High-alert medications are recognised as those carrying heightened risk of causing significant patient harm when used erroneously.
Objective
To develop a high-alert medications self-assessment tool for Finnish community pharmacies.
Methods
The tool was developed using a three-phase Delphi method and is based on the Institute for Safe Medication Practices´ Medication Safety Self Assessment® for High-Alert Medications, which comprises 380 items. A pre-Delphi round was first conducted to assess tool's applicability for Finnish pharmacies, followed by two Delphi rounds with a multidisciplinary expert panel evaluating the applicability and desirability of each item. A consensus rate of 70 % was defined. Following the Delphi rounds, the tool was finalized through refinement, removal of duplicates, and reorganization.
Results
Consensus was reached on 114 items, resulting in a finalized self-assessment tool organized into eight sections covering medicine groups such as insulin and oral diabetes medicines, anticoagulants, opioids, immunosuppressants, methotrexate, and over-the-counter high-alert medications. After the first Delphi round, 33 items were accepted without changes and 97 were revised. After the second Delphi round, 77 items were transferred to the final tool as such, 35 were modified and 21 were removed.
Conclusion
The developed high-alert self-assessment tool offers a structured method for evaluating existing practices and implementing targeted safety measures, addressing a specific need in community pharmacies, where such resources are limited. While further validation and implementation research are needed, the tool represents a practical step toward enhancing medication safety and promoting continuous improvement in pharmacy practice.
{"title":"Developing a medication safety self-assessment tool for high-alert medications in community pharmacies","authors":"Rositsa Koleva , Anita Währn , Ercan Celikkayalar , Sonja Kallio , Raisa Laaksonen","doi":"10.1016/j.rcsop.2025.100664","DOIUrl":"10.1016/j.rcsop.2025.100664","url":null,"abstract":"<div><h3>Background</h3><div>High-alert medications are recognised as those carrying heightened risk of causing significant patient harm when used erroneously.</div></div><div><h3>Objective</h3><div>To develop a high-alert medications self-assessment tool for Finnish community pharmacies.</div></div><div><h3>Methods</h3><div>The tool was developed using a three-phase Delphi method and is based on the Institute for Safe Medication Practices´ Medication Safety Self Assessment® for High-Alert Medications, which comprises 380 items. A pre-Delphi round was first conducted to assess tool's applicability for Finnish pharmacies, followed by two Delphi rounds with a multidisciplinary expert panel evaluating the applicability and desirability of each item. A consensus rate of 70 % was defined. Following the Delphi rounds, the tool was finalized through refinement, removal of duplicates, and reorganization.</div></div><div><h3>Results</h3><div>Consensus was reached on 114 items, resulting in a finalized self-assessment tool organized into eight sections covering medicine groups such as insulin and oral diabetes medicines, anticoagulants, opioids, immunosuppressants, methotrexate, and over-the-counter high-alert medications. After the first Delphi round, 33 items were accepted without changes and 97 were revised. After the second Delphi round, 77 items were transferred to the final tool as such, 35 were modified and 21 were removed.</div></div><div><h3>Conclusion</h3><div>The developed high-alert self-assessment tool offers a structured method for evaluating existing practices and implementing targeted safety measures, addressing a specific need in community pharmacies, where such resources are limited. While further validation and implementation research are needed, the tool represents a practical step toward enhancing medication safety and promoting continuous improvement in pharmacy practice.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100664"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265321","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 : 2025-09-30DOI: 10.1016/j.rcsop.2025.100666
Ingrid Ferrer López , Antonio Olry de Labry-Lima , Alicia Gutiérrez-Valencia , Encarnación García Bermúdez , Francisco Atienza Martín , Amalia García-Delgado Morente , María Dolores Murillo Fernández , Yolanda Sánchez Cañete , Clara Bermúdez-Tamayo
Background
Multicomponent strategies can reduce benzodiazepine (BZD) use. BenzoStopJuntos (Spanish for “Stop Benzos Together”), a multidisciplinary deprescribing programme of the Andalusian Health Service, supports patients to taper/stop BZD through education, behavioral support, and non-pharmacological alternatives. We evaluated whether early changes (6 months) in risk perception and attitudes—and secondarily, quality of life—were associated with long-term discontinuation of BZD.
Methods
In a quasi-experimental pre–post study in two primary care centres (Seville, Spain; n = 243), the intervention included patient education, tapering support, and alternatives for anxiety/insomnia delivered by a multidisciplinary team. Primary outcomes were (a) short-term (6-month) changes in risk perception and attitudes and (b) long-term BZD discontinuation over 5.5 years; the secondary outcome was quality of life (WONCA/COOP), monitored to detect potential harms. Multivariable logistic regression examined whether 6-month changes in beliefs/attitudes predicted subsequent discontinuation, adjusting for sociodemographic and clinical factors.
Results
BZD discontinuation increased from 31.3 % at 6 months to 40.7 % at 5.5 years. Participants who considered BZD safe long-term were more likely to continue use (OR = 2.0; 95 % CI: 1.6–2.6). Fears of worsened anxiety/sleep strongly predicted persistence (OR = 4.7; 95 % CI: 3.6–6.1). Prior intermittent vs continuous use favored discontinuation (OR = 4.9; 95 % CI: 3.7–6.5). Quality of life improved in emotional, social, and physical domains, with no deterioration observed during follow-up.
Conclusions
Tailored education and behavioral strategies changed risk perceptions and attitudes, which in turn facilitated sustained BZD discontinuation without adverse effects on quality of life. Addressing patient beliefs and encouraging intermittent use patterns may enhance deprescribing success.
{"title":"Risk perception, attitudes, and quality of life in a multicomponent benzodiazepine deprescription strategy","authors":"Ingrid Ferrer López , Antonio Olry de Labry-Lima , Alicia Gutiérrez-Valencia , Encarnación García Bermúdez , Francisco Atienza Martín , Amalia García-Delgado Morente , María Dolores Murillo Fernández , Yolanda Sánchez Cañete , Clara Bermúdez-Tamayo","doi":"10.1016/j.rcsop.2025.100666","DOIUrl":"10.1016/j.rcsop.2025.100666","url":null,"abstract":"<div><h3>Background</h3><div>Multicomponent strategies can reduce benzodiazepine (BZD) use. BenzoStopJuntos (Spanish for “Stop Benzos Together”), a multidisciplinary deprescribing programme of the Andalusian Health Service, supports patients to taper/stop BZD through education, behavioral support, and non-pharmacological alternatives. We evaluated whether early changes (6 months) in risk perception and attitudes—and secondarily, quality of life—were associated with long-term discontinuation of BZD.</div></div><div><h3>Methods</h3><div>In a quasi-experimental pre–post study in two primary care centres (Seville, Spain; <em>n</em> = 243), the intervention included patient education, tapering support, and alternatives for anxiety/insomnia delivered by a multidisciplinary team. Primary outcomes were (a) short-term (6-month) changes in risk perception and attitudes and (b) long-term BZD discontinuation over 5.5 years; the secondary outcome was quality of life (WONCA/COOP), monitored to detect potential harms. Multivariable logistic regression examined whether 6-month changes in beliefs/attitudes predicted subsequent discontinuation, adjusting for sociodemographic and clinical factors.</div></div><div><h3>Results</h3><div>BZD discontinuation increased from 31.3 % at 6 months to 40.7 % at 5.5 years. Participants who considered BZD safe long-term were more likely to continue use (OR = 2.0; 95 % CI: 1.6–2.6). Fears of worsened anxiety/sleep strongly predicted persistence (OR = 4.7; 95 % CI: 3.6–6.1). Prior intermittent vs continuous use favored discontinuation (OR = 4.9; 95 % CI: 3.7–6.5). Quality of life improved in emotional, social, and physical domains, with no deterioration observed during follow-up.</div></div><div><h3>Conclusions</h3><div>Tailored education and behavioral strategies changed risk perceptions and attitudes, which in turn facilitated sustained BZD discontinuation without adverse effects on quality of life. Addressing patient beliefs and encouraging intermittent use patterns may enhance deprescribing success.</div></div><div><h3>Trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> <span><span>NCT06209827</span><svg><path></path></svg></span></div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100666"},"PeriodicalIF":1.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265319","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}
Geriatric patients constitute the largest consumers of non-prescription medications. Understanding their patterns and consequences is essential.
Aim
This study investigated OTC medication misuse among adults aged 65 and older in Saudi Arabia. It aimed to determine the extent of misuse, identify common medication classes, and analyze associated health risks.
Methods
The study used a cross-sectional approach with 386 participants from various cities. Data were collected using a structured questionnaire delivered via two modes: an online survey and in-person interviews addressing demographics, medication use, drug interaction awareness, and educational needs. The sample ensured statistical accuracy, with a 5 % margin of error and a 95 % confidence level.
Results
The majority of participants (80.7 %) used over-the-counter medications, primarily painkillers (66.4 %). Notably, 28.5 % use five or more regular medications. Some exhibited misuse behaviors, including overdosing (14.2 %) and using OTC medications for non-recommended purposes. Additionally, 24.9 % reported drug-drug interactions. Awareness gaps were significant: 39.4 % were unaware of the dangers of misuse, 38.3 % did not know potential side effects, 43.5 % were unaware of interactions with prescribed medications, and 56.2 % did not know about contraindications. Correlation analysis revealed that participants aware of potential side effects (80.1 %) were less likely to misuse OTC drugs than those unaware (89.2 %) (p = 0.046), and those who understood contraindications (75.5 %) showed lower misuse rates than the unaware (86.6 %) (p = 0.049).
Conclusion
The study showed that most participants frequently used OTC medications, primarily analgesics, yet lacked knowledge about these drugs. It underscores the urgent need for interventions to prevent OTC misuse among the aging population, focusing on enhancing health literacy and safe drug practices. Recommended strategies include media campaigns and clinical programs to raise awareness about OTC misuse risks.
{"title":"Prevalence and impact of non-prescription medication misuse in the geriatric population","authors":"Moaddey Alfarhan , Jala Ashqar , Jawaher Ajeebi , Munira Ghazwani , Nouf Alnahdi , Yunus Yatimi , Talal AlMohammed , Khalid Khubrani , Dania Saleh , Haya Alsharif , Saeed A. Alqahtani","doi":"10.1016/j.rcsop.2025.100663","DOIUrl":"10.1016/j.rcsop.2025.100663","url":null,"abstract":"<div><h3>Background</h3><div>Geriatric patients constitute the largest consumers of non-prescription medications. Understanding their patterns and consequences is essential.</div></div><div><h3>Aim</h3><div>This study investigated OTC medication misuse among adults aged 65 and older in Saudi Arabia. It aimed to determine the extent of misuse, identify common medication classes, and analyze associated health risks.</div></div><div><h3>Methods</h3><div>The study used a cross-sectional approach with 386 participants from various cities. Data were collected using a structured questionnaire delivered via two modes: an online survey and in-person interviews addressing demographics, medication use, drug interaction awareness, and educational needs. The sample ensured statistical accuracy, with a 5 % margin of error and a 95 % confidence level.</div></div><div><h3>Results</h3><div>The majority of participants (80.7 %) used over-the-counter medications, primarily painkillers (66.4 %). Notably, 28.5 % use five or more regular medications. Some exhibited misuse behaviors, including overdosing (14.2 %) and using OTC medications for non-recommended purposes. Additionally, 24.9 % reported drug-drug interactions. Awareness gaps were significant: 39.4 % were unaware of the dangers of misuse, 38.3 % did not know potential side effects, 43.5 % were unaware of interactions with prescribed medications, and 56.2 % did not know about contraindications. Correlation analysis revealed that participants aware of potential side effects (80.1 %) were less likely to misuse OTC drugs than those unaware (89.2 %) (<em>p</em> = 0.046), and those who understood contraindications (75.5 %) showed lower misuse rates than the unaware (86.6 %) (<em>p</em> = 0.049).</div></div><div><h3>Conclusion</h3><div>The study showed that most participants frequently used OTC medications, primarily analgesics, yet lacked knowledge about these drugs. It underscores the urgent need for interventions to prevent OTC misuse among the aging population, focusing on enhancing health literacy and safe drug practices. Recommended strategies include media campaigns and clinical programs to raise awareness about OTC misuse risks.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100663"},"PeriodicalIF":1.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265316","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}
In crisis-affected settings like Lebanon, community pharmacists face mounting challenges in securing quality medications and supporting patient care. This study aims to explore the association between pharmacy services, pharmacist-patient relationships, and patient quality of life during Lebanon's ongoing socioeconomic collapse.
Methods
A cross-sectional study was conducted in April 2023, using an online convenience sampling. Validated tools, including the 5-Level EuroQol (EQ-5D-5L) and EQ visual analog scale (EQ-VAS), were used to assess quality of life among a sample of 865 Lebanese adults recruited via social media platforms. Due to the absence of a national census, random sampling was not feasible, limiting generalizability.
Results
Higher EQ-VAS scores were significantly associated with better financial well-being (Beta = 0.18, p < 0.001), high monthly income (Beta = 7.04, p < 0.001), regular pharmacy visits (Beta = 3.06, p = 0.035), and perceiving pharmacists as medication counselors (Beta = 5.43; p = 0.003). Lower scores were associated with a higher number of chronic diseases (Beta = −2.66; p < 0.001), obtaining chronic medications from the pharmacy (Beta = −6.20), frequent pharmacy visits for medical care or counseling (Beta = −7.00; p = 0.003), spending more than 10 min with the pharmacist for counseling about a medication and/or medical condition (Beta = −6.31).
Conclusion
This study uniquely quantifies the association between pharmacist-patient interactions and quality of life in a context of systemic disruption. While previous literature has acknowledged pharmacists' roles, our findings demonstrate that their perceived counseling function and continuity of care are independently associated with improved well-being, even after adjusting for socioeconomic and health-related factors.
{"title":"Community pharmacy services and patient quality of life in Lebanon's socioeconomic crisis: Findings from the IMPHACT-LB study","authors":"Aline Hajj , Marwan Akel , Rony M. Zeenny , Hala Sacre , Chadia Haddad , Jihan Safwan , Fouad Sakr , Pascale Salameh","doi":"10.1016/j.rcsop.2025.100659","DOIUrl":"10.1016/j.rcsop.2025.100659","url":null,"abstract":"<div><h3>Background</h3><div>In crisis-affected settings like Lebanon, community pharmacists face mounting challenges in securing quality medications and supporting patient care. This study aims to explore the association between pharmacy services, pharmacist-patient relationships, and patient quality of life during Lebanon's ongoing socioeconomic collapse.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted in April 2023, using an online convenience sampling. Validated tools, including the 5-Level EuroQol (EQ-5D-5L) and EQ visual analog scale (EQ-VAS), were used to assess quality of life among a sample of 865 Lebanese adults recruited via social media platforms. Due to the absence of a national census, random sampling was not feasible, limiting generalizability.</div></div><div><h3>Results</h3><div>Higher EQ-VAS scores were significantly associated with better financial well-being (Beta = 0.18, <em>p</em> < 0.001), high monthly income (Beta = 7.04, p < 0.001), regular pharmacy visits (Beta = 3.06, <em>p</em> = 0.035), and perceiving pharmacists as medication counselors (Beta = 5.43; <em>p</em> = 0.003). Lower scores were associated with a higher number of chronic diseases (Beta = −2.66; p < 0.001), obtaining chronic medications from the pharmacy (Beta = −6.20), frequent pharmacy visits for medical care or counseling (Beta = −7.00; p = 0.003), spending more than 10 min with the pharmacist for counseling about a medication and/or medical condition (Beta = −6.31).</div></div><div><h3>Conclusion</h3><div>This study uniquely quantifies the association between pharmacist-patient interactions and quality of life in a context of systemic disruption. While previous literature has acknowledged pharmacists' roles, our findings demonstrate that their perceived counseling function and continuity of care are independently associated with improved well-being, even after adjusting for socioeconomic and health-related factors.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100659"},"PeriodicalIF":1.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218976","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}
The advancement of Information and Communication Technologies (ICT) has transformed multiple sectors, including healthcare, by enhancing access to information, optimizing service management, and reshaping interactions between healthcare professionals and users.
Objective
(1) To enhance the accessibility and quality of PC services, (2) to advance digital health implementation in Colombia by integrating pharmaceutical practice with innovative technological solutions that promote patient empowerment and patient- centered care models, (3) to demonstrate a comprehensive workflow for developing e- health applications using a User-Centered Design (UCD) approach.
Methods
The study employed a User-Centered Design (UCD) approach, structured in four phases: (1) identification of user needs through an exploratory review and a descriptive study; (2) gathering and prioritization of functional requirements using the MoSCoW method; (3) design and development of a prototype based on six thematic databases; and (4) usability testing through task-based user evaluations and satisfaction rating scales.
Results
A total of 72 functional requirements were identified and categorized into two main groups: those related to information provision and those linked to specific application features. Twenty functionalities were prioritized as essential, including drug information searches, healthy lifestyle guidance, medication intake reminders, and pharmacy geolocation. The final prototype comprised eight functional modules.Usability testing showed that 100 % of users completed most tasks, with task times under one minute and high satisfaction scores across all evaluated components.
Conclusions
The application demonstrated high levels of acceptance and usability, establishing itself as a potentially effective tool to improve access to pharmaceutical care services, empower patients, and promote safe medication use in outpatient settings. Additionally, the methodology presented in this study may serve as a reference for the development of future digital health tools.
{"title":"Design and development of a mobile application for drug information and other health data for users and patients of pharmacies and outpatient pharmaceutical services","authors":"Raquel Agudelo , Johan Granados , Mauricio Ceballos , Jaime Andrés Pereañez","doi":"10.1016/j.rcsop.2025.100661","DOIUrl":"10.1016/j.rcsop.2025.100661","url":null,"abstract":"<div><h3>Background</h3><div>The advancement of Information and Communication Technologies (ICT) has transformed multiple sectors, including healthcare, by enhancing access to information, optimizing service management, and reshaping interactions between healthcare professionals and users.</div></div><div><h3>Objective</h3><div>(1) To enhance the accessibility and quality of PC services, (2) to advance digital health implementation in Colombia by integrating pharmaceutical practice with innovative technological solutions that promote patient empowerment and patient- centered care models, (3) to demonstrate a comprehensive workflow for developing e- health applications using a User-Centered Design (UCD) approach.</div></div><div><h3>Methods</h3><div>The study employed a User-Centered Design (UCD) approach, structured in four phases: (1) identification of user needs through an exploratory review and a descriptive study; (2) gathering and prioritization of functional requirements using the MoSCoW method; (3) design and development of a prototype based on six thematic databases; and (4) usability testing through task-based user evaluations and satisfaction rating scales.</div></div><div><h3>Results</h3><div>A total of 72 functional requirements were identified and categorized into two main groups: those related to information provision and those linked to specific application features. Twenty functionalities were prioritized as essential, including drug information searches, healthy lifestyle guidance, medication intake reminders, and pharmacy geolocation. The final prototype comprised eight functional modules.Usability testing showed that 100 % of users completed most tasks, with task times under one minute and high satisfaction scores across all evaluated components.</div></div><div><h3>Conclusions</h3><div>The application demonstrated high levels of acceptance and usability, establishing itself as a potentially effective tool to improve access to pharmaceutical care services, empower patients, and promote safe medication use in outpatient settings. Additionally, the methodology presented in this study may serve as a reference for the development of future digital health tools.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100661"},"PeriodicalIF":1.8,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158290","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 : 2025-09-19DOI: 10.1016/j.rcsop.2025.100662
Johanna Villén , Nicole Ljungdahl , Björn Wettermark , Helle Håkonsen , Marmar Nekoro , Sofia Kälvemark Sporrong
Background
Pharmaceutical pollution is an increasing environmental concern. As key actors in the healthcare chain, community pharmacies play an important role in managing pharmaceuticals from an environmental perspective. Although environmental initiatives exist at the corporate level in Sweden, it remains unclear how well these are known to, or implemented by, pharmacy staff.
Objectives
To explore how community pharmacy staff in Sweden perceive their role in reducing pharmaceutical pollution, and identify the opportunities and challenges they face in promoting environmentally friendly use of pharmaceuticals.
Methods
Focus group discussions and individual semi-structured interviews were conducted with pharmacy staff in Sweden between May 2024 and February 2025. All focus group discussions and interviews were audio recorded, transcribed, and analysed using inductive qualitative content analysis.
Results
Four focus group discussions and five individual interviews were conducted. The analysis resulted in three main categories. First, while there was an awareness of environmental issues, participants expressed a lack of concrete guidance and requested more information, such as lists of environmentally harmful pharmaceuticals. Second, pharmaceutical waste, originating both from households and pharmacies, was highlighted as a major concern. Third, there appeared to be a sense of limited agency and a wish for support from, for example, regulatory authorities to address pharmaceutical pollution.
Conclusion
Swedish pharmacy staff view themselves as potential contributors to reducing pharmaceutical pollution, but struggle to identify concrete actions. They are concerned about pharmaceutical waste and responsibility is often shifted to other stakeholders.
{"title":"“We throw away an incredible amount of unused medicines“: Community pharmacy staff perspectives on environmental responsibility","authors":"Johanna Villén , Nicole Ljungdahl , Björn Wettermark , Helle Håkonsen , Marmar Nekoro , Sofia Kälvemark Sporrong","doi":"10.1016/j.rcsop.2025.100662","DOIUrl":"10.1016/j.rcsop.2025.100662","url":null,"abstract":"<div><h3>Background</h3><div>Pharmaceutical pollution is an increasing environmental concern. As key actors in the healthcare chain, community pharmacies play an important role in managing pharmaceuticals from an environmental perspective. Although environmental initiatives exist at the corporate level in Sweden, it remains unclear how well these are known to, or implemented by, pharmacy staff.</div></div><div><h3>Objectives</h3><div>To explore how community pharmacy staff in Sweden perceive their role in reducing pharmaceutical pollution, and identify the opportunities and challenges they face in promoting environmentally friendly use of pharmaceuticals.</div></div><div><h3>Methods</h3><div>Focus group discussions and individual semi-structured interviews were conducted with pharmacy staff in Sweden between May 2024 and February 2025. All focus group discussions and interviews were audio recorded, transcribed, and analysed using inductive qualitative content analysis.</div></div><div><h3>Results</h3><div>Four focus group discussions and five individual interviews were conducted. The analysis resulted in three main categories. First, while there was an awareness of environmental issues, participants expressed a lack of concrete guidance and requested more information, such as lists of environmentally harmful pharmaceuticals. Second, pharmaceutical waste, originating both from households and pharmacies, was highlighted as a major concern. Third, there appeared to be a sense of limited agency and a wish for support from, for example, regulatory authorities to address pharmaceutical pollution.</div></div><div><h3>Conclusion</h3><div>Swedish pharmacy staff view themselves as potential contributors to reducing pharmaceutical pollution, but struggle to identify concrete actions. They are concerned about pharmaceutical waste and responsibility is often shifted to other stakeholders.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100662"},"PeriodicalIF":1.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218978","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 : 2025-09-19DOI: 10.1016/j.rcsop.2025.100660
Tim Ingram , Sofia Rubi , Jennifer L. Brown , Joel Sprunger , Aimee Shadwick , Clark Crago , Michael S. Lyons , T. John Winhusen
Background
Naloxone is one of the most successful drugs in reversing the pharmacological effects of opioids and, in turn, preventing overdose. Increasing naloxone availability is an effective way to combat opioid-related overdose deaths. Recent changes in legislation across the United States have provided the jurisdiction to make naloxone more readily available. Naloxboxes are transparent, unsecured containers stocked with naloxone that are strategically placed in semi-private public spaces, such as restrooms.
Objective
To assess the effectiveness of installing naloxboxes at highway rest areas in Ohio as a strategy to increase public access to naloxone. This assessment draws on the pilot partnerships with the Ohio Department of Transportation, emergency medical services, and public health agencies, and explores implications for broader community implementation.
Methods
In collaboration with existing Ohio organizations, the HEALing Communities Study leveraged local and national funding to facilitate the expansion of naloxone use through the deployment of naloxone boxes at Ohio highway rest areas.
Results
Naloxboxes were found to be well accepted by the public and sustainable in highway rest areas. Their successful implementation and ongoing maintenance relied on multisectoral support, requiring collaboration across community organizations, public health agencies, and other stakeholders.
Conclusion
This innovative approach promoted the widespread distribution of naloxone while still preserving anonymity.
{"title":"Increasing access: Making naloxone available at highway rest areas","authors":"Tim Ingram , Sofia Rubi , Jennifer L. Brown , Joel Sprunger , Aimee Shadwick , Clark Crago , Michael S. Lyons , T. John Winhusen","doi":"10.1016/j.rcsop.2025.100660","DOIUrl":"10.1016/j.rcsop.2025.100660","url":null,"abstract":"<div><h3>Background</h3><div>Naloxone is one of the most successful drugs in reversing the pharmacological effects of opioids and, in turn, preventing overdose. Increasing naloxone availability is an effective way to combat opioid-related overdose deaths. Recent changes in legislation across the United States have provided the jurisdiction to make naloxone more readily available. Naloxboxes are transparent, unsecured containers stocked with naloxone that are strategically placed in semi-private public spaces, such as restrooms.</div></div><div><h3>Objective</h3><div>To assess the effectiveness of installing naloxboxes at highway rest areas in Ohio as a strategy to increase public access to naloxone. This assessment draws on the pilot partnerships with the Ohio Department of Transportation, emergency medical services, and public health agencies, and explores implications for broader community implementation.</div></div><div><h3>Methods</h3><div>In collaboration with existing Ohio organizations, the HEALing Communities Study leveraged local and national funding to facilitate the expansion of naloxone use through the deployment of naloxone boxes at Ohio highway rest areas.</div></div><div><h3>Results</h3><div>Naloxboxes were found to be well accepted by the public and sustainable in highway rest areas. Their successful implementation and ongoing maintenance relied on multisectoral support, requiring collaboration across community organizations, public health agencies, and other stakeholders.</div></div><div><h3>Conclusion</h3><div>This innovative approach promoted the widespread distribution of naloxone while still preserving anonymity.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100660"},"PeriodicalIF":1.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218977","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 : 2025-09-14DOI: 10.1016/j.rcsop.2025.100657
Karin Svensberg , Lea Axelsson , Lina Hellström
Background and aim
Medication management in primary care faces challenges that affect patient outcomes.
The inclusion of clinical pharmacists in care teams aims to address these issues. In Nordic countries, the role of clinical pharmacy services in primary care is still evolving with limited research. The Systems Engineering Initiative for Patient Safety (SEIPS) model provides a framework for evaluating healthcare systems by examining the system factors and processes that influence outcomes. This study aimed to identify factors influencing the integration and advancement of the role of pharmacists in primary care using the SEIPS model.
Methods
A focus group study was conducted with four groups (n = 17): managers, pharmacists, nurses, and general practitioners. Deductive thematic analysis guided by the SEIPS model was used to structure the data.
Results
Despite taking time to establish the pharmacist as a colleague, the participants expressed satisfaction with the collaboration and the pharmacist's role within the work system and processes at healthcare centres. Central factors for system and process development were identified, including a needs-based and structured approach to implementation, pharmacists with the right qualities and skills, teamwork, and physical presence. Perceived outcomes included increased pharmaceutical knowledge among coworkers and patients, reduced workload for staff, and improved patient safety regarding therapies.
Conclusion
Participants emphasised the potential of integrating pharmacists into primary care to address medication-management challenges. The SEIPS model provides insights into work system dynamics and can help develop the role of pharmacists in healthcare.
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Pub Date : 2025-09-14DOI: 10.1016/j.rcsop.2025.100658
Hayley Man , Ajesh George , Arash Rudman , Meng-Wong Taing , Angela Masoe , Leanne Smith , Woosung Sohn , Bradley Christian
Introduction
Oral diseases are a significant public health issue globally, however timely access to healthcare can assist in reducing this disease burden. Pharmacists and pharmacy staff are increasingly being recognised as a valuable health service resource, especially in rural-remote areas where access to dental services is limited. Access to oral health training is a challenge that has been identified to enable pharmacists and staff to integrate oral healthcare into their routine practice.
Aim
To identify and examine the characteristics of existing oral health education interventions for pharmacy staff including evaluation outcomes of the identified interventions.
Method
Medline, Embase and CINAHL databases were searched. Citation searching and a structured grey literature search was performed using search engine Google, OAIster, BASE, dental and pharmacy organization websites. The review method was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (the PRISMA-ScR). Studies were eligible if they described an educational intervention focused on oral health for pharmacists or pharmacy staff, in any setting, and reported characteristics, content, delivery, or evaluation outcomes.
Findings
Ten oral health educational interventions for pharmacists and pharmacy staff were identified. The most common topics covered were general oral health promotion and management of common oral presentations in pharmacies. Most interventions had a single delivery format, such as a standalone online module or printed resource, rather than a suite of complementary materials combining multiple formats. Four were accredited as continuing professional development. Three identified interventions required membership to professional organisations. One resource had published literature on an evaluation process which reported that participants considered the content acceptable, relevant, and feasible to incorporate into pharmacy practice; however, it did not measure changes in knowledge, attitudes, confidence, or practice quantitatively.
Conclusions
There are very limited publicly accessible oral health educational interventions for pharmacy staff, and little evidence on their impact including KAP (Knowledge Attitudes and Practices), confidence, feasibility and acceptability. Addressing these gaps could support pharmacists to play a greater role in meeting oral health needs, particularly in underserved areas.
口腔疾病是全球重大的公共卫生问题，但及时获得卫生保健可有助于减轻这一疾病负担。药剂师和药房工作人员日益被认为是宝贵的保健服务资源，特别是在获得牙科服务的机会有限的偏远农村地区。获得口腔健康培训是一项挑战，已确定使药剂师和工作人员能够将口腔保健纳入其日常实践。目的探讨现有针对药学人员的口腔健康教育干预措施的特点，并对这些干预措施的效果进行评价。方法检索medline、Embase和CINAHL数据库。使用谷歌、OAIster、BASE、牙科和药房组织网站进行引文检索和结构化灰色文献检索。评价方法由系统评价和荟萃分析扩展范围评价的首选报告项目（PRISMA-ScR）告知。如果研究描述了在任何环境下针对药剂师或药房工作人员的口腔健康的教育干预，并报告了其特征、内容、方式或评估结果，则该研究符合条件。结果确定了针对药师和药学人员的口腔健康教育干预措施。最常见的主题是一般口腔健康促进和药房常见口腔疾病的管理。大多数干预措施采用单一的交付格式，例如独立的在线模块或印刷资源，而不是组合多种格式的一套补充材料。其中四人获认可为持续专业发展。三个确定的干预措施需要成为专业组织的成员。一种资源发表了关于评价过程的文献，其中报告说参与者认为内容是可接受的、相关的和可行的，可以纳入药学实践；然而，它并没有定量地衡量知识、态度、信心或实践方面的变化。结论面向药学人员的公共口腔健康教育干预措施非常有限，其影响包括KAP （Knowledge Attitudes and Practices，知识态度和实践）、信心、可行性和可接受性方面的证据也很少。解决这些差距可以支持药剂师在满足口腔健康需求方面发挥更大的作用，特别是在服务不足的地区。
{"title":"Oral health educational interventions for pharmacists and pharmacy staff: A scoping review","authors":"Hayley Man , Ajesh George , Arash Rudman , Meng-Wong Taing , Angela Masoe , Leanne Smith , Woosung Sohn , Bradley Christian","doi":"10.1016/j.rcsop.2025.100658","DOIUrl":"10.1016/j.rcsop.2025.100658","url":null,"abstract":"<div><h3>Introduction</h3><div>Oral diseases are a significant public health issue globally, however timely access to healthcare can assist in reducing this disease burden. Pharmacists and pharmacy staff are increasingly being recognised as a valuable health service resource, especially in rural-remote areas where access to dental services is limited. Access to oral health training is a challenge that has been identified to enable pharmacists and staff to integrate oral healthcare into their routine practice.</div></div><div><h3>Aim</h3><div>To identify and examine the characteristics of existing oral health education interventions for pharmacy staff including evaluation outcomes of the identified interventions.</div></div><div><h3>Method</h3><div>Medline, Embase and CINAHL databases were searched. Citation searching and a structured grey literature search was performed using search engine Google, OAIster, BASE, dental and pharmacy organization websites. The review method was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (the PRISMA-ScR). Studies were eligible if they described an educational intervention focused on oral health for pharmacists or pharmacy staff, in any setting, and reported characteristics, content, delivery, or evaluation outcomes.</div></div><div><h3>Findings</h3><div>Ten oral health educational interventions for pharmacists and pharmacy staff were identified. The most common topics covered were general oral health promotion and management of common oral presentations in pharmacies. Most interventions had a single delivery format, such as a standalone online module or printed resource, rather than a suite of complementary materials combining multiple formats. Four were accredited as continuing professional development. Three identified interventions required membership to professional organisations. One resource had published literature on an evaluation process which reported that participants considered the content acceptable, relevant, and feasible to incorporate into pharmacy practice; however, it did not measure changes in knowledge, attitudes, confidence, or practice quantitatively.</div></div><div><h3>Conclusions</h3><div>There are very limited publicly accessible oral health educational interventions for pharmacy staff, and little evidence on their impact including KAP (Knowledge Attitudes and Practices), confidence, feasibility and acceptability. Addressing these gaps could support pharmacists to play a greater role in meeting oral health needs, particularly in underserved areas.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100658"},"PeriodicalIF":1.8,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120863","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 : 2025-09-13DOI: 10.1016/j.rcsop.2025.100653
John M. Vasko , Erin Shirley Orey , Carolanne Wartman , James K. Rowlett , Jefferson D. Parker , Donna M. Platt , Julie A. Schumacher
Background
Increased availability and access to FDA-approved medications for opioid use disorder (MOUD) can improve efforts to address the ongoing opioid public health crisis. Pharmacist collaboration is essential yet often inconsistent in MOUD access. This unpredictability creates a treatment bottleneck, especially in rural areas.
Objective
To investigate the reasons for independent pharmacies' reluctance to collaborate with the Mississippi Horizons Project, a program designed to improve patient access to MOUD.
Methods
A Horizons team member contacted pharmacies using a script to inquire about accepting payment for a patient's MOUD prescription. Pharmacist responses about collaboration (i.e., collaborated or denied collaboration) after initial contact and follow-up were summarized. A single coder inductively derived categories within which responses about collaboration were totaled.
Results
After initial contact and follow-up, only slightly more than half of pharmacies contacted (53.5 %) collaborated with the Horizons project to accept payment for and dispense MOUD. Categories for non-collaboration included regulatory misperceptions, unfamiliarity with patients and providers, and payment and logistical barriers. Successful efforts for collaboration after initial contact included utilizing existing relationships with pharmacies and providing additional information about the Horizons project.
Conclusion
Integrating educational interventions with structural and policy measures, while fostering collaborative partnerships with pharmacies and other key stakeholders, can help increase familiarity, reduce stigma, address operational challenges, and enhance cooperation to increase pharmacy collaboration and MOUD access to patients in rural areas and nationwide.
{"title":"Leveraging pharmacy partnerships and Grant funding to improve access to medications for opioid use disorder","authors":"John M. Vasko , Erin Shirley Orey , Carolanne Wartman , James K. Rowlett , Jefferson D. Parker , Donna M. Platt , Julie A. Schumacher","doi":"10.1016/j.rcsop.2025.100653","DOIUrl":"10.1016/j.rcsop.2025.100653","url":null,"abstract":"<div><h3>Background</h3><div>Increased availability and access to FDA-approved medications for opioid use disorder (MOUD) can improve efforts to address the ongoing opioid public health crisis. Pharmacist collaboration is essential yet often inconsistent in MOUD access. This unpredictability creates a treatment bottleneck, especially in rural areas.</div></div><div><h3>Objective</h3><div>To investigate the reasons for independent pharmacies' reluctance to collaborate with the Mississippi Horizons Project, a program designed to improve patient access to MOUD.</div></div><div><h3>Methods</h3><div>A Horizons team member contacted pharmacies using a script to inquire about accepting payment for a patient's MOUD prescription. Pharmacist responses about collaboration (i.e., collaborated or denied collaboration) after initial contact and follow-up were summarized. A single coder inductively derived categories within which responses about collaboration were totaled.</div></div><div><h3>Results</h3><div>After initial contact and follow-up, only slightly more than half of pharmacies contacted (53.5 %) collaborated with the Horizons project to accept payment for and dispense MOUD. Categories for non-collaboration included regulatory misperceptions, unfamiliarity with patients and providers, and payment and logistical barriers. Successful efforts for collaboration after initial contact included utilizing existing relationships with pharmacies and providing additional information about the Horizons project.</div></div><div><h3>Conclusion</h3><div>Integrating educational interventions with structural and policy measures, while fostering collaborative partnerships with pharmacies and other key stakeholders, can help increase familiarity, reduce stigma, address operational challenges, and enhance cooperation to increase pharmacy collaboration and MOUD access to patients in rural areas and nationwide.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100653"},"PeriodicalIF":1.8,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120864","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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