Background: The coronavirus disease 2019 (COVID-19) pandemic accelerated digital health transformation, forcing healthcare providers to immediately implement telehealth services without adequate assessment of their readiness.
Objective: This study aims to explore the readiness of healthcare providers to scale up telehealth services in Indonesia.
Methods: A sequential mixed method was used with an explanatory study design. A cross-sectional survey using the translated and validated Telehealth Readiness Assessment (TRA) tool was conducted among general practitioners and pharmacists from public clinics in Bandung City, Indonesia. This was followed by a qualitative study using in-depth interviews and focus group discussions (FGDs) to explore the underlying reasons among those who showed low readiness observed from quantitative results. Quantitative and qualitative data analyses were performed for each type of healthcare provider.
Results: The results showed that in total, 63 general practitioners and 86 pharmacists, completed the survey, a majority of whom were female including 64 % of general practitioners and 72 % of pharmacists. Most of general practitioners showed moderate readiness, while most of pharmacists demonstrated high readiness to implement telehealth services. There were no significant correlations between readiness to implement telehealth services with age, sex, education level, and duration of experience (p > 0.05). A total of six females aged between 26 and 50 years participated in the in-depth interviews and FGDs. Among those who showed low readiness, organizational leadership, financial considerations, operational difficulties, staff engagement, and patient participation were mentioned as the main reasons. Differences in these underlying reasons were observed between general practitioners and pharmacists.
Conclusion: Differences are observed in the levels at which general practitioners and pharmacists are ready to scale up telehealth services. The underlying reasons for the low readiness are specific to the type of healthcare providers and affected by organizational, operational, and technological factors, but independent of sociodemographic factors.
Background: Colorectal cancer (CRC) is a major public health concern, for which early screening is crucial, although overall participation rates remain insufficient. Due to their frequent contact with patient, pharmacists are well positioned to improve CRC screening uptake. Yet, their roles and added value are not clearly evaluated.
Objective: This systematic review was performed to determine and assess pharmacists' contributions to CRC screening across different countries.
Methods: Following PRISMA guidelines, a literature search was performed in PubMed, Web of Science, Science Direct, Cochrane Central, and Google Scholar. Mesh terms and keywords were used, targeting major themes in the literature: "Pharmacy", "Colorectal Cancer", and "Screening". Data from relevant articles were independently reviewed, extracted, and assessed by two reviewers.
Results: Thirty-eight articles met the eligibility criteria: 35 (92.1 %) observational articles and 3 (7.9 %) reviews. Six major pharmacist contributions emerged for improving the CRC screening: (i) promoting CRC education and awareness, (ii) delivering comprehensive CRC screening practices, (iii) offering personalized support and guidance for patients, (iv) monitoring patient participation in the CRC screening process, (v) contributing to research and evidence generation for CRC screening, and (vi) optimizing collaboration strategies with Primary Care Providers (PCPs). These contributions are mainly from North America and Europe, representing 79.0 % of the data.
Conclusion: Pharmacists contributions appeared valuable across healthcare systems, when appropriately recognized, supported, and remunerated.
Background: 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.
Objectives: 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.
Methods: 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.
Results: Micromedex® demonstrated the highest accuracy (55.7 %) and completeness (53.2 %), significantly outperforming Epocrates® (p < 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.
Conclusions: 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.
Background: Medication adherence among people experiencing homelessness (PEH) is consistently low. There is limited research investigating the factors related to adherence in PEH.
Objective: To describe and examine the relationship between traditional and vulnerable predisposing, enabling, and need (PEN) factors and medication adherence among PEH.
Methods: 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 (1 = all of the time to 4 = none of the time), 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.
Results: 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 < 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.
Conclusion: Healthcare professionals can consider tailoring medication adherence counseling to focus on strategies to mitigate psychological distress and medication affordability challenges.
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.
Accessible health services play a crucial role in the management of chronic conditions such as asthma and chronic obstructive pulmonary disease, and the associated reduction in their corresponding morbidity and mortality rates. The evolution of the community pharmacist's role, combined with the highly accessible community pharmacy setting, positions pharmacists as key providers of timely, preventive, and supportive interventions for respiratory health. Despite the use of theories such as the Capability, Opportunity, Motivation, and Behavior (COM-B) model or Theoretical Domains Framework to guide the implementation of professional services, the uptake of respiratory health services in community pharmacies remains inconsistent across pharmacies and service types, presenting a lost opportunity to improve outcomes for people living with chronic respiratory conditions. Whilst these frameworks recognize communication and marketing as key factors influencing successful service implementation, they were not developed to guide the systematic marketing, communication, or promotion of these services to patients and the wider community. The commercial sector has long leveraged evidence-based marketing frameworks, segmentation and targeting approaches, and promotional strategies to systematically guide the planning, execution, and evaluation of its marketing activities. These frameworks or models are designed to provide clarity and consistency, ensuring that marketing decisions are not ad hoc or reactive, but are instead aligned with the broader goals of the organizations involved. Given the success of these approaches, we assert that adapting such frameworks within pharmacy health services can enhance understanding of consumer psychology and, in turn, enable us to market these services more effectively. This commentary advocates the need for exploring how pharmacy services can be better communicated and marketed to potential health consumers, using respiratory health services as an example.
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.
Background: 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.
Objective: This review maps the education, qualifications, and scope of practice of PTs across Europe, highlighting differences in professional titles and regulatory approaches.
Methods: 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.
Results: 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.
Conclusion: 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.
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