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Researchers aim to understand patients’ perception of whether or not they have sufficient information on contraceptives.

Inadequate Contraceptive Information Hinders Equity in Reproductive Care

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Amid the pandemic, how effectively pharmacists embraced their role as frontline care providers could change the profession forever.

The Pharmacist’s Role Beyond COVID-19

CVS and Walgreens will limit their offerings for the COVID-19 vaccine, even for those who meet the new criteria from the FDA, according to 

 The new criteria limit who can receive a COVID-19 vaccine, with 4 different vaccines having different indications on who can receive the immunization.

CVS will now offer COVID-19 vaccines in 13 of 16 states and the District of Columbia to those who have a prescription from their physician or other medical provider. The states include Arizona, Colorado, Florida, Georgia, Kentucky, Louisiana, Maine, North Carolina, New York, Pennsylvania, Utah, Virginia, and West Virginia. CVS will not offer COVID-19 vaccines in Massachusetts, Nevada, and New Mexico. According to 

, CVS will offer updated COVID-19 vaccines in the remaining states pending Advisory Committee on Immunization Practice (ACIP) guidelines. For Walgreens, patients need prescriptions for 16 states but not all of them overlap with CVS, and it is unclear which states include these 16, according to 

The FDA recently approved 4 updated COVID-19 vaccines: Pfizer and BioNTech’s Comirnaty, Novavax’s Nuvaxovid, and Moderna’s Spikevax and mNexspike. All have been approved for adults 65 years and older to prevent COVID-19. Other indications include

Nuvaxovid: for patients aged 12 years through 64 with at high risk of severe disease with least 1 underlying condition

Spikevax: for patients 6 months through 64 years at high risk of severe disease with at least 1 underlying condition

mNexspike: for patients aged 12 through 64 years at high risk of severe disease with at least 1 underlying condition

Comirnaty: for patients aged 5 through 64 years at high risk for severe disease with at least 1 underlying condition

Guidance and information on the upcoming 2025-2026 respiratory season have been met with confusion. Recommendations, which were once aligned across organizations, are now conflicting, which included government organizations, such as the CDC, as well as the health care organizations, such as the American Academy of Pediatrics (AAP). Pregnancy has been removed from the adult schedule, even though some health care providers consider it an underlying condition leading to severe disease.

“We need to take the politics out of immunizations and rely on medical experts with years of education, the experience, and the knowledge to interpret that data to provide evidence-based recommendations," Laura Knockel, PharmD, BCACP, clinical associate professor at the University of Iowa College of Pharmacy, said.

AAP published its annual immunization schedule, which covers guidance for influenza, respiratory syncytial virus, and COVID-19. Although recommendations from the organization typically follow ACIP guidelines, this year the schedule differs from the recent recommendations from the committee.

“[Patients are] understandably confused. The space around vaccines is changing so rapidly,” Knockel said.

 “There's so much misinformation and disinformation out there, so I really think the first step is to acknowledge that concern, and again, coming from the point of they want to do what's best for their child.”

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1. Astor M, Blum D. CDC uncertainty upends COVID vaccine access at CVS and Walgreens. 

. August 28, 2025. Accessed September 2, 2025. https://www.nytimes.com/2025/08/28/well/cvs-pharmacy-covid-vaccine-16-states.html

2. Levy S. CVS, Walgreens limiting offerings of new COVID-19 vaccines. 

. September 2, 2025. Accessed September 2, 2025. https://drugstorenews.com/cvs-walgreens-limiting-offerings-new-covid-19-vaccines

3. Gallagher A. FDA approves COVID-19 vaccines for patients 65 years and older. 

. August 23, 2025. Accessed September 2, 2025. https://www.drugtopics.com/view/fda-approves-covid-19-vaccines-for-patients-65-years-and-older

4. Gallagher A. New COVID-19 vaccine recommendations cause confusion among public, health care providers. 

. June 10, 2025. Accessed September 2, 2025. https://www.drugtopics.com/view/new-covid-19-vaccine-recommendations-cause-confusion-among-public-health-care-providers

5. Gallagher A, Knockel L. Q&A: pharmacist advocates for evidence-based immunization guidelines for COVID-19 vaccines. 

. September 1, 2025. Accessed September 2, 2025. https://www.drugtopics.com/view/q-a-pharmacist-advocates-for-evidence-based-immunization-guidelines-for-covid-19-vaccines

6. Gallagher A. FDA approves updated 2025-2026 COVID-19 vaccine for patients 65 years and older. 

. August 27, 2025. Accessed September 2, 2025. https://www.drugtopics.com/view/fda-approves-updated-2025-2026-covid-19-vaccine-for-patients-65-years-and-older

CVS will not offer COVID-19 vaccines in Massachusetts, Nevada, and New Mexico.

Clinical

CVS, Walgreens Will Limit COVID-19 Vaccine Offerings in 16 States

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.

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

Community-based approaches to diabetes and cardiovascular disease (CVD) management were found to improve health outcomes in predominantly Black communities, according to data from a study published in the 

Journal of the American Pharmacists Association

“Improved access to evidence-based chronic disease prevention and management programs, as well as increased access to affordable and nutritious food and safe spaces for exercise, are critical in underserved communities,” wrote the authors of the study. “Research suggests that pharmacists are the most accessible and frequently visited members of the health care team, and therefore essential in prevention and optimizing management of patients with chronic disease.”

With many concerted efforts to improve health care initiatives in low- and middle-income communities, pharmacists have established themselves as key providers to manage community-wide patient outcomes. According to findings published in 

Exploratory Research in Clinical and Social Pharmacy

, clinical evidence supports the pharmacist’s ability to improve economic, clinical, and humanistic outcomes through chronic disease management.

Q&A: Cross-Training Pharmacy Teams to Address Social Needs

Despite the expanding evidence of pharmacists’ crucial role in disease management, however, they are still significantly underrecognized as primary care providers in today’s health care landscape. With reports of a notable disconnect between patients and pharmacists,

 despite their sheer accessibility compared with other providers, experts are looking for alternative ways to properly employ pharmacists within an integrated chronic disease management team.

In the current study, researchers explored pharmacists’ abilities in a low-income community-focused program for improving diabetes and CVD outcomes among a majority of Black patients.

“The Prescription for Change (Rx for Change) program is a multifaceted, pharmacist-led, program created by Duquesne University's Center for Integrative Health (DUCIH), Center for Pharmacy Care (CPH), and School of Pharmacy as a response to the health disparities and high burden of chronic disease among the African American community in Pittsburgh,” they continued.

 “This pilot study hypothesizes that accessible, well-coordinated, and integrative approaches to diabetes and CVD prevention and management through [community-clinical linkages] will improve health outcomes in African American communities.”

To bolster evidence regarding pharmacists’ chronic disease prevention and management, researchers explored results from the Rx for Change pilot study, hypothesizing that the program would make a significantly positive impact on the Black community members of Pittsburgh’s Allegheny County.

Researchers recruited study participants from March 2021 to March 2022 and only enrolled patients who were 18 years or older; screened positive for prediabetes, diabetes, and/or hypertension; were Medicaid or Medicare recipients; and resided in one of the 4 included Allegheny County zip codes.

Those participating in the Rx for Change program experienced quarterly visits with a pharmacist, enrollment in chronic disease prevention and management programs, and support to implement a variety of pharmacist-led recommendations. All these actions required of study participants occurred during a 1-year study period. Researchers examined differences in demographics, clinical characteristics, program referrals, and overall participation of the study’s patients compared with baseline data.

The pilot study program included 52 participants (average age, 60.7 years; 82.7% women; 71.2% Black). Regarding previously recorded chronic disease instances, around 33% of patients reported previously diagnosed type 2 diabetes, 17.3% had prediabetes, and 51.9% had hypertension.

“The community-based implementation approach supported engagement of the target population,” wrote the authors.

 “Overall, patient engagement with the Rx for Change Program was excellent, with 82.7% of participants attending 60% [or more] of their scheduled quarterly visits with a pharmacist.”

Throughout the study year, a majority of participants attended at least 60% of their quarterly pharmacist visits, highlighting patients’ desires to seek chronic disease management to improve their diabetes and CVD outcomes. They also discovered improved hemoglobin A

Using results from the Rx for Change program in Pittsburgh, Pennsylvania, researchers explored an integrative approach to cardiometabolic disease management among Black patients.

Steve Riddle, PharmD, MSIM, FASHP, BCPS

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