{
  "abstract": "Background\n\nWe developed a novel, community pharmacy-based, pharmacist-driven atrial fibrillation (AF) stroke prevention model involving pharmacist prescription of oral anticoagulants (OAC) in Alberta, Canada. Generalizability to healthcare systems outside Canada is unknown.Objective\n\nWe recruited 5 California pharmacies for a proof-of-concept pilot study aimed at evaluating the prevalence of \"actionable\" AF and the feasibility, safety, and barriers to implementing a pharmacist OAC prescription program.Methods\n\nBefore implementation, pharmacist and physician stakeholders were surveyed to identify potential barriers. Pharmacists identified adults aged ≥60 years with a CHA2DS2-VASc score of ≥2 (men) or ≥3 (women), and \"actionable\" AF, defined as (1) untreated, (2) sub-optimally treated, or (3) inappropriately treated. Participants were enrolled in a 3-month intervention in which pharmacists optimized OAC. Participant satisfaction was assessed at 3 months. Safety endpoints were assessed at 6, 9, and 12 months. Pharmacist-reported implementation barriers were assessed at 1 and 3 months.Results\n\n\"Actionable\" AF prevalence ranged from 14% to 41%. A total of 14 participants were enrolled. At baseline, 50% of participants were untreated, whereas 50% were sub-optimally treated. At 3 months, 91% of participants were on guideline-concordant OAC therapy. There were no major bleeding events and no prescription overrides. Participants reported high satisfaction with pharmacist services. Perceived barriers reflected reported the following implementation challenges: (1) lack of time, (2) insufficient access to medical records, and (3) adequate reimbursement.Conclusion\n\nCommunity-based, pharmacist-driven OAC prescription offers an opportunity to effectively close gaps in stroke risk reduction therapy for patients with AF. Scalability in the United States will depend on policy and infrastructure changes that address implementation challenges.Trial registration\n\nClinicalTrials.gov Identifier: NCT04907825.",
  "abstract_shown": true,
  "affiliations": [
    "Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California.",
    "Sutter Medical Center-Sacramento, Sacramento, California.",
    "Kaiser Permanente, Department of Research & Evaluation, Los Angeles, California.",
    "University of Southern California, Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, Los Angeles, California.",
    "Mass General Brigham, Department of Cardiology, Boston, Massachusetts.",
    "University of Calgary, Libin Cardiovascular Institute, Calgary, Alberta, Canada."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ciantel Adair Blyler"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Elizabeth M Jones"
    },
    {
      "affs": [
        2
      ],
      "name": "Brian S Mittman"
    },
    {
      "affs": [
        3
      ],
      "name": "Steven W Chen"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Christine M Albert"
    },
    {
      "affs": [
        0,
        5
      ],
      "name": "Roopinder K Sandhu"
    },
    {
      "name": "APOTHECARY AF Collaborators"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1s1rsb00ex8w4.bib",
  "cited_by": 0,
  "doi": "10.1016/j.hroo.2026.07.012",
  "fulltext_url": "https://europepmc.org/articles/PMC13700374",
  "id": "1s1rsb00ex8w4",
  "issns": [
    "2666-5018"
  ],
  "landing_url": "https://europepmc.org/article/MED/42936080",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2705|Atrial Fibrillation Management and Outcomes"
    ]
  ],
  "openalex": "W7196985044",
  "pdf_url": "https://europepmc.org/articles/PMC13700374?pdf=render",
  "pmcid": "PMC13700374",
  "pmid": "42936080",
  "published": "2026-08-07",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/1s1rsb00ex8w4.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:22:24Z",
      "native_id": "MED:42936080",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42936080"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Atrial Fibrillation Management and Outcomes",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Pharmacist management of oral anticoagulation for atrial fibrillation in the community: The APOTHECARY AF study.",
  "title_text": "Pharmacist management of oral anticoagulation for atrial fibrillation in the community: The APOTHECARY AF study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:24Z",
  "url": "https://research.draconitic.com/paper/1s1rsb00ex8w4",
  "venue": "Heart rhythm O2",
  "versions": []
}