drug Topics

 since 2022 and has been with the publication's parent company, MJH Life Sciences

, since 2011. She has an MA in business and economic reporting from New York University.

The 2024-2025 updated COVID-19 vaccine containing the Omicron JN.1 lineage did not increase the risk of 29 adverse events of special interest. 

Updated COVID-19 mRNA Vaccine Did Not Increase Risk for Adverse Events

Videos

With expertise into the growing issue of pharmacy deserts, Michael Murphy, PharmD, MBA, discussed exactly what patients are losing when their community no longer has pharmacy access.

Pharmacy Closures Limiting Access to Preventative Patient Care

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

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Lydia Newsom, PharmD, discusses injection techniques, managing side effects, and the importance of collaboration between the healthcare team.

Q&A: Pharmacist Strategies for Optimizing GLP-1 Therapy Outcomes

Lydia Newsom, PharmD, discusses how to support patients who are struggling with injection techniques or gastrointestinal side effects of GLP-1s.

How Pharmacists Can Support Adherence Among Patients Using GLP-1s

Lydia Newsom, PharmD, discuses how pharmacists can support patients using GLP-1s.

Q&A: Pharmacists’ Role in GLP-1 Diet, Exercise Counseling

A conversation with Lydia Newsom, PharmD, clinical associate professor of pharmacy practice at Mercer University College of Pharmacy.

Pharmacists Play Key Role in Supporting Patients Using GLP-1s

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

Don’t get left behind: Sign up today for our 

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

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.

Pharmacy practice is always changing. Stay ahead of the curve: Sign up for our 

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

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

Although many experts may argue that pharmacists' role in health care is expanding in real time, several barriers remain to their recognition as contributors to a fully integrated care team. However, due to their expertise and knowledge of the disease state, pharmacists have promising opportunities to stand out within diabetes management.

“We're having physicians asking for help, and pharmacists are ideally positioned to be able to take that next step in helping to combat medication therapy problems with this disease but also to drive engagement with diabetes and [help] patients understand more holistically what's going on with their diseases,” Jon Easter, RPh, associate faculty director at the University of North Carolina Center for the Business of Health, told 

Following his presentation at the American Diabetes Association (ADA) 85th Scientific Sessions, titled “Adding Pharmacists to the Team—Enhancing Access and Patient Engagement for Better Outcomes,” Easter sat down with 

to discuss trends in pharmacists’ roles surrounding diabetes management. He also mentioned their barriers to expansion and the changes that need to be made to facilitate that expansion.

Physicians Looking to Pharmacists for Patient Engagement in Diabetes Management | ADA 2025

: Can you start by explaining how the pharmacist’s role in diabetes management has changed recently, and where it is headed in the near future?

It was a pleasure to be able to talk with a team of physicians at the ADA conference about team-based care, and [it] really reiterated for them the important role that pharmacists play in diabetes management. Coming from UNC Eshelman School of Pharmacy, we know that pharmacists are trained at the top of their license in diabetes management, and we can see the growth of pharmacists engaged here, not only with academic centers where you have clinic settings where pharmacists are embedded.... Many...pharmacists in the community setting are getting involved as certified diabetes educators. They're getting involved as [part of the] DPP..., Diabetes Prevention Program, and actually getting reimbursed and paid for these programs.

I'm watching, and we're all watching, to see the expansion of pharmacist engagement around diabetes management because the medications are so complex and because the disease is so complex. We're having physicians asking for help, and pharmacists are ideally positioned to be able to take that next step in helping to combat medication therapy problems with this disease, but also to drive engagement with diabetes and [help] patients understand more holistically what's going on with their diseases.

There are accessibility opportunities with pharmacy in the community settings. [Patients] might have an otherwise difficult time seeing an endocrinologist or primary care all the time, but combining that medication expertise with physician communication and patient engagement [is] really why we're seeing the growth of diabetes management and pharmacist engagement there.

: What are the most significant barriers preventing pharmacists from being fully integrated into the health care team, and how can these be overcome?

The barriers for team-based care and adding pharmacists to the team, I think,...start with reimbursement. Pharmacists have traditionally been reimbursed for the dispensing of medications, and we all know that. That has worked well for a while to be able to offer services while also being paid to dispense products. We know that the challenges that now sort of lead down the path of reimbursement and dispensing of medications have really pushed us to a place where reimbursement for services [is] super important.

I think there are plenty of opportunities to be able to ramp up physician-pharmacist collaboration, interdisciplinary practice, as we think about rural areas, as we think about the community setting. Those are growth opportunities there. Traditionally, physicians don't understand what pharmacists can bring to the table beyond a dispensing function. That educational process, those protocols, being able to put collaborative practice agreements in place, I think, are all barriers that we could overcome from [those] cultural differences in bringing primary care physicians and pharmacists together as they begin to train together in the community setting, and then practice together, and then teach them how to develop these collaborative practice agreements and other things.

I think the last thing in terms of barriers and opportunities really is connectivity. If you have physicians and providers who understand the value of the pharmacist, they're building collaborative practice agreements or other contracts to be able to work together to facilitate diabetes care. Then they need to figure out how best to connect with one another. Access to EHRs [and] bidirectional, read-write access...are really important, and we're seeing positive trends in that direction.

Read more from our coverage of the ADA’s 85th Scientific Sessions

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.

In a recap of his presentation at the American Diabetes Association’s 85th Scientific Sessions, Jon Easter, RPh, discussed the role of pharmacists in team-based diabetes care.

Q&A: The Evolving Role Pharmacists Play in Team-Based Diabetes Care | ADA 2025

This episode explores how pharmacists can navigate their careers with clarity and purpose by grounding themselves in their professional oath, organizational mission, and core values.

Dispensing Leadership: Navigating Your Pharmacy Career with Purpose

In Dispensing Leadership, a podcast offering from 

 and RPhAlly, Shawn Bjorndal, PharmD, RPh, a visionary health care executive with over 16 years of experience and founder of PGxAlly, and Jesse McCullough, PharmD, a pharmacist-turned-entrepreneur with a passion for leadership development, discuss essential leadership skills for pharmacists, how to develop them, and, ultimately, how to advance the pharmacy profession.

In this episode, Shawn and Jesse dive into the idea of creating a “career GPS” using 3 key reference points: the Oath of a Pharmacist, your organization's mission, and your core values. Jesse shares stories about rediscovering the pharmacist's oath, the impact of clearly defined core values on team culture, and why understanding these foundations can help pharmacy professionals align their work with their purpose. Whether you're a pharmacy technician, student, or seasoned pharmacist, this conversation will get you thinking about what truly guides your professional path.

“If you want to know where you’re going in your pharmacy career, you need a GPS—and that starts with knowing 3 things: the promises you’ve made in the Oath of a Pharmacist, the mission of the organization you’re part of, and the core values that guide your decisions,” Jesse said. “When those 3 points are clear, you can navigate challenges, align your actions, and lead with purpose.”

 for important conversations that will help you develop your skills to become an effective pharmacy leader. All episodes of Dispensing Leadership will be available in a video format via 

, with an audio version available through Spotify.

Dispensing Leadership: Navigating Your Pharmacy Career With Purpose

Among the ongoing and notable challenges within retail pharmacy today, pharmacists have increasingly struggled to deliver sustainable and patient-centered care. Despite movement on the federal and state levels limiting the power of pharmacy benefit managers (PBMs), many experts believe more change is necessary to ensure patient access and valued care at pharmacies.

“It's a sad moment for the industry and a strong indicator that something truly does need to change,” Walgreens Chief Pharmacy Officer and Chairman of the National Association of Chain Drug Stores Rick Gates told 

. “Financial pressures are intensifying, pharmacy burnout continues to be a challenge, and access to care is truly a risk when you look at the closures that were just announced. I'm a pharmacist myself, and I understand this from a personal level, but for those [at] the professional level, it's really a little bit scary.”

While touching on the prominent barriers impeding pharmacy businesses, Gates also looked ahead at some of the exciting developments and opportune chances for pharmacies to expand. From the emergence of artificial intelligence (AI) in pharmacy to the legislation that community pharmacies have continuously advocated for, Gates explored the full scope of retail and independent pharmacies in the US today.

“Pharmacies are closing at an alarming rate, often due to unfair reimbursement practices by a few large, vertically integrated conglomerates,” noted Gates. “If the industry doesn't really take a close look at making meaningful changes to the pharmacy reimbursement model, patients will need to look elsewhere for health care services.”

Stay tuned for weekly podcast episodes on 

 every Thursday afternoon. Check out our previous episode with 

, who discussed the Pharmaceutical Strategies Group’s 2025 Trends in Drug Benefit Design report.

Don’t get left behind: Sign up today for our 

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

As state-level PBM reform heats up amid dire situations for many retail pharmacies, Walgreens Chief Pharmacy Officer Rick Gates joins Drug Topics to discuss ongoing industry challenges.

The Ongoing Challenges Causing Need for Reform in Retail Pharmacy

How State-Level PBM Reform Can Lead to Federal Legislation

In part 3 of our interview with Iowa State Representative Brett Barker, PharmD, he discusses how legislation at the state level is gradually informing decisions at the federal level.

Lydia Newsom, PharmD

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