{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T17:27:29Z","timestamp":1767374849322,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T00:00:00Z","timestamp":1684540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacy"],"abstract":"<jats:p>Safe dispensing of coronavirus disease 2019 (COVID-19) oral antivirals requires comprehensive patient assessment to identify and address significant medication-related problems (MRPs). Given the fast-paced environment of community pharmacies and limited access to outside patient records, there are challenges with pharmacists ensuring the safe and appropriate dispensing of these medications. An independent community pharmacy in Pennsylvania developed and implemented a COVID-19 oral antiviral assessment protocol to systematically review all prescriptions dispensed for nirmatrelvir\/ritonavir (Paxlovid\u2122) and molnupiravir (Lagevrio\u2122) to identify and address MRPs. A retrospective review was conducted to assess documented MRPs, including significant drug\u2013drug interactions and inappropriate dosing requiring intervention, for prescriptions dispensed from 9 February 2022 to 29 April 2022. Pharmacists identified one or more significant MRPs requiring intervention on 42 of the 54 nirmatrelvir\/ritonavir prescriptions (78%) and 0 of the 7 molnupiravir prescriptions. Most pharmacist interventions involved drug\u2013drug interactions between nirmatrelvir\/ritonavir and HMG-CoA reductase inhibitors and calcium channel blockers, along with four renal dose adjustments for nirmatrelvir\/ritonavir. This study highlights the ability of community pharmacists to identify and address MRPs and promotes the use of a protocol to encourage safe dispensing practices for medications prone to MRPs.<\/jats:p>","DOI":"10.3390\/pharmacy11030087","type":"journal-article","created":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T02:28:42Z","timestamp":1684722522000},"page":"87","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Medication-Related Problems Identified and Addressed by Pharmacists Dispensing COVID-19 Antivirals at a Community Pharmacy"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8940-6298","authenticated-orcid":false,"given":"Danielle","family":"Kieck","sequence":"first","affiliation":[{"name":"Nesbitt School of Pharmacy, Wilkes University, 84 W South Street, Wilkes-Barre, PA 18766, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leeann","family":"Mahalick","sequence":"additional","affiliation":[{"name":"Nesbitt School of Pharmacy, Wilkes University, 84 W South Street, Wilkes-Barre, PA 18766, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thanh Truc","family":"Vo","sequence":"additional","affiliation":[{"name":"Nesbitt School of Pharmacy, Wilkes University, 84 W South Street, Wilkes-Barre, PA 18766, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1038\/s43588-020-00007-6","article-title":"Lessons from the COVID-19 Pandemic for Advancing Computational Drug Repurposing Strategies","volume":"1","author":"Galindez","year":"2021","journal-title":"Nat. Comput. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"825","DOI":"10.15585\/mmwr.mm7125e1","article-title":"Dispensing of Oral Antiviral Drugs for Treatment of COVID-19 by ZIP Code\u2013Level Social Vulnerability\u2014United States, December 23, 2021\u2013May 21, 2022","volume":"71","author":"Gold","year":"2022","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_3","unstructured":"(2023, March 30). CDC COVID Data Tracker, Available online: https:\/\/covid.cdc.gov\/covid-data-tracker\/."},{"key":"ref_4","unstructured":"COVID-19 Treatment Guidelines Panel (2023, March 30). Coronavirus Disease 2019 (COVID-19) Treatment Guidelines, Available online: https:\/\/www.covid19treatmentguidelines.nih.gov\/."},{"key":"ref_5","unstructured":"Office for Civil Rights (2023, March 30). Guidance on \u201cLong COVID\u201d as a Disability under the Ada, Section, Available online: https:\/\/www.hhs.gov\/civil-rights\/for-providers\/civil-rights-covid19\/guidance-long-covid-disability\/index.html."},{"key":"ref_6","unstructured":"Fact Sheet For Health Care Providers: Emergency Use Authorization for Paxlovid (Nirmatrelvir\/Ritonavir) (2023, March 30). Pfizer, Available online: https:\/\/www.fda.gov\/media\/155050\/download."},{"key":"ref_7","unstructured":"Fact Sheet For Health Care Providers: Emergency Use Authorization for Molnupiravir (2023, March 30). Merck & Co., Inc. Revised, Available online: https:\/\/www.fda.gov\/media\/155054\/download."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"11","DOI":"10.24926\/iip.v13i3.4961","article-title":"A Community Pharmacist\u2019s Guide to Oral COVID-19 Antivirals","volume":"13","author":"Melton","year":"2022","journal-title":"Innov. Pharm."},{"key":"ref_9","unstructured":"U.S. Department of Health & Human Services (2023, March 30). COVID-19 Public Therapeutic Locator, Available online: https:\/\/healthdata.gov\/Health\/COVID-19-Public-Therapeutic-Locator\/rxn6-qnx8."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2048","DOI":"10.1016\/j.clinthera.2009.09.009","article-title":"Completeness of Retail Pharmacy Claims Data: Implications for Pharmacoepidemiologic Studies and Pharmacy Practice in Elderly Patients","volume":"31","author":"Polinski","year":"2009","journal-title":"Clin. Ther."},{"key":"ref_11","unstructured":"Office of the Commissioner (2023, March 30). Coronavirus (COVID-19) Update: FDA Authorizes Additional Oral Antiviral for Treatment of COVID-19 in Certain Adults, Available online: https:\/\/www.fda.gov\/media\/155053\/download?mc_cid=53f1304cf4&mc_eid=0ebc9ec2e4."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1016\/j.japh.2022.07.003","article-title":"Access to Community Pharmacies: A Nationwide Geographic Information Systems Cross-Sectional Analysis","volume":"62","author":"Berenbrok","year":"2022","journal-title":"J. Am. Pharm. Assoc."},{"key":"ref_13","unstructured":"(2023, March 30). Inequity to COVID-19 Test to Treat Access\u2014Pharmacists Can Help If Permitted. Available online: https:\/\/www.pharmacist.com\/Advocacy\/Issues\/Inequity-to-COVID-19-Test-to-Treat-Access-Pharmacists-can-help-if-permitted."},{"key":"ref_14","unstructured":"Tariq, R.A., Vashisht, R., Sinha, A., and Scherbak, Y. (2023, March 30). Medication Dispensing Errors and Prevention\u2014Statpearls\u2014NCBI Bookshelf, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK519065\/."},{"key":"ref_15","unstructured":"(2023, March 30). Liverpool COVID-19 Interactions. Available online: https:\/\/www.covid19-druginteractions.org\/checker."},{"key":"ref_16","unstructured":"(2023, March 30). Underlying Medical Conditions Associated with Higher Risk for Severe COVID-19: Information for Healthcare Professionals, Available online: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/clinical-care\/underlyingconditions.html."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/S2213-2600(21)00068-0","article-title":"COVID-19: A Heavy Toll on Health-Care Workers","volume":"9","author":"Mehta","year":"2021","journal-title":"Lancet Respir. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2002","DOI":"10.1016\/j.sapharm.2020.07.001","article-title":"Impact of the COVID-19 Epidemic on the Provision of Pharmaceutical Care in Community Pharmacies","volume":"17","author":"Koster","year":"2021","journal-title":"Res. Soc. Adm. Pharm."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1016\/j.japh.2021.12.013","article-title":"Expanded Roles of Community Pharmacists in COVID-19: A Scoping Literature Review","volume":"62","author":"Pantasri","year":"2022","journal-title":"J. Am. Pharm. Assoc."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1177\/0897190020980626","article-title":"Community Pharmacists Roles during the COVID-19 Pandemic","volume":"35","author":"Hess","year":"2020","journal-title":"J. Pharm. Pract."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1111\/jrh.12439","article-title":"COVID-19: How Can Rural Community Pharmacies Respond to the Outbreak?","volume":"37","author":"Adunlin","year":"2021","journal-title":"J. Rural Health"},{"key":"ref_22","unstructured":"(2023, March 30). Medication Safety Issues with Newly Authorized Paxlovid. Available online: https:\/\/www.ismp.org\/alerts\/medication-safety-issues-newly-authorized-paxlovid."},{"key":"ref_23","unstructured":"(2023, March 30). Numerous Wrong Dose Errors with Paxlovid. Available online: https:\/\/www.ismp.org\/resources\/numerous-wrong-dose-errors-paxlovid."},{"key":"ref_24","unstructured":"(2023, March 30). PAXLOVID Patient Eligibility Screening Checklist Tool for Prescribers, Available online: https:\/\/www.fda.gov\/media\/158165\/download."},{"key":"ref_25","unstructured":"(2023, March 30). Molnupiravir Checklist Tool for Prescribers: Patient Eligibility, Available online: https:\/\/www.fda.gov\/media\/155118\/download."},{"key":"ref_26","unstructured":"SingleCare Team (2023, March 30). Medication Errors Statistics. Available online: https:\/\/www.singlecare.com\/blog\/news\/medication-errors-statistics\/."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1002\/jhm.1921","article-title":"Nurse-Pharmacist Collaboration on Medication Reconciliation Prevents Potential Harm","volume":"7","author":"Feldman","year":"2012","journal-title":"J. Hosp. Med."},{"key":"ref_28","unstructured":"Pulupa, K. (2023, March 30). Current State of the Health Center Workforce. Available online: https:\/\/www.nachc.org\/current-state-of-the-health-center-workforce\/."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Jaam, M., Naseralallah, L.M., Hussain, T.A., and Pawluk, S.A. (2021). Pharmacist-Led Educational Interventions Provided to Healthcare Providers to Reduce Medication Errors: A Systematic Review and Meta-Analysis. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0253588"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Lazer, D., Uslu, A., Qu, H., Santillana, M., Perlis, R., Ognyanova, K., Baum, M., Druckman, J., Trujillo, K.L., and Safarpour, A. (OSF, 2022). The COVID States Project #90: Utilization Rates of Antivirals for COVID-19, OSF, preprint.","DOI":"10.31219\/osf.io\/pvqwt"}],"container-title":["Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2226-4787\/11\/3\/87\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:39:16Z","timestamp":1760125156000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2226-4787\/11\/3\/87"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,20]]},"references-count":30,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["pharmacy11030087"],"URL":"https:\/\/doi.org\/10.3390\/pharmacy11030087","relation":{},"ISSN":["2226-4787"],"issn-type":[{"type":"electronic","value":"2226-4787"}],"subject":[],"published":{"date-parts":[[2023,5,20]]}}}