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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

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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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Senior Director of Immunizations at Walgreens

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.

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

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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

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.

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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.

For the primary outcomes in each study, the longitudinal survey sought e-cigarette, cannabis, or dual use initiation at 1-year follow-up among baseline never-users of e-cigarettes and cannabis. For the second study, they uncovered the past-month use of either product or the past-month use of both.

“The studies found that although baseline frequent exposure to e-cigarette content broadly on social media was not associated with subsequent e-cigarette or cannabis use initiation, frequent exposure to cannabis content was associated with solo e-cigarette use (inconsistently), solo cannabis use, and dual use initiation 1 year later,” they wrote.

 “Frequent exposure to e-cigarette posts on TikTok and exposure to e-cigarette and/or cannabis social media posts from friends and microinfluencers were associated with cannabis and dual use initiation or past-month use.”

In their first study, researchers revealed that 22.9% of adolescents reported frequent exposure to e-cigarette content and 12% reported frequent cannabis content. At follow-up, exposure to cannabis content was associated with solo cannabis, solo e-cigarette, and dual uses among adolescents.

With both cannabis- and e-cigarette–related content leading to the use of either product, researchers confirmed their hypotheses. Despite some social media channels contributing to use more than others (eg, TikTok), as well as cannabis content contributing more to overall use of these products, the study results were enough to inform the researchers’ suggestions. Those suggestions included a deeper exploration of social media and general marketing policies to avoid increased substance use among adolescents across the country.

“Future research should explore whether shifts in tobacco and cannabis policies (eg, state-level cannabis legalization or a tightened premarket application review process for e-cigarette product market entry), social media community guideline enforcement (eg, prompt detection and removal of influencer vaping posts, regardless of the substance depicted), and prevention programs contribute to these associations,” the authors concluded.

 “Improving social media guidelines and regulation of substance-related marketing, especially influencer promotions of e-cigarettes and cannabis, may help limit adolescent exposure and mitigate public health risks associated with youth e-cigarette and cannabis use.”

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

1. Vassey J, Cho J, Vogel EA, et al. E-cigarette and cannabis social media posts and adolescent substance use. 

. 2025;8(6):e2517611. doi:10.1001/jamanetworkopen.2025.17611

2. E-cigarette use among youth. CDC. October 17, 2024. Accessed August 18, 2025. https://www.cdc.gov/tobacco/e-cigarettes/youth.html

3. Galoustian G. Dramatic drop in marijuana use among US youth over a decade. Florida Atlantic University News Desk. October 28, 2024. Accessed August 18, 2025. https://www.fau.edu/newsdesk/articles/marijuana-use-teens-study

4. Vogels EA, Gelles-Watnick R, Massarat N. Teens, social media and technology 2022. Pew Research Center. August 10, 2022. Accessed August 18, 2025. https://www.pewresearch.org/internet/2022/08/10/teens-social-media-and-technology-2022/

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

Data Show Social Media Exposure Is Associated With Adolescent Cannabis, e-Cigarette Use

The FDA has approved a label update for inclisiran (Leqvio), which can now be used as a monotherapy with diet and exercise to reduce low-density lipoprotein cholesterol (LDL-C) in adults with hypercholesterolemia. The FDA requested the label update due to data on the therapy’s ability to lower LDL-C.

"This first-line label update reinforces Leqvio's proven ability to effectively lower LDL-C, a critical risk factor for heart disease," Victor Bultó, president of Novartis US, said in a news release.

 "With this new indication enabling [inclisiran's] use as monotherapy along with diet and exercise, we now have the potential to help even more patients achieve their LDL-C–lowering goals earlier in their treatment journey."

The updated label removes the requirement that inclisiran should be used on top of or in combination with statin therapies. Other updates included revising primary hyperlipidemia to hypercholesterolemia to accurately focus on LDL-C reduction.

) study, investigators aimed to determine if inclisiran could effectively reduce LDL-C from baseline to day 150 compared with the placebo or ezetimibe. They studied the drug as a 300-mg monotherapy dosage. Patients were screened for up to 14 days, entered a double-blind treatment period of 150 days, and had a safety follow-up conducted up to 30 days after the double-blind period. The primary end points included percentage change in LDL-C from baseline to day 150 compared with the placebo and ezetimibe. For secondary outcomes, investigators included absolute change from baseline to day 150, percentage change in proprotein convertase subtilisin/Kexin type 9 to 150 days, percentage change of non–high-density lipoprotein cholesterol (HDL-C) to 150 days, percentage change for total cholesterol/HDL-C ratio, percentage change in apolipoprotein B (Apo B) to day 150, percentage change in Apo B/Apo A-1 ratio to day 150, and percentage change in lipoprotein (a) to 150 days.

Investigators found that monotherapy with inclisiran met its primary end point, showing reductions in LDL-C levels for patients who were not receiving lipid-lowering therapies. Participants included 350 patients who received randomized treatment 2:1:1, with 175 receiving inclisiran, 89 receiving ezetimibe, and 87 receiving the placebo.

 The mean percentage change in LDL-C from baseline was 1.4% for the placebo, –11.2% for ezetimibe, and –46.5% for inclisiran, according to the study authors. Inclisiran also demonstrated favorable improvements in other lipid and lipoprotein(a) levels. Further, the treatment had a favorable safety profile with no new safety concerns. The incidence of treatment-emergent adverse events was similar for inclisiran (31%), ezetimibe (30.3%), and placebo (28.7%).

Furthermore, inclisiran showed that the drug could also be added to statin therapy and helped reduce LDL-C levels more than typical statin therapy alone in another study (

). LDL-C reductions with inclisiran were at 60% compared with 7% for the usual care.

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The updated label removes the requirement that inclisiran should be used on top of or in combination with statin therapies.

Samantha Picking, PharmD

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