The role of pharmacists in community settings is expanding, and understanding patient experience– an essential indicator of person-centered care–is crucial for improving pharmacy service quality. However, the extent to which patient experience has been studied in community pharmacies remains unclear. This scoping review aimed to explore the scope of research on patient experience in community pharmacies.
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive literature search was conducted in October 2024 using PubMed, Web of Science, and Google Scholar with predefined keywords, including “patient-centered,” “experience,” and “community pharmacy.”
Of the 121 records identified, 15 studies, published between 2008 and 2024, met the eligibility criteria. These studies were conducted in Australia (n = 4), the United States (n = 3), and the United Kingdom (n = 3), with six studies published in non-English languages. Study methodologies included qualitative (n = 7), quantitative (n = 5), and mixed (n = 2). Four studies used patient-reported experience measures (PREMs). Terminology for study participants varied, with “patients” (n = 10), “consumers” (n = 3), and “customers” (n = 1). In addition, one study included pharmacists (n = 1) and another included caregivers (n = 1).
This review emphasizes advancing person-centered care in pharmacy practice, with a growing focus on patient experience in community pharmacies. Future studies should develop and implement patient-reported experience measures tailored to different social contexts to enhance care and service evaluation.
The effectiveness of Community-Based Clinical Training (CBCT) in increasing the number of general practice physicians remains uncertain. In Japan, where the population is rapidly aging and shrinking, the demand for general practice physicians has significantly escalated to ensure adequate health care for the public, particularly in rural and underserved areas. General practice physicians are expected to play a vital role in providing comprehensive and continuous care to the aging population. Therefore, finding an effective strategy to secure an adequate number of general practice physicians is a crucial social issue.
CBCT is considered a promising approach to addressing this issue. It provides students and residents opportunities to engage with various aspects of community healthcare, including outpatient care, home visiting care, nurse home care, preventive care, health education, and more, particularly in rural and underserved areas. First introduced in the United States, CBCT has been implemented in numerous countries. It has spread rapidly worldwide since the 1990s, and nearly all medical schools and teaching hospitals in Japan offer this clinical training program.
Several studies have examined the effects of CBCT. Trainees report that their experiences during CBCT profoundly influence their understanding of general practice. They acknowledge the importance of acquiring diverse perspectives, understanding the physician's role, recognizing the significance of community care, respecting individual lifestyles, addressing multimorbidity, navigating various healthcare settings, and collaborating with different professionals.1 This training has a positive short-term impact on attitudes and awareness related to general practice and community healthcare. Participants' ratings of their attitudes and awareness significantly improved after the training, not only in rural areas,1 but also in urban settings.2
However, the effect of CBCT is insufficient regarding career preferences for general practice physicians. The research conducted with graduates from a single medical university suggests that conventional CBCT might not be sufficient in Japan for effectively developing general practice physicians.3 Additionally, a study at one teaching hospital indicated no positive relationship between the amount of compulsory undergraduate education in community-based medicine and the subsequent rise in the number of residents choosing general practice majors in Japan.4
A Longitudinal Integrated Clerkship (LIC) is a novel model of CBCT where students participate in the comprehensive care of patients over time and maintain ongoing learning relationships with both patients and supervising clinicians across multiple disciplines. Although there is no definitive minimum duration for student placements in an LIC program, severa
The involvement of primary care physicians (PCPs) is essential to meet the diverse needs of cancer survivors, yet their engagement remains insufficient. Consequently, identifying the factors associated with PCPs' practices in each component of cancer survivorship care is crucial. However, there is no study on the factors for individual care components. Therefore, we conducted a survey to identify the involvement and factors related to PCPs' practice of each component of cancer survivorship care.
A web-based questionnaire was distributed to 1091 family physicians in Japan. We identified four cancer survivorship care components: surveillance of recurrence, care for late effects, care for psychological problems, and care for social problems. The association between the practice of the components and the presence of knowledge or information resources, access to oncologists, and requests from patients and oncologists was evaluated.
A total of 191 PCPs (response rate: 17.5%) responded, and 180 were included in the analysis. Multivariate logistic regression analyses revealed that knowledge or information resources were associated with care for late effects (odds ratio (OR), 5.09; 95% confidence interval (CI), 1.54–23.1) and psychological problems (OR, 4.77; 95% CI, 1.52–17.8). Access to oncologists was associated with surveillance of recurrence (OR, 2.97; 95% CI, 1.08–8.75). Requests from patients and oncologists were associated with almost all survivorship care components.
Requests from patients and oncologists might be key to PCPs' involvement in cancer survivorship care. PCPs need to be proactive in identifying patient needs and fostering trust from patients and oncologists for better cancer survivorship care.
Kawasaki disease (KD) is an acute systemic vasculitis managed mainly through intravenous immunoglobulin (IVIG), aspirin, and steroids. Although gastrointestinal symptoms are common, gastrointestinal bleeding is rare. We present the case of an 11-month-old girl with incomplete KD who developed severe gastrointestinal bleeding due to multiple gastric ulcers, despite prophylactic H2-receptor antagonist therapy, requiring blood transfusion therapy. This case illustrates that gastrointestinal bleeding can occur as a direct consequence of KD and from the combined effects of corticosteroids and nonsteroidal anti-inflammatory drugs. It emphasizes the need for vigilant monitoring and further research to efficiently prevent gastrointestinal bleeding in patients with KD.
Acute uncomplicated cystitis (AUC) is a urinary tract infection and is generally treated using antimicrobial therapy. Escherichia coli is the main causative agent of AUC. Recently, the prevalence of fluoroquinolone (FQ)-resistant-E. coli has demonstrated a noticeable increase. In this study, we aimed to investigate the effectiveness of appropriate antimicrobial treatment in AUC caused by E. coli in real-world clinical settings.
This retrospective cohort study reviewed the records of patients with AUC treated at the urology department of Minami Cooperative Hospital between April 2016 and December 2020. Effectiveness was defined as clinical improvement.
The study cohort of 730 patients had a median age of 65.5 years (interquartile range, 57–78 years) and 23.2% were aged <55 years. E. coli was detected in 73.4% of patients, of whom 26.7% had levofloxacin (LVFX)-resistant strains. LVFX-resistant E. coli was associated with age ≥55 years and recurrent cases. Effectiveness was determined in 75.1% of cases, of which 75% complied with the Japanese or other international guidelines. The overall treatment effectiveness was highest with β-lactam (BL)/β-lactamase inhibitor (BLI) combinations (94.7%). The effectiveness of first- and third-generation cephalosporins (CPs) was 81.1–83.3%, and that of FQs and sulfamethoxazole–trimethoprim (ST) was 82.6–83.8%. For LVFX-resistant E. coli, the treatment effectiveness was highest (100%) with BL/BLI combinations, intermediate (75–81%) with first- and third-generation CPs and ST, and lowest (50%) with FQs.
BL/BLI combinations had the highest effectiveness for the treatment of AUC.
This narrative review identifies pitfalls in managing constipation in older adults and provides evidence-based recommendations to avoid them.
A selective literature search was conducted across electronic databases (PubMed, MEDLINE, Embase, and Cochrane Library) to identify relevant publications on constipation management in older adults. Randomized controlled trials, meta-analyses, systematic reviews, evidence-based clinical practice guidelines, and selected expert consensus statements and narrative reviews were included.
Constipation significantly impacts quality of life and healthcare costs in older adults. It is not a consequence of normal aging but results from decreased mobility, medications, underlying diseases, and pelvic floor dysfunction. A stepwise diagnostic and therapeutic approach is recommended, recognizing that multiple etiologic mechanisms often coexist in elderly patients. Before pharmacological interventions, initial management should include thorough history-taking, physical examination, medication review, and dietary and lifestyle modifications.
Common management mistakes include inadequate assessment, overlooking underlying conditions, insufficient diagnostic workup, ignoring multifactorial causes, premature medication use, and neglecting patient education. Effective management requires systematic evaluation and personalized interventions.
Clinicians should adopt a stepwise approach, from clinical assessment to diagnostic testing or medications. Patient education and individualized treatment based on comorbidities and preferences are essential, with regular efficacy reassessment.
We read with great interest the recent article by Fujikawa et al., “Family physicians have greater ambiguity tolerance in the clinical context: a nationwide cross-sectional study”.1 The authors' contribution is timely and valuable, particularly for those of us involved in postgraduate training and professional development in family medicine.
Their findings reinforce what we often observe in our own practice and in the mentoring of new physicians: that tolerance for clinical ambiguity is an essential characteristic in primary care. This is especially true when facing diagnostic uncertainty, multimorbidity, and limited access to immediate investigations—hallmarks of both rural and urban family practice. The use of the J-TAMSAD scale represents a validated and appropriate method for evaluating this cognitive-emotional construct.2
While the cross-sectional methodology effectively highlights differences in tolerance levels between physicians, it also opens doors to several future inquiries. First, a longitudinal design could clarify how ambiguity tolerance evolves over time, from undergraduate training to clinical maturity.3 Second, qualitative inquiry may help explore how physicians conceptualize and respond to ambiguity in culturally distinct ways. In our Latin American context, ambiguity is not only a clinical challenge but also a sociopolitical and systemic reality. Family physicians often manage patients with complex needs, in under-resourced environments, without clear protocols or referral pathways.4
Moreover, we wish to underline the importance of ambiguity tolerance as a teachable and assessable competency. It is closely related to emotional resilience, clinical reasoning, and professional identity formation. Curricular models that integrate case-based learning, reflection, and feedback on uncertainty management may help future physicians to not only tolerate but also effectively navigate ambiguity.5 This is of particular importance in global family medicine, where adaptability to diverse contexts is essential for equitable care.
Fujikawa et al. provide critical evidence to support a broader, competency-based approach to medical education and ongoing professional development. Their article should stimulate further research and international dialogue, especially among educators and clinicians working in complex, variable, and resource-constrained settings like those frequently found across Latin America.
Manuel Millán-Hernández: Conceptualization; methodology; investigation; supervision; writing – review and editing. Daniela F. Albarrán-Pérez: Conceptualization; investigation; formal analysis; writing – original draft.
The authors have stated explicitly that there are no conflicts of interest in connection with this article.
To assess the effects of a two-night hospitalization program conducted at our hospital as part of a domestic health guidance system. This program is designed for lifestyle modification within a health checkup framework for metabolic syndrome.
This is a single-center, retrospective observational study. We reviewed the medical records of 170 subjects who completed the two-night hospitalization program between June 1, 2019, and October 31, 2023. The ideal dietary caloric intake was calculated based on standard body weight (kg) × 25 kcal/kg. Participants were advised to maintain a regular lifestyle and received face-to-face instruction from nurses, nutritionists, physiotherapists, technicians, and physicians. We instructed the patients to visit the outpatient clinic twice, one month and three months after discharge. We compared body weight, systolic and diastolic blood pressure, and various metabolic parameters from those recorded before the program to the final outpatient visit after the program.
Roughly half of the participants had been previously diagnosed with obesity and metabolic syndrome. At the second outpatient visit after completing the program, participants showed a significant body weight reduction (71.6 ± 13.5 kg vs. 70.1 ± 13.3 kg, p < 0.001). Additionally, significant reductions in blood pressure and improvements in liver enzymes, glucose, and lipid metabolism were observed. Correlation analysis indicated that weight loss was associated with the amelioration of multiple metabolic abnormalities.
The findings suggest that the two-night hospitalization program may offer significant benefits for managing coronary risk factors associated with metabolic syndrome.
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：