Prediabetes is highly prevalent in the United States affecting over 88 million adults. In 2010, the Centers for Disease Control and Prevention (CDC) established the National Diabetes Prevention Program (NDPP), an intensive lifestyle program consisting of a 16-lesson curriculum focused on diet, exercise, and behavior modification, with the ultimate goal to reduce progression from prediabetes to diabetes. Despite tens of millions of adults potentially qualifying to participate in the program, the uptake of the NDPP has been exceedingly low. As a result, the CDC has focused its efforts on engaging with local health departments and community partners, including community pharmacies, across the United States to scale-up enrollment in the NDPP. In this commentary we discuss factors affecting implementation of the NDPP in community pharmacies and other settings where pharmacists practice, including training, space, personnel, recruitment and enrollment, retention, and sustainability.

Objective: The Outcomes and Assessment Committee at the Virginia Commonwealth University School of Pharmacy was tasked with refining the school's key performance indicators (KPIs) to improve programmatic assessment by focusing on the most important measures. Methods: Initially, 56 KPIs were tracked, nine of which were university mandated, divided into 10 modules: admissions, community outreach, continuing education, diversity, faculty experience and success, fundraising, graduate program, research and scholarship, staff experience and success, and student experience and success. Using a three-round Delphi consensus technique, KPIs were reviewed by faculty and staff. Each participant responded whether they considered each KPI to be essential or not essential for school quality assessment and improvement. Consensus for the first, second, and third rounds was defined as ≥90%, ≥80%, and ≥75% agreement, respectively. Results: Of 109 faculty and staff invited, 49 participated in the first round, 51 in the second, and 42 in the third. At the end of the third round, accumulated consensus was achieved for 35 out of 88 (39.8%) KPIs that were considered essential and 3 out of 88 (3.4%) that were considered non-essential. Consensus percentage per module was: 15.4% (2/13) admissions, 28.6% (2/7) community outreach, 33.3% (3/9) continuing education, 27.3% (3/11) diversity, 62.5% (5/8) faculty experience and success, 55.6% (5/9) fundraising, 40% (4/10) graduate program, 33.3% (3/9) research and scholarship, 57.1% (4/7) staff experience and success, and 66.7% (4/6) student experience and success. Conclusions: Ultimately, 35 KPIs achieved consensus as essential to measure achievement of benchmarks for the school, which totals 44 KPIs, including nine university mandated KPIs. The process facilitated faculty and staff involvement in KPI selection and achieved improved focus for programmatic assessment.

The United States (US) has a complex healthcare system with a mix of public, private, nonprofit, and for-profit insurers, healthcare institutions and organizations, and providers. Unlike other developed countries, there is not a single payer healthcare system or a national pharmaceutical benefits scheme/plan. Despite spending over USD 10,000 per capita in healthcare, the US is among the worst performers compared to other developed countries in outcomes including life expectancy at birth, infant mortality, safety during childbirth, and unmanaged chronic conditions (e.g., asthma, diabetes). Primary care is delivered by physicians and advanced practice providers (i.e., nurse practitioners and physician assistants) in a variety of settings including large health systems, federally qualified health centers or free clinics that provide care to the underserved, or specific facilities for veterans or American Indian and Alaska native peoples. Since 2010, primary care delivery has shifted toward providing patient-centered, coordinated, comprehensive care focused on providing proactive, rather than reactive, population health management, and on the quality, versus volume, of care. Community pharmacy comprises a mix of independently owned, chain, supermarket and mass merchant pharmacies. Community pharmacies provide services such as immunizations, medication therapy management, medication packaging, medication synchronization, point-of-care testing and, in specific states where legislation has been passed, hormonal contraception, opioid reversal agents, and smoking cessation services. There has been criticism regarding the lack of standard terminology for services such as medication synchronization and medication therapy management, their components and how they should be provided, which hampers comparability across studies. One of the main challenges for pharmacists in the US is the lack of provider status at the federal level. This means that pharmacists are not allowed to use existing fee-for-service health insurance billing codes to receive reimbursement for non-dispensing services. In addition, despite there being regulatory infrastructure in multiple states, the extent of service implementation is either low or unknown. Research found that pharmacists face numerous barriers when providing some of these services. State fragmentation and the lack of a single pharmacy organization and vision for the profession are additional challenges.

Abstract Peer review provides the foundation for the scholarly publishing system. The conventional peer review system consists of using authors of articles as reviewers for other colleagues' manuscripts in a collaborative-basis system. However, authors complain about a theoretical overwhelming number of invitations to peer review. It seems that authors feel that they are invited to review many more manuscripts than they should when taking into account their participation in the scholarly publishing system. The high number of scientific journals and the existence of predatory journals were reported as potential causes of this excessive number of reviews required. In this editorial, we demonstrate that the number of reviewers required to publish a given number of articles depends exclusively on the journals' rejection rate and the number of reviewers intended per manuscript. Several initiatives to overcome the peer review crises are suggested.

Telemedicine refers to the delivery of clinical services using technology that allows two-way, real time, interactive communication between the patient and the clinician at a distant site. Commonly, telemedicine is used to improve access to general and specialty care for patients in rural areas. This review aims to provide an overview of existing telemedicine models involving the delivery of care by pharmacists via telemedicine (including telemonitoring and video, but excluding follow-up telephone calls) and to highlight the main areas of chronic-disease management where these models have been applied. Studies within the areas of hypertension, diabetes, asthma, anticoagulation and depression were identified, but only two randomized controlled trials with adequate sample size demonstrating the positive impact of telemonitoring combined with pharmacist care in hypertension were identified. The evidence for the impact of pharmacist-based telemedicine models is sparse and weak, with the studies conducted presenting serious threats to internal and external validity. Therefore, no definitive conclusions about the impact of pharmacist-led telemedicine models can be made at this time. In the Unites States, the increasing shortage of primary care providers and specialists represents an opportunity for pharmacists to assume a more prominent role managing patients with chronic disease in the ambulatory care setting. However, lack of reimbursement may pose a barrier to the provision of care by pharmacists using telemedicine.

CONTEXTO E OBJETIVO O Beliefs about Medicines Questionnaire (BMQ-Específico) tem se mostrado útil na mensuração sobre as crenças dos pacientes e associando-os à não adesão ao tratamento em vários grupos de doença. O objetivo foi realizar a adaptação transcultural do BMQ-Específico em Português para a população geral de usuários de medicamentos. TIPO DE ESTUDO E LOCAL Estudo transversal conduzido com usuários de hospitais públicos e clínicas ambulatoriais em Guarda e Covilhã, Portugal. MÉTODOS O BMQ-Específico foi traduzido utilizando-se recomendações internacionais para realizar a adaptação transcultural e foi administrado a 300 pacientes. Uma primeira análise de componentes principais (ACP) com critério de extração eigenvalue > 1.0 foi realizada, seguida de uma segunda ACP com restrição para dois componentes. A confiabilidade foi avaliada calculando-se o coeficiente alfa de Cronbach. RESULTADOS Os escores médios obtidos para as subescalas de Necessidade e Preocupação do BMQ-específico em Português foram de 19,9 (desvio padrão, DP = 2,8; intervalo 10 a 25) e 17,7 (DP = 3,9; intervalo 6 a 30), respectivamente. A primeira ACP produziu estrutura instável de três componentes para o BMQ-específico em português. A solução final de ACP produziu estrutura de dois componentes idênticos à versão original em inglês (subescala de Necessidade de 5 itens e subescala de Preocupação de 6 itens), explicando 44% da variância. Alfa de Cronbach para o BMQ-Específico em Português completo foi de 0,70, sendo 0,76 e 0,67 para as subescalas de Necessidade e Preocupação, respectivamente. CONCLUSÃO A versão adaptada do questionário BMQ-Específico em português para ser utilizada na população em geral dos usuários de medicamentos foi obtida, apresentando boa consistência interna e estrutura do componente idêntica à versão original em inglês.

CONTEXT AND OBJECTIVES The Beliefs about Medicines Questionnaire (BMQ-Specific) has proven useful for measuring patients' beliefs and associating them with non-adherence to treatment in several illness groups. The aim was to cross-culturally adapt the BMQ-Specific into Portuguese for the general population of medicine users. DESIGN AND SETTING Cross-sectional study conducted among users of public hospitals and outpatient clinics in Guarda and Covilhã, Portugal. METHODS The BMQ-Specific was translated using international recommendations for performing cross-cultural adaptation and was administered to 300 patients. An initial principal component analysis (PCA) was conducted with the extraction criterion of eigenvalue > 1.0, followed by a second PCA with restriction to two components. Reliability was assessed by calculating Cronbach's alpha coefficient. RESULTS The mean scores obtained for the Necessity and Concerns subscales of the Portuguese BMQ-Specific were 19.9 (standard deviation, SD = 2.8) (range 10 to 25) and 17.7 (SD = 3.9) (range 6 to 30), respectively. The first PCA produced an unstable three-component structure for the Portuguese BMQ-Specific. The final PCA solution yielded a two-component structure identical to the original English version (a five-item Necessity and a six-item Concerns subscale), and explained 44% of the variance. Cronbach's alpha for the complete Portuguese BMQ-Specific was 0.70, and 0.76 and 0.67 for the Necessity and Concerns subscales, respectively. CONCLUSION A cross-culturally adapted Portuguese version of the BMQ-Specific questionnaire for use among the general population of medicine users was obtained, presenting good internal consistency and component structure identical to the original English version.