Pub Date : 2026-03-03DOI: 10.3390/pharmacy14020041
Jessica Pace, Andrew Bartlett, Tiffany Iu, Jonathan Penm
(1) Background: Simulation is an effective way to develop practical pharmacy skills; combining simulation and self-reflection can increase impacts on learning. While existing literature highlights the benefits of reflection in developing self-awareness, critical thinking, and professional skills, there are few specific insights into how reflective practices enhance learning in patient counselling role-plays. This study aimed to explore pharmacy students' perceptions of self-reflection and peer and educator feedback on the development of patient counselling skills. (2) Methods: Thematic analysis of student reflections on learning in patient counselling activities. Responses to four structured self-reflection prompts were collected and analyzed thematically. (3) Results: Reflections from 201 students were analyzed. We identified four themes and ten associated subthemes: impact of peer feedback (subthemes supportive peer dynamics and developing a personal counselling style through peer practice); impact of self-reflection and assessment (subthemes goal setting through self-reflection and video review as a tool for skill refinement); impact of educator feedback (subthemes feedback variation in learning growth and addressing self-doubt); and professional identity (subthemes value pharmacists can bring, struggles in real-life practice, incorporating feedback to working opportunities, and reinforcing skills to self-reflect in future practice). (4) Conclusions: Integrating consistent, high-quality feedback from educators and peers with self-reflection in patient counselling activities is perceived as valuable to enhancing enhances students' learning experiences and preparing them for professional practice.
{"title":"Pharmacy Students' Perceptions of Self-Reflection and Peer and Educator Feedback on the Development of Patient Counselling Skills: A Qualitative Analysis.","authors":"Jessica Pace, Andrew Bartlett, Tiffany Iu, Jonathan Penm","doi":"10.3390/pharmacy14020041","DOIUrl":"10.3390/pharmacy14020041","url":null,"abstract":"<p><p>(1) Background: Simulation is an effective way to develop practical pharmacy skills; combining simulation and self-reflection can increase impacts on learning. While existing literature highlights the benefits of reflection in developing self-awareness, critical thinking, and professional skills, there are few specific insights into how reflective practices enhance learning in patient counselling role-plays. This study aimed to explore pharmacy students' perceptions of self-reflection and peer and educator feedback on the development of patient counselling skills. (2) Methods: Thematic analysis of student reflections on learning in patient counselling activities. Responses to four structured self-reflection prompts were collected and analyzed thematically. (3) Results: Reflections from 201 students were analyzed. We identified four themes and ten associated subthemes: impact of peer feedback (subthemes supportive peer dynamics and developing a personal counselling style through peer practice); impact of self-reflection and assessment (subthemes goal setting through self-reflection and video review as a tool for skill refinement); impact of educator feedback (subthemes feedback variation in learning growth and addressing self-doubt); and professional identity (subthemes value pharmacists can bring, struggles in real-life practice, incorporating feedback to working opportunities, and reinforcing skills to self-reflect in future practice). (4) Conclusions: Integrating consistent, high-quality feedback from educators and peers with self-reflection in patient counselling activities is perceived as valuable to enhancing enhances students' learning experiences and preparing them for professional practice.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-02DOI: 10.3390/pharmacy14020040
Stephanie W K Teoh, Tamara Lebedevs, Geena Dickson, Marcus Femia, Nabeelah Mukadam
(1) Background: Medication-related problems (MRPs) are a significant burden on health care systems. Pharmacists play an important role in preventing and reducing MRPs through clinical review, education, and policy governance. This study analyzed pharmacist interventions within a 92-bed neonatal clinical care unit to better understand MRPs and guide targeted medication safety initiatives. (2) Methods: All pharmacist interventions documented in REDCap® between 1 July 2022 and 30 June 2025 were analyzed identifying MRP incidence, types, and acceptability following interventions. (3) Results: A total of 873 pharmacist interventions were recorded during the study period. The most common MRPs were related to dosing errors (320/873, 36.7%), compliance with hospital policy (152/873, 17.4%), no indication apparent (106/873, 12.1%), drug interactions (66/873, 7.6%), and inadequate laboratory monitoring (40/873, 4.6%). Of these, 545/873, 62.4% were accepted by prescribers, while 228/873, 26.1% had unknown outcomes at the time of data entry. 343/873, 39.3% of interventions documented were from the Neonatal Intensive Care Unit, involving medications such as gentamicin (n = 46/343, 13.4%), benzylpenicillin (n = 37/343, 10.8%), caffeine (n = 34/343, 9.9%), parenteral nutrition (n = 23/343, 6.7%), and morphine (n = 16/343, 4.7%) and meropenem (n = 16/343, 4.7%)). (4) Conclusions: Regular analysis of pharmacist interventions provides valuable insights into local MRP trends and highlights opportunities for quality improvement and education.
{"title":"Analysis of Pharmacist Interventions to Reduce Medication-Related Problems in a Neonatal Clinical Care Unit.","authors":"Stephanie W K Teoh, Tamara Lebedevs, Geena Dickson, Marcus Femia, Nabeelah Mukadam","doi":"10.3390/pharmacy14020040","DOIUrl":"10.3390/pharmacy14020040","url":null,"abstract":"<p><p>(1) Background: Medication-related problems (MRPs) are a significant burden on health care systems. Pharmacists play an important role in preventing and reducing MRPs through clinical review, education, and policy governance. This study analyzed pharmacist interventions within a 92-bed neonatal clinical care unit to better understand MRPs and guide targeted medication safety initiatives. (2) Methods: All pharmacist interventions documented in REDCap<sup>®</sup> between 1 July 2022 and 30 June 2025 were analyzed identifying MRP incidence, types, and acceptability following interventions. (3) Results: A total of 873 pharmacist interventions were recorded during the study period. The most common MRPs were related to dosing errors (320/873, 36.7%), compliance with hospital policy (152/873, 17.4%), no indication apparent (106/873, 12.1%), drug interactions (66/873, 7.6%), and inadequate laboratory monitoring (40/873, 4.6%). Of these, 545/873, 62.4% were accepted by prescribers, while 228/873, 26.1% had unknown outcomes at the time of data entry. 343/873, 39.3% of interventions documented were from the Neonatal Intensive Care Unit, involving medications such as gentamicin (<i>n</i> = 46/343, 13.4%), benzylpenicillin (<i>n</i> = 37/343, 10.8%), caffeine (<i>n</i> = 34/343, 9.9%), parenteral nutrition (<i>n</i> = 23/343, 6.7%), and morphine (<i>n</i> = 16/343, 4.7%) and meropenem (<i>n</i> = 16/343, 4.7%)). (4) Conclusions: Regular analysis of pharmacist interventions provides valuable insights into local MRP trends and highlights opportunities for quality improvement and education.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-02DOI: 10.3390/pharmacy14020039
Dušan Vukmirović, Dušanka Krajnović, Marina Odalović
Diabetes mellitus is a growing global health challenge, and digital health technologies offer new opportunities to support self-management. Mobile applications can benefit both patients and healthcare professionals; however, awareness and integration of these tools into community pharmacy practice remain limited. As accessible frontline providers, pharmacists are well positioned to promote digital health, yet their readiness and engagement require further investigation. A cross-sectional survey was conducted among community pharmacists in Serbia using a structured questionnaire. Developed through a consensus-based process, the instrument assessed pharmacists' awareness, attitudes, and experiences with digital health technologies, focusing on mobile applications for diabetes self-management. Only 15.8% of pharmacists were aware of such applications, and 2.4% reported receiving relevant training. Higher digital health technology literacy was associated with greater awareness, confidence, and preference for digital learning. Most participants supported expanding pharmacists' roles in advising patients on digital tools and expressed interest in structured education and official guidance. These findings indicate limited awareness and training in mobile health applications among community pharmacists. Enhancing digital competencies through targeted education and structured guidance may facilitate greater integration of digital tools into routine pharmacy practice and strengthen pharmacists' roles in chronic disease management.
{"title":"Exploring Community Pharmacists' Awareness, Attitudes, and Experiences with Digital Health Technologies: A Focus on Mobile Applications for Diabetes Mellitus Self-Management.","authors":"Dušan Vukmirović, Dušanka Krajnović, Marina Odalović","doi":"10.3390/pharmacy14020039","DOIUrl":"10.3390/pharmacy14020039","url":null,"abstract":"<p><p>Diabetes mellitus is a growing global health challenge, and digital health technologies offer new opportunities to support self-management. Mobile applications can benefit both patients and healthcare professionals; however, awareness and integration of these tools into community pharmacy practice remain limited. As accessible frontline providers, pharmacists are well positioned to promote digital health, yet their readiness and engagement require further investigation. A cross-sectional survey was conducted among community pharmacists in Serbia using a structured questionnaire. Developed through a consensus-based process, the instrument assessed pharmacists' awareness, attitudes, and experiences with digital health technologies, focusing on mobile applications for diabetes self-management. Only 15.8% of pharmacists were aware of such applications, and 2.4% reported receiving relevant training. Higher digital health technology literacy was associated with greater awareness, confidence, and preference for digital learning. Most participants supported expanding pharmacists' roles in advising patients on digital tools and expressed interest in structured education and official guidance. These findings indicate limited awareness and training in mobile health applications among community pharmacists. Enhancing digital competencies through targeted education and structured guidance may facilitate greater integration of digital tools into routine pharmacy practice and strengthen pharmacists' roles in chronic disease management.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-02DOI: 10.3390/pharmacy14020038
Sepideh Sharif, Carla Dillon, Shane Scahill, Carlo Marra
Introduction: This repeated cross-sectional study examined community pharmacies in Aotearoa New Zealand and the services they provide, including retail, dispensing, and expanded scope services (e.g., minor ailment management).
Methods: Two cross-sectional surveys were conducted in 2021 (n = 504) and 2023 (n = 1000). Both assessed demographics, service use, and perceptions of pharmacists. The 2021 survey focused on trust, approachability, and role awareness, while the 2023 survey added willingness to pay, telehealth use, and comparisons with other health professionals. Best-Worst Scaling and logistic regression quantified and compared preferences.
Results: Prescription filling remained the most preferred service, while beauty product sales were least preferred. Preference for vaccination declined, indicating post-pandemic shifts in preventive care. Trust in pharmacists remained high, with strong comfort discussing health needs. Awareness of pharmacist roles improved slightly, though cost barriers persisted.
Conclusions: Consumer priorities for prescription services remained stable, while interest in vaccination declined. The low preference for non-clinical retail activities suggests pharmacies should focus on health services. The high trust in pharmacists supports expanded clinical roles, but targeted policies and funding are needed to reduce cost barriers and enhance equitable access to primary healthcare.
{"title":"Impact of the COVID-19 Pandemic on Community Pharmacy Services in New Zealand: A Repeated Cross-Sectional Best-Worst Scaling Analysis.","authors":"Sepideh Sharif, Carla Dillon, Shane Scahill, Carlo Marra","doi":"10.3390/pharmacy14020038","DOIUrl":"10.3390/pharmacy14020038","url":null,"abstract":"<p><strong>Introduction: </strong>This repeated cross-sectional study examined community pharmacies in Aotearoa New Zealand and the services they provide, including retail, dispensing, and expanded scope services (e.g., minor ailment management).</p><p><strong>Methods: </strong>Two cross-sectional surveys were conducted in 2021 (n = 504) and 2023 (n = 1000). Both assessed demographics, service use, and perceptions of pharmacists. The 2021 survey focused on trust, approachability, and role awareness, while the 2023 survey added willingness to pay, telehealth use, and comparisons with other health professionals. Best-Worst Scaling and logistic regression quantified and compared preferences.</p><p><strong>Results: </strong>Prescription filling remained the most preferred service, while beauty product sales were least preferred. Preference for vaccination declined, indicating post-pandemic shifts in preventive care. Trust in pharmacists remained high, with strong comfort discussing health needs. Awareness of pharmacist roles improved slightly, though cost barriers persisted.</p><p><strong>Conclusions: </strong>Consumer priorities for prescription services remained stable, while interest in vaccination declined. The low preference for non-clinical retail activities suggests pharmacies should focus on health services. The high trust in pharmacists supports expanded clinical roles, but targeted policies and funding are needed to reduce cost barriers and enhance equitable access to primary healthcare.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-13DOI: 10.3390/pharmacy14010037
Ashim Malhotra
As pharmacy career pathways diversify, professional doctoral programs such as PharmD face increasing pressure to demonstrate measurable workforce readiness outcomes within accreditation-constrained curricula. This study describes and evaluates PharmReaDy, a longitudinal, theory-informed workforce readiness platform embedded within a U.S. PharmD program. Guided by Tinto's student retention framework, the platform integrates curricular, co-curricular, and experiential elements, including an industry-focused elective course, national professional competitions, targeted skills workshops, micro-credentialing opportunities, and experiential placements. Outcomes were assessed using enrollment trends, aggregate course evaluation data, academic performance indicators, and downstream participation in industry-aligned opportunities. Enrollment in the elective increased from 8 to 20 to 30 students across three offerings. Mean course evaluation scores across seven learning domains remained consistently high, ranging from 3.7 to 3.9 on a 4-point scale, with no statistically significant differences between cohorts (Welch's t-tests, adjusted p > 0.05) and small positive effect sizes observed over time (Hedges' g ≈ 0.20-0.29). Students demonstrated strong academic performance and increased participation in industry-focused competitions, scholarships, and post-graduate fellowship pathways. Findings from PharmReaDy indicate that workforce readiness can be meaningfully operationalized as a structured educational function embedded within professional curricula rather than being exclusively deferred to post-graduate training.
{"title":"<i>PharmReaDy</i>: A Longitudinal Platform for Industry Career Preparation for Student Pharmacists in the U.S.","authors":"Ashim Malhotra","doi":"10.3390/pharmacy14010037","DOIUrl":"10.3390/pharmacy14010037","url":null,"abstract":"<p><p>As pharmacy career pathways diversify, professional doctoral programs such as PharmD face increasing pressure to demonstrate measurable workforce readiness outcomes within accreditation-constrained curricula. This study describes and evaluates <i>PharmReaDy</i>, a longitudinal, theory-informed workforce readiness platform embedded within a U.S. PharmD program. Guided by Tinto's student retention framework, the platform integrates curricular, co-curricular, and experiential elements, including an industry-focused elective course, national professional competitions, targeted skills workshops, micro-credentialing opportunities, and experiential placements. Outcomes were assessed using enrollment trends, aggregate course evaluation data, academic performance indicators, and downstream participation in industry-aligned opportunities. Enrollment in the elective increased from 8 to 20 to 30 students across three offerings. Mean course evaluation scores across seven learning domains remained consistently high, ranging from 3.7 to 3.9 on a 4-point scale, with no statistically significant differences between cohorts (Welch's <i>t</i>-tests, adjusted <i>p</i> > 0.05) and small positive effect sizes observed over time (Hedges' <i>g</i> ≈ 0.20-0.29). Students demonstrated strong academic performance and increased participation in industry-focused competitions, scholarships, and post-graduate fellowship pathways. Findings from <i>PharmReaDy</i> indicate that workforce readiness can be meaningfully operationalized as a structured educational function embedded within professional curricula rather than being exclusively deferred to post-graduate training.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-12DOI: 10.3390/pharmacy14010034
Ashim Malhotra
Critical thinking is emphasized across ACPE Standards 2025, the Pharmacist Patient Care Process, interprofessional education (IPE) frameworks, and licensure preparation (NAPLEX). Despite this, pharmacy education lacks a practical, theory-grounded framework that operationalizes critical thinking as an observable, assessable reasoning process, particularly in team-based and interprofessional contexts. We developed the AIM (Analyze-Interpret-Manage) framework by integrating the Delphi Consensus definition of critical thinking with the AAC&U VALUE framework, translating foundational theory into a concise, measurable, stage-based model applicable to both individual and collective cognition. AIM was tested using qualitative analysis of transcripts of student team discursive narratives of an assigned IPE scenario. Reasoning behaviors were coded by AIM stage and mapped to the 2016 IPEC Core Competencies and the 2025 NAPLEX competencies to ensure professional relevance and external validity. AIM reliably distinguished discrete stages of critical thinking across teams, revealing consistent patterns in how learners analyzed information, interpreted clinical and ethical significance, and managed decisions collaboratively. Mapping demonstrated strong alignment between AIM stages and IPEC and NAPLEX competencies. Our novel AIM framework offers a scalable approach for defining, teaching, and assessing team-based critical thinking in pharmacy education. By operationalizing critical thinking as a staged reasoning process aligned with professional standards, AIM fills a critical gap between educational theory, interprofessional practice, and licensure preparation.
{"title":"<i>AIM</i> (Analyze-Interpret-Manage): A Novel NAPLEX-Aligned Analytical Assessment Framework for Measuring Individual and Team Critical Thinking Using Generative AI.","authors":"Ashim Malhotra","doi":"10.3390/pharmacy14010034","DOIUrl":"10.3390/pharmacy14010034","url":null,"abstract":"<p><p>Critical thinking is emphasized across ACPE Standards 2025, the Pharmacist Patient Care Process, interprofessional education (IPE) frameworks, and licensure preparation (NAPLEX). Despite this, pharmacy education lacks a practical, theory-grounded framework that operationalizes critical thinking as an observable, assessable reasoning process, particularly in team-based and interprofessional contexts. We developed the AIM (<i>Analyze-Interpret-Manage</i>) framework by integrating the Delphi Consensus definition of critical thinking with the AAC&U VALUE framework, translating foundational theory into a concise, measurable, stage-based model applicable to both individual and collective cognition. AIM was tested using qualitative analysis of transcripts of student team discursive narratives of an assigned IPE scenario. Reasoning behaviors were coded by AIM stage and mapped to the 2016 IPEC Core Competencies and the 2025 NAPLEX competencies to ensure professional relevance and external validity. AIM reliably distinguished discrete stages of critical thinking across teams, revealing consistent patterns in how learners analyzed information, interpreted clinical and ethical significance, and managed decisions collaboratively. Mapping demonstrated strong alignment between AIM stages and IPEC and NAPLEX competencies. Our novel AIM framework offers a scalable approach for defining, teaching, and assessing team-based critical thinking in pharmacy education. By operationalizing critical thinking as a staged reasoning process aligned with professional standards, AIM fills a critical gap between educational theory, interprofessional practice, and licensure preparation.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-12DOI: 10.3390/pharmacy14010036
Marius Calin Chereches, Mihaela Simona Naidin, Alexandra Grosan, Radu Antoniu Patrascu, Anca-Maria Capraru, Marina Daniela Dimulescu, Adina Turcu-Stiolica
Although pharmacist-led vaccination is a global standard for expanding immunization coverage, its adoption in Romania remains at an early stage. While previous studies have focused on early adopters, this research evaluates barriers, perceptions, and readiness among community pharmacies that do not yet provide this service, thereby addressing a critical knowledge gap regarding the "non-vaccinating" majority. A cross-sectional mixed-methods study was conducted among 208 pharmacists representing national chains, regional networks, and independent pharmacies. Quantitative data were analyzed using Chi-square tests and Spearman correlations to identify structural disparities, while a thematic analysis was employed to explore qualitative insights related to professional identity and operational barriers. We identified a clear mismatch between pharmacies' willingness to provide vaccination services and their practical ability to implement them. Independent pharmacies demonstrated a strong intention to adopt vaccination services (71.4%) but were limited by financial constraints, with high implementation costs identified as a significant barrier (p = 0.014). In contrast, national pharmacy chains had sufficient resources yet faced marked staff resistance, with 43.9% reporting extreme reluctance (p = 0.038). These chains were concentrated in the capital region (p = 0.002), thereby positioning other pharmacies as key providers in underserved areas. Furthermore, thematic analysis revealed a deep-seated "professional identity" crisis, in which pharmacists struggle with the transition from medication specialists to clinical practitioners. The expansion of vaccination services cannot rely on a "one-size-fits-all" strategy. Successful national implementation requires a segmented policy approach, including financial subsidies to support independent pharmacies, change management strategies to engage the corporate workforce, and targeted regulatory education for regional networks to prevent vaccination deserts.
{"title":"Pharmacist-Led Flu Vaccination Services in Romanian Community Pharmacies: Barriers, Perceptions, and Implementation Challenges.","authors":"Marius Calin Chereches, Mihaela Simona Naidin, Alexandra Grosan, Radu Antoniu Patrascu, Anca-Maria Capraru, Marina Daniela Dimulescu, Adina Turcu-Stiolica","doi":"10.3390/pharmacy14010036","DOIUrl":"10.3390/pharmacy14010036","url":null,"abstract":"<p><p>Although pharmacist-led vaccination is a global standard for expanding immunization coverage, its adoption in Romania remains at an early stage. While previous studies have focused on early adopters, this research evaluates barriers, perceptions, and readiness among community pharmacies that do not yet provide this service, thereby addressing a critical knowledge gap regarding the \"non-vaccinating\" majority. A cross-sectional mixed-methods study was conducted among 208 pharmacists representing national chains, regional networks, and independent pharmacies. Quantitative data were analyzed using Chi-square tests and Spearman correlations to identify structural disparities, while a thematic analysis was employed to explore qualitative insights related to professional identity and operational barriers. We identified a clear mismatch between pharmacies' willingness to provide vaccination services and their practical ability to implement them. Independent pharmacies demonstrated a strong intention to adopt vaccination services (71.4%) but were limited by financial constraints, with high implementation costs identified as a significant barrier (<i>p</i> = 0.014). In contrast, national pharmacy chains had sufficient resources yet faced marked staff resistance, with 43.9% reporting extreme reluctance (<i>p</i> = 0.038). These chains were concentrated in the capital region (<i>p</i> = 0.002), thereby positioning other pharmacies as key providers in underserved areas. Furthermore, thematic analysis revealed a deep-seated \"professional identity\" crisis, in which pharmacists struggle with the transition from medication specialists to clinical practitioners. The expansion of vaccination services cannot rely on a \"one-size-fits-all\" strategy. Successful national implementation requires a segmented policy approach, including financial subsidies to support independent pharmacies, change management strategies to engage the corporate workforce, and targeted regulatory education for regional networks to prevent vaccination deserts.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Type 2 diabetes mellitus (T2DM) is a prevalent chronic disease requiring effective pharmacological treatment, sustained self-management, and patient education. Pharmacists are increasingly recognized as key contributors to diabetes care; however, their role remains underutilized in Bulgaria. This study aimed to assess self-management behaviors, medication adherence, patient awareness, and the perceived role of pharmacists among patients with T2DM in Bulgarian primary care.
Methods: A cross-sectional observational study was conducted among 105 patients with T2DM using an anonymous questionnaire based on the Diabetes Self-Management Questionnaire and supplementary items adapted to the local healthcare context. Data were analyzed using descriptive statistics and non-parametric tests to explore associations between demographic characteristics, treatment patterns, self-management behaviors, and educational needs.
Results: Most patients were treated with oral antidiabetic therapy (90.0%), predominantly metformin-based regimens (64.0%). Adherence to prescribed pharmacological treatment was high (93.0%), while adherence to dietary recommendations (70.0%), regular physical activity (60.0%), and blood glucose self-monitoring (63.0%) was less consistent. Although 92.0% of participants reported good or excellent disease awareness, 41.0% expressed a need for additional education, particularly regarding confidence in managing hypoglycemia and the use of digital monitoring tools. More than half of respondents (54.0%) had received diabetes-related information from a pharmacist; however, only 38.0% expressed willingness to participate in pharmacist-led education, while 34.0% were undecided. Female sex was associated with a higher prevalence of comorbidities (p = 0.010), while increasing age was associated with reduced metformin use (p = 0.004).
Conclusions: Despite good pharmacological adherence and self-reported awareness, gaps remain in lifestyle-related self-management and patient education. The findings support an expanded role for pharmacists in diabetes care, particularly through structured educational and counseling interventions to enhance self-management and complement physician-led treatment.
{"title":"Self-Management, Adherence, and the Role of Pharmaceutical Care in Patients with T2DM in Primary Practice: A Cross-Sectional Survey in Bulgaria.","authors":"Petya Milushewa, Nataliya Chenesheva, Valentina Petkova","doi":"10.3390/pharmacy14010035","DOIUrl":"10.3390/pharmacy14010035","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is a prevalent chronic disease requiring effective pharmacological treatment, sustained self-management, and patient education. Pharmacists are increasingly recognized as key contributors to diabetes care; however, their role remains underutilized in Bulgaria. This study aimed to assess self-management behaviors, medication adherence, patient awareness, and the perceived role of pharmacists among patients with T2DM in Bulgarian primary care.</p><p><strong>Methods: </strong>A cross-sectional observational study was conducted among 105 patients with T2DM using an anonymous questionnaire based on the Diabetes Self-Management Questionnaire and supplementary items adapted to the local healthcare context. Data were analyzed using descriptive statistics and non-parametric tests to explore associations between demographic characteristics, treatment patterns, self-management behaviors, and educational needs.</p><p><strong>Results: </strong>Most patients were treated with oral antidiabetic therapy (90.0%), predominantly metformin-based regimens (64.0%). Adherence to prescribed pharmacological treatment was high (93.0%), while adherence to dietary recommendations (70.0%), regular physical activity (60.0%), and blood glucose self-monitoring (63.0%) was less consistent. Although 92.0% of participants reported good or excellent disease awareness, 41.0% expressed a need for additional education, particularly regarding confidence in managing hypoglycemia and the use of digital monitoring tools. More than half of respondents (54.0%) had received diabetes-related information from a pharmacist; however, only 38.0% expressed willingness to participate in pharmacist-led education, while 34.0% were undecided. Female sex was associated with a higher prevalence of comorbidities (<i>p</i> = 0.010), while increasing age was associated with reduced metformin use (<i>p</i> = 0.004).</p><p><strong>Conclusions: </strong>Despite good pharmacological adherence and self-reported awareness, gaps remain in lifestyle-related self-management and patient education. The findings support an expanded role for pharmacists in diabetes care, particularly through structured educational and counseling interventions to enhance self-management and complement physician-led treatment.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-11DOI: 10.3390/pharmacy14010033
Parker Kaleo, Natt Patimavirujh, Kristen Greene, Nicholas Piccicacco, Melissa O'Neal
Penicillin (PCN) allergies are frequently reported despite a true prevalence of less than 1%, leading to unnecessary avoidance of beta-lactams, broader antimicrobial use, and increased healthcare costs. Pharmacist-driven de-labeling programs offer a strategy to improve antimicrobial stewardship. This single-center, retrospective study evaluated hospitalized adults with a documented PCN allergy and screened by the pharmacist-driven penicillin allergy de-labeling service (PADLS) between 16 January and 26 June 2025. Patients were categorized into a screened cohort and a Full Allergy Reconciliation (FAR) cohort if interviewed using PEN-FAST. Eligible patients underwent direct oral challenge (DOC), penicillin skin testing (PST) plus DOC, or direct de-labeling based on PEN-FAST scoring. Sixty-three patients were screened, and 32 (50.8%) underwent full reconciliation. Among FAR patients, the median PEN-FAST score was 0, and 25 (78.1%) underwent DOC. De-labeling was successful in 28 FAR patients (87.5%). One patient (4%) experienced a mild reaction. Allergy field updates occurred in 69.8% of screened and 96.9% of FAR patients. Antibiotic optimization occurred in 12 FAR patients, saving 78 days of therapy. Estimated cost savings totaled $37,632. PADLS effectively and safely de-labeled PCN allergies, resulting in improved antimicrobial selection, and could generate cost savings, supporting broader implementation of pharmacist-led allergy stewardship programs.
{"title":"Impact of a Pharmacist-Driven Penicillin Allergy De-Labeling Service (PADLS) on Hospitalized Patients.","authors":"Parker Kaleo, Natt Patimavirujh, Kristen Greene, Nicholas Piccicacco, Melissa O'Neal","doi":"10.3390/pharmacy14010033","DOIUrl":"10.3390/pharmacy14010033","url":null,"abstract":"<p><p>Penicillin (PCN) allergies are frequently reported despite a true prevalence of less than 1%, leading to unnecessary avoidance of beta-lactams, broader antimicrobial use, and increased healthcare costs. Pharmacist-driven de-labeling programs offer a strategy to improve antimicrobial stewardship. This single-center, retrospective study evaluated hospitalized adults with a documented PCN allergy and screened by the pharmacist-driven penicillin allergy de-labeling service (PADLS) between 16 January and 26 June 2025. Patients were categorized into a screened cohort and a Full Allergy Reconciliation (FAR) cohort if interviewed using PEN-FAST. Eligible patients underwent direct oral challenge (DOC), penicillin skin testing (PST) plus DOC, or direct de-labeling based on PEN-FAST scoring. Sixty-three patients were screened, and 32 (50.8%) underwent full reconciliation. Among FAR patients, the median PEN-FAST score was 0, and 25 (78.1%) underwent DOC. De-labeling was successful in 28 FAR patients (87.5%). One patient (4%) experienced a mild reaction. Allergy field updates occurred in 69.8% of screened and 96.9% of FAR patients. Antibiotic optimization occurred in 12 FAR patients, saving 78 days of therapy. Estimated cost savings totaled $37,632. PADLS effectively and safely de-labeled PCN allergies, resulting in improved antimicrobial selection, and could generate cost savings, supporting broader implementation of pharmacist-led allergy stewardship programs.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nuclear medicine is a medical specialty combining parenteral radioactive drug handling and complex clinical workflows, making systematic process-related incident (PRI) analysis essential to support healthcare quality improvement. This study reports a four-year single-center retrospective analysis of PRIs in a nuclear medicine department and describes the development and implementation of a scenario-based radiopharmacy training program for nuclear medicine technologists (NMTs) derived from these findings. PRIs were extracted from the institutional reporting system and categorized according to a structured classification. Training scenarios were designed from recurrent radiopharmacy-related PRIs, and their impact was evaluated using a knowledge questionnaire administered pre and post training. A total of 223 PRIs were analyzed, of which 38.6% (n = 86) were related to the radiopharmaceutical circuit. Among these, 28.3% occurred exclusively within the radiopharmacy cleanroom. Administration (19%), dispensing (15%), delivery and reception (15%), and preparation and quality control (15%) of radiopharmaceuticals were the most frequently involved stages. No PRI exceeded a moderate criticality level. Eight NMTs participated in the training program, consisting of an analysis of videos depicting the developed scenarios. The mean knowledge score increased significantly from 7.51/10 before training to 8.46/10 four weeks after training (p = 0.02), with marked improvements in hygiene- and radioactivity-related topics. These results support the use of retrospective PRI analysis as an operational basis for specific, scenario-based training to strengthen safety practices in radiopharmacy settings.
{"title":"Process-Related Incidents in Nuclear Medicine: A Four-Year Single-Center Retrospective Analysis to Support the Implementation of a Scenario-Based Radiopharmacy Training.","authors":"Yasmine Soualy, Stéphane C Renaud, Jade Torchio, Juliette Fouillet, Julie Ensenat, Léa Rubira, Cyril Fersing","doi":"10.3390/pharmacy14010032","DOIUrl":"10.3390/pharmacy14010032","url":null,"abstract":"<p><p>Nuclear medicine is a medical specialty combining parenteral radioactive drug handling and complex clinical workflows, making systematic process-related incident (PRI) analysis essential to support healthcare quality improvement. This study reports a four-year single-center retrospective analysis of PRIs in a nuclear medicine department and describes the development and implementation of a scenario-based radiopharmacy training program for nuclear medicine technologists (NMTs) derived from these findings. PRIs were extracted from the institutional reporting system and categorized according to a structured classification. Training scenarios were designed from recurrent radiopharmacy-related PRIs, and their impact was evaluated using a knowledge questionnaire administered pre and post training. A total of 223 PRIs were analyzed, of which 38.6% (n = 86) were related to the radiopharmaceutical circuit. Among these, 28.3% occurred exclusively within the radiopharmacy cleanroom. Administration (19%), dispensing (15%), delivery and reception (15%), and preparation and quality control (15%) of radiopharmaceuticals were the most frequently involved stages. No PRI exceeded a moderate criticality level. Eight NMTs participated in the training program, consisting of an analysis of videos depicting the developed scenarios. The mean knowledge score increased significantly from 7.51/10 before training to 8.46/10 four weeks after training (<i>p</i> = 0.02), with marked improvements in hygiene- and radioactivity-related topics. These results support the use of retrospective PRI analysis as an operational basis for specific, scenario-based training to strengthen safety practices in radiopharmacy settings.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}