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Articles

As continuous glucose monitoring becomes more common, pharmacists are essential in patient education but face barriers of time, training, and reimbursement.

Q&A: Pharmacists Play Key Role in Expanding Access to CGMs

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

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

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Mark Cuban’s Cost Plus Drugs business has entered into agreements with Capital Blue Cross and Rightway.

Cost Plus Drugs Making Deals with Payers

Two reports show that drug-related deaths are skyrocketing among people 65 years and older.

Drug-related Deaths in Older Adults on the Rise

EmsanaRx, a pharmacy benefit manager launched by the Purchaser Business Group on Health, started operations in January.

Employers Launch EmsanaRx PBM 

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 

 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

A majority of clinicians reported a lack of confidence when helping adolescents access abortion, especially in states with post-

 restrictions, according to study data published in 

Dobbs v Jackson Women’s Health Organization

 drastically altered abortion access in the US, with 24 states currently characterized as having substantially restrictive abortion policies,” wrote authors of the study. “Adolescents’ barriers to abortion pre-

 (eg, travel challenges, financial constraints, and confidentiality concerns) are likely further exacerbated by additional restrictions.”

 issues of abortion access and rights have been heavily debated. But aside from the moral standings behind the politicization of abortion in the US, the pressures toward access have correlated with an overall decrease in abortions since 2013.

Equipping Pharmacists for Evidence-Based Abortion Medication Access

CDC data show that abortion rates decreased during 2013-2022. With patients under 15 accounting for the lowest rates of abortion, questions and concerns regarding abortion access for adolescents have risen.

“Minor adolescents face significant barriers to abortion care due to travel challenges, financial constraints, limited access to medication abortion, and parental notification and consent requirements limiting confidentiality,” according to authors of a study published in the 

 “While most adolescents have [the] developmental capacity to make independent health care decisions, they may have less experience navigating reproductive health care decisions than older individuals, potentially needing tailored education and resources when seeking abortion.”

According to the study’s data, adolescents have the highest abortion ratio of any age group despite only representing a small portion of all individuals seeking abortions each year. With at least 50,000 individuals under 19 seeking abortion access annually and the perceived barriers this age group commonly faces, researchers were led to explore the provider side of adolescent abortion access.

“Little is known about clinicians’ ability to help their adolescent patients navigate abortion access, including making referrals and assisting with other logistics, in the increasingly complicated post-

 landscape,” continued authors of the 

 “Our study addresses this gap by examining US clinicians’ confidence [in] helping adolescent patients access abortion, comparing clinicians in states with and without post-

In the study, researchers conducted an online, cross-sectional survey for clinicians who commonly serve adolescent patients. Survey respondents included physicians, physician assistants, nurse practitioners, midwives, nurses, social workers, case managers, family planning counselors, abortion fund workers and volunteers, abortion hotline workers and volunteers, and community health workers.

The researchers’ first objective was to understand the self-reported confidence of providers in helping adolescents facilitate access to abortions in a post-

 US. They also sought to uncover providers’ confidence in interpreting abortion laws in their respective states.

They surveyed 188 providers (87% women; 74% practiced in states with no post-

 restrictions) between September and December of 2024.

Unsurprisingly, participants who lived in states without post-

restrictions exhibited more confidence than those in states with existing restrictions. Furthermore, respondents in post-

 restriction states were also less confident in their states’ abortion laws than clinicians living in states with no restrictions.

“Many clinicians lack confidence helping adolescents navigate common logistics of abortion access, including gestational limits, available telehealth, parental involvement requirements, judicial bypass, cost, and appointment logistics,” they wrote.

 “Those providing care in restricted settings demonstrated lower confidence in their ability to help adolescents find an abortion provider and determine appointment logistics as compared [with] those not facing such restrictions.”

Survey organizers and authors of the study were not surprised by the results. They believe the lack of confidence in clinicians from restricted states, as opposed to those in states with no restrictions, is due to the overall impact of post-

laws and the confusion caused by constantly updated statutes.

Amid this significant lack of confidence among US clinicians, opportunities for pharmacists to exhibit themselves as abortion care providers have grown increasingly prominent. 

"Pharmacists can really work within a health care system to be an advocate for evidence-based medication care and evidence-based medication abortion care," Nicole Cieri-Hutcherson, PharmD, BCPS, MSCP, FCCP, clinical associate professor at the University at Buffalo, told 

 "They can provide their expertise in terms of protocol development, guideline development, and advocacy work in ensuring access to medication abortion."

The lack of confidence among clinicians opens a door for pharmacists to help boost overall access to abortions. In the case of community pharmacists, the most accessible health care providers in the US,

 their pharmacy locations can make a significant difference for adolescents seeking an abortion.

“Clinicians’ lack of confidence [in] helping adolescents access abortion, regardless of state-level abortion laws, is concerning given adolescents’ reliance on clinicians for reliable abortion information,” the authors concluded.

 “Interventions must be developed across all states to increase clinician confidence in their ability to support their patients’ abortion access in the post-

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

1. Bryson AE, Oberman M, Lehmann LS, et al. Navigating a new frontier: an exploratory study of clinicians’ confidence in their ability to help adolescents access abortion post-Dobbs. 

2. US Supreme Court takes away the constitutional right to abortion. Center for Reproductive Rights. June 24, 2022. Accessed August 6, 2025. 

https://reproductiverights.org/supreme-court-takes-away-right-to-abortion/

3. Ramer S, Nguyen AT, Hollier LM, et al. Abortion surveillance — United States, 2022. 

4. Hoopes AJ, Maslowsky J, Baca MA, et al. Elevating the needs of minor adolescents in a landscape of reduced abortion access in the United States. 

. 2022;71(5):530-532. doi:10.1016/j.jadohealth.2022.08.007

5. Meara K, Cieri-Hutcherson N. Q&A: Pharmacists help close gaps in abortion medication access. 

. June 30, 2025. Accessed August 19, 2025. 

https://www.drugtopics.com/view/q-a-pharmacists-help-close-gaps-in-abortion-medication-access

6. Valliant SN, Burbage SC, Pathak S, Urick BY. Pharmacists as accessible health care providers: quantifying the opportunity. 

. 2022;28(1):85-90. doi:=10.18553/jmcp.2022.28.1.85

Researchers gathered a group of adolescent-serving clinicians and asked them about their confidence in helping patients with abortion access.

Susan Ladika

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