Research in Social & Administrative Pharmacy最新文献

{"title":"Factors related to medication adherence among people experiencing homelessness","authors":"James O. Baffoe ,&nbsp;Leticia R. Moczygemba ,&nbsp;Anton L.V. Avanceña ,&nbsp;Carolyn M. Brown ,&nbsp;Emily M. Seales","doi":"10.1016/j.sapharm.2025.12.005","DOIUrl":"10.1016/j.sapharm.2025.12.005","url":null,"abstract":"<div><h3>Background</h3><div>Medication adherence among people experiencing homelessness (PEH) is consistently low. There is limited research investigating the factors related to adherence in PEH.</div></div><div><h3>Objective</h3><div>To describe and examine the relationship between traditional and vulnerable predisposing, enabling, and need (PEN) factors and medication adherence among PEH.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted at two homeless services agencies in central Texas, from June to August 2024. PEH who were at least 18 years old, took at least one oral prescription for a chronic condition, used the healthcare system in the past six months, and communicated in English were eligible. The dependent variable, medication adherence, was measured using the nine-item Hill-Bone Medication Adherence Scale (<em>1 = all of the time to 4 = none of the time</em>), range 9 – 36; higher scores indicated higher adherence. The independent variables were the traditional and vulnerable PEN factors. Data analysis included descriptive, bivariate, and linear regression analyses.</div></div><div><h3>Results</h3><div>Participants (n = 150) were 49.0 (± 10.8) years old and were homeless for 5.0 (± 6.0) years. Most were male (72.0%), half (50.0%) were White, and a quarter (25.3%) were Hispanic. The mean adherence score was 29.6 ± 4.4/36, where 4.4 represents the standard deviation (SD). Substance use, psychological distress, affordability of medications, access to transportation, access to medication storage, competing needs/priorities, and number of medications were related to medication adherence (p &lt; 0.05) in the bivariate analyses. After adjusting for independent variables, psychological distress (p = 0.0025) and medication affordability (p = 0.0055) were associated with medication adherence.</div></div><div><h3>Conclusion</h3><div>Healthcare professionals can consider tailoring medication adherence counseling to focus on strategies to mitigate psychological distress and medication affordability challenges.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 3","pages":"Pages 465-473"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacy technicians in Europe: exploring the diversity in training, roles, and regulation","authors":"Carolina Valeiro ,&nbsp;Vitor Silva ,&nbsp;Ângelo Jesus ,&nbsp;João Joaquim ,&nbsp;Cristiano Matos","doi":"10.1016/j.sapharm.2025.12.001","DOIUrl":"10.1016/j.sapharm.2025.12.001","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacy technicians are increasingly recognized as essential healthcare professionals who contribute significantly to the delivery of pharmacy services. However, in Europe, the education, training, and regulatory frameworks governing pharmacy technicians vary substantially, influencing their scope of practice and integration within healthcare systems.</div></div><div><h3>Objective</h3><div>This review maps the education, qualifications, and scope of practice of PTs across Europe, highlighting differences in professional titles and regulatory approaches.</div></div><div><h3>Methods</h3><div>A review was conducted using publicly available data from the EU Regulated Professions Database and data collected from national organizations representing pharmacy technicians across Europe. Data on professional titles, qualification levels, regulations, program duration, and role delineation were extracted and summarized for comparison.</div></div><div><h3>Results</h3><div>Findings from 28 European countries revealed significant variability in pharmacy technician qualification levels (EQF 4–6), training duration (2–4.5 years), and national regulation. Regulation ranges from mandatory licensing with protected titles to a lack of regulation. The scope of practice differs, from basic dispensing and inventory tasks to broader clinical and technical responsibilities.</div></div><div><h3>Conclusion</h3><div>The landscape of pharmacy technician education and regulation in Europe remains fragmented. Although PTs share core responsibilities, qualification levels, program durations, and regulatory protections vary widely, limiting professional identity, mobility, and workforce planning. Developing a shared European framework for education and professional recognition could facilitate professional mobility, reduce professional and skill disparities, and support safe, high-quality pharmacy services, ultimately optimizing the contribution of PTs to healthcare systems.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 3","pages":"Pages 370-381"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-cultural adaptation of patient-reported outcome measures: Methodological guidance for a better practice","authors":"Sundos Q. Al-Ebrahim ,&nbsp;Jeff Harrison ,&nbsp;Timothy F. Chen ,&nbsp;Mohammed A. Mohammed","doi":"10.1016/j.sapharm.2025.12.002","DOIUrl":"10.1016/j.sapharm.2025.12.002","url":null,"abstract":"<div><div>Literature on the development of patient-reported outcome measures (PROMs) has continue to expand over the past two decades. With the increasing global use of PROMs in research and clinical practice, there is a need for their rigorous and systematic translation and cultural adaptation to ensure appropriate use in new contexts. This requires a structured approach to ensure linguistic and cultural equivalence, the quality of cross-cultural adaptation (CCA), and psychometric properties of the adapted PROMs. Poor CCA can be a challenge to the transferability and applicability of PROMs. A reasonable approach to ensure high-quality CCA could involve selecting certified translators, reconciling feedback, conducting pilot tests with end users, forming an expert committee, and consulting with the original tool developers. However, there are gaps in how the process of CCA was applied and reported. Although numerous guidelines for CCA exist, none are regarded as a gold standard. In addition, there is a lack of consensus on the best and most effective method of translation. This methodological paper addresses these gaps by describing methodological guidance for CCA, including comprehensive, step-by-step instructions and toolkits to enhance researchers' understanding and application of the CCA process.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 3","pages":"Pages 459-464"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immigration timing modifies the association between medication non-adherence and cognitive function in older adults","authors":"Yuan Fang ,&nbsp;Jayoung Han","doi":"10.1016/j.sapharm.2025.11.011","DOIUrl":"10.1016/j.sapharm.2025.11.011","url":null,"abstract":"<div><h3>Background</h3><div>The aging U.S. immigrant population exhibits higher rates of dementia than U.S.-born residents, yet traditional diagnostic methods often fail to detect decline due to cultural and linguistic barriers. Unintentional medication non-adherence (MNA) may serve as an early, noninvasive marker of cognitive decline, but little is known about how immigration timing and other modifiers shape this relationship.</div></div><div><h3>Methods</h3><div>We analyzed data from 10,854 participants aged ≥65 years in the Health and Retirement Study (2012–2016). Cognitive function was assessed using standardized latent cognitive scores. Immigration status was classified as U.S.-born or immigrant, with immigrants further stratified by age at arrival (child/adolescent, early, middle, and late adulthood). Unintentional and intentional MNA were investigated separately, and a moderated moderation regression on cognitive function tested interactions between unintentional MNA, immigration status/timing, and education adjusted for demographic, socioeconomic, and health covariates.</div></div><div><h3>Results</h3><div>Unintentional MNA, being an immigrant (compared to non-immigrants), and older age at immigration were associated with lower cognitive scores, while higher education was protective. Significant two-way interactions indicated that immigration status (β = −0.38 ± 0.14, p = 0.0006), timing (β = −0.13 ± 0.03, p &lt; 0.0001), and education (β = −0.09 ± 0.03, p = 0.003) moderated the MNA-cognition association, though three-way interaction was not significant. Subgroup analysis showed that unintentional MNA was generally linked to poorer cognition, but the moderating roles of immigration timing and education varied across ethnicity-immigration subgroups. The potential for residual confounding and other study limitations should be considered when interpreting these results.</div></div><div><h3>Conclusion</h3><div>In conclusion, unintentional MNA is a sensitive marker of cognitive decline, with risk magnified among immigrants who arrived in middle-late adulthood. Integrating adherence and immigration history into clinical assessments may improve early identification and guide targeted interventions for diverse older adults.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 3","pages":"Pages 451-458"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"For a more comprehensive view of organizational culture in implementation research","authors":"Blete Isufi ,&nbsp;Celia Piquer-Martinez ,&nbsp;Maria José Zarzuelo Romero ,&nbsp;Shane P. Desselle","doi":"10.1016/j.sapharm.2025.12.004","DOIUrl":"10.1016/j.sapharm.2025.12.004","url":null,"abstract":"<div><div>Organizational culture has an important role in implementation science, but unfortunately, it is often defined inconsistently or treated as a unidimensional construct, sometimes, even by equating individual perceptions of the culture with the organization, itself. This commentary advocates for a systematic, multidimensional way of defining and measuring organizational culture in implementation research, with particular attention to pharmacy practice and medication use services. Using organization theory, we describe how culture exists within a dynamic interaction between internal processes and external forces. By reviewing frameworks and empirical studies, we show that culture is multifactorial and evolves alongside implementation; it influences readiness, leadership engagement, and practice behaviors in healthcare and pharmacy settings. An example from rural community pharmacies further illustrates how cultural support for change can coexist with uneven structural capacity, underscoring the need for context-sensitive, multidimensional assessment. Research indicates that differences in how cultural dimensions are perceived within an organization can shape outcomes, suggesting that implementation strategies may need adaptation for different subgroups. Multidimensional tools like the Organizational Culture Profile and PRACTICE offer stronger approaches to assessing cultural conditions relevant to implementation. A multidimensional perspective indicates that strategies must be determined based on the cultural climate of the organization. Furthermore, sustainable change depends on assessing culture before planning and implementation, and pharmacies must continually review the internal and external cultural conditions to safeguard patient welfare.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 3","pages":"Pages 504-506"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A community pharmacy vaccination nudge intervention: Final results of a nationwide study","authors":"Kenneth C. Hohmeier ,&nbsp;Andrea Brookhart ,&nbsp;Olivia Kinney ,&nbsp;Kayla Dillon ,&nbsp;Chi-Yang Chiu ,&nbsp;Kelsey D. Frederick ,&nbsp;Tracy Hagemann ,&nbsp;Sujith Ramachandran ,&nbsp;Justin Gatwood","doi":"10.1016/j.sapharm.2025.11.010","DOIUrl":"10.1016/j.sapharm.2025.11.010","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Community pharmacy is involved in an increasing number of clinical services, although this has been hindered by barriers related to workload and workflow. Borrowing from theories in behavioral economics, “nudges” aim to influence behavior through non-conscious decisions. One large area of potential impact for “nudge” theory is provider-facing screening and recommendations for vaccinations, but the manner in which these mechanisms have been adopted over time is not well understood. To date no evidence exists on the effectiveness of these “nudges” in the community pharmacy setting.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The objective of this study is to report on final results of a pharmacist-targeted behavioral “nudge” to improve second dose completion rates for herpes zoster (HZ) vaccination. A secondary objective was to explore pharmacist acceptance of the nudge-based intervention.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A multi-methods approach was used to assess this quality improvement exercise in a large community pharmacy chain, including vaccine uptake counts and semi-structured interviews with community pharmacists. Changes in second-dose completion of a two-dose HZ vaccine were abstracted from the pharmacy dispensing system and assessed over 17 months once the clinical decision support (CDS) intervention became active. The qualitative arm of the project involved semi-structured, in-depth telephone interviews with pharmacists. Qualitative data was assessed using the Consolidated Framework for Implementation Research (CFIR) to assess contextual barriers and enablers to the intervention. Linear trend analysis examined both series completion and dosing intervals over the observation period.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Thirty-six states were represented across 2271 pharmacies. Despite initial declines in completion percentages and increases in the vaccine dosing windows once the CDS system was implemented, overall improvements in both measures were realized over the course of the observation period (p &lt; 0.01 for completion percentage trend; p &lt; 0.001 for linear trend in mean inter-dose window). Themes derived from a total of 12 in-depth interviews included that the “nudge” positively impacted pharmacist performance expectancy, facilitated patient screening and recommendation process, integrated seamlessly into existing clinical workflows, and social influence positively impacted acceptance of “nudge.”&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Community pharmacies may further their impact on public health via the use of “nudges” and other clinical decision support tools to support workflow integration. Pharmacists generally regard such interventions positively given their desire to provide more clinical services but not having adequate time to screen patients within workflow. To engage community pharmacies future research should identify means for technology to overcome workload constraints, such as “nudg","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 3","pages":"Pages 443-450"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pharmacist-led antibiotic stewardship audit-feedback intervention; systematic review and meta-analysis","authors":"Duaa Salem Jawhar ,&nbsp;Amer Hayat Khan ,&nbsp;Khurshid Alam ,&nbsp;Rabbiya Ahmad","doi":"10.1016/j.sapharm.2025.11.002","DOIUrl":"10.1016/j.sapharm.2025.11.002","url":null,"abstract":"<div><h3>Background</h3><div>The escalating threat of antimicrobial resistance continues to burden healthcare systems globally. Antimicrobial stewardship programs (ASPs) are recognized as a cornerstone strategy to mitigate inappropriate antibiotic use and curb resistance. Despite their growing implementation, the impact of pharmacist-led audit and feedback interventions within ASPs remains insufficiently explored.</div></div><div><h3>Objective</h3><div>To synthesize the evidence on the effect of pharmacist-led audit-feedback interventions within ASPs.</div></div><div><h3>Methods</h3><div>In accordance with PRISMA guidelines, the pooled estimate of pharmacist-led ASP audit-feedback interventions was calculated using a random-effects model. The Cochrane risk of bias tools were employed to assess the quality of the studies. We searched PubMed, SCOPUS, EBSCO/CINAHL, and Web of Science from January 1, 2000, to June 30, 2024. We included randomized controlled trials, cohort studies, case-control studies, and quasi-experimental studies. Sensitivity analyses were conducted using the leave-one-out method. Publication bias was assessed through funnel plot and Egger's regression test. Study protocol registered with PROSPERO (CRD420251036088).</div></div><div><h3>Results</h3><div>A total of 69,666 studies were screened, with 14 ultimately included in the final qualitative and quantitative analysis. Including 17805 patients in the pooled analysis. Pharmacist-led ASP audit-feedback intervention associated with reduction in antibiotic days of therapy, length of hospital stay (MD = −5.93, 95 % CI -12.90-1.03, I² 97.7 %), significant increase in appropriate antibiotic prescribing practice (OR 2.72, 95 % CI 1.51–4.88, I² 75 %) and 25 % reduction in mortality (OR 0.75, 95 % CI 0.55–1.03, I² 88 %)</div></div><div><h3>Conclusion</h3><div>This systematic review and meta-analysis provide growing evidence that pharmacist-led audit and feedback interventions within ASPs are associated with a significant improvement in appropriate antibiotic prescribing and reduction in mortality, length of hospital stay, and days of therapy. These findings support the integration of pharmacists as key leaders in ASPs and highlight the potential for policymakers to prioritize investment in pharmacist-led stewardship roles.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 3","pages":"Pages 415-424"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing accuracy and completeness of drug information in mobile apps compared with Micromedex®: An AI-based study in Thai online communities","authors":"Yutthapoom Meepradist ,&nbsp;Somchart Chokchaitam ,&nbsp;Nuttinee Teerakulkittipong ,&nbsp;Phakdee Sukpornsawan","doi":"10.1016/j.sapharm.2025.12.007","DOIUrl":"10.1016/j.sapharm.2025.12.007","url":null,"abstract":"<div><h3>Background</h3><div>Ensuring access to accurate and complete drug information is fundamental to rational medication use. Mobile medical applications (MMAs) are increasingly used by healthcare providers; however, their quality compared with institutional databases remains underexplored, especially in non-English and resource-limited settings. Natural Language Processing (NLP), particularly using Thai-language transformer models such as WangchanBERTa, enables automated screening and classification of real-world drug-related queries derived from public online communities.</div></div><div><h3>Objectives</h3><div>This study aimed to compare the accuracy and completeness of drug information from three MMAs—Lexicomp®, Medscape®, and Epocrates®—against the institutional gold standard, Micromedex®, using AI-classified Thai-language clinical questions.</div></div><div><h3>Methods</h3><div>A total of 1500 Thai-language questions about drug therapy were collected from online health forums (Pharmacafe, Pantip, Reddit). Using WangchanBERTa for text classification and stratified sampling, 194 representative questions were mapped to 13 pharmacoinformatic domains. Each question was answered using the three MMAs and Micromedex®. Three licensed pharmacists independently scored each response for accuracy and completeness using a validated binary checklist (1 = correct/complete; 0 = incorrect/incomplete). Inter-rater consensus was achieved through group discussion. Accuracy and completeness were expressed as percentages and analyzed via one-way ANOVA with Tukey HSD post-hoc testing.</div></div><div><h3>Results</h3><div>Micromedex® demonstrated the highest accuracy (55.7 %) and completeness (53.2 %), significantly outperforming Epocrates® (p &lt; 0.05). Among MMAs, Lexicomp® showed superior performance (accuracy = 32.3 %; completeness = 29.4 %), whereas Medscape® (accuracy = 31.6 %; completeness = 28.8 %) and Epocrates® (accuracy = 20.7 %; completeness = 18.0 %) ranked lower. The weighted composite score used previously (60 % accuracy + 40 % completeness) was removed for simplicity and clarity.</div></div><div><h3>Conclusions</h3><div>While Lexicomp® demonstrates potential as a practical alternative to Micromedex® in ambulatory and community-based pharmacy environments, none of the MMAs achieved equivalent reliability. Real-world Thai-language data analyzed through NLP pipelines provide a reproducible framework for pharmacoinformatic benchmarking. This approach supports rational medication use and guides digital-tool selection in low-resource healthcare systems.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 3","pages":"Pages 474-481"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare costs and cost determinants of minor ailments: A population-based retrospective cohort study","authors":"Vanessa Koo,&nbsp;Diedron Lewis,&nbsp;Mhd Wasem Alsabbagh,&nbsp;Nardine Nakhla,&nbsp;William W.L. Wong","doi":"10.1016/j.sapharm.2025.11.006","DOIUrl":"10.1016/j.sapharm.2025.11.006","url":null,"abstract":"<div><h3>Background</h3><div>Estimating the cost of providing healthcare services for minor ailments (MA) is essential to address the impact of newly legislated pharmacist prescribing on the burden these conditions place on healthcare budgets.</div></div><div><h3>Objectives</h3><div>This study aims to quantify the healthcare costs associated with minor ailment management in Ontario, describe patient characteristics by cost burden, and identify predictors of high-cost encounters.</div></div><div><h3>Methods</h3><div>This study employed a population-based retrospective cohort design, utilizing linked health administrative data from 2011 to 2019. The cost of care, in 2019 Canadian dollars, for up to 30 days after seeing a physician for MA was estimated from the perspective of a public payer. It included expenses from inpatient or physician visits, prescribed medication and emergency department visits. A gamma regression model with a logarithmic link was used to evaluate the impact of age, sex, income, residence, and a history of comorbidities on total cost.</div></div><div><h3>Results</h3><div>Over 34 million cases of MA were identified during the study period, with musculoskeletal sprains and strains accounting for 23.7 % of these cases. This ailment was also the costliest ($15.8 billion). Inpatient and physician care were the most expensive services. Higher costs were associated with older population groups, males, individuals with lower incomes, those living in urban spaces, and those with comorbidities.</div></div><div><h3>Conclusion</h3><div>Hospital and physician-based care pose a substantial financial burden to the Ontario government. An understanding of how the determinants of cost and care pathways influence health budgets is essential to inform decisions on more efficient yet equally effective strategies, such as pharmacist prescribing for MA.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 3","pages":"Pages 425-434"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a preliminary, stakeholder-validated service framework for people with intellectual disability: Insights and limitations from a co-design study","authors":"Chelsea Felkai ,&nbsp;Suzanne Neilsen ,&nbsp;Joyce Cooper ,&nbsp;David Newby ,&nbsp;Hayley Croft","doi":"10.1016/j.sapharm.2025.12.010","DOIUrl":"10.1016/j.sapharm.2025.12.010","url":null,"abstract":"<div><h3>Background</h3><div>People with intellectual disability experience inequities in access to primary healthcare and pharmacists are well positioned to support this population. This study aimed to co-create a pharmacist-led primary care service framework for people with intellectual disability, grounded in participatory principles and informed by stakeholders lived experience.</div></div><div><h3>Methods</h3><div>Within a Participatory Action Research approach, two co-design workshops (online) were conducted with 18 stakeholders, including people with intellectual disability, carers, and health professionals, in the Newcastle/Hunter Region, Australia. A convergent qualitative approach integrated workshop transcripts, field notes, and facilitator debriefs via reflexive thematic analysis to iteratively develop and validate themes. Nominal Group Technique was used to prioritise and refine service concepts.</div></div><div><h3>Results</h3><div>Stakeholders co-developed a preliminary six-domain service framework: (1) Medication Management; (2) Preventative Care; (3) Monitoring and Referral; (4) Interprofessional Collaboration; (5) Communication and Education; and (6) Availability and Accessibility. Key features included structured chronic disease screening, immunisation delivery, flagging of physical challenges to prompt follow-up, shared care planning across professionals, and communication supports ensuring health literacy.</div></div><div><h3>Conclusion</h3><div>The participatory co-design process produced a preliminary, stakeholder-validated, multi-dimensional framework. Given the limited lived-experience representation and short duration of engagement, the framework should be considered an early prototype requiring further refinement, pilot testing, and broader validation before generalisation.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 3","pages":"Pages 491-500"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}