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Proactive planning, patient engagement, and strong community partnerships can help pharmacies manage vaccine demand and protect high-risk populations during respiratory illness season.

Community Pharmacy Strategies for Respiratory Disease Season

Articles

Using a web-based survey of people in Japan, researchers determined the perceived barriers pharmacists face when counseling patients with gender-specific diseases.

Community Pharmacists Face Barriers Providing Gender-Specific Guidance

Dae Lee, PharmD, Esq, CPBS, discusses the legal and billing challenges hindering
pharmacy practices and opportunities to overcome them.

Navigating Legal, Billing Challenges in Pharmacists’ Clinical Services

Ashley Kay Pendrick, PharmD, owner of Prosper Rx Consulting, provided insights on how pharmacists can expand their scope within the confines of current practice regulations.

Opportunities to Expand Pharmacist Role Amid Current Federal, State Regulations

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On June 26, 2024, the FDA approved ensifentrine (Ohtuvayre) for the treatment of COPD.

FDA Approves Ensifentrine, Novel Treatment for Chronic Obstructive Pulmonary Disease

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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 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

Ashley Kay Pendrick, PharmD, owner of Prosper Rx Consulting, believes the best way to capitalize on a successful pharmacy career is through self-inflection, the homing in of clinical skills, and gaining an entrepreneurial spirit for financial growth.

“First, [the] big picture is really starting to think about what it is that you enjoy,” Pendrick told 

. “I'd hate for people to start building something or getting into an area, and then a year, 3 years later, they're not satisfied and it just doesn't align with them. My first advice and tips that I share [is] that you want to reflect internally a lot, as to, what is it that you would wake up and do for free.”

As the owner of Prosper Rx, Pendrick connects a myriad of clinical providers to advocate for and improve health outcomes of patients diagnosed with diseases like diabetes. She recently joined 

 to tell us more about her business, how she was able to step outside of traditional pharmacy roles, and the ways in which prospective pharmacy professionals can find exactly the role they were called to fulfill.

Learn more about Pendrick’s business ventures in the pharmacy profession and stay tuned for more from our interview as she dives deeper into pharmacists’ roles within the greater health care community.

How the Pharmacist Views Expansion of Clinical Role

: What advice would you give to a pharmacist looking to leave a retail or independent setting and enter a pharmacy consulting or non-traditional pharmacy role?

First, [the] big picture is really starting to think about what it is that you enjoy. I'd hate for people to start building something or getting into an area, and then a year, 3 years later, they're not satisfied and it just doesn't align with them. My first advice and tips that I share with any of, even [the] business coaches I’m mentoring, I share with them that you want to reflect internally a lot, as to, what is it that you would wake up and do for free. From that, start building your confidence, get out there, showcase your value, document the interactions that you're having, and find what you're enjoying most.

Start getting into some of the billing. I went through a good amount of billing and coding and understanding that. Understand collaborative practice agreements, if that's the area that you're looking [toward], providing actual care and working directly with practices and health systems, if you want more of that autonomy. [It’s also] learning to speak the language of the business or your client. If you're looking to get into consulting or [become] an entrepreneur, you want to think, what is it that people are looking for and struggling with; what's their pain point, and overall, how can you come in and help solve that? What's that transformation look like for them? After they've worked with you, what does it look like after? And if you can't speak to that quite yet, take some time.

You can build and do these things on the side. I shared actually recently, there's some MBA-type programming that's available online for free. There's plenty of options where you want to start putting some time in and really finding out what your strengths are, where you belong. And then start with action. One step, 10 minutes, 20 minutes a day, and I think eventually you'll have something that you'll land in, whether it's through networking or you've built something that you're proud to call your own.

: What are your overall hopes for the profession, and realistically, where do you see it going in the near future?

Overall, my biggest hope for the profession is for pharmacists to find fulfillment in the work that they're doing. I know that that might seem rainbows and butterflies, but realistically, a lot of us get into becoming a pharmacist, and then we end up finding that we're burnt out, or it's just not in alignment with what we're really feeling called to [do]. I feel like pharmacists are clinical team members, and we're essential in every health system. The PharmD program is a STEM degree. Use it to your heart's desire. Find what works for you and what you enjoy. It's not a shackle or the golden handcuffs, as they say, but really a huge launching pad.

For us, Prosper, and for pharmacists, I do really feel like, if you're looking to move towards more of the clinical autonomy and actually practicing direct patient care, there is a need for it. We're building that right now with the potential for more and more clinical pharmacists needed in these community health hubs, pharmacies, and medical practices. Learn the language of business. And overall, I'm hoping there will be a pharmacist partnered with a practitioner, medical doctor, or [advanced practice provider] in almost every practice. That way we all will see better overall patient care. We'll see an improvement in hospitalizations, disease progression, and preventative health care—what we're all looking for. The future for pharmacists is really bright.

How the Rise in US Pharmacy Deserts Impacts Patients’ Health

Ready to impress your pharmacy colleagues with the latest drug information, industry trends, and patient care tips? Sign up today for our 

As a clinical pharmacy consultant with more than a decade of experience, Ashley Kay Pendrick, PharmD, shared her insights into non-traditional pharmacy roles.

Total Pharmacy Interviews

Q&A: How Pharmacists Find Themselves in Non-Traditional Roles

According to the J.D. Power 2025 US Pharmacy Study, customer satisfaction with mail order pharmacies is steadily increasing as the prominence of brick-and-mortar pharmacies declines.

 With a significant reduction in satisfaction with brick-and-mortar locations, customers are now reporting the most satisfaction toward supermarkets and mass-market retailers for their medication needs.

“Chain drugstore customers are significantly more likely than supermarket or mass market merchandiser pharmacy customers to say they ‘definitely will’ or ‘probably will’ switch pharmacies in the next 12 months,” Christopher Lis, managing director of global health care intelligence at J.D. Power, said in a news release.

 “That openness to switching, combined with steadily increasing satisfaction scores at mail order pharmacies, helps set the stage for a tipping point in the pharmacy space.”

Brick-and-mortar pharmacies have been closing at a persistent and alarming rate throughout most of the 21st century. Amid significant numbers of Walgreens and CVS closures, as well as Rite Aid filing for bankruptcy, nearly 1 in 3 pharmacies operating in the US between 2010 and 2020 had shut down by 2021.

 Furthermore, according to independent pharmacy operator and advocate Benjamin Jolley, PharmD, 2275 pharmacies closed within the first 9 months of 2024.

Pharmacy Closures Limiting Access to Preventative Patient Care

Regardless of the trajectory brick-and-mortar locations have been headed on over the last 15 years, J.D. Power’s 2024 report still had these pharmacies ranked higher in customer satisfaction than mail order, supermarket, and mass market retail pharmacies. Indeed, the highest-rated chain drugstore (Good Neighbor Pharmacy) was more satisfactory than the highest-rated mail order pharmacy, PillPack by Amazon Pharmacy.

However, trends from the 2024 report continued in 2025, showing that satisfaction with chain drugstores has dipped below that of supermarkets such as Wegmans and mass market retailers such as Sam’s Club. In addition to alternative pharmacy locations gradually taking over, mail order pharmacies are also on the rise.

Ultimately, with continuous declines in the satisfaction with and prominence of the drugstores the US has always gravitated toward, the pharmacy industry is at a tipping point that could forever change how patients are dispensed prescription drugs and medication services.

Chain drugstores saw a minimal increase in average customer satisfaction scores over the past year, increasing by 1 point from 642 to 643. However, when compared with their competitors, chain drugstores are significantly falling behind.

“Despite the incremental improvement, satisfaction scores for chain drug stores are 54 points lower than the average satisfaction score for mail order pharmacies (697), 63 points lower than mass market merchandisers (706), and 72 points lower than supermarkets (715),” wrote the authors of the report.

 “Mail order pharmacies show the largest year-over-year gains in satisfaction, rising 7 points to 697 in 2025.”

Chain drugstores are gradually declining as the least satisfactory drug dispensing destination compared with supermarkets, mass retailers, and mail order pharmacies. The report states that supermarkets and mass retailers are outperforming brick-and-mortar locations in staffing, trust in their pharmacists, ease in filling prescriptions, and timing.

The report authors further highlighted the “digital tipping point” facing the pharmacy industry regarding the increase in mail order pharmacy customer satisfaction. While only 67% of survey respondents claimed they were aware of digital pharmacies, 63% of those individuals were “somewhat” or “very” interested in using a digital pharmacy to fill their prescriptions.

Aside from customers’ feelings and preferences toward pharmacy locations, external financial pressures have made the sustainability of chain drugstores increasingly difficult in the US. As independent and chain drugstores continue to face hardships from declining reimbursements and staff burnout, they will also have to navigate the mass migration of customers who are starting to prefer alternative pharmacy locations.

However, although brick-and-mortar pharmacies are in a dire situation, experts believe mass-market retailers and supermarkets will capitalize on the opportunity created by chain stores closing across the country.

“The US Pharmacy Study, now in its 17th year, measures customer satisfaction with brick-and-mortar and mail order pharmacies,” concluded the authors of the report.

 “The 2025 study is based on responses from 14,700 pharmacy customers who filled a prescription within the past 12 months and was fielded from May 2024 through May 2025.”

To see how these trends have evolved in the past year, check out our article on J.D. Power’s 2024 US Pharmacy Study: 

Patient Satisfaction with Mail Order Pharmacies Increases, but Shrinks for Chain Stores

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

1. Chain drug store closures create big opportunities for supermarkets, mass merchandisers, and online pharmacies, J.D. Power finds. News release. J.D. Power. July 29, 2025. Accessed July 29, 2025. https://www.jdpower.com/business/press-releases/2025-us-pharmacy-study

2. Nearly 30% of US drugstores closed in one decade, study shows. 

. December 3, 2024. Accessed July 29, 2025. https://www.usnews.com/news/health-news/articles/2024-12-03/nearly-30-of-us-drugstores-closed-in-one-decade-study-shows

3. Jolley B. 2275 pharmacies have closed so far in 2024. Ramblings of a pharmacist. September 17, 2024. Accessed July 29, 2025. https://benjaminjolley.substack.com/p/2275-pharmacies-have-closed-so-far

4. As mail order pharmacies continue to climb in customer satisfaction, chain drug stores fall behind, J.D. Power finds. News release. J.D. Power. July 30, 2024. Accessed July 29, 2025. https://www.jdpower.com/business/press-releases/2024-us-pharmacy-study

JD Power released its 2025 US Pharmacy Study detailing customer satisfaction with brick-and-mortar, mail order, supermarket, and mass-market retail pharmacies.

Brick-and-Mortar Pharmacy Satisfaction Lags Behind Supermarket, Mail Order Pharmacies

Through the theory of planned behavior (TPB), researchers uncovered a variety of factors that encourage or deter pharmacists from offering medication take-back services, according to data from a study published in 

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

Molly Csere, PharmD

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