{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T02:49:26Z","timestamp":1791514166904,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Am Coll Clin Pharm"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anti\u2010amyloid therapies (AATs) for Alzheimer's disease complicate emergency stroke care due to the risk of amyloid\u2010related imaging abnormalities (ARIA), which can mimic acute ischemic stroke (AIS) and increase hemorrhagic risk. We evaluated emergency medicine (EM) providers' (physicians and advanced practice providers) and pharmacists' knowledge, confidence, and clinical decision\u2010making related to AAT\u2010associated ARIA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional, web\u2010based survey of EM providers and pharmacists practicing in United States hospital\u2010based emergency care settings between February and April 2026 was conducted. Survey domains included familiarity with AATs, confidence in ARIA recognition and management, clinical decision\u2010making, institutional preparedness, and barriers and facilitators to care. Results are reported descriptively, with subgroup comparisons between EM providers and pharmacists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Clinical experience with AAT\u2010related scenarios was limited among the 204 survey participants; 77.5% reported no prior modification of thrombolytic or anticoagulant therapy because of AATs. Self\u2010reported knowledge of AATs was low (mean 2.4\u2009\u00b1\u20091.3 on a five\u2010point scale), and confidence in recognizing and managing ARIA was limited. EM pharmacists reported greater knowledge and higher confidence in medication\u2010related decision\u2010making than EM providers. Frequent barriers were unfamiliarity with AAT and ARIA, diagnostic overlap with acute ischemic stroke, and limited institutional resources. Most (83.3%) reported a need for additional education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EM providers and pharmacists demonstrated substantial gaps in preparedness for patients receiving AATs, including limited knowledge, low confidence, minimal clinical experience, and inadequate institutional support. These findings highlight opportunities for pharmacist\u2010led education, clinical decision support, and multidisciplinary implementation strategies to improve safe management of AAT\u2010associated neurologic emergencies as therapies continue to expand.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jac5.70291","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:55:31Z","timestamp":1789106131000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Cross\u2010Sectional Survey of Knowledge, Confidence, and Decision\u2010Making in Acute Stroke in the Era of Anti\u2010Amyloid Therapies"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8355-5217","authenticated-orcid":false,"given":"Preeyaporn","family":"Sarangarm","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine University of New Mexico  Albuquerque New Mexico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7649-9624","authenticated-orcid":false,"given":"Nicole M.","family":"Acquisto","sequence":"additional","affiliation":[{"name":"Departments of Pharmacy and Emergency Medicine University of Rochester Medicine  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9661-0895","authenticated-orcid":false,"given":"David E.","family":"Zimmerman","sequence":"additional","affiliation":[{"name":"Duquesne University School of Pharmacy, School of Pharmacy Building  Pittsburgh Pennsylvania USA"},{"name":"Department of Pharmacy, UPMC Mercy Hospital  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8348-0422","authenticated-orcid":false,"given":"Adis","family":"Keric","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Regions Hospital  Saint Paul Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7280-4831","authenticated-orcid":false,"given":"Christian","family":"Kroll","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5759-9857","authenticated-orcid":false,"given":"Brett","family":"Faine","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Pharmacy University of Iowa  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6542-518X","authenticated-orcid":false,"given":"Megan A.","family":"Rech","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines  Hines Illinois USA"},{"name":"Skaggs School of Pharmacy and Pharmaceutical Sciences University of Colorado Anschutz Medical Campus  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"EMPHARM\u2010NET","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30499-X"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/neurolint17060092"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2212948"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.13239"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2100708"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2024.12.002"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.14223"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2021.5205"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000213483"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13195-024-01441-8"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000208096"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2215148"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/13554794.2025.2566151"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.14283\/jpad.2023.30"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000480"},{"issue":"2","key":"e_1_2_11_17_1","article-title":"Alzheimer's Disease Drug Development Pipeline: 2025","volume":"11","author":"Cummings J. 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