Pharmacy最新文献

Background: Topical Corticosteroids (TCS) are potent therapeutic agents associated with severe local and systemic adverse effects if misused. In Jordan, the unauthorized supply of TCS for cosmetic purposes and the mismanagement of dermatological conditions remain significant public health concerns. This study utilized a repeated-measures simulated patient (SP) methodology to evaluate community pharmacists' stewardship of TCS across a spectrum of clinical risks. Methods: A national cross-sectional study was conducted across 380 randomly selected community pharmacies in Jordan. Each pharmacy received four covert visits (N = 1520) corresponding to four distinct clinical scenarios representing different risk levels: cosmetic whitening, acne management, fungal infection, and pediatric diaper rash. The primary outcome was appropriate Practice, defined as the refusal to dispense unsafe medication or the provision of evidence-based alternatives. Results: Stewardship behavior varied significantly by clinical context (p < 0.001). Pharmacists demonstrated a hierarchy of safety, adhering to guidelines most strictly in the Pediatric scenario (82.1% appropriate refusal) but frequently abandoning safety standards in the Cosmetic scenario (30.0% appropriate refusal). Notably, 70.0% of pharmacists dispensed potent steroids for facial whitening, and 26.1% voluntarily offered to compound unauthorized steroid mixtures (Khaltat). In the acne scenario, 52.1% dispensed the contraindicated TCS, while only 37.9% appropriately switched the patient to an evidence-based alternative. In the fungal scenario, 60.0% failed to visually inspect the lesion, leading to a 40.0% rate of inappropriate TCS dispensing. Multivariable regression indicated that pharmacists working in chain pharmacies (aOR: 2.15, 95% CI: 1.68-2.75) and those holding advanced degrees (PharmD/MSc) (aOR > 1.38) were significantly more likely to practice appropriate TCS stewardship. High workload (>200 prescriptions/day) was a significant barrier to safety (aOR: 0.55). Conclusions: Community pharmacists in Jordan exhibited selective TCS stewardship, demonstrating high vigilance for pediatric safety, but widespread illegal practice regarding cosmetic misuse and differential diagnosis that may be unethical. The study results warrant the need for further urgent research to understand why these practices are occurring and how best to address them.

Background: Written educational materials are widely used in community pharmacies to support patient education, and available evidence suggests their effectiveness in improving short-term knowledge. However, there remains a need for well-documented, practice-oriented evaluations of pharmacist-developed materials in real-world community pharmacy settings. The aim of this study was to evaluate the immediate impact of a pharmacist-developed educational leaflet on women's health knowledge and its perceived usefulness, clarity, and acceptability.

Methods: This study evaluated pharmacist-developed educational leaflets addressing women's health topics using a pre-post study design. The study was conducted in Poland and involved 266 adult women. All participants completed a five-question knowledge test before and immediately after reading the educational leaflet, followed by a self-assessment of perceived usefulness, clarity, and visual appeal. Descriptive statistics were performed to summarize the results.

Results: A statistically significant increase in knowledge was observed after exposure to the educational material, with mean scores rising from 2.8 ± 1.2 to 4.6 ± 0.7 (out of 5, p < 0.001). The greatest improvements were noted in topics related to sexually transmitted infection self-testing and pregnancy testing. Most participants rated the leaflet as useful, comprehensible, attractive, and engaging, with higher ratings reported among younger and better-educated respondents.

Conclusions: Pharmacist-developed educational leaflets can support short-term knowledge acquisition and are perceived positively by women across age groups. These findings highlight the potential role of community pharmacies in delivering accessible written health education, while underscoring the need for future studies to assess long-term knowledge retention, behavioral outcomes, and topic-specific, targeted materials.

This study aims to describe oral contraceptive knowledge among adolescents and young women, and to examine individuals' characteristics associated with oral contraceptive knowledge. A cross-sectional survey was administered using an online panel. Females aged 16 to 24 were recruited. Oral contraceptive knowledge was measured using nine items with six domains, including oral contraceptive use, efficacy, indication, mechanism of action, risks, and side effects. A summated score was created, with a score of 9 indicating highest level of knowledge. Multivariable regression was used to examine significant socio-demographics and clinical characteristics. Among the 700 included responses, largest proportion of respondents were White (45.43%) and were covered by public insurance (43.14%). A total of 446 (63.71%) respondents expressed at least slight interest in using over-the-counter oral contraceptives. Overall, the mean score of knowledge was 4.08 out of 9. Most did not correctly answer questions about side effects, the mechanism of action and appropriate use. Similar patterns were observed among those who were interested in over-the-counter oral contraceptives (mean = 4.11). Adolescents and young women had a low level of oral contraceptive knowledge. With a high proportion of individuals interested in over-the-counter oral contraceptives, additional information support is needed to support informed contraception choice and use.

The use of Connected Medical Devices (CMDs) is growing significantly throughout the world. Although they are not dispensed in pharmacies and are not part of the pharmacy-only drug dispensing system, clinical pharmacists must be able to support patients in the use of these new technologies, which are central to their care. The aim of this study is to identify the role of the community pharmacist in supporting patients who use CMDs, using the case of connected watches in electrophysiology. Semi-structured interviews were conducted between 15 February and 20 April 2024 by a pharmacy student. The questionnaires were drafted in collaboration with a pharmacist, a cardiac electrophysiologist, a methodologist specializing in the evaluation of medical devices, and an ethical philosopher specializing in the support and acceptability of new technologies. The aim of these questionnaires was to study the use of connected watches and support for patients who own them. A total of 4 cardiac electrophysiologists and 10 cardiac electrophysiology patients were interviewed, and then 6 pharmacists were also questioned about the roles identified by physicians and patients. This study identified a major need on the part of specialist physicians for clinical pharmacist support in helping patients use connected watches. Patients expressed a high level of confidence in their pharmacists to support them, and in the motivation of pharmacists' ability to take up these challenges. A number of challenges remain, such as the effective integration of this support into pharmacy practice, remuneration, and the organization of collaboration between clinical pharmacists and hospital electrophysiologists.

Background: Burnout is a significant occupational risk among healthcare professionals, including community pharmacy staff, whose differing roles and responsibilities may influence burnout determinants. This study aimed to compare burnout levels and associated work characteristics between master pharmacists (MPs) and assistant pharmacists (APs) working in community pharmacies in Northeastern Bulgaria.

Methods: A cross-sectional observational survey was conducted between November 2023 and December 2024 using an anonymous, self-administered online questionnaire completed by 221 MPs and 151 APs. Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey for Medical Personnel, measuring emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). Work characteristics were evaluated using items adapted from an internationally recognized European Commission guideline on occupational health and safety risks in the healthcare sector.

Results: High levels of EE and DP were observed in both groups, with no statistically significant differences in mean burnout scores. Age and years of professional experience were not significantly associated with burnout. However, work environment factors differed: poor team communication and a negative workplace climate affected both groups, whereas lack of recognition and support was more influential for MPs, and physical workload and frequent interruptions were more prominent stressors for APs.

Conclusions: Burnout is prevalent among community pharmacy professionals, with role-specific organizational factors shaping its determinants and highlighting the need for targeted preventive strategies.

Background: Pharmacology plays a central role in linking biomedical science concepts with their application in clinical practice across medical and healthcare education. Globally, the pharmacological curriculum has evolved, just like other disciplines, through the integration of case-based, problem-based, and hybrid teaching models that led to firm clinical reasoning and long-term learning. Thus, this study aims to evaluate and compare the learning outcomes of pharmacology curricula across the globe by adopting a systematic review and meta-analysis research approach.

Methods: This comprehensive review was conducted with transparency and integrity in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines and was registered with PROSPERO (CRD420251207753). Five electronic databases, including MEDLINE (PubMed), EMBASE, CINAHL, PsycINFO, and the Cochrane Library were searched from January 2000 to October 2025. The Cochrane Library tool was used for the risk of bias assessment of randomised controlled trials, while the Joanna Briggs Institute (JBI) checklist was used for mixed-design, quasi-experimental, and cross-sectional cohorts. Review Manager 5.4 was used for statistical analysis.

Results: Out of 3300 identified studies, 11 met the inclusion criteria, spanning 11 countries (published between 2007 and 2025). Integrated and case-based curricula significantly improved pharmacology knowledge compared to traditional lecture-based methods (SMD = 0.35; 95% CI: 0.07-0.64; I² = 75%). Student satisfaction also favours integrated learning (OR = 1.53; 95% CI: 1.16-2.02; I² = 46%). Most included studies were of moderate-to-high methodological quality.

Conclusion: Globally, active and integrated pharmacology curricula foster greater cognitive understanding and learner satisfaction than conventional models. However, significant variability persists in resource-limited settings, leading to unequal competency in prescribing and therapeutic reasoning. Australian pharmacology programmes align broadly with international standards but require greater standardisation in assessment and experiential learning.

Optimizing medication management and improving patient health outcomes depend primarily on the strength of primary healthcare services, where collaboration between general practitioners (GPs) and pharmacists plays a critical role. This scoping review aimed to identify the main facilitators and barriers influencing pharmacist-GP collaboration. The review was conducted in line with PRISMA-ScR guidelines. A comprehensive search of PubMed, Scopus, and Web of Science identified studies published in English between January 2019 and May 2025, of which twenty met the inclusion criteria. Key facilitators of collaboration included pharmacist co-location within GP practices, clearly defined professional responsibilities, access to shared electronic health records, and supportive government policies. Barriers most frequently reported were limited communication pathways, insufficient interprofessional training, and financial constraints. Overall, the findings suggest that effective pharmacist-GP collaboration relies on structural integration, professional trust, and policy initiatives that enable sustained cooperation. Long-term investment in collaborative infrastructure and workforce development will be essential to strengthen primary care, support patient outcomes, and ensure more efficient use of healthcare resources.

(1) Background: Regulations governing food supplements vary considerably across countries, allowing products that are prohibited in one jurisdiction to be legally sold in another. Furthermore, online sales enable and facilitate this practice. Regarding pharmaceutical malpractice, the absence of a standardized European framework complicates the evaluation of pharmacist liability. As a result, the specific elements of the liability framework are defined by the national legislation of each Member State. The aim of our review is to map the global regulatory landscape of food supplements and to examine the pharmacist's professional responsibilities, including instances of malpractice related to this area. (2) Methods: A literature review covering publications from January 2020 to December 2024 was performed using four databases: Scopus, PubMed, Embase, and Web of Science. The search retrieved 8243 records, of which 77 studies fulfilled the eligibility criteria. The extracted data were organized into five main themes: pharmacist responsibility and malpractice, food supplement regulation, consumer safety, health claims, and pharmacist knowledge. (3) Results: The literature reviewed indicated a relatively low number of malpractice cases within the pharmacy profession compared to other professions. A higher incidence of cases is observed among male pharmacists and those practicing in the private sector. Notably, no cases have been identified addressing pharmacists' responsibilities in the dispensing of food supplements. In the context of food supplement regulation, the reviewed literature highlights a lack of standardized terminology and harmonized legislation across different jurisdictions. Therefore, products may be classified differently across jurisdictions. Another observed barrier is the considerable variation in market access requirements across countries. Regarding consumer safety, several irregularities have been observed. Substantial non-compliance in both product composition and labeling has been observed, reflecting insufficient quality control measures. Concerning health claims, significant regulatory non-compliance with European Union regulations has been documented. In addition, widespread misleading advertising practices have been observed. With respect to pharmacists' knowledge, the reviewed literature identifies several professional challenges within pharmacy practice, particularly those concerning the dispensing of food supplements. (4) Conclusions: This research offers a comprehensive analysis of the literature published over the past five years concerning pharmaceutical malpractice cases, as well as an examination of food supplement regulation and the professional responsibilities of pharmacists. A recurring barrier identified is the absence of unified regulatory frameworks worldwide. This results in uncertainty concerning the pharmacist's professional role and responsibilities.

Background: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are often used in hypertensive patients. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the coronavirus disease 2019 (COVID-19) pandemic, binds the ACE2 receptor on the cell surface. This study aimed to identify the risk factors influencing COVID-19 infection in hypertensive patients.

Methods: This is a part of a single-center, retrospective, observational study investigating patients ≥ 20 years old at Kenwakai Hospital (Nagano, Japan). COVID-19 was diagnosed by polymerase chain reaction. All patients received antihypertensive drugs.

Results: Among 316 patients (mean age, 75.0 ± 13.4 years; men, 55.1%), COVID-19 was diagnosed in 39 (12.3%). Multiple logistic regression analysis after adjustment for age, sex, and smoking status identified increased serum creatinine (Scr) as a significant risk factor for COVID-19 (odds ratio [OR] 1.10; 95% confidence interval [CI] 1.00-1.20; p = 0.046). Conversely, lower serum chloride was associated with COVID-19 (OR 0.92; 95% CI 0.85-0.99; p = 0.047). There was no significant association between COVID-19 and the use of ACEIs and ARBs.

Conclusions: Scr was independently associated with COVID-19 risk, whereas ACEI/ARB use was not associated with COVID-19 risk in Japanese hypertensive patients, suggesting that these users need not discontinue or change their treatment. The study population included a very high proportion of patients with advanced chronic kidney disease, which makes the cohort substantially different from the general hypertensive population. However, our results can help guide targeted treatment strategies, improving patient outcomes in healthcare settings.

Medication adherence following myocardial infarction (MI) is essential for effective secondary prevention, yet adherence rates remain suboptimal. Healthcare professionals (HCPs) are central to promoting adherence through clinical decision-making, patient education, and ongoing behavioural support. Understanding how HCPs perceive and experience the factors' influencing adherence is key to developing effective, context-specific interventions. This study explored HCPs' perspectives on medication adherence post-MI and identified behavioural determinants influencing medication management across the care pathway. A qualitative descriptive study was conducted using semi-structured interviews with HCPs in the southwest of Ireland. Participants included hospital pharmacists, community pharmacists, general practitioners (GPs), cardiologists, and nurses, recruited through purposive, convenience, and snowball sampling. Interviews were recorded, transcribed verbatim, and analysed using directed content analysis guided by the Theoretical Domains Framework (TDF). Twelve HCPs (eight female) were interviewed between December 2024 and May 2025, including four pharmacists, two GPs, three cardiologists and three nurses. Interviews lasted 30-50 min (mean 41 min). Analysis identified 15 facilitators, 13 barriers, and 7 dual-role determinants across 10 TDF domains. Novel contributions include demonstrating how HCPs' real-world experiences contextualise adherence issues in the distinct post-MI setting characterised by abrupt care transitions, polypharmacy, and emotional vulnerability and identifying where HCPs feel most constrained and where their expertise could directly inform targeted intervention design. HCPs' insights reveal complex, context-specific behavioural determinants influencing post-MI medication adherence and highlight the need for multidisciplinary, tailored, and system-level solutions. Enhancing collaboration, supporting patient-centred communication, and addressing resource barriers could empower HCPs to deliver more effective, personalised adherence support and inform the development of targeted intervention strategies.