Exploratory research in clinical and social pharmacy最新文献

{"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":"2025-12-01","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":"Community pharmacy services and patient quality of life in Lebanon's socioeconomic crisis: Findings from the IMPHACT-LB study","authors":"Aline Hajj ,&nbsp;Marwan Akel ,&nbsp;Rony M. Zeenny ,&nbsp;Hala Sacre ,&nbsp;Chadia Haddad ,&nbsp;Jihan Safwan ,&nbsp;Fouad Sakr ,&nbsp;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> &lt; 0.001), high monthly income (Beta = 7.04, p &lt; 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 &lt; 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":"2025-12-01","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}

{"title":"Comparison of length of stay in community-acquired pneumonia patients who fit protocol for pharmacy driven de-escalation of ceftriaxone to standard of care","authors":"Brady Raab ,&nbsp;Faith Furst ,&nbsp;Katelyn Zumpf ,&nbsp;Tina Samson ,&nbsp;Timothy F. Murrey","doi":"10.1016/j.rcsop.2025.100640","DOIUrl":"10.1016/j.rcsop.2025.100640","url":null,"abstract":"<div><h3>Purpose</h3><div>Community-acquired pneumonia (CAP) represents a significant burden on healthcare systems, often necessitating prolonged hospital stays and substantial costs. Studies have demonstrated the safety and efficacy of early switching from intravenous (IV) to oral antibiotics in CAP, yet there remains underutilization of this practice, particularly for antibiotics with no bioequivalent analogs like ceftriaxone. This study evaluated the outcomes of pharmacy driven protocol to switch patients from IV to oral antibiotics in CAP.</div></div><div><h3>Methods</h3><div>This retrospective, multi-center, observational cohort study evaluated the impact of a pharmacy-led protocol for IV to oral de-escalation of ceftriaxone in CAP patients within a large healthcare system. A collaborative drug therapy management agreement enabled pharmacists to initiate de-escalation in eligible patients meeting pre-specified stability criteria.</div></div><div><h3>Results</h3><div>Analysis of 2314 participants (pre-implementation <em>n</em> = 1735; post-implementation <em>n</em> = 579) revealed a modest but statistically significant reduction in length of stay (4.87 to 4.57 days, <em>p</em> = 0.0461) and duration of ceftriaxone therapy (3.24 to 2.77 days, <em>p</em> &lt; 0.01) post-implementation. Total antibiotic duration increased slightly post-implementation without statistical significance (12.7 to 13.3 days, <em>p</em> = 0.11), and there was no significant difference in all-cause 30-day readmission rates (<em>p</em> = 0.36).</div></div><div><h3>Conclusion</h3><div>These findings underscore the potential benefits of pharmacist driven IV to oral de-escalation protocols in optimizing antibiotic and resource utilization in CAP management. Future prospective studies are needed to validate these findings and explore broader implementation strategies in diverse healthcare settings.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100640"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831194","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":"Does pharmacist–patient gender discordance influence medication guidance for gender-specific diseases?","authors":"Manato Nomi ,&nbsp;Ryota Kumaki ,&nbsp;Rieko Takehira ,&nbsp;Etsuko Arita ,&nbsp;Keiko Kishimoto","doi":"10.1016/j.rcsop.2025.100642","DOIUrl":"10.1016/j.rcsop.2025.100642","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to determine whether community pharmacists perceive barriers to providing medication guidance for gender-specific diseases and to clarify whether these perceived barriers are influenced by pharmacist and patient gender concordance or discordance.</div></div><div><h3>Methods</h3><div>A web-based survey was conducted with pharmacists from five pharmacy groups in Japan. The questionnaire evaluated pharmacists' hesitancy and uncertainty in knowledge using a 7-point Likert scale across 10 gender-specific and three nongender-specific diseases. Each disease was examined under conditions of gender concordance and discordance between a pharmacist and patient. Results were visualized using scatter plots, and the factors contributing to barriers were examined using multivariable logistic regression.</div></div><div><h3>Results</h3><div>A total of 1315 responses were obtained, including 696 from female pharmacists and 583 from male pharmacists. Among the 10 gender-specific diseases, 9 were in the first quadrant, indicating high hesitancy and uncertainty under gender discordance. However, some diseases exhibited high perceived barriers even under gender concordance. Multivariate logistic regression analysis revealed that pharmacists' implicit assumptions, such as perceiving patients' unwillingness to receive guidance, significantly contributed to stronger perceived barriers. Furthermore, neither years of professional experience nor medication guidance frequency was associated with reduced barriers.</div></div><div><h3>Conclusion</h3><div>Community pharmacists perceived significant barriers to providing medication guidance for certain gender-specific diseases. These barriers existed in cases of gender discordance and concordance with patients. Pharmacists' experience alone is insufficient to reduce these perceptions, highlighting the need for educational interventions addressing implicit assumptions related to gender-specific care.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100642"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831193","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":"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":"2025-12-01","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 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":"2025-12-01","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":"Leveraging pharmacy partnerships and Grant funding to improve access to medications for opioid use disorder","authors":"John M. Vasko ,&nbsp;Erin Shirley Orey ,&nbsp;Carolanne Wartman ,&nbsp;James K. Rowlett ,&nbsp;Jefferson D. Parker ,&nbsp;Donna M. Platt ,&nbsp;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":"2025-12-01","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}

{"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":"2025-12-01","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":"Community pharmacy resiliency during Covid-19 pandemic in Iran: A qualitative study","authors":"Zhivan Zomorodi ,&nbsp;Faezeh Valaei Sharif ,&nbsp;Najmeh Moradi ,&nbsp;Zahra Sharif","doi":"10.1016/j.rcsop.2025.100670","DOIUrl":"10.1016/j.rcsop.2025.100670","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic has profoundly impacted global healthcare systems. This qualitative study explores how community pharmacists in Iran demonstrated resilience during this disaster. Despite challenges like medication shortages, Personal Protective Equipment deficiencies, and staffing issues, pharmacists implemented innovative measures such as social distancing protocols, remote consultations, and home delivery services. Insights from this study inform strategies to enhance healthcare system preparedness for future public health preparedness.</div></div><div><h3>Objective</h3><div>This study qualitatively explores experiences of Iranian pharmacists during the COVID-19 pandemic, focusing on resilience, emergency management strategies, challenges faced and future emergency preparedness.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with 25 pharmacists (14 men, 11 women; mean practice experience: 10–14 years) in Tehran and Alborz provinces. Data were analyzed thematically using MAXQDA and following Braun and Clarke's six-phase framework<em>.</em></div></div><div><h3>Results</h3><div>Analysis of 1260 codes and 11 categories revealed that pharmacists faced operational challenges, including increased work load, psychological strain, financial constraints, and supply shortages. In response, they adapted creatively, employing strategies such as teleconsultations, public health education, inventory sharing, and strict safety protocols. However, participants consistently highlighted policy and systemic gaps, including insufficient governmental support and the limited integration of pharmacists into crisis management frameworks.</div></div><div><h3>Conclusion</h3><div>Community pharmacies played a critical role during the COVID-19 pandemic by adapting rapidly and expanding public health services. Strengthening telepharmacy infrastructure, supply chain policies, and integrating pharmacists into national preparedness frameworks is essential to improve healthcare system resilience in future healthcare emergencies<em>.</em></div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100670"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319929","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":"Adherence to oral anticancer medications in metastatic versus nonmetastatic breast cancer patients: Insights from a low-middle-income country","authors":"Abdel-Hameed I.M. Ebid ,&nbsp;Rana Elshewy ,&nbsp;Mahmoud I. Mostafa ,&nbsp;Reem Eid ,&nbsp;Emad Shash ,&nbsp;Mohamed A. Mobarez","doi":"10.1016/j.rcsop.2025.100682","DOIUrl":"10.1016/j.rcsop.2025.100682","url":null,"abstract":"<div><h3>Background</h3><div>Optimal treatment outcomes in breast cancer rely heavily on patient adherence to oral anticancer medications (OAMs).</div></div><div><h3>Aim</h3><div>This study aimed to assess adherence to OAMs and identify factors associated with nonadherence in metastatic and nonmetastatic breast cancer patients.</div></div><div><h3>Methods</h3><div>In this cross-sectional study at the National Cancer Institute, Cairo University, 500 breast cancer patients were categorised into metastatic (45.6 %) and nonmetastatic (54.4 %) groups. Adherence was measured using the Morisky Medication Adherence Scale (MMAS-8) and the Medication Possession Ratio (MPR), with nonadherence defined as an MMAS-8 score &lt; 8 or an MPR &lt; 80 %. Data collection was augmented by patient interviews and examinations of outpatient pharmacy dispensing records.</div></div><div><h3>Results</h3><div>Adherence rates were 46.4 % as per MMAS-8 and 71 % according to MPR. Specifically, in the nonmetastatic group, MMAS-8 revealed a 28.3 % adherence rate, MPR showed 75.4 % adherence rate. Metastatic patients displayed significantly higher adherence (MASS-8, 68 %) (<em>p</em> &lt; 0.001). There was a notable inverse correlation between adherence and the severity of side effects like musculoskeletal pain, neurological symptoms, fatigue, and hot flushes (<em>p</em> &lt; 0.001). Additionally, adherence varied with treatment duration, with shorter periods associated with better adherence.</div></div><div><h3>Conclusion</h3><div>This study confirms that adherence to OAMs is significantly affected by both the metastatic status and the severity of side effects. This highlights the urgent need for enhanced educational and management strategies tailored to the specific challenges faced by breast cancer patients, especially those dealing with severe side effects. Ongoing research should focus on developing and testing targeted interventions to improve adherence in these patient groups.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100682"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519450","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}