Exploratory research in clinical and social pharmacy最新文献

{"title":"Off-label prescribing of tamsulosin: A nationwide retrospective study combining prescription and regulatory data","authors":"Anna Artner ,&nbsp;Ákos Niedermüller ,&nbsp;Máté Attila Csapó ,&nbsp;Nikoletta Ngo Hanh ,&nbsp;Emília Fekete ,&nbsp;Romána Zelkó ,&nbsp;Szilvia Sebők","doi":"10.1016/j.rcsop.2025.100679","DOIUrl":"10.1016/j.rcsop.2025.100679","url":null,"abstract":"<div><h3>Background</h3><div>Off-label use of medicines raises important safety and regulatory concerns. Tamsulosin, an alpha-1 adrenergic receptor blocker originally approved for benign prostatic hyperplasia (BPH) in men, is also prescribed beyond licensed indications.</div></div><div><h3>Aim</h3><div>This study aimed to describe national on-label and off-label prescribing patterns of tamsulosin in Hungary using insurance and regulatory data.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, cross-sectional descriptive analysis of two national datasets: the National Health Insurance Fund (NEAK) database of reimbursed prescriptions (2019–2023) and the National Institute of Pharmacy and Nutrition (NNGYK) records of off-label authorisations (2009–2023). Prescriptions were analyzed by sex and International Classification of Diseases 10th Revision (ICD-10) codes.</div></div><div><h3>Results</h3><div>A total of 906,011 prescriptions were linked to 214 ICD-10 codes; 805 entries lacked identifiable codes. Of these, 888,830 (98.1 %) were for men and 17,181 (1.9 %) for women. Female prescriptions most frequently carried codes for ureteral stones (2805; 16.3 %), dysuria (1872; 10.9 %), urinary retention (1722; 10.0 %), and kidney stones (1498; 8.7 %). Notably, 2845 prescriptions (16.6 %) in women were linked to prostate-related codes, suggesting coding errors. NNGYK approved eight individual off-label requests, mainly for urological indications.</div></div><div><h3>Conclusions</h3><div>Off-label tamsulosin prescribing in Hungary is relatively infrequent but concentrated in women. These findings highlight the importance of pharmacovigilance, clinician awareness, and further research to clarify its therapeutic role in non-BPH indications.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100679"},"PeriodicalIF":1.8,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465657","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 triple burden: A systematic review and meta-analysis of essential medicine availability, price, and affordability across Ethiopian health facilities","authors":"Tsegaye Melaku,&nbsp;Dula Dessalegn,&nbsp;Mestawet Getachew","doi":"10.1016/j.rcsop.2025.100674","DOIUrl":"10.1016/j.rcsop.2025.100674","url":null,"abstract":"<div><h3>Background</h3><div>Access to essential medicines is a fundamental component of achieving universal health coverage, as outlined by the World Health Organization's(WHO) framework. Despite various efforts to improve access to essential medicines, there remains a gap in comprehensive data regarding their availability, price, and affordability at health facilities in Ethiopia. This systematic review and meta-analysis aimed to assess the pooled estimates of availability, price, and affordability of generic essential medicines at health facilities in Ethiopia.</div></div><div><h3>Methods</h3><div>We conducted a complete search of electronic databases (PubMed/MEDLINE, EMBASE, Science Direct, Web of Science, Scopus, African Index Medicus, AJOL, Google Scholar, and Organization repositories such as the Ministry of Health, Ethiopian Pharmaceuticals Supply Service) to find relevant articles on the topic from inception to August 2025. Data was analyzed using STATA version 18.0. Random-effect model meta-analysis and descriptive statistics were performed to determine the pooled availability and affordability, respectively. Statistical significance was considered at a <em>p</em>-value less than 0.05.</div></div><div><h3>Results</h3><div>A total of 46 studies, encompassing data from 2302 health facilities, were included in the final analysis. The overall mean availability of essential medicines was 63.89 % (± 19.48 SD). In public health facilities, the pooled availability was 64 % (95 % CI: 58 %–70 %), while in private facilities it was lower at 54 % (95 % CI: 42 %–66 %). The pooled proportion of unaffordable medicines was 62 % (95 % CI: 45 %–79 %). Analysis of the Median Price Ratios (MPRs) revealed that, in public health facilities, MPRs ranged from 0.55 to 5.21, with an overall median (IQR) of 1.45 (1.26–2.31). In private health facilities, MPRs ranged from 0.88 to 11.17, with a higher overall median (IQR) of 3.66 (2.12–4.10), reflecting greater price variability and reduced affordability in the private sector.</div></div><div><h3>Conclusion</h3><div>The availability of generic essential medicines in Ethiopia was below the WHO target of 80 % in both public and private health facilities. Prices of these medicines were higher than international reference prices, with significant variations across sectors. About two-thirds of the evaluated medicines were unaffordable. Addressing these challenges will require coordinated efforts, including policy refinement, supply chain improvements, and context-specific interventions, to progressively enhance equitable access to essential medicines across all sectors.</div><div><strong>Systematic review registration number:</strong> PROSPERO CRD420251137000.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100674"},"PeriodicalIF":1.8,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415759","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":"Design and evaluation of a comprehensive training program for hospital-based clinical pharmacists - various, active, and work-integrated learning","authors":"Marianne Lea ,&nbsp;Elin Trapnes ,&nbsp;Hanne Steen ,&nbsp;Nina Bjerketveit Ødegaard","doi":"10.1016/j.rcsop.2025.100677","DOIUrl":"10.1016/j.rcsop.2025.100677","url":null,"abstract":"<div><h3>Background</h3><div>Medication reconciliation and -reviews are not emphasized in the pharmacy curriculums in Norway and graduated pharmacists are at novice level. Therefore, a postgraduate training program for hospital-based clinical pharmacists was developed. The aim of this paper is to describe the program design and evaluation of the last four years (2021–2024).</div></div><div><h3>Method</h3><div>The training program, established in 2012, used Southern Sweden's training in Integrated Medicines Management as inspiration. Experienced clinical pharmacists in Norway have further developed and improved the program. The training program comprises i) a three-day in-class and skill training course in a simulation lab ii) eight days in a hospital ward performing medication reconciliations and - reviews under individual supervision from a clinical supervisor, i.e. an experienced clinical pharmacist, and iii) independently conducted medication reconciliations and –reviews presented to the supervisor for feedback and reflection.</div></div><div><h3>Results</h3><div>Of 46 participants in the last four years, 39 (85 %) completed a questionnaire. Participants scored their overall satisfaction with a median of 6 (range 4–6) on a scale from 1 to 6. Participants highlighted the way the course is organized and facilitated by skilled lecturers, active learning with feedback, peer learning, and work relevance as positive factors.</div></div><div><h3>Conclusion</h3><div>A comprehensive work-integrated training program with various and active learning methods that can be used as a template in settings where pharmacists graduate at novice level in medication reconciliation and -reviews has been developed. The program is appreciated by participants, seems to improve their professional confidence, and could ensure standardised high quality clinical pharmacy services.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100677"},"PeriodicalIF":1.8,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571225","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 short medication adherence scale (SMAS-7): Development and psychometric validation in a general population sample","authors":"Fouad Sakr ,&nbsp;Mariam Dabbous ,&nbsp;Jihan Safwan ,&nbsp;Mohamad Rahal ,&nbsp;Pascale Salameh","doi":"10.1016/j.rcsop.2025.100676","DOIUrl":"10.1016/j.rcsop.2025.100676","url":null,"abstract":"<div><h3>Background</h3><div>Medication adherence is essential for treatment success across both chronic and acute conditions. However, concise, multidimensional, and broadly applicable validated tools to measure medication adherence remain scarce.</div></div><div><h3>Objectives</h3><div>This study primarily aimed to develop and validate the Short Medication Adherence Scale (SMAS-7) and, secondarily, to assess adherence levels and related factors in a general adult population.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted among Lebanese adults aged ≥18 years from the general population. Individuals who declined follow-up contact for the test-retest phase were excluded. The 7-item SMAS-7, developed from the LMAS-14, was administered electronically in Arabic using an online questionnaire. Exploratory and confirmatory factor analyses (EFA and CFA) were performed on two random subsamples to assess factorial structure and model fit. Internal consistency (Cronbach's α, McDonald's ω), test-retest reliability (ICC), and construct and criterion validity were evaluated. Multivariable logistic regression identified predictors of adherence using a ROC curve-derived SMAS-7 cut-off score.</div></div><div><h3>Results</h3><div>A total of 501 participants were included in the study. EFA revealed a 3-factor structure, psychological, economic, and behavioral domains, supported by KMO = 0.830 and significant Bartlett's test (<em>P</em> &lt; 0.001). CFA confirmed the structure with excellent fit (χ²/df = 1.757, CFI = 0.992, TLI = 0.985, RMSEA = 0.055, SRMR = 0.020). The SMAS-7 demonstrated high internal consistency (α = 0.889, ω = 0.945) and test-retest reliability (ICC = 0.779). Criterion validity was excellent (AUC = 0.985; sensitivity = 91.2 %; specificity = 96.0 %). Suboptimal adherence was observed in 52.3 % of participants. Significant predictors of adherence included gender (<em>P</em> = 0.030), region (<em>P</em> = 0.014), financial well-being (<em>P</em> = 0.002), chronic illness (<em>P</em> = 0.009), communication barriers (<em>P</em> = 0.013), and patient perception (<em>P</em> = 0.029).</div></div><div><h3>Conclusion</h3><div>The SMAS-7 demonstrated strong preliminary psychometric properties in this initial validation study. It offers a valuable resource for researchers, clinicians, and policymakers seeking to monitor and enhance adherence behaviors. While these findings are encouraging, further studies in diverse populations and clinical settings are required to confirm its external validity and generalizability. The findings revealed suboptimal adherence and underscored the multifaceted nature of its predictors, highlighting the need for targeted, multidimensional interventions.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100676"},"PeriodicalIF":1.8,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415761","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":"A data-driven approach to optimizing waiting times in outpatient pharmacy services: Interrupted time series analysis","authors":"Hazzaa Alghamdi ,&nbsp;Talal S. Alshihayb ,&nbsp;Yazeed Alharbi ,&nbsp;Mohammad Alawagi ,&nbsp;Abdullah Aleissa ,&nbsp;Yasser Albogami","doi":"10.1016/j.rcsop.2025.100672","DOIUrl":"10.1016/j.rcsop.2025.100672","url":null,"abstract":"<div><h3>Background</h3><div>Operational efficiency in outpatient pharmacies is a critical factor in healthcare delivery, directly impacting patient satisfaction and adherence to prescribed treatments. Prolonged waiting times in pharmacies can lead to patient dissatisfaction, reduced medication adherence, and potential health risks.</div></div><div><h3>Objective</h3><div>This study aimed to analyze the impact of a data-driven intervention on reducing patient waiting times in an outpatient pharmacy at a tertiary hospital, with a goal of ensuring that patients are served within 30 min of ticket issuance.</div></div><div><h3>Methods</h3><div>The study utilized data from the “Qsmart” ticketing system, covering October 2022 to November 2023. A descriptive analysis was conducted to identify peak service hours and assess staffing patterns. An interrupted time series analysis (ITSA) was employed to evaluate the effectiveness of an intervention implemented between January 22 and February 26, 2023. The intervention included increased staffing during peak hours, adjustments to break schedules, and enhanced pre-peak hour preparations.</div></div><div><h3>Results</h3><div>The descriptive analysis revealed peak service hours between 9 AM and 11 AM, with the highest number of tickets issued at 10 AM. The intervention produced a significant immediate level reduction in waiting times of 0.1540 (95 %CI: 0.0421,0.2659) but there was <strong>no additional post-intervention slope change</strong>, indicating that the improvement was not progressively increasing over time.</div></div><div><h3>Conclusion</h3><div>The data-driven intervention effectively reduced waiting times in the outpatient pharmacy, with significant immediate improvements observed. This study highlights the potential of strategic operational adjustments to enhance service efficiency and patient satisfaction. Further research is needed to validate the sustainability and generalizability of these findings in other settings.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100672"},"PeriodicalIF":1.8,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465616","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":"Unmet information needs and knowledge gaps in cancer patients undergoing oral anticancer therapy","authors":"Anna K. Moritz ,&nbsp;Wolfgang Fehrmann ,&nbsp;Markus K. Schuler ,&nbsp;Stephanie Stock ,&nbsp;Ulrich Jaehde ,&nbsp;Nicole Ernstmann","doi":"10.1016/j.rcsop.2025.100678","DOIUrl":"10.1016/j.rcsop.2025.100678","url":null,"abstract":"<div><h3>Background</h3><div>The increasing use of oral anticancer therapy (OAT) requires self-management skills from cancer patients. Adequate information and counseling, as well as medication literacy, are key elements of safe and successful therapy in the patient's home.</div></div><div><h3>Objective</h3><div>The aim of the study was to identify unmet information needs and knowledge gaps of cancer patients regarding their therapy with OAT.</div></div><div><h3>Methods</h3><div>Semi-structured, guideline-based interviews with cancer patients undergoing OAT were conducted, recorded and professionally transcribed. The transcripts were analysed using qualitative content analysis.</div></div><div><h3>Results</h3><div>A total of 21 interviews were conducted. Fifteen of the interviewees were female, the median age was 69.6 years. Patients with solid tumours as well as those with blood cancers were interviewed. In the interviews, experiences were reported with various classes of OATs (chemotherapy; anti-hormonal therapy; targeted therapy). The following themes were identified: 1) Therapy-related information needs; 2) No information received; 3) No awareness for information needs; 4) No need for more information; 5) Therapy-related knowledge gaps; 6) Potentially inadequate knowledge. Deficits were identified in relation to correct use, possible interactions, and dealing with adverse events. Individual patients also report actively avoiding information.</div></div><div><h3>Conclusion</h3><div>The identified information needs and knowledge gaps of patients undergoing OAT highlight the need to optimize information and counseling in order to ensure treatment safety and success. In addition to providing knowledge, the self-management skills of patients should also be specifically strengthened. Furthermore, improvements to the structural framework in the outpatient setting are necessary, particularly with regard to the availability of counseling services. The results can be used as a basis for the development of specific interprofessional educational interventions for those affected.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100678"},"PeriodicalIF":1.8,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465617","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":"Overemployment and underemployment of part-time pharmacists: Prevalence and connection to work-life characteristics","authors":"David A. Mott ,&nbsp;William R. Doucette ,&nbsp;Eilan Alhersh ,&nbsp;Vibhuti Arya ,&nbsp;Brianne K. Bakken ,&nbsp;Caroline Gaither ,&nbsp;David H. Kreling ,&nbsp;Jon C. Schommer ,&nbsp;Matthew Witry","doi":"10.1016/j.rcsop.2025.100673","DOIUrl":"10.1016/j.rcsop.2025.100673","url":null,"abstract":"<div><h3>Background</h3><div>Overemployment and underemployment are associated with fluctuations in labor supply and can negatively impact psychosocial aspects of work and worker health.</div></div><div><h3>Objectives</h3><div>The objectives of this study were to 1) determine the prevalence and characteristics of underemployment, overemployment and matched employment among part-time pharmacists; 2) examine differences in actual and ideal hours worked for overemployed and underemployed part-time pharmacists; and 3) test associations between overemployment, underemployment and matched employment and part-time pharmacists' perceptions of job quality and work-life characteristics.</div></div><div><h3>Methods</h3><div>Data for 636 pharmacists self-reporting working part-time (≤ 30 h/week) were extracted from the 2019 National Pharmacists Workforce Study. The difference in self-reported actual and ideal hours worked weekly was calculated and used to classify part-time pharmacists as overemployed, underemployed or matched employed. Differences between the variables were tested with multivariate ordinary least squares regression models.</div></div><div><h3>Results</h3><div>Being matched employed was most common (41.3 %) followed by underemployed (34.9 %) and being overemployed (23.8 %). Of underemployed respondents, over half (54.1 %) reported wanting to work full-time, which likely is reflective of the relatively loose national pharmacist labor market in 2019. Overemployed and underemployed respondents reported significantly lower levels of several of the work-life characteristics relative to those with matched employment.</div></div><div><h3>Conclusion</h3><div>The higher rate of underemployment among pharmacists working part-time is consistent with the surplus of US pharmacists in 2019. The results show that for pharmacists working part-time, a lack of control over how much they work is negatively associated with job quality and work-life characteristics relative to pharmacists with work schedule control.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100673"},"PeriodicalIF":1.8,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415762","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 community leaders on rational drug use literacy: A structural equation modeling","authors":"Thunpitcha Sakpirom ,&nbsp;Kusawadee Maluangnon ,&nbsp;Chaoncin Sooksriwong ,&nbsp;Apinya Ingard","doi":"10.1016/j.rcsop.2025.100675","DOIUrl":"10.1016/j.rcsop.2025.100675","url":null,"abstract":"<div><h3>Background</h3><div>Irrational drug use remains a global health challenge, particularly in underserved communities with limited healthcare access. In Thailand, despite the Rational Drug Use (RDU) initiative, problems such as antibiotic misuse and selfmedication persist. Rational Drug Use Literacy (RDUL)—the ability to access, understand, evaluate, and apply drug information—is vital for improving medication behaviors. While most efforts focus on health professionals, the role of community leaders has been less explored.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 328 participants in Pathum Thani Province, including 168 community members and 160 community leaders selected through stratified random sampling. Data were collected using a structured questionnaire and a validated RDUL tool. Structural Equation Modeling (PLS-SEM) was used to assess direct and moderating effects of situational and socioenvironmental factors on RDUL.</div></div><div><h3>Results</h3><div>Community leaders exhibited higher Rational Drug Use Literacy (RDUL) than community members (M = 41.90 vs. 39.48, <em>p</em> = .003), particularly in accessing, appraising, and applying drug information. Structural Equation Modeling revealed that both situational factors (β = 0.357, <em>p</em> &lt; .001) and socio-environmental factors (β = 0.168, <em>p</em> = .021) positively influenced RDUL, indicating that favorable circumstances and supportive environments enhance individuals' medication literacy. Importantly, leadership played a nuanced role: it diminished the influence of situational factors on RDUL (β = −0.634, <em>p</em> &lt; .001) while moderately amplifying the effect of socioenvironmental factors (β = 0.327, <em>p</em> = .058). These results highlight that community leaders not only enhance overall medication literacy but also alter how contextual factors contribute to informed drug use.</div></div><div><h3>Conclusions</h3><div>Community leaders play a complex but crucial role in shaping RDUL. While they strengthen certain literacy dimensions, their influence also alters contextual effects. RDUL strategies should leverage leaders as trusted figures while enhancing their capacity to promote informed medication use. Incorporating community leadership into health programs may increase the effectiveness and sustainability of RDU efforts in resource-limited settings.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100675"},"PeriodicalIF":1.8,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415760","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":"Assessment of insulin pen injection practices and the effectiveness of pharmacist interventions in improving injection technique among patients with diabetes mellitus","authors":"Bidur Sharma ,&nbsp;Devindra Kumar Neupane ,&nbsp;Rahi Bikram Thapa ,&nbsp;Rajani Shakya ,&nbsp;Rojeena Koju Shrestha ,&nbsp;Pooja Rimal","doi":"10.1016/j.rcsop.2025.100671","DOIUrl":"10.1016/j.rcsop.2025.100671","url":null,"abstract":"<div><h3>Background</h3><div>Insulin therapy is crucial for Type 1 and advanced Type 2 diabetes management. Despite the convenience of insulin pens, improper use persists due to limited patient education. Pharmacists' expertise in counseling and medication safety uniquely positions them to address these gaps through individualized guidance on use, adherence, and monitoring.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the impact of pharmacist-led interventions on improving insulin injection practices among diabetes patients.</div></div><div><h3>Methods</h3><div>A pre–post interventional study was conducted at Dhulikhel Hospital (April–September 2018) among 81 consecutively enrolled insulin pen users (≥12 years; on pens ≥2 weeks) from inpatient and outpatient wards. Patients underwent baseline assessment of 16 injection technique elements, received one-to-one pharmacist-led training with demonstration, and were reassessed immediately and after 2 weeks. The primary outcome was the total technique score (0–16), analyzed using Friedman's test and Wilcoxon signed-rank test.</div></div><div><h3>Results</h3><div>Cold chain maintenance was suboptimal, with 51.9 % of patients transporting insulin cartridges without an icepack. Unsafe needle disposal was common, with 40.7 % discarding needles in municipal vehicles, 13.6 % in bushes, and 4.9 % in rivers. Pharmacist-led interventions significantly improved all practices (<em>p</em> &lt; 0.05). Proper cartridge storage increased from 77.8 % pre-intervention to 91.4 % post-intervention and 88.6 % at two weeks. Correct room temperature pen storage rose from 49.4 % to 95.1 % post-intervention, declining slightly to 70.8 % at two weeks. Correct insulin mixing surged from 7.8 % to 100 % post-intervention, remaining at 81.1 % at two weeks. Injection technique scores significantly improved (median pre = 10, post = 15) and were largely sustained (median two-weeks = 14).</div></div><div><h3>Conclusion</h3><div>Pharmacist-led education significantly improved insulin injection techniques. Integrating pharmacists into routine diabetes care and reinforcing education is essential to sustain these improvements. These findings underscore that clinical pharmacy interventions make a tangible difference in improving healthcare outcomes.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100671"},"PeriodicalIF":1.8,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319930","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 impact of patient information on prescribing errors: Insights from pharmaceutical interventions","authors":"Daisuke Koike ,&nbsp;Masahiro Ito ,&nbsp;Keiko Tomomatsu ,&nbsp;Ryuta Shindo ,&nbsp;Terumi Miyashita ,&nbsp;Junichi Yamakami ,&nbsp;Akihiko Horiguchi ,&nbsp;Shigeki Yamada","doi":"10.1016/j.rcsop.2025.100665","DOIUrl":"10.1016/j.rcsop.2025.100665","url":null,"abstract":"<div><h3>Background</h3><div>Medication errors are more likely to occur in patients with complex conditions, where appropriate prescribing requires accurate and comprehensive patient information. Inadequate use of such information, such as overlooking laboratory results or patient weight, can lead to dosing errors or contraindicated prescriptions, even with electronic checking systems. This study aimed to analyze prescribing errors detected through pharmaceutical interventions, focusing on the patient information in the hospital information system.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 9774 pharmaceutical interventions performed between April 2019 and March 2020. Of these, 3372 interventions related to patient information stored in hospital information system were included. Prescribing errors were categorized into five patient-specific information categories: allergy information, laboratory data, concomitant drugs, patient weight, and patient status and history. Demographic and prescription data were analyzed, and a heatmap was developed to visualize high-risk areas.</div></div><div><h3>Results</h3><div>Among the included interventions, 1352 (40.1 %) prescriptions involved corrections of prescribing errors, with laboratory data being the most frequently utilized patient information source (<em>n</em> = 2526). Error rates were higher in weekend settings compared to weekday settings (56.2 % vs. 38.3 %, <em>P</em> &lt; 0.001, Cramér's V = 0.111), and prescriptions for patients younger than 20 years exhibited the highest error rates among age groups (66.9 %; <em>P</em> &lt; 0.001). Error rates were significantly varied by drug type (P &lt; 0.001, Cramér's V = 0.395). Among these, digestive drugs showed the highest error rates (69.1 %), particularly those requiring renal dosing adjustments. Conversely, anti-tumor agents demonstrated a lower error rate (15.9 %) due to stringent monitoring processes. The high-risk heatmap highlighted specific risks, such as weight data for younger patients and patient status for anti-inflammatory drugs.</div></div><div><h3>Conclusion</h3><div>Laboratory data were the most frequently used information source, to prevent prescribing errors. The risk heatmap demonstrated weekends, pediatric patients, and renal dosing as high-risk areas. These findings suggest that future information systems should enhance the utility of laboratory data and incorporate tailored alerting strategies focused on high-risk patient conditions and clinical settings, such as real-time lab data alerts or weight-based dosing calculators, and potentially explore the use of AI for proactive error prevention.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100665"},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265317","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}