Research in Social & Administrative Pharmacy最新文献

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.

Background: 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.

Methods: 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.

Results: 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 < 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.

Conclusion: 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.

The EAHOP trial (Enhancing Allied Health for Older People in Residential Care) Outcomes of pharmacist interventions.

Background: The pharmacist has a critical role in the multidisciplinary team (MDT) when contributing to the care of older people living in residential aged care. The EAHOP study is a clinical trial that embedded a pharmacist within an MDT in a residential aged care home. This abstract reports on the pharmacy results of the study.

Method: This study used a mixed method to describe key pharmacy outcome measures of direct and indirect time per resident, number of recommendations accepted and to describe the thoughts, opinions and experience of key stakeholders.

Results: There were 124 recommendations made by the pharmacist for 34 residents, an average of 3.65 per resident, higher than the usual 2.7 recommendations per RMMR. At the GP case conferences 70 % were accepted, 9 % were declined and 21 % were not discussed. An average of 61 min direct time and 246 min of indirect time was spent per resident. Qualitative findings showed the pharmacy role improved care for residents by enhancing communication between health professionals, staff, residents and families.

Conclusion: The EAHOP model can supplement existing models of pharmacy intervention in residential care by providing organised multidisciplinary collaboration between the General Practitioner, nursing, pharmacist and allied health disciplines.