The interagency care team: A new model to integrate social and medical care for older adults in primary care.

To integrate management of social drivers of health with complex clinical needs of older adults, we connected patients aged 60 and above from primary care practices with a nurse practitioner (NP) led Interagency Care Team (ICT) of geriatrics providers and community partners via electronic consult. The NP conducted a geriatric assessment via telephone, then the team met to determine recommendations. Thirteen primary care practices referred 123 patients (median age = 76) who had high rates of emergency department use and hospitalization (28.9% and 17.4% respectively). Issues commonly identified included medication management (84%), personal safety (72%), disease management (69%), food insecurity (63%), and cognitive decline (53%). Referring providers expressed heightened awareness of older adults' social needs and high satisfaction with the program. The ICT is a scalable model of care that connects older adults with complex care needs to geriatrics expertise and community services through partnerships with primary care providers.

Medication Access in America and Medicare Part D: Prescription Shopping Saves but May Be Costly.

This article is a reflection of some of the changes we have witnessed in pharmacy over the years, including the rise in medication use and prices and the transformation of how medicines are paid for in the United States, with growing concern over pricing transparency. We discuss the complex Medicare Part D prescription drug benefit, how enrollees can save by comparing plans annually, and the influence of preferred pharmacies. We review options for medication assistance other than Part D and share our belief that, although Medicare Part D has dramatically improved access to medicines, more needs to be done to decrease Medicare's and individuals' out-of-pocket spending and, as importantly, to ensure that medicines are doing more good than harm.

The pharmacist as a primary care provider for the medically underserved.

Opportunities abound for pharmacists to expand their practices by providing clinical services or assuring access to affordable pharmaceuticals to the medically underserved. The PSSC is a recently established resource at APhA that provides the pharmacy community and HRSA grantees with information and technical assistance on HRSA programs and projects. By participating in HRSA demonstration projections, pharmacists can implement much greatly needed patient care services to reduce disparities in health care. Becoming a 340B-contracted pharmacy can help pharmacists build prescription volume, expand their clinical services, and better serve the health care needs of their communities.

First-line pharmacotherapy for tobacco use and dependence.

First-line pharmacotherapies for tobacco use and dependence (namely, nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, and sustained-release bupropion) are safe and have been empirically determined to be efficacious and should always be considered part of a tobacco treatment intervention program unless contraindicated. Studies published subsequent to the literature synthesized in TTUD support previously determined efficacy of first-line pharmacologic medications for treatment of tobacco use and dependence. Further studies will be necessary to define clearly the efficacy and relative safety of combination treatments.