Exploratory research in clinical and social pharmacy最新文献

{"title":"The use of automated dispensing cabinets in hospitals","authors":"Melanie Dalby","doi":"10.1016/j.rcsop.2025.100603","DOIUrl":"10.1016/j.rcsop.2025.100603","url":null,"abstract":"","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100603"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060187","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}

{"title":"The role of the community pharmacist in antibiotic use – a commentary on current status and future perspectives","authors":"Maarten Lambert ,&nbsp;Liset van Dijk ,&nbsp;Ria Benko ,&nbsp;Carl Llor ,&nbsp;Jesper Lykkegaard ,&nbsp;Aukje K. Mantel-Teeuwisse ,&nbsp;Lisa Pont ,&nbsp;Katja Taxis","doi":"10.1016/j.rcsop.2025.100652","DOIUrl":"10.1016/j.rcsop.2025.100652","url":null,"abstract":"<div><div>Most antibiotics are prescribed, dispensed, and consumed in the community setting. Community pharmacists have a great potential to optimise antibiotic use and mitigate antibiotic resistance in this setting through antibiotic stewardship. This commentary aims to highlight critical areas where community pharmacists can contribute to optimising antibiotic use and to offer suggestions for how this can be implemented in practice.</div><div>Currently, the role of the community pharmacist is mostly limited to dispensing of antibiotics and treatment of minor infectious ailments. This role needs to evolve to optimise antibiotic use and mitigate resistance development. Following the Social Care Framework for applying person-centred healthcare, there are five strategies through which the role of the community pharmacist can evolve: awareness, adjustment, assistance, alignment, and advocacy. Concretely, this could include many different activities such as better informing and counselling patients, optimising antibiotic treatment duration and choice, exact quantity dispensing, performing point-of-care tests, pharmacist prescribing of antibiotics, and joining academic detailing and public health campaigns.</div><div>To achieve this, education, policy, and research need to be further aligned. In many countries, pharmacy education on antimicrobial stewardship needs a stronger basis in universities, followed by early career specialisation and continuous professional development. National and international policy changes are needed to recognise such specialisations and allow more advanced pharmacy services. Pharmacy research must be expanded and tailored to the community setting with innovative and practice-based designs. This will allow community pharmacists to fully embrace an enhanced position in antibiotic use and primary care.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100652"},"PeriodicalIF":1.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019012","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}

{"title":"Environmentally friendly inhaler decision-making with personalized care in asthma and chronic obstructive pulmonary disease: a qualitative study","authors":"Claire D. Visser ,&nbsp;Alan Sulaiman ,&nbsp;Narrin Bakr ,&nbsp;Henk-Jan Guchelaar ,&nbsp;Martina Teichert","doi":"10.1016/j.rcsop.2025.100651","DOIUrl":"10.1016/j.rcsop.2025.100651","url":null,"abstract":"<div><h3>Background</h3><div>Green behavioral shifts in prescribing habits, device selection and patient counseling have been proposed to deliver low-carbon sustainable healthcare, including the transition from pressurized metered-dose inhalers (pMDIs) to propellant-free inhalers.</div></div><div><h3>Objective</h3><div>This study explores the extent to which healthcare professionals (HCPs) and patients can factor the environmental impact into inhaler decision-making with personalized care in asthma and chronic obstructive pulmonary disease (COPD).</div></div><div><h3>Methods</h3><div>An exploratory qualitative study was conducted involving seven focus groups and one semi-structured interview with 22 participants consisting of general practitioners, community pharmacists, pulmonologists, assistants and patients. Data was analyzed deductively to identify challenges and facilitators related to capability, opportunity and motivation; and inductively for actions to foster environmentally conscious behavior.</div></div><div><h3>Results</h3><div>Overall, participants felt a moral responsibility and were willing to opt for environmentally friendly inhaler initiatives including a shift from pMDIs to dry-powder inhalers (DPIs), if clinically appropriate and performed as outcome of shared decision-making. Collaboration between researchers and relevant stakeholders was required to strengthen their capacity to advance in this area. Proposed strategies covered five areas: (1) communication, education and awareness; (2) appropriate inhaler prescribing; (3) promotion of smarter inhaler choices; (4) optimization of quality of care; and (5) appropriate inhaler disposal.</div></div><div><h3>Conclusion</h3><div>These findings guide the delivery of a range of opportunities to improve quality of care while simultaneously reduce carbon footprint. This requires a multifactorial and interdisciplinary approach with HCPs playing a central role in engaging and educating patients to determine the viability of environmentally friendly alternatives, promote correct inhaler use and appropriate disposal.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100651"},"PeriodicalIF":1.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019013","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}

{"title":"Impact of pharmacist-led chemotherapy counseling on health-related quality of life and psychological outcomes of oncology patients in cancer hospital: A single center, open-label, randomized controlled trial","authors":"Barsha Poudel ,&nbsp;Sabina Sankhi ,&nbsp;Nabin Pathak ,&nbsp;Bijaya Basyal ,&nbsp;Shishir Paudel ,&nbsp;Nirmal Raj Marasine","doi":"10.1016/j.rcsop.2025.100649","DOIUrl":"10.1016/j.rcsop.2025.100649","url":null,"abstract":"<div><h3>Background</h3><div>Chemotherapy often imposes significant psychological distress and impairs the health-related quality of life (HRQoL) of oncology patients. This study aimed to assess the impact of pharmacist-led chemotherapy counseling on HRQoL and psychological outcomes among oncology patients in a cancer hospital in Nepal.</div></div><div><h3>Methods</h3><div>A single-blind, randomized controlled trial was conducted from December 2022 to July 2023 among 128 patients receiving chemotherapy. Patients were randomly allocated in a 1:1 ratio to a control group (usual care) or an intervention group (pharmacist-led counseling plus usual care). The intervention comprised a structured 20–25 min face-to-face counseling session and an educational leaflet addressing cancer, chemotherapy, psychological aspects, and lifestyle modifications. Primary outcomes—anxiety (GAD-7), depression (PHQ-9), and HRQoL (EQ-5D-3L)—were measured at baseline and three months post-intervention. For GAD-7 and PHQ-9, lower scores indicate fewer symptoms; for EQ-5D-3L, higher scores reflect poorer quality of life. Data were analyzed using an intention-to-treat approach and a generalized estimating equation (GEE) model.</div></div><div><h3>Results</h3><div>The intervention group demonstrated significant improvements in anxiety (GAD-7: 13.57 ± 4.08 to 10.90 ± 3.79; <em>p</em> &lt; 0.001), depression (PHQ-9: 17.71 ± 4.57 to 13.50 ± 4.17; p &lt; 0.001), and HRQoL (EQ-5D-3L: 11.82 ± 3.41 to 9.85 ± 2.51; p &lt; 0.001) at three months. The control group showed no significant changes in GAD-7 or EQ-5D-3L scores, but a small increase in PHQ-9 scores was observed. Adjusted GEE analyses confirmed significant reductions in anxiety and depression symptoms, as well as improvements in HRQoL for the intervention group compared with the control group.</div></div><div><h3>Conclusion</h3><div>Pharmacist-led chemotherapy counseling significantly improved psychological well-being and HRQoL among oncology patients, highlighting the valuable role of pharmacists in comprehensive cancer care, especially in low-resource settings.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100649"},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932706","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}

{"title":"Stakeholder feedback regarding a statewide protocol for pharmacists to prescribe tobacco cessation medications","authors":"Lindsey Votaw ,&nbsp;Karen Suchanek Hudmon ,&nbsp;Tiffany R. Shin ,&nbsp;Elizabeth Ablah","doi":"10.1016/j.rcsop.2025.100650","DOIUrl":"10.1016/j.rcsop.2025.100650","url":null,"abstract":"<div><h3>Background</h3><div>Smoking contributes to negative clinical and economic outcomes in the United States, yet most adults who smoke and report wanting to quit do not access counseling or use medications to assist cessation. In rural states, such as Kansas, access to evidence-based tobacco treatment is more challenging, and most quit attempts go unassisted. Although legislation introducing a statewide policy for pharmacists to prescribe all FDA-approved tobacco cessation medications has been implemented in other states, it is unknown if such legislation would be supported in Kansas.</div></div><div><h3>Objective</h3><div>The objective of this study was to characterize stakeholder perceptions of model language for a statewide policy permitting pharmacists to prescribe medications for tobacco cessation in Kansas.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was administered to tobacco control stakeholders, who were asked to review the Indiana Statewide Protocol for Dispensing Tobacco Cessation Products by Pharmacists and provide feedback on each section, via a web-based survey. Associations, insurance carriers, governmental entities, and community pharmacies were approached for recruitment. Collected data were analyzed to identify sections receiving support and to summarize feedback for recommendations to modify the protocol language.</div></div><div><h3>Results</h3><div>Fifteen surveys (34 %) were completed, representing various stakeholder organizations and community pharmacies in Kansas. Sections receiving the most feedback include the introduction, purpose, pharmacist qualifications, products covered, health screening, and referral of high-risk patients.</div></div><div><h3>Conclusion</h3><div>Findings suggest that most tobacco control stakeholders in Kansas will be supportive of a statewide protocol for pharmacists to independently prescribe tobacco cessation products. Sections will be modified, based on respondents' feedback, to create a revised protocol that will be mutually acceptable to all stakeholders.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100650"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925856","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}

{"title":"Driven to stay or leave: Exploring motivation, engagement, and turnover intentions among pharmacists in the healthcare system","authors":"Muna Sabah Murad ,&nbsp;Mohammad Waheedi ,&nbsp;Fatima Jeragh Alhaddad ,&nbsp;Maryam Yousef Baqer ,&nbsp;Farah Atallah Alenezi","doi":"10.1016/j.rcsop.2025.100645","DOIUrl":"10.1016/j.rcsop.2025.100645","url":null,"abstract":"<div><h3>Background</h3><div>High pharmacist turnover remains a global concern, as pharmacists' intention to leave their jobs can lead to increased financial burdens and reduced quality of pharmaceutical care. Understanding the psychological and organizational factors that drive this intention to leave is essential for designing effective retention strategies.</div></div><div><h3>Objectives</h3><div>This study aimed to identify the variables related to motivational needs and work engagement which are associated with pharmacists' intention to leave.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted using a self-administered questionnaire among 288 pharmacists in eight hospitals. The survey assessed multidimensional work motivation, job engagement (UWES-9), and turnover intention. Structural equation modeling (SEM) was used to analyze the interrelations between constructs and demographic variables.</div></div><div><h3>Results</h3><div>Work engagement was negatively associated with turnover intention (β = −0.49), Amotivation was directly associated with higher turnover intention (β = 0.17) and lower engagement (β = − 0.10). Intrinsic motivation had a statistically significant and positive effect on work engagement (β = 0.81). Pharmacists in public hospitals reported higher turnover intention than those in private hospitals (β = − 0.19). Pharmacists less than 40 years old and those in certain hospitals exhibited higher amotivation and intention to leave. Organizational setting influenced several motivational types, with intrinsic, extrinsic social motivation and identified motivation more prevalent among public sector pharmacists.</div></div><div><h3>Conclusion</h3><div>Work engagement and motivation were critical factors impacting pharmacists' turnover intention, with organizational context and age acting as important moderators. Strategies aimed at boosting intrinsic motivation and work engagement, particularly for younger pharmacists, are vital for decreasing turnover and fostering a more stable pharmacy workforce within healthcare systems.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100645"},"PeriodicalIF":1.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913162","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}

{"title":"Australian pharmacists' experiences and perspectives in implementing a chronic kidney disease screening service in community pharmacies: A qualitative study","authors":"Ayana Korsa ,&nbsp;Ines Krass ,&nbsp;Connie Van ,&nbsp;Wubshet Tesfaye ,&nbsp;Natasa Gisev ,&nbsp;Anh Tran ,&nbsp;Rita McMorrow ,&nbsp;Breonny Robson ,&nbsp;Judith Fethney ,&nbsp;Vincent Versace ,&nbsp;Kamal Sud ,&nbsp;Lukas Kairaitis ,&nbsp;David Johnson ,&nbsp;Judy Mullan ,&nbsp;Sanjyot Vagholkar ,&nbsp;Ronald L. Castelino","doi":"10.1016/j.rcsop.2025.100643","DOIUrl":"10.1016/j.rcsop.2025.100643","url":null,"abstract":"<div><h3>Background</h3><div>The emerging role of pharmacists in chronic kidney disease (CKD) care prompted the pharmacy-led screening and quality use of medicines in CKD trial (QUM-CKD), a pharmacy-led screening initiative to detect previously undiagnosed CKD and improve medication safety.Objective: To explore pharmacists' experiences and perspectives on the implementation of the QUM-CKD trial in Australian community pharmacies.</div></div><div><h3>Methods</h3><div>A descriptive phenomenological qualitative approach was employed, involving in-depth, semi-structured telephone interviews with thirteen metropolitan and rural community pharmacists in the trial. Pharmacists were selected via purposive maximum variation sampling and were recruited mid-trial. Interviews were audio- recorded, transcribed verbatim, and thematically analysed using both deductive and inductive approaches in NVivo 14.</div></div><div><h3>Results</h3><div>Most participating pharmacists reported having positive experiences with the trial's implementation. Facilitators of implementation included pharmacists' knowledge and beliefs, the availability of resources, support and training. The alignment with roles, values, and systems, along with perceived benefits of the service, the point-of-care testing service, a whole-team approach, and patient acceptance coupled with positive feedback, also facilitated implementation. Barriers included insufficient pharmacist staffing, time constraints, heavy workload, trial software and documentation issues, patients' lack of time, interest or unfavourable perceptions of the service, and interprofessional communication challenges between pharmacists and general practitioners (GPs). Pharmacists also suggested several potential improvements and expressed concerns about the sustainability of the service.</div></div><div><h3>Conclusions</h3><div>Australian community pharmacists generally reported positive experiences in implementing the QUM-CKD trial. To ensure the service's success and sustainability, we recommend adequate pharmacy staffing, appropriate pharmacist remuneration, active stakeholder promotion and strong interprofessional collaboration. Pharmacists' suggestions for service improvement should also be considered.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100643"},"PeriodicalIF":1.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902165","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}

{"title":"Factors affecting career-related decisions within the contemporary pharmacy workforce in Australia","authors":"Jocelyn Bussing,&nbsp;Lorraine Smith,&nbsp;Bandana Saini","doi":"10.1016/j.rcsop.2025.100648","DOIUrl":"10.1016/j.rcsop.2025.100648","url":null,"abstract":"<div><h3>Introduction</h3><div>Pharmacists are essential to healthcare delivery in Australia, making effective workforce planning critical to ensure equitable health outcomes. This study explores factors influencing the career decisions of Australian pharmacists from diverse demographic and geographical backgrounds with implications for recruitment, retention and policy strategies to address workforce shortages.</div></div><div><h3>Method</h3><div>We conducted semi-structured interviews between November 2022–February 2024. An interview guide informed by relevant literature was used to facilitate the interview process. Participants were recruited through purposive convenience sampling complemented by passive snowballing. All interviews were recorded, field notes were taken and the data transcribed, deidentified, and analysed using NVivo software through an inductive thematic process.</div></div><div><h3>Results</h3><div>Participants exhibited a range of ages, genders, practice settings and locations, which revealed distinct career trajectories and decision-making influences. Three main themes emerged: career initiation (choosing pharmacy as a profession), career development, satisfaction and retention, and the roles of gender, geography and other life issues. Findings indicate that the initial choice to pursue pharmacy was driven by personal aptitude, accessible training locations, promising employability, gender-suitable work configurations, flexibility, and early educational exposure. Early career decisions were shaped by factors such as mentorship, specialised roles, employee benefits, and supportive work environments, while personal life factors further influenced career trajectories. Leadership or ownership aspirations were notably tied to mentors and role models. Limitations include underrepresented perspectives, limited gender diversity among participants, and an all-female research team.</div></div><div><h3>Conclusion</h3><div>These nuanced insights offer Australian pharmacy leaders and policy makers factors to address or capitalise on, to ensure a robust, equitably distributed and motivated workforce.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100648"},"PeriodicalIF":1.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907230","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}

{"title":"Impact of pharmaceutical care interventions on antidepressants adherence and clinical outcomes in depressed patients: A systematic review","authors":"Nirmal Raj Marasine ,&nbsp;Sabina Sankhi ,&nbsp;Shishir Paudel ,&nbsp;Anisha Chalise ,&nbsp;Rajendra Lamichhane","doi":"10.1016/j.rcsop.2025.100644","DOIUrl":"10.1016/j.rcsop.2025.100644","url":null,"abstract":"<div><h3>Background</h3><div>Medication non-adherence, impaired health-related quality of life (HRQoL), increased depression severity, and patient dissatisfaction are common challenges among patients with depression. This systematic review aimed to evaluate the impact of pharmaceutical care interventions (PCIs) on antidepressant adherence, HRQoL, depression severity, and patient satisfaction.</div></div><div><h3>Methods</h3><div>This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted across PubMed, EMBASE, Web of Science, Scopus, PsycINFO, and CINAHL for randomized controlled trials (RCTs) published between 2000 and 2024. Studies evaluating pharmacist-led pharmaceutical care interventions aimed at improving antidepressant use and related outcomes were included. Data extraction and risk of bias assessment were performed using standardized forms and the Cochrane Collaboration's Risk of Bias tool.</div></div><div><h3>Results</h3><div>Fifteen RCTs met the inclusion criteria. Common intervention strategies included patient education, counseling, telephone follow-ups, and drug monitoring. Nine studies reported statistically significant improvements in antidepressant adherence. Of the three studies assessing HRQoL, one demonstrated significant improvement. Four of thirteen studies showed a significant reduction in depression severity, and three of five studies reported increased patient satisfaction in the intervention group compared to controls<strong>.</strong></div></div><div><h3>Conclusion</h3><div>Pharmaceutical care interventions, particularly patient education and counseling, contribute meaningfully in improving antidepressant adherence and related patient outcomes. However, findings across studies are inconsistent due to variability in intervention components, measurement tools, delivery methods, and outcome measures. Further research should focus on well-designed, large randomized trials with standardized, therory-based interventions.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100644"},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892834","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}

{"title":"Criteria pharmacists use to refer patients to a post discharge pharmacist review clinic","authors":"Adrienne Kostellar ,&nbsp;Michael Barras ,&nbsp;Ian Coombes ,&nbsp;Andrew Hale ,&nbsp;Carla Scuderi ,&nbsp;Neil Cottrell ,&nbsp;Nazanin Falconer","doi":"10.1016/j.rcsop.2025.100647","DOIUrl":"10.1016/j.rcsop.2025.100647","url":null,"abstract":"<div><h3>Background</h3><div>The transition from hospital discharge to primary care is a critical period in a patient's healthcare journey. Health system errors occur, due to a breakdown in communication or lack of structured planning which can lead to medication related harm or hospital readmission. At a quaternary referral hospital in Australia, pharmacists refer Internal Medicine patients to a pharmacist-led clinic for post-discharge medication review. While clinical resources exist to guide identification of at-risk patients, it remains unclear if and to what extent, pharmacists incorporate these criteria into their referral.</div></div><div><h3>Aim</h3><div>To determine the criteria and reasons used by pharmacists to refer Internal Medicine patients to a post discharge pharmacist review clinic.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with hospital pharmacists who had worked in Internal Medicine and previously referred patients to the post discharge review clinic. Interviews were conducted until data saturation was obtained. Interviews were audio recorded, transcribed and coded using NVivo®. Themes and subthemes were identified through inductive thematic analysis and finalised via discussion within the research team.</div></div><div><h3>Results</h3><div>Eleven pharmacists were interviewed. Five themes emerged describing referral criteria and reasons: (1) medication criteria including the use of high-risk medications and adjustments; (2) patient criteria including health status, frailty and social aspects of health including carer supports; (3) system pressures including patient flow and time constraints in care delivery; (4) post-discharge care including medication liaison and evaluation of tolerability and; (5) clinical judgement described as “worry” about the patient, highlighting the role of clinical reasoning.</div></div><div><h3>Conclusion</h3><div>Pharmacists used established criteria from clinical resources to identify high-risk patients for referral; however, they also relied on clinical judgement. Referrals aimed to prevent medication related harm and improve communication with patients and healthcare providers. Future research should evaluate the effectiveness of clinical judgement to ensure high-risk patients are identified for transition of care services.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100647"},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895772","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}