Pub Date : 2026-01-21DOI: 10.1016/j.rcsop.2026.100707
Kanza Amalina Rosyida , Susi Ari Kristina , Aditya Lia Ramadona , Bandana Saini
Background
Asthma affects over 260 million people worldwide and remains poorly controlled. Pharmacists play an increasing role in management, yet evidence on which pharmacy service attributes patients value is limited.
Objective
This review aimed to identify and synthesize the attributes and levels used in discrete choice experiments (DCEs) for patient-centered pharmacy interventions related to asthma.
Methods
Following (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) PRISMA guidelines, PubMed, Scopus, and Google Scholar were searched for studies published from 1990 to 2025. Eligible studies included patients with asthma, caregivers, clinicians, or members of the general population reporting preference outcomes derived from DCEs or conjoint analyses (CA). Data on study characteristics, attribute development, pretesting, design, analytical models, and behavioral outcomes were extracted. Attributes were grouped into domains.
Results
Of the 3287 records, seven studies met the inclusion criteria. Attributes clustered into symptoms, exacerbations, rescue medication use, treatment risks, device convenience, costs, and service processes. Clinical outcomes, especially symptom control and exacerbation prevention, were consistently prioritized. In contrast, pharmacy-specific attributes, including pharmacist counseling, private consultations, and continuity of care, were rarely included. Methodological quality varied, with limited patient involvement in attribute development and inconsistent pretesting procedures.
Conclusion
Evidence emphasizes clinical outcomes rather than pharmacy service features in asthma-related DCEs. Future preference studies should incorporate pharmacy-relevant attributes and adopt more standardized, patient-informed methodologies to support patient-centered, pharmacist-led asthma interventions.
{"title":"Attributes and levels in discrete choice experiments for pharmacy services: A systematic review to inform asthma intervention design","authors":"Kanza Amalina Rosyida , Susi Ari Kristina , Aditya Lia Ramadona , Bandana Saini","doi":"10.1016/j.rcsop.2026.100707","DOIUrl":"10.1016/j.rcsop.2026.100707","url":null,"abstract":"<div><h3>Background</h3><div>Asthma affects over 260 million people worldwide and remains poorly controlled. Pharmacists play an increasing role in management, yet evidence on which pharmacy service attributes patients value is limited.</div></div><div><h3>Objective</h3><div>This review aimed to identify and synthesize the attributes and levels used in discrete choice experiments (DCEs) for patient-centered pharmacy interventions related to asthma.</div></div><div><h3>Methods</h3><div>Following (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) PRISMA guidelines, PubMed, Scopus, and Google Scholar were searched for studies published from 1990 to 2025. Eligible studies included patients with asthma, caregivers, clinicians, or members of the general population reporting preference outcomes derived from DCEs or conjoint analyses (CA). Data on study characteristics, attribute development, pretesting, design, analytical models, and behavioral outcomes were extracted. Attributes were grouped into domains.</div></div><div><h3>Results</h3><div>Of the 3287 records, seven studies met the inclusion criteria. Attributes clustered into symptoms, exacerbations, rescue medication use, treatment risks, device convenience, costs, and service processes. Clinical outcomes, especially symptom control and exacerbation prevention, were consistently prioritized. In contrast, pharmacy-specific attributes, including pharmacist counseling, private consultations, and continuity of care, were rarely included. Methodological quality varied, with limited patient involvement in attribute development and inconsistent pretesting procedures.</div></div><div><h3>Conclusion</h3><div>Evidence emphasizes clinical outcomes rather than pharmacy service features in asthma-related DCEs. Future preference studies should incorporate pharmacy-relevant attributes and adopt more standardized, patient-informed methodologies to support patient-centered, pharmacist-led asthma interventions.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"21 ","pages":"Article 100707"},"PeriodicalIF":1.8,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-17DOI: 10.1016/j.rcsop.2026.100705
Ying-Jen Lin , Morris Fabbri , Michael P. Dorsch , F. Jacob Seagull , Geoffrey D. Barnes , Shawna N. Smith
Background
While Direct Oral Anticoagulant (DOAC) medications like apixaban and rivaroxaban have overtaken warfarin as first-line therapy for atrial fibrillation (AF) and venous thromboembolism (VTE), 10–20% of DOAC prescriptions deviate from the United States Food and Drug Administration (FDA) evidence-based package label instructions. To improve prescribing, we implemented electronic health record (EHR) alerts that encourage collaboration between prescribers and anticoagulation clinic pharmacists.
Objective
This study investigates patients' acceptance and perceptions of outreach from anticoagulation pharmacists with whom they may not have preexisting relationships.
Methods
We administered a 10-item structured questionnaire to 30 patients (or caregivers as proxies) who had received DOAC dosing recommendations directly from pharmacists following an EHR-based prescribing alert. The first 20 participants also answered open-ended interview questions. Mean scores were calculated for structured acceptability questions on a 5-point Likert scale. Interview transcripts were analyzed to identify facilitators and barriers to acceptance of pharmacist involvement in DOAC management. We also assessed alignment between quantitative and qualitative data.
Results
Overall, patients found direct pharmacist outreach acceptable (mean acceptability score: 4.3, SD 0.15). Facilitators included pharmacists' expertise, clear communication, and friendly demeanor. Barriers included a perceived limit to pharmacists' prescribing authority and the timing of the advice. Pharmacists may mitigate these barriers by emphasizing that patients' doctors endorse the dosing recommendations and offering to answer additional questions at the end of calls.
Conclusions
Anticoagulation pharmacists' direct outreach to patients can be valuable for DOAC management and is generally well-accepted. Addressing role confusion could further facilitate their direct patient contact.
{"title":"Evaluating patient acceptability of clinical pharmacist engagement following clinical decision support","authors":"Ying-Jen Lin , Morris Fabbri , Michael P. Dorsch , F. Jacob Seagull , Geoffrey D. Barnes , Shawna N. Smith","doi":"10.1016/j.rcsop.2026.100705","DOIUrl":"10.1016/j.rcsop.2026.100705","url":null,"abstract":"<div><h3>Background</h3><div>While Direct Oral Anticoagulant (DOAC) medications like apixaban and rivaroxaban have overtaken warfarin as first-line therapy for atrial fibrillation (AF) and venous thromboembolism (VTE), 10–20% of DOAC prescriptions deviate from the United States Food and Drug Administration (FDA) evidence-based package label instructions. To improve prescribing, we implemented electronic health record (EHR) alerts that encourage collaboration between prescribers and anticoagulation clinic pharmacists.</div></div><div><h3>Objective</h3><div>This study investigates patients' acceptance and perceptions of outreach from anticoagulation pharmacists with whom they may not have preexisting relationships.</div></div><div><h3>Methods</h3><div>We administered a 10-item structured questionnaire to 30 patients (or caregivers as proxies) who had received DOAC dosing recommendations directly from pharmacists following an EHR-based prescribing alert. The first 20 participants also answered open-ended interview questions. Mean scores were calculated for structured acceptability questions on a 5-point Likert scale. Interview transcripts were analyzed to identify facilitators and barriers to acceptance of pharmacist involvement in DOAC management. We also assessed alignment between quantitative and qualitative data.</div></div><div><h3>Results</h3><div>Overall, patients found direct pharmacist outreach acceptable (mean acceptability score: 4.3, SD 0.15). Facilitators included pharmacists' expertise, clear communication, and friendly demeanor. Barriers included a perceived limit to pharmacists' prescribing authority and the timing of the advice. Pharmacists may mitigate these barriers by emphasizing that patients' doctors endorse the dosing recommendations and offering to answer additional questions at the end of calls.</div></div><div><h3>Conclusions</h3><div>Anticoagulation pharmacists' direct outreach to patients can be valuable for DOAC management and is generally well-accepted. Addressing role confusion could further facilitate their direct patient contact.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"21 ","pages":"Article 100705"},"PeriodicalIF":1.8,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-06DOI: 10.1016/j.rcsop.2026.100703
Rachel S. Pierce , Devon N. Crews , Benjamin J. Pierce , Courtney K. Wulffson
Background
Continuity of oral contraceptive use during hospitalization is critical for reproductive health, yet behavioral health settings often deprioritize this need. At a Midwestern community hospital, pre-admission oral contraceptives were frequently withheld due to absent workflows, inventory limitations, and provider uncertainty.
Objective
The purpose of this quality improvement initiative was to design, implement, and evaluate a structured oral contraceptive procurement workflow to improve continuity of care and support reproductive autonomy for hospitalized behavioral health patients.
Methods
A quality improvement initiative introduced a structured oral contraceptive procurement workflow in an adult inpatient behavioral health unit. Using Plan-Do-Study-Act cycles, the multidisciplinary team addressed medication reconciliation, pharmacy coordination, and provider education. Data were collected retrospectively (2022−2023) and prospectively (January–April 2025) for females aged 18–49 prescribed oral contraceptives prior to admission.
Results
Oral contraceptive administration improved from 33 % (17/51) pre-intervention to 78 % (7/9) post-intervention (p = .023). Patients were seven times more likely to receive oral contraceptives after implementation, with a 95 % confidence interval ranging from 1.31 to 37.40. Missed doses persisted due to provider unawareness of workflow and outpatient pharmacy stock constraints.
Conclusions
Implementing a standardized workflow significantly enhanced oral contraceptive continuity for behavioral health inpatients. This systems-based approach demonstrates the value of interdisciplinary collaboration and pharmacy integration in closing reproductive care gaps. Future priorities include sustainability, electronic medical record integration, and broader adoption to advance reproductive health equity.
{"title":"Optimizing inpatient access to oral contraceptives: A quality improvement approach in behavioral health","authors":"Rachel S. Pierce , Devon N. Crews , Benjamin J. Pierce , Courtney K. Wulffson","doi":"10.1016/j.rcsop.2026.100703","DOIUrl":"10.1016/j.rcsop.2026.100703","url":null,"abstract":"<div><h3>Background</h3><div>Continuity of oral contraceptive use during hospitalization is critical for reproductive health, yet behavioral health settings often deprioritize this need. At a Midwestern community hospital, pre-admission oral contraceptives were frequently withheld due to absent workflows, inventory limitations, and provider uncertainty.</div></div><div><h3>Objective</h3><div>The purpose of this quality improvement initiative was to design, implement, and evaluate a structured oral contraceptive procurement workflow to improve continuity of care and support reproductive autonomy for hospitalized behavioral health patients.</div></div><div><h3>Methods</h3><div>A quality improvement initiative introduced a structured oral contraceptive procurement workflow in an adult inpatient behavioral health unit. Using Plan-Do-Study-Act cycles, the multidisciplinary team addressed medication reconciliation, pharmacy coordination, and provider education. Data were collected retrospectively (2022−2023) and prospectively (January–April 2025) for females aged 18–49 prescribed oral contraceptives prior to admission.</div></div><div><h3>Results</h3><div>Oral contraceptive administration improved from 33 % (17/51) pre-intervention to 78 % (7/9) post-intervention (<em>p</em> = .023). Patients were seven times more likely to receive oral contraceptives after implementation, with a 95 % confidence interval ranging from 1.31 to 37.40. Missed doses persisted due to provider unawareness of workflow and outpatient pharmacy stock constraints.</div></div><div><h3>Conclusions</h3><div>Implementing a standardized workflow significantly enhanced oral contraceptive continuity for behavioral health inpatients. This systems-based approach demonstrates the value of interdisciplinary collaboration and pharmacy integration in closing reproductive care gaps. Future priorities include sustainability, electronic medical record integration, and broader adoption to advance reproductive health equity.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"21 ","pages":"Article 100703"},"PeriodicalIF":1.8,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.rcsop.2025.100702
Aleksandar Jovanović , Milica Drobac , Bojana Vidović , Dušanka Krajnović , Dragana Pavlović , Ivana Tadić
Background
The role of pharmacists in managing urinary tract infections (UTIs) is crucial, yet there is no instrument to assess their attitudes and practices in this area. The study aimed to develop and initially validate a questionnaire to evaluate pharmacists' attitudes and practices concerning patient counselling for UTIs, with the ultimate goal of supporting improvements in pharmacy practice and enhancing the quality of patient care.
Methods
The questionnaire was developed and initially validated (content and face) through a multi-phase mixed-methods approach consisting of: 1) initial item generation applying a comprehensive literature review, 2) first expert panel discussion, 3) content and cultural validation by pharmacists (focus group discussion), 4) second expert panel discussion, and 5) pretesting by the target population. The necessity, relevance, and clarity were assessed by calculating the Content Validity Ratio (CVR), Item-Level Content Validity Index (I-CVI), and Scale-Level Content Validity Index (S-CVI/Ave). Qualitative data was analyzed using an ethnographic content analysis.
Results
The initial questionnaire consisted of 33 items, divided into two domains: pharmaceutical practice and attitudes. After phases 2–4, all items were rated with satisfactory CVR and I-CVI values (over 0.99 and 0.83, respectively). The final phase of content validation resulted in the questionnaire final version of 25 items with S-CVI/Ave = 0.98 for relevance and S-CVI/Ave = 1 for clarity. Internal consistency analysis demonstrated high reliability for the attitudes toward antibiotics subscale (Cronbach's α = 0.850) and acceptable reliability for the attitudes toward herbal products subscale (Cronbach's α = 0.735).
Conclusions
The developed questionnaire is concise, easy to use and has satisfactory content and face validity. The developed questionnaire can be used to assess pharmacists' practices and attitudes in counselling patients with UTI symptoms, contributing to the identification of areas for improvement in pharmacy practice and patient safety.
{"title":"Development and initial content and face validation of a questionnaire to evaluate pharmacists' attitudes and practices in counselling urinary tract infection patients: A mixed methods study","authors":"Aleksandar Jovanović , Milica Drobac , Bojana Vidović , Dušanka Krajnović , Dragana Pavlović , Ivana Tadić","doi":"10.1016/j.rcsop.2025.100702","DOIUrl":"10.1016/j.rcsop.2025.100702","url":null,"abstract":"<div><h3>Background</h3><div>The role of pharmacists in managing urinary tract infections (UTIs) is crucial, yet there is no instrument to assess their attitudes and practices in this area. The study aimed to develop and initially validate a questionnaire to evaluate pharmacists' attitudes and practices concerning patient counselling for UTIs, with the ultimate goal of supporting improvements in pharmacy practice and enhancing the quality of patient care.</div></div><div><h3>Methods</h3><div>The questionnaire was developed and initially validated (content and face) through a multi-phase mixed-methods approach consisting of: 1) initial item generation applying a comprehensive literature review, 2) first expert panel discussion, 3) content and cultural validation by pharmacists (focus group discussion), 4) second expert panel discussion, and 5) pretesting by the target population. The necessity, relevance, and clarity were assessed by calculating the Content Validity Ratio (CVR), Item-Level Content Validity Index (I-CVI), and Scale-Level Content Validity Index (S-CVI/Ave). Qualitative data was analyzed using an ethnographic content analysis.</div></div><div><h3>Results</h3><div>The initial questionnaire consisted of 33 items, divided into two domains: pharmaceutical practice and attitudes. After phases 2–4, all items were rated with satisfactory CVR and I-CVI values (over 0.99 and 0.83, respectively). The final phase of content validation resulted in the questionnaire final version of 25 items with S-CVI/Ave = 0.98 for relevance and S-CVI/Ave = 1 for clarity. Internal consistency analysis demonstrated high reliability for the attitudes toward antibiotics subscale (Cronbach's α = 0.850) and acceptable reliability for the attitudes toward herbal products subscale (Cronbach's α = 0.735).</div></div><div><h3>Conclusions</h3><div>The developed questionnaire is concise, easy to use and has satisfactory content and face validity. The developed questionnaire can be used to assess pharmacists' practices and attitudes in counselling patients with UTI symptoms, contributing to the identification of areas for improvement in pharmacy practice and patient safety.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"21 ","pages":"Article 100702"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-24DOI: 10.1016/j.rcsop.2025.100701
Chris Hayes , Keren Rodriguez , Rachel Chelewski , Katie Cruchelow , Autumn D. Zuckerman , Bridget Lynch , Ryan Moore , Leena Choi
Tacrolimus is available as generic twice-daily, immediate-release capsules (IR-Tac) or branded once-daily, extended-release tablets (LCPT). Prescribers may be hesitant to prescribe LCPT due to the price of the branded drug. This single-center, retrospective study evaluated if adult kidney transplant patients paid significantly more for IR-Tac or LCPT prescriptions where institutional assistance is available. Adult kidney transplant recipients filling prescriptions for IR-Tac or LCPT from January 1, 2021 through June 30, 2022 were included. Descriptive statistics were used to summarize the amount of out-of-pocket costs covered by secondary insurance and by institutional assistance. Of 18,411 fills (n = 16,262 IR-Tac, n = 2149 LCPT), the average out-of-pocket cost was $2.90 more for IR-Tac (mean $8.10, standard deviation [SD] 26.2) than LCPT (mean $5.20, SD 33.0). Secondary insurance covered an average $42.10 per fill for IR-Tac and $152.96 for LCPT. Institutional assistance covered an average $32.74 per fill for IR-Tac and $198.53 for LCPT in patients without secondary insurance. Patients prescribed LCPT were significantly less likely to have higher out-of-pocket cost (odds ratio [OR] 0.16 [0.09, 0.3], p < 0.001). No additional financial burden was placed on patients taking LCPT. However, patients with high copay or deductible primary insurance are at risk for high out-of-pocket costs for both IR-Tac and LCPT.
他克莫司有每日两次的速释胶囊（IR-Tac）或每日一次的品牌缓释片（LCPT）。由于品牌药的价格，开处方者可能会犹豫是否开LCPT。这项单中心、回顾性研究评估了成人肾移植患者在获得机构援助的情况下是否会为IR-Tac或LCPT处方支付更多费用。包括2021年1月1日至2022年6月30日期间服用IR-Tac或LCPT处方的成人肾移植受者。描述性统计用于总结二级保险和机构援助支付的自付费用数额。在18,411次填充（n = 16,262次IR-Tac， n = 2149次LCPT）中，IR-Tac的平均自付费用比LCPT（平均5.20美元，SD为33.0）高出2.90美元（平均8.10美元，标准差[SD] 26.2）。二级保险为IR-Tac和LCPT的平均每次填充支付42.10美元和152.96美元。对于没有二级保险的患者，机构援助平均为每次填充IR-Tac支付32.74美元，LCPT支付198.53美元。处方LCPT的患者自费费用较高的可能性显著降低（优势比[OR] 0.16 [0.09, 0.3], p < 0.001）。服用LCPT的患者没有额外的经济负担。然而，拥有高自付额或免赔额的初级保险的患者在IR-Tac和LCPT的自付费用中都有很高的风险。
{"title":"Financial burden of once daily extended-release tacrolimus and twice daily immediate-release tacrolimus for kidney transplant recipients","authors":"Chris Hayes , Keren Rodriguez , Rachel Chelewski , Katie Cruchelow , Autumn D. Zuckerman , Bridget Lynch , Ryan Moore , Leena Choi","doi":"10.1016/j.rcsop.2025.100701","DOIUrl":"10.1016/j.rcsop.2025.100701","url":null,"abstract":"<div><div>Tacrolimus is available as generic twice-daily, immediate-release capsules (IR-Tac) or branded once-daily, extended-release tablets (LCPT). Prescribers may be hesitant to prescribe LCPT due to the price of the branded drug. This single-center, retrospective study evaluated if adult kidney transplant patients paid significantly more for IR-Tac or LCPT prescriptions where institutional assistance is available. Adult kidney transplant recipients filling prescriptions for IR-Tac or LCPT from January 1, 2021 through June 30, 2022 were included. Descriptive statistics were used to summarize the amount of out-of-pocket costs covered by secondary insurance and by institutional assistance. Of 18,411 fills (<em>n</em> = 16,262 IR-Tac, <em>n</em> = 2149 LCPT), the average out-of-pocket cost was $2.90 more for IR-Tac (mean $8.10, standard deviation [SD] 26.2) than LCPT (mean $5.20, SD 33.0). Secondary insurance covered an average $42.10 per fill for IR-Tac and $152.96 for LCPT. Institutional assistance covered an average $32.74 per fill for IR-Tac and $198.53 for LCPT in patients without secondary insurance. Patients prescribed LCPT were significantly less likely to have higher out-of-pocket cost (odds ratio [OR] 0.16 [0.09, 0.3], <em>p</em> < 0.001). No additional financial burden was placed on patients taking LCPT. However, patients with high copay or deductible primary insurance are at risk for high out-of-pocket costs for both IR-Tac and LCPT.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"21 ","pages":"Article 100701"},"PeriodicalIF":1.8,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-22DOI: 10.1016/j.rcsop.2025.100699
Karin Svensberg , Björn Wettermark , Jenna Ramsin Eklund , Mohammadhossein Hajiebrahimi , Marie Ekenberg , Albin Tranberg , Sofia Kälvemark Sporrong
Background
Poor adherence is a well-known problem for statins, key medicines for reducing cardiovascular morbidity and mortality. Community pharmacy services have been identified as a way to increase adherence. We assessed the effect of motivating counseling in Swedish community pharmacies on treatment persistence in patients starting statin therapy.
Methods
In this cohort study, one-year persistence was evaluated in patients who initiated statin therapy (ATC C10AA) between October 2022 and June 2023 following pharmacy-based counseling, and compared with five age- and sex-matched controls per patient from pharmacies not providing the service. Data were collected from Swedish national health registers on dispensed medications, diagnoses and socioeconomic characteristics of patients. Odds ratios for being persistent with 95 % confidence intervals were calculated using a logistic regression model adjusted for socioeconomics, cardiovascular comorbidity and pharmacy size.
Results
A total of 902 patients who had data available in the Swedish national registers received the intervention. They had a higher education and income, mostly Swedish born and they had less history of cardiovascular disease, compared to the 4510 age- and sex-matched controls. The one-year persistence was significantly higher among those who received the service compared to controls (80.2 % compared to 73.6 %). Adjusted odds ratios for being persistent after the intervention was 1.43 (95 % CI 1.19–1.71).
Conclusion
Patients who receive a motivating counseling service in community pharmacies have a higher persistence to statin treatment, one year after initiation, after adjustment for differences in patient characteristics.
作为降低心血管疾病发病率和死亡率的关键药物，他汀类药物的依从性差是一个众所周知的问题。社区药房服务已被确定为增加依从性的一种方式。我们评估了瑞典社区药房的激励咨询对开始他汀类药物治疗的患者治疗持久性的影响。方法在这项队列研究中，评估了在2022年10月至2023年6月期间接受药物咨询后开始他汀类药物治疗（ATC C10AA）的患者一年的持续性，并与来自未提供该服务的药店的5名患者进行了年龄和性别匹配的对照。从瑞典国家卫生登记中收集了关于分配的药物、诊断和患者的社会经济特征的数据。使用经社会经济学、心血管合并症和药房规模调整后的逻辑回归模型计算持久性的优势比，置信区间为95%。结果共有902例瑞典国家登记数据的患者接受了干预。与4510名年龄和性别匹配的对照组相比，他们受教育程度和收入都较高，大多出生在瑞典，心血管疾病史较少。与对照组相比，接受这项服务的人一年的持久性明显更高（80.2%比73.6%）。干预后持续治疗的校正优势比为1.43 （95% CI 1.19-1.71）。结论在社区药房接受激励性咨询服务的患者在调整患者特征差异后，对他汀类药物治疗的坚持度较高。
{"title":"Improved persistence to statin therapy through a patient counseling intervention in community pharmacies – A nationwide cohort study","authors":"Karin Svensberg , Björn Wettermark , Jenna Ramsin Eklund , Mohammadhossein Hajiebrahimi , Marie Ekenberg , Albin Tranberg , Sofia Kälvemark Sporrong","doi":"10.1016/j.rcsop.2025.100699","DOIUrl":"10.1016/j.rcsop.2025.100699","url":null,"abstract":"<div><h3>Background</h3><div>Poor adherence is a well-known problem for statins, key medicines for reducing cardiovascular morbidity and mortality. Community pharmacy services have been identified as a way to increase adherence. We assessed the effect of motivating counseling in Swedish community pharmacies on treatment persistence in patients starting statin therapy.</div></div><div><h3>Methods</h3><div>In this cohort study, one-year persistence was evaluated in patients who initiated statin therapy (ATC C10AA) between October 2022 and June 2023 following pharmacy-based counseling, and compared with five age- and sex-matched controls per patient from pharmacies not providing the service. Data were collected from Swedish national health registers on dispensed medications, diagnoses and socioeconomic characteristics of patients. Odds ratios for being persistent with 95 % confidence intervals were calculated using a logistic regression model adjusted for socioeconomics, cardiovascular comorbidity and pharmacy size.</div></div><div><h3>Results</h3><div>A total of 902 patients who had data available in the Swedish national registers received the intervention. They had a higher education and income, mostly Swedish born and they had less history of cardiovascular disease, compared to the 4510 age- and sex-matched controls. The one-year persistence was significantly higher among those who received the service compared to controls (80.2 % compared to 73.6 %). Adjusted odds ratios for being persistent after the intervention was 1.43 (95 % CI 1.19–1.71).</div></div><div><h3>Conclusion</h3><div>Patients who receive a motivating counseling service in community pharmacies have a higher persistence to statin treatment, one year after initiation, after adjustment for differences in patient characteristics.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"21 ","pages":"Article 100699"},"PeriodicalIF":1.8,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.rcsop.2025.100700
Kezhen Feng , Xinyan Han , Nan Lv , Chaogang Xiong , Yajing Li , Bo Yang , Jingjing Yi , Tao Zhang
Background
In response to China's National Health Commission mandates promoting unit-based clinical pharmacists, healthcare institutions face severe workforce shortages, creating a critical policy-resource disparity.
Objective
This study aimed to implement and evaluate a hybrid unit-based clinical pharmacist model in respiratory wards to address this gap.
Methods
A structured workflow was implemented, integrating morning clinical activities (joint physician-pharmacist rounds, medication reconciliation, and real-time interventions) with afternoon analytical tasks (medication order surveillance). The model was evaluated quantitatively from 2021 to 2024.
Results
Post-implementation, antimicrobial use density dropped from 114.43 to 103.82 DDDs/100 patient-days (a 9.3 % reduction), dual antimicrobial therapy fell from 29.89 % to 11.34 % (a 62.1 % reduction), and pharmacist-patient interactions rose 3.3-fold. Medication safety was enhanced, with adverse drug reaction reports growing from 34 to 61 (a 79.4 % increase). Seven representative cases illustrated the resolution of critical drug therapy issues, demonstrating the framework's capacity to augment stewardship and safety despite staffing constraints.
Conclusions
The hybrid model provides a scalable framework for hospitals addressing the clinical pharmacy staffing gap in China. By strategically allocating limited pharmacist resources, it enhances antimicrobial stewardship and medication safety while complying with national reforms.
{"title":"Integrated pharmaceutical care model by unit-based clinical pharmacists: Implementation and clinical impact","authors":"Kezhen Feng , Xinyan Han , Nan Lv , Chaogang Xiong , Yajing Li , Bo Yang , Jingjing Yi , Tao Zhang","doi":"10.1016/j.rcsop.2025.100700","DOIUrl":"10.1016/j.rcsop.2025.100700","url":null,"abstract":"<div><h3>Background</h3><div>In response to China's National Health Commission mandates promoting unit-based clinical pharmacists, healthcare institutions face severe workforce shortages, creating a critical policy-resource disparity.</div></div><div><h3>Objective</h3><div>This study aimed to implement and evaluate a hybrid unit-based clinical pharmacist model in respiratory wards to address this gap.</div></div><div><h3>Methods</h3><div>A structured workflow was implemented, integrating morning clinical activities (joint physician-pharmacist rounds, medication reconciliation, and real-time interventions) with afternoon analytical tasks (medication order surveillance). The model was evaluated quantitatively from 2021 to 2024.</div></div><div><h3>Results</h3><div>Post-implementation, antimicrobial use density dropped from 114.43 to 103.82 DDDs/100 patient-days (a 9.3 % reduction), dual antimicrobial therapy fell from 29.89 % to 11.34 % (a 62.1 % reduction), and pharmacist-patient interactions rose 3.3-fold. Medication safety was enhanced, with adverse drug reaction reports growing from 34 to 61 (a 79.4 % increase). Seven representative cases illustrated the resolution of critical drug therapy issues, demonstrating the framework's capacity to augment stewardship and safety despite staffing constraints.</div></div><div><h3>Conclusions</h3><div>The hybrid model provides a scalable framework for hospitals addressing the clinical pharmacy staffing gap in China. By strategically allocating limited pharmacist resources, it enhances antimicrobial stewardship and medication safety while complying with national reforms.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"21 ","pages":"Article 100700"},"PeriodicalIF":1.8,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Due to altered drug clearance, renal impairment necessitates drug dose adjustments to prevent toxicity or therapeutic failure, yet inappropriate dosing persists. The utility of AI tools (e.g., ChatGPT®, DeepSeek®) in supporting renal dose adjustments remains understudied.
Objective
Evaluate renal dose adjustment practices in hospitalized patients and compare AI models (ChatGPT®, DeepSeek®) against UpToDate® guidelines.
Method
A prospective observational study (January–April 2024) included hospitalized patients with creatinine clearance <60 mL/min in a general medicine ward. Medication regimens were assessed against UpToDate® guidelines. Five AI models (ChatGPT® 3.5, ChatGPT® 4.0, ChatGPT® 5.0, DeepSeek®, DeepThink®) were tested using 348 tailored prompts; sensitivity, specificity, and accuracy were calculated.
Results
Renal impairment prevalence was 30.9 %. Of 1461 drug orders, 23.8 % (348) required adjustment, with 63.5 % (221/348) inappropriately dosed in 76.4 % (113/148) of patients. Errors included 134 (38.5 %) unadjusted, 75 (21.6 %) inappropriately adjusted, and 12 (3.4 %) contraindicated regimens. Piperacillin/tazobactam (66.7 %), levofloxacin (83.33 %), and ranitidine (89.1 %) were most frequently inappropriately dosed. Severe renal impairment (CrCl ≤30 mL/min) increased improper dosing risk (AOR: 3.34; p = 0.004). DeepThink® showed the highest sensitivity (81.6 %) but low specificity (29 %) and 67.5 % accuracy. With advances in the ChatGPT® model, there was a modest improvement in prediction capacity, with the latest ChatGPT® 5.0 achieving balanced performance (64.3 % sensitivity, 54.8 % specificity, 61.7 % accuracy).
Conclusion
Inappropriate renal dosing is prevalent among hospitalized patients with renal impairment. While AI models show promise as clinical decision support tools, their accuracy limitations require further optimization via evidence-based database training, prompt refinement, and integration of clinical expertise for reliable implementation.
背景：由于药物清除率的改变，肾脏损害需要调整药物剂量以防止毒性或治疗失败，但不适当的剂量仍然存在。人工智能工具（如ChatGPT®，DeepSeek®）在支持肾脏剂量调整方面的效用仍未得到充分研究。目的评估住院患者肾脏剂量调整实践，并将AI模型（ChatGPT®、DeepSeek®）与UpToDate®指南进行比较。方法前瞻性观察研究（2024年1月- 4月）纳入普通内科病房肌酸酐清除率60 mL/min的住院患者。根据UpToDate®指南评估药物治疗方案。五个人工智能模型（ChatGPT®3.5,ChatGPT®4.0,ChatGPT®5.0,DeepSeek®，DeepThink®）使用348个定制提示进行测试；计算敏感性、特异性和准确性。结果肾损害发生率为30.9%。在1461份药物订单中，23.8%（348份）需要调整，76.4%（113/148）的患者中有63.5%（221/348）的患者给药不当。错误包括134例（38.5%）未调整，75例（21.6%）调整不当，12例（3.4%）禁忌方案。哌拉西林/他唑巴坦（66.7%）、左氧氟沙星（83.33%）和雷尼替丁（89.1%）是最常见的用药不当。严重肾功能损害（CrCl≤30 mL/min）增加给药不当风险（AOR: 3.34; p = 0.004）。DeepThink®的灵敏度最高（81.6%），但特异性较低（29%），准确率为67.5%。随着ChatGPT®模型的进步，预测能力有了适度的提高，最新的ChatGPT®5.0实现了平衡的性能（64.3%的灵敏度，54.8%的特异性，61.7%的准确性）。结论肾损害住院患者中，肾脏给药不当现象普遍存在。虽然人工智能模型有望成为临床决策支持工具，但其准确性限制需要通过基于证据的数据库培训、及时改进和整合临床专业知识来进一步优化，以实现可靠的实施。
{"title":"Dosage adjustments in renal impairment among medical ward patients: ChatGPT® and DeepSeek® models' effectiveness in assessing those adjustments","authors":"Rahi Bikram Thapa , Ravindra Khadka , Prasanna Dahal , Subash Karki , Sabin Shrestha","doi":"10.1016/j.rcsop.2025.100698","DOIUrl":"10.1016/j.rcsop.2025.100698","url":null,"abstract":"<div><h3>Background</h3><div>Due to altered drug clearance, renal impairment necessitates drug dose adjustments to prevent toxicity or therapeutic failure, yet inappropriate dosing persists. The utility of AI tools (e.g., ChatGPT®, DeepSeek®) in supporting renal dose adjustments remains understudied.</div></div><div><h3>Objective</h3><div>Evaluate renal dose adjustment practices in hospitalized patients and compare AI models (ChatGPT®, DeepSeek®) against UpToDate® guidelines.</div></div><div><h3>Method</h3><div>A prospective observational study (January–April 2024) included hospitalized patients with creatinine clearance <60 mL/min in a general medicine ward. Medication regimens were assessed against UpToDate® guidelines. Five AI models (ChatGPT® 3.5, ChatGPT® 4.0, ChatGPT® 5.0, DeepSeek®, DeepThink®) were tested using 348 tailored prompts; sensitivity, specificity, and accuracy were calculated.</div></div><div><h3>Results</h3><div>Renal impairment prevalence was 30.9 %. Of 1461 drug orders, 23.8 % (348) required adjustment, with 63.5 % (221/348) inappropriately dosed in 76.4 % (113/148) of patients. Errors included 134 (38.5 %) unadjusted, 75 (21.6 %) inappropriately adjusted, and 12 (3.4 %) contraindicated regimens. Piperacillin/tazobactam (66.7 %), levofloxacin (83.33 %), and ranitidine (89.1 %) were most frequently inappropriately dosed. Severe renal impairment (CrCl ≤30 mL/min) increased improper dosing risk (AOR: 3.34; <em>p</em> = 0.004). DeepThink® showed the highest sensitivity (81.6 %) but low specificity (29 %) and 67.5 % accuracy. With advances in the ChatGPT® model, there was a modest improvement in prediction capacity, with the latest ChatGPT® 5.0 achieving balanced performance (64.3 % sensitivity, 54.8 % specificity, 61.7 % accuracy).</div></div><div><h3>Conclusion</h3><div>Inappropriate renal dosing is prevalent among hospitalized patients with renal impairment. While AI models show promise as clinical decision support tools, their accuracy limitations require further optimization via evidence-based database training, prompt refinement, and integration of clinical expertise for reliable implementation.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"21 ","pages":"Article 100698"},"PeriodicalIF":1.8,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-11DOI: 10.1016/j.rcsop.2025.100697
Samar J. Melhem , Hamzeh Almomani , Rimal Mousa , Qais Alefan , Nadia Al Mazrouei , Beisan A. Mohammed , Iman Amrani , Rula M. Darwish , Razan Tubeileh , Yazan AlRashadan , Nailya Bulatova , Ibrahim Alabbadi
Background
Social media is now a major arena for Arabic women's health discourse in the MENA region, yet it is unclear how pharmacists' expertise influences both the accuracy and visibility of information across platforms.
Objective
To compare pharmacists' visibility and accuracy with other author groups and to assess how platform, sentiment, and follower dynamics shape the gap between information quality and reach.
Methods
We conducted a cross-sectional content analysis of 682 public Arabic-language posts on women's self-medication and over-the-counter care from Instagram, YouTube, TikTok, Threads, Facebook, and X (January 2024–March 2025). Two independent coders rated accuracy on a four-point scale and classified sentiment (κ > 0.80). Engagement was summarized using the Virtual Presence Index (VPI), an equally weighted composite of standardized likes, comments, and shares/reposts. Proportional-odds ordinal logistic regression modeled predictors of higher accuracy; a non-circular binary logistic model examined determinants of high engagement (above-median VPI) with platform, author type, sentiment, topic, and linear plus quadratic log₁₀(follower count) as covariates.
Results
Pharmacists authored 49.6 % of posts; physicians and other health professionals contributed 37.1 %. Overall, 71.8 % of posts were rated accurate, rising to 94.1 % for pharmacist-authored content. Platform was the strongest predictor of accuracy: compared with Instagram, Facebook, YouTube, Threads, and X had higher odds of higher accuracy, with TikTok showing a smaller but significant advantage. Pharmacist authorship independently predicted higher accuracy, whereas follower count did not. For engagement, platform dominated. With X as the reference, all other platforms had lower adjusted odds of high VPI. Positive sentiment increased the likelihood of high VPI, and follower count showed a U-shaped association, with mid-sized accounts disadvantaged. After adjustment, author-type differences in visibility were modest: pharmacists' posts were more accurate but did not enjoy consistent visibility advantages, especially on highly visual, fast-scroll platforms.
Conclusion
In Arabic women's health discourse online, who speaks matters less for reach than where and how they speak. Pharmacists deliver the most accurate content but often remain “invisible experts” in environments that reward aesthetics and emotion over credentials. The VPI helps quantify this quality–reach gap and can guide platform-specific, culturally attuned strategies to make evidence-based voices more discoverable.
{"title":"Behind the counter, behind the discourse: The paradox of pharmacist influence in Arabic women's health online","authors":"Samar J. Melhem , Hamzeh Almomani , Rimal Mousa , Qais Alefan , Nadia Al Mazrouei , Beisan A. Mohammed , Iman Amrani , Rula M. Darwish , Razan Tubeileh , Yazan AlRashadan , Nailya Bulatova , Ibrahim Alabbadi","doi":"10.1016/j.rcsop.2025.100697","DOIUrl":"10.1016/j.rcsop.2025.100697","url":null,"abstract":"<div><h3>Background</h3><div>Social media is now a major arena for Arabic women's health discourse in the MENA region, yet it is unclear how pharmacists' expertise influences both the accuracy and visibility of information across platforms.</div></div><div><h3>Objective</h3><div>To compare pharmacists' visibility and accuracy with other author groups and to assess how platform, sentiment, and follower dynamics shape the gap between information quality and reach.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional content analysis of 682 public Arabic-language posts on women's self-medication and over-the-counter care from Instagram, YouTube, TikTok, Threads, Facebook, and X (January 2024–March 2025). Two independent coders rated accuracy on a four-point scale and classified sentiment (κ > 0.80). Engagement was summarized using the Virtual Presence Index (VPI), an equally weighted composite of standardized likes, comments, and shares/reposts. Proportional-odds ordinal logistic regression modeled predictors of higher accuracy; a non-circular binary logistic model examined determinants of high engagement (above-median VPI) with platform, author type, sentiment, topic, and linear plus quadratic log₁₀(follower count) as covariates.</div></div><div><h3>Results</h3><div>Pharmacists authored 49.6 % of posts; physicians and other health professionals contributed 37.1 %. Overall, 71.8 % of posts were rated accurate, rising to 94.1 % for pharmacist-authored content. Platform was the strongest predictor of accuracy: compared with Instagram, Facebook, YouTube, Threads, and X had higher odds of higher accuracy, with TikTok showing a smaller but significant advantage. Pharmacist authorship independently predicted higher accuracy, whereas follower count did not. For engagement, platform dominated. With X as the reference, all other platforms had lower adjusted odds of high VPI. Positive sentiment increased the likelihood of high VPI, and follower count showed a U-shaped association, with mid-sized accounts disadvantaged. After adjustment, author-type differences in visibility were modest: pharmacists' posts were more accurate but did not enjoy consistent visibility advantages, especially on highly visual, fast-scroll platforms.</div></div><div><h3>Conclusion</h3><div>In Arabic women's health discourse online, who speaks matters less for reach than where and how they speak. Pharmacists deliver the most accurate content but often remain “invisible experts” in environments that reward aesthetics and emotion over credentials. The VPI helps quantify this quality–reach gap and can guide platform-specific, culturally attuned strategies to make evidence-based voices more discoverable.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"21 ","pages":"Article 100697"},"PeriodicalIF":1.8,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antibiotics are among the most widely prescribed medicines and fall within a well-defined framework for access and supply. Despite existing regulatory systems for antibiotic control, weak regulatory enforcement has led to non-prescription access from community drug retail outlets and widespread self-medication with antibiotics.
Objective
To explore the factors associated with the over-the-counter supply of antibiotics within community pharmacies across Ghana.
Method
The exploratory qualitative study employed semi-structured interviews. The study population consisted of pharmacy practitioners randomly recruited from the medicine retail outlets situated in rural, peri-urban, and urban communities in Ghana. The interview questions were organised within the framework of the theory of planned behaviour and investigated participants' attitudes, social norms, and perceived control over antibiotic use. The data was transcribed, coded, and thematically analysed using NVivo version 10.
Results
Twenty-three pharmacy practitioners (i.e., pharmacists, pharmacy technicians, and medicine counter assistants) participated in the study. Participants described how economic incentives, sales targets, and the perceived social status of customers often pressured them to supply antibiotics without prescriptions, especially in an environment where regulatory oversight was viewed as weak or absent. Many noted that customers felt increasingly entitled to request antibiotics, drawing confidence from online health information and limited public education. Although the participants knew about antibiotics and antimicrobial resistance, their awareness of existing national antimicrobial policies was limited.
Conclusion
The over-the-counter supply of antibiotics in Ghana is fuelled by various factors that differ slightly along the lines of community urbanisation and development. Policy makers must take full cognisance of these factors and adopt community-tailored strategies that target medicine retailers.
抗生素是处方最广泛的药物之一，属于明确界定的获取和供应框架。尽管现有抗生素控制监管体系，但监管执法不力导致从社区药物零售店获得非处方药物，并广泛使用抗生素自行用药。目的探讨加纳社区药店非处方抗生素供应的相关因素。方法采用半结构化访谈法进行探索性质的研究。研究人群包括从加纳农村、城郊和城市社区的药品零售网点随机招募的药学从业人员。访谈问题是在计划行为理论的框架内组织的，调查了参与者的态度、社会规范和对抗生素使用的感知控制。使用NVivo version 10对数据进行转录、编码和主题分析。结果共有23名药学从业人员（药师、药学技术人员和药品柜台助理）参与研究。与会者描述了经济激励、销售目标和客户的社会地位如何常常迫使他们在没有处方的情况下供应抗生素，尤其是在监管被视为薄弱或缺乏监管的环境中。许多人指出，消费者越来越觉得自己有资格要求使用抗生素，这从网上健康信息和有限的公共教育中获得了信心。虽然与会者了解抗生素和抗菌素耐药性，但他们对现有国家抗菌素政策的认识有限。结论加纳非处方抗生素供应受到各种因素的推动，这些因素在社区城市化和发展过程中略有不同。决策者必须充分认识到这些因素，并采取针对药品零售商的针对社区的策略。
{"title":"Informal over-the-counter supply of antibiotics in Ghana: A qualitative analysis of practices in community pharmacies","authors":"Radolf Ansbert Nortey , Irene Akwo Kretchy , Mercy Naa Aduele Opare-Addo","doi":"10.1016/j.rcsop.2025.100696","DOIUrl":"10.1016/j.rcsop.2025.100696","url":null,"abstract":"<div><h3>Background</h3><div>Antibiotics are among the most widely prescribed medicines and fall within a well-defined framework for access and supply. Despite existing regulatory systems for antibiotic control, weak regulatory enforcement has led to non-prescription access from community drug retail outlets and widespread self-medication with antibiotics.</div></div><div><h3>Objective</h3><div>To explore the factors associated with the over-the-counter supply of antibiotics within community pharmacies across Ghana.</div></div><div><h3>Method</h3><div>The exploratory qualitative study employed semi-structured interviews. The study population consisted of pharmacy practitioners randomly recruited from the medicine retail outlets situated in rural, peri-urban, and urban communities in Ghana. The interview questions were organised within the framework of the theory of planned behaviour and investigated participants' attitudes, social norms, and perceived control over antibiotic use. The data was transcribed, coded, and thematically analysed using NVivo version 10.</div></div><div><h3>Results</h3><div>Twenty-three pharmacy practitioners (i.e., pharmacists, pharmacy technicians, and medicine counter assistants) participated in the study. Participants described how economic incentives, sales targets, and the perceived social status of customers often pressured them to supply antibiotics without prescriptions, especially in an environment where regulatory oversight was viewed as weak or absent. Many noted that customers felt increasingly entitled to request antibiotics, drawing confidence from online health information and limited public education. Although the participants knew about antibiotics and antimicrobial resistance, their awareness of existing national antimicrobial policies was limited.</div></div><div><h3>Conclusion</h3><div>The over-the-counter supply of antibiotics in Ghana is fuelled by various factors that differ slightly along the lines of community urbanisation and development. Policy makers must take full cognisance of these factors and adopt community-tailored strategies that target medicine retailers.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"21 ","pages":"Article 100696"},"PeriodicalIF":1.8,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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