Pub Date : 2025-08-21DOI: 10.1016/j.rcsop.2025.100648
Jocelyn Bussing, Lorraine Smith, Bandana Saini
Introduction
Pharmacists are essential to healthcare delivery in Australia, making effective workforce planning critical to ensure equitable health outcomes. This study explores factors influencing the career decisions of Australian pharmacists from diverse demographic and geographical backgrounds with implications for recruitment, retention and policy strategies to address workforce shortages.
Method
We conducted semi-structured interviews between November 2022–February 2024. An interview guide informed by relevant literature was used to facilitate the interview process. Participants were recruited through purposive convenience sampling complemented by passive snowballing. All interviews were recorded, field notes were taken and the data transcribed, deidentified, and analysed using NVivo software through an inductive thematic process.
Results
Participants exhibited a range of ages, genders, practice settings and locations, which revealed distinct career trajectories and decision-making influences. Three main themes emerged: career initiation (choosing pharmacy as a profession), career development, satisfaction and retention, and the roles of gender, geography and other life issues. Findings indicate that the initial choice to pursue pharmacy was driven by personal aptitude, accessible training locations, promising employability, gender-suitable work configurations, flexibility, and early educational exposure. Early career decisions were shaped by factors such as mentorship, specialised roles, employee benefits, and supportive work environments, while personal life factors further influenced career trajectories. Leadership or ownership aspirations were notably tied to mentors and role models. Limitations include underrepresented perspectives, limited gender diversity among participants, and an all-female research team.
Conclusion
These nuanced insights offer Australian pharmacy leaders and policy makers factors to address or capitalise on, to ensure a robust, equitably distributed and motivated workforce.
{"title":"Factors affecting career-related decisions within the contemporary pharmacy workforce in Australia","authors":"Jocelyn Bussing, Lorraine Smith, Bandana Saini","doi":"10.1016/j.rcsop.2025.100648","DOIUrl":"10.1016/j.rcsop.2025.100648","url":null,"abstract":"<div><h3>Introduction</h3><div>Pharmacists are essential to healthcare delivery in Australia, making effective workforce planning critical to ensure equitable health outcomes. This study explores factors influencing the career decisions of Australian pharmacists from diverse demographic and geographical backgrounds with implications for recruitment, retention and policy strategies to address workforce shortages.</div></div><div><h3>Method</h3><div>We conducted semi-structured interviews between November 2022–February 2024. An interview guide informed by relevant literature was used to facilitate the interview process. Participants were recruited through purposive convenience sampling complemented by passive snowballing. All interviews were recorded, field notes were taken and the data transcribed, deidentified, and analysed using NVivo software through an inductive thematic process.</div></div><div><h3>Results</h3><div>Participants exhibited a range of ages, genders, practice settings and locations, which revealed distinct career trajectories and decision-making influences. Three main themes emerged: career initiation (choosing pharmacy as a profession), career development, satisfaction and retention, and the roles of gender, geography and other life issues. Findings indicate that the initial choice to pursue pharmacy was driven by personal aptitude, accessible training locations, promising employability, gender-suitable work configurations, flexibility, and early educational exposure. Early career decisions were shaped by factors such as mentorship, specialised roles, employee benefits, and supportive work environments, while personal life factors further influenced career trajectories. Leadership or ownership aspirations were notably tied to mentors and role models. Limitations include underrepresented perspectives, limited gender diversity among participants, and an all-female research team.</div></div><div><h3>Conclusion</h3><div>These nuanced insights offer Australian pharmacy leaders and policy makers factors to address or capitalise on, to ensure a robust, equitably distributed and motivated workforce.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100648"},"PeriodicalIF":1.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medication non-adherence, impaired health-related quality of life (HRQoL), increased depression severity, and patient dissatisfaction are common challenges among patients with depression. This systematic review aimed to evaluate the impact of pharmaceutical care interventions (PCIs) on antidepressant adherence, HRQoL, depression severity, and patient satisfaction.
Methods
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted across PubMed, EMBASE, Web of Science, Scopus, PsycINFO, and CINAHL for randomized controlled trials (RCTs) published between 2000 and 2024. Studies evaluating pharmacist-led pharmaceutical care interventions aimed at improving antidepressant use and related outcomes were included. Data extraction and risk of bias assessment were performed using standardized forms and the Cochrane Collaboration's Risk of Bias tool.
Results
Fifteen RCTs met the inclusion criteria. Common intervention strategies included patient education, counseling, telephone follow-ups, and drug monitoring. Nine studies reported statistically significant improvements in antidepressant adherence. Of the three studies assessing HRQoL, one demonstrated significant improvement. Four of thirteen studies showed a significant reduction in depression severity, and three of five studies reported increased patient satisfaction in the intervention group compared to controls.
Conclusion
Pharmaceutical care interventions, particularly patient education and counseling, contribute meaningfully in improving antidepressant adherence and related patient outcomes. However, findings across studies are inconsistent due to variability in intervention components, measurement tools, delivery methods, and outcome measures. Further research should focus on well-designed, large randomized trials with standardized, therory-based interventions.
研究背景：药物依从性差、健康相关生活质量（HRQoL）受损、抑郁严重程度增加和患者不满是抑郁症患者面临的共同挑战。本系统综述旨在评估药学服务干预（PCIs）对抗抑郁药物依从性、HRQoL、抑郁严重程度和患者满意度的影响。方法本综述遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南。综合检索PubMed、EMBASE、Web of Science、Scopus、PsycINFO和CINAHL，检索2000年至2024年间发表的随机对照试验（rct）。评估以药剂师为主导的旨在改善抗抑郁药使用和相关结果的药学服务干预措施的研究被纳入其中。使用标准化表格和Cochrane协作的偏倚风险工具进行数据提取和偏倚风险评估。结果15项rct符合纳入标准。常见的干预策略包括患者教育、咨询、电话随访和药物监测。9项研究报告了抗抑郁药物依从性的统计学显著改善。在评估HRQoL的三项研究中，一项研究显示有显著改善。13项研究中有4项显示抑郁症严重程度显著降低，5项研究中有3项报告说，与对照组相比，干预组的患者满意度提高。结论药学服务干预，特别是患者教育和咨询，对改善抗抑郁依从性和相关患者预后有重要作用。然而，由于干预成分、测量工具、交付方法和结果测量的可变性，研究结果不一致。进一步的研究应侧重于设计良好的大型随机试验，采用标准化的、基于理论的干预措施。
{"title":"Impact of pharmaceutical care interventions on antidepressants adherence and clinical outcomes in depressed patients: A systematic review","authors":"Nirmal Raj Marasine , Sabina Sankhi , Shishir Paudel , Anisha Chalise , Rajendra Lamichhane","doi":"10.1016/j.rcsop.2025.100644","DOIUrl":"10.1016/j.rcsop.2025.100644","url":null,"abstract":"<div><h3>Background</h3><div>Medication non-adherence, impaired health-related quality of life (HRQoL), increased depression severity, and patient dissatisfaction are common challenges among patients with depression. This systematic review aimed to evaluate the impact of pharmaceutical care interventions (PCIs) on antidepressant adherence, HRQoL, depression severity, and patient satisfaction.</div></div><div><h3>Methods</h3><div>This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted across PubMed, EMBASE, Web of Science, Scopus, PsycINFO, and CINAHL for randomized controlled trials (RCTs) published between 2000 and 2024. Studies evaluating pharmacist-led pharmaceutical care interventions aimed at improving antidepressant use and related outcomes were included. Data extraction and risk of bias assessment were performed using standardized forms and the Cochrane Collaboration's Risk of Bias tool.</div></div><div><h3>Results</h3><div>Fifteen RCTs met the inclusion criteria. Common intervention strategies included patient education, counseling, telephone follow-ups, and drug monitoring. Nine studies reported statistically significant improvements in antidepressant adherence. Of the three studies assessing HRQoL, one demonstrated significant improvement. Four of thirteen studies showed a significant reduction in depression severity, and three of five studies reported increased patient satisfaction in the intervention group compared to controls<strong>.</strong></div></div><div><h3>Conclusion</h3><div>Pharmaceutical care interventions, particularly patient education and counseling, contribute meaningfully in improving antidepressant adherence and related patient outcomes. However, findings across studies are inconsistent due to variability in intervention components, measurement tools, delivery methods, and outcome measures. Further research should focus on well-designed, large randomized trials with standardized, therory-based interventions.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100644"},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-20DOI: 10.1016/j.rcsop.2025.100647
Adrienne Kostellar , Michael Barras , Ian Coombes , Andrew Hale , Carla Scuderi , Neil Cottrell , Nazanin Falconer
Background
The transition from hospital discharge to primary care is a critical period in a patient's healthcare journey. Health system errors occur, due to a breakdown in communication or lack of structured planning which can lead to medication related harm or hospital readmission. At a quaternary referral hospital in Australia, pharmacists refer Internal Medicine patients to a pharmacist-led clinic for post-discharge medication review. While clinical resources exist to guide identification of at-risk patients, it remains unclear if and to what extent, pharmacists incorporate these criteria into their referral.
Aim
To determine the criteria and reasons used by pharmacists to refer Internal Medicine patients to a post discharge pharmacist review clinic.
Methods
Semi-structured interviews were conducted with hospital pharmacists who had worked in Internal Medicine and previously referred patients to the post discharge review clinic. Interviews were conducted until data saturation was obtained. Interviews were audio recorded, transcribed and coded using NVivo®. Themes and subthemes were identified through inductive thematic analysis and finalised via discussion within the research team.
Results
Eleven pharmacists were interviewed. Five themes emerged describing referral criteria and reasons: (1) medication criteria including the use of high-risk medications and adjustments; (2) patient criteria including health status, frailty and social aspects of health including carer supports; (3) system pressures including patient flow and time constraints in care delivery; (4) post-discharge care including medication liaison and evaluation of tolerability and; (5) clinical judgement described as “worry” about the patient, highlighting the role of clinical reasoning.
Conclusion
Pharmacists used established criteria from clinical resources to identify high-risk patients for referral; however, they also relied on clinical judgement. Referrals aimed to prevent medication related harm and improve communication with patients and healthcare providers. Future research should evaluate the effectiveness of clinical judgement to ensure high-risk patients are identified for transition of care services.
{"title":"Criteria pharmacists use to refer patients to a post discharge pharmacist review clinic","authors":"Adrienne Kostellar , Michael Barras , Ian Coombes , Andrew Hale , Carla Scuderi , Neil Cottrell , Nazanin Falconer","doi":"10.1016/j.rcsop.2025.100647","DOIUrl":"10.1016/j.rcsop.2025.100647","url":null,"abstract":"<div><h3>Background</h3><div>The transition from hospital discharge to primary care is a critical period in a patient's healthcare journey. Health system errors occur, due to a breakdown in communication or lack of structured planning which can lead to medication related harm or hospital readmission. At a quaternary referral hospital in Australia, pharmacists refer Internal Medicine patients to a pharmacist-led clinic for post-discharge medication review. While clinical resources exist to guide identification of at-risk patients, it remains unclear if and to what extent, pharmacists incorporate these criteria into their referral.</div></div><div><h3>Aim</h3><div>To determine the criteria and reasons used by pharmacists to refer Internal Medicine patients to a post discharge pharmacist review clinic.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with hospital pharmacists who had worked in Internal Medicine and previously referred patients to the post discharge review clinic. Interviews were conducted until data saturation was obtained. Interviews were audio recorded, transcribed and coded using NVivo®. Themes and subthemes were identified through inductive thematic analysis and finalised via discussion within the research team.</div></div><div><h3>Results</h3><div>Eleven pharmacists were interviewed. Five themes emerged describing referral criteria and reasons: (1) medication criteria including the use of high-risk medications and adjustments; (2) patient criteria including health status, frailty and social aspects of health including carer supports; (3) system pressures including patient flow and time constraints in care delivery; (4) post-discharge care including medication liaison and evaluation of tolerability and; (5) clinical judgement described as “worry” about the patient, highlighting the role of clinical reasoning.</div></div><div><h3>Conclusion</h3><div>Pharmacists used established criteria from clinical resources to identify high-risk patients for referral; however, they also relied on clinical judgement. Referrals aimed to prevent medication related harm and improve communication with patients and healthcare providers. Future research should evaluate the effectiveness of clinical judgement to ensure high-risk patients are identified for transition of care services.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100647"},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-19DOI: 10.1016/j.rcsop.2025.100646
Emily L. Hoffins , Jamie A. Stone , Aaron M. Gilson , Taylor L. Watterson , Jason S. Chladek , Michelle A. Chui
Background
Over-the-counter medications are an integral component of community pharmacies, providing patients with accessible options for addressing health concerns independently. However, this increases the potential for adverse drug events, particularly among older adults, due to overestimating medication safety. Pharmacy layouts, often informed by retail store principles, frequently prioritize product profitability over patient safety.
Objective
This study evaluates the impact of Senior Safe™, a physical redesign of pharmacy aisles, on older adults' visual attention during medication selection to enhance patient safety.
Methods
Senior Safe rearranged over-the-counter products based on safety designation and human factors engineering principles. Older adult participants wore eye-tracking glasses and engaged in a scenario-based simulation to measure gaze behavior during medication selection. Simulations were conducted pre- and post-intervention to analyze fixation durations within each medication safety category.
Results
Thirty-eight older adult participants completed this portion of the study. Post-intervention participants spent significantly more time fixating on Senior Safe medications (μ = 25.17 s) compared to pre-implementation participants (μ = 9.40s). Post-intervention participants also spent more time selecting OTCs overall.
Conclusion
This study demonstrates how environmental redesign influences patient visual attention behavior. These findings emphasize the role of environmental design in enhancing patient safety and support eye-tracking as an effective method for measuring patient behavior in community pharmacy settings.
{"title":"From the patient point of view: Using eye tracking to evaluate older adult shopping behavior change with a community pharmacy OTC intervention","authors":"Emily L. Hoffins , Jamie A. Stone , Aaron M. Gilson , Taylor L. Watterson , Jason S. Chladek , Michelle A. Chui","doi":"10.1016/j.rcsop.2025.100646","DOIUrl":"10.1016/j.rcsop.2025.100646","url":null,"abstract":"<div><h3>Background</h3><div>Over-the-counter medications are an integral component of community pharmacies, providing patients with accessible options for addressing health concerns independently. However, this increases the potential for adverse drug events, particularly among older adults, due to overestimating medication safety. Pharmacy layouts, often informed by retail store principles, frequently prioritize product profitability over patient safety.</div></div><div><h3>Objective</h3><div>This study evaluates the impact of Senior Safe™, a physical redesign of pharmacy aisles, on older adults' visual attention during medication selection to enhance patient safety.</div></div><div><h3>Methods</h3><div>Senior Safe rearranged over-the-counter products based on safety designation and human factors engineering principles. Older adult participants wore eye-tracking glasses and engaged in a scenario-based simulation to measure gaze behavior during medication selection. Simulations were conducted pre- and post-intervention to analyze fixation durations within each medication safety category.</div></div><div><h3>Results</h3><div>Thirty-eight older adult participants completed this portion of the study. Post-intervention participants spent significantly more time fixating on Senior Safe medications (μ = 25.17 s) compared to pre-implementation participants (μ = 9.40s). Post-intervention participants also spent more time selecting OTCs overall.</div></div><div><h3>Conclusion</h3><div>This study demonstrates how environmental redesign influences patient visual attention behavior. These findings emphasize the role of environmental design in enhancing patient safety and support eye-tracking as an effective method for measuring patient behavior in community pharmacy settings.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100646"},"PeriodicalIF":1.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890940","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 : 2025-08-07DOI: 10.1016/j.rcsop.2025.100640
Brady Raab , Faith Furst , Katelyn Zumpf , Tina Samson , Timothy F. Murrey
Purpose
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.
Methods
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.
Results
Analysis of 2314 participants (pre-implementation n = 1735; post-implementation n = 579) revealed a modest but statistically significant reduction in length of stay (4.87 to 4.57 days, p = 0.0461) and duration of ceftriaxone therapy (3.24 to 2.77 days, p < 0.01) post-implementation. Total antibiotic duration increased slightly post-implementation without statistical significance (12.7 to 13.3 days, p = 0.11), and there was no significant difference in all-cause 30-day readmission rates (p = 0.36).
Conclusion
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.
{"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 , Faith Furst , Katelyn Zumpf , Tina Samson , 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> < 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":"2025-08-07","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}
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.
Methods
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.
Results
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.
Conclusion
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.
{"title":"Does pharmacist–patient gender discordance influence medication guidance for gender-specific diseases?","authors":"Manato Nomi , Ryota Kumaki , Rieko Takehira , Etsuko Arita , 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":"2025-08-05","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}
Unused medicines present significant public health, environmental risks and economic challenges. Understanding their prevalence and determinants is crucial for designing appropriate interventions. This systematic review and meta-analysis aimed to estimate the pooled prevalence and determinants of unused medicines among households in Ethiopia.
Method
A comprehensive search was conducted across major databases, including Scopus, Science Direct, Embase, PubMed/MEDLINE, Google Scholar, and Research Gate, to identify relevant studies published up to January 10, 2025. Eligible studies reporting the prevalence and determinants of unused medicines in Ethiopian households were included. Data were extracted via a Microsoft Excel spreadsheet and analyzed using STATA version 11.0, applying a random-effects model to estimate the pooled prevalence and account for heterogeneity. Subgroup and sensitivity analyses were performed to explore variations across studies.
Result
A total of 12 studies involving 6123 households were included. The pooled prevalence of unused medicines was estimated at 44.34 % (95 % CI: 32.83, 55.84), with substantial heterogeneity among studies (I2 = 99.0 %, p value =0.000). Subgroup analyses revealed higher prevalence rates in urban households at 47.8 % compared to rural households at 26.89 % and regional disparities. Antibiotics were the most frequently unused class of medications, accounting for 31.49 % of all unused medicines in households, followed by analgesics at 26.14 %, while antacids constituted 8.7 %. The primary reasons for the accumulation of unused medicines included self-discontinuation upon symptom relief at 34.21 %, while anticipation of future use constitute 20.47 %. Factors such as self-medication with NSAIDs, acquisition of medications without prescriptions, and higher household income were significantly associated with the prevalence of unused medicines among households in Ethiopia.
Conclusion
This systematic review and meta-analysis revealed that unused medicines among households in Ethiopian was prevalent, with significant regional variations. Antibiotics were the most commonly unused medications, followed by analgesics, while cardiovascular medicines and dietary supplements were the least reported. The primary reasons for the accumulation of unused medicines included self-discontinuation upon symptom relief, and anticipation of future use. Key determinants such as self-medication with NSAIDs, acquisition of medications without prescriptions, and higher household income were significantly associated with the prevalence of unused medicines. These findings underscore the need for context specific interventions to address the high prevalence of unused medicines in Ethiopia, particularly in urban settings and regions with higher rates.
{"title":"Prevalence and determinants of unused medicines among households in Ethiopia: A systematic review and meta-analysis","authors":"Tekletsadik Tekleslassie Alemayehu , Gebremariam Wulie Geremew , Eskedar Dires Gebremeskel , Zemenu Wube Bayleyegn , Ayelign Eshete Fitgu , Tefera Minwagaw , Mulugojjam Jegnie Tagele , Rahel Belete Abebe , Tirsit Ketsela Zeleke , Abaynesh Fentahun Bekalu , Masho Tigabie Tekle , Mekonnen Derese Mekete , Mulugeta Assefa Estifo , Abebech Tewabe Gelaye , Tadele Mesfin Demelash , Fraol Zeleke Desta , Elsabeth Alemayehu Haile , Simon Zemenfes Hailu , Adugna Tadesse Gemeda , Tesfaye Birhanu Abebe","doi":"10.1016/j.rcsop.2025.100639","DOIUrl":"10.1016/j.rcsop.2025.100639","url":null,"abstract":"<div><h3>Background</h3><div>Unused medicines present significant public health, environmental risks and economic challenges. Understanding their prevalence and determinants is crucial for designing appropriate interventions. This systematic review and meta-analysis aimed to estimate the pooled prevalence and determinants of unused medicines among households in Ethiopia.</div></div><div><h3>Method</h3><div>A comprehensive search was conducted across major databases, including Scopus, Science Direct, Embase, PubMed/MEDLINE, Google Scholar, and Research Gate, to identify relevant studies published up to January 10, 2025. Eligible studies reporting the prevalence and determinants of unused medicines in Ethiopian households were included. Data were extracted via a Microsoft Excel spreadsheet and analyzed using STATA version 11.0, applying a random-effects model to estimate the pooled prevalence and account for heterogeneity. Subgroup and sensitivity analyses were performed to explore variations across studies.</div></div><div><h3>Result</h3><div>A total of 12 studies involving 6123 households were included. The pooled prevalence of unused medicines was estimated at 44.34 % (95 % CI: 32.83, 55.84), with substantial heterogeneity among studies (I<sup>2</sup> = 99.0 %, <em>p</em> value =0.000). Subgroup analyses revealed higher prevalence rates in urban households at 47.8 % compared to rural households at 26.89 % and regional disparities. Antibiotics were the most frequently unused class of medications, accounting for 31.49 % of all unused medicines in households, followed by analgesics at 26.14 %, while antacids constituted 8.7 %. The primary reasons for the accumulation of unused medicines included self-discontinuation upon symptom relief at 34.21 %, while anticipation of future use constitute 20.47 %. Factors such as self-medication with NSAIDs, acquisition of medications without prescriptions, and higher household income were significantly associated with the prevalence of unused medicines among households in Ethiopia.</div></div><div><h3>Conclusion</h3><div>This systematic review and meta-analysis revealed that unused medicines among households in Ethiopian was prevalent, with significant regional variations. Antibiotics were the most commonly unused medications, followed by analgesics, while cardiovascular medicines and dietary supplements were the least reported. The primary reasons for the accumulation of unused medicines included self-discontinuation upon symptom relief, and anticipation of future use. Key determinants such as self-medication with NSAIDs, acquisition of medications without prescriptions, and higher household income were significantly associated with the prevalence of unused medicines. These findings underscore the need for context specific interventions to address the high prevalence of unused medicines in Ethiopia, particularly in urban settings and regions with higher rates.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100639"},"PeriodicalIF":1.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144781013","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 : 2025-07-31DOI: 10.1016/j.rcsop.2025.100641
Goar Alvarez , Taylor Harris , Erika Zwachte Fennick , Leanne Lai , Jesús Sánchez , Rawan Alkhamisi
Background
Community pharmacists have expanded their roles beyond traditional medication dispensing to include various clinical services. They play a critical role in reducing medication-related errors and enhancing patient safety. However, their effectiveness is significantly influenced by their work environment and associated challenges.
Objectives
This cross-sectional study evaluates the stress levels of community pharmacists in Florida, USA, and examines how stress impacts patient care.
Methods
A survey was developed and emailed to 23,016 licensed pharmacists in Florida. Responses were collected from March 9 to April 15, 2022. The primary outcomes measured were workplace stressor frequency in community pharmacies and the relationship between work environment factors and patient care quality. Secondary outcomes assessed differences in average Perceived Stress Scores (PSS) between chain and independent pharmacists and between those in managerial versus non-managerial roles.
Results
Of 361 responses, 257 pharmacists completed the survey. Most (84.8 %) were chain pharmacists, 15.2 % independent. The primary stressor was staffing issues (57.98 %). Additionally, 71.9 % deemed working conditions unsafe, and 78.4 % struggled to provide quality care due to work stress. Chain pharmacists had significantly different PSS scores (22.72) versus independent pharmacists (22.82, p = 0.0034). No difference existed between managerial (25.44) and non-managerial pharmacists (25.11, p = 0.5962). Spearman correlations showed significant negative associations between PSS scores and difficulty providing quality care (ρ = −0.47, p < 0.0001) and unsafe conditions perceptions (ρ = −0.51, p < 0.0001). Patient care measures correlated positively (ρ = 0.71, p < 0.0001).
Conclusion
Stress significantly impacts community pharmacists' ability to provide quality care.
社区药剂师已经扩大了他们的角色，超越了传统的药物分配，包括各种临床服务。它们在减少与药物有关的错误和加强患者安全方面发挥着关键作用。然而，他们的工作效率受到工作环境和相关挑战的显著影响。目的：本横断面研究评估美国佛罗里达州社区药剂师的压力水平，并探讨压力如何影响患者护理。方法开展了一项调查，并通过电子邮件向佛罗里达州23,016名有执照的药剂师进行了调查。调查于2022年3月9日至4月15日进行。主要测量结果是社区药房工作场所压力源频率以及工作环境因素与患者护理质量的关系。次要结果评估连锁药剂师和独立药剂师以及管理角色和非管理角色之间的平均感知压力得分（PSS）差异。结果361份问卷中，完成调查的药师257名。连锁药师占84.8%，独立药师占15.2%。主要压力源为人员配备问题（57.98%）。此外，71.9%的人认为工作条件不安全，78.4%的人由于工作压力而难以提供高质量的护理。连锁药师的PSS评分为22.72分，独立药师的PSS评分为22.82分，p = 0.0034分。管理药师（25.44）与非管理药师（25.11,p = 0.5962）差异无统计学意义。Spearman相关性显示PSS评分与提供优质护理的难度呈显著负相关(ρ = - 0.47, p <；0.0001)和不安全条件感知(ρ = - 0.51, p <；0.0001)。患者护理措施正相关(ρ = 0.71, p <；0.0001)。结论应激对社区药师提供优质护理的能力有显著影响。
{"title":"Community pharmacy working conditions: Is stress impacting patient care?","authors":"Goar Alvarez , Taylor Harris , Erika Zwachte Fennick , Leanne Lai , Jesús Sánchez , Rawan Alkhamisi","doi":"10.1016/j.rcsop.2025.100641","DOIUrl":"10.1016/j.rcsop.2025.100641","url":null,"abstract":"<div><h3>Background</h3><div>Community pharmacists have expanded their roles beyond traditional medication dispensing to include various clinical services. They play a critical role in reducing medication-related errors and enhancing patient safety. However, their effectiveness is significantly influenced by their work environment and associated challenges.</div></div><div><h3>Objectives</h3><div>This cross-sectional study evaluates the stress levels of community pharmacists in Florida, USA, and examines how stress impacts patient care.</div></div><div><h3>Methods</h3><div>A survey was developed and emailed to 23,016 licensed pharmacists in Florida. Responses were collected from March 9 to April 15, 2022. The primary outcomes measured were workplace stressor frequency in community pharmacies and the relationship between work environment factors and patient care quality. Secondary outcomes assessed differences in average Perceived Stress Scores (PSS) between chain and independent pharmacists and between those in managerial versus non-managerial roles.</div></div><div><h3>Results</h3><div>Of 361 responses, 257 pharmacists completed the survey. Most (84.8 %) were chain pharmacists, 15.2 % independent. The primary stressor was staffing issues (57.98 %). Additionally, 71.9 % deemed working conditions unsafe, and 78.4 % struggled to provide quality care due to work stress. Chain pharmacists had significantly different PSS scores (22.72) versus independent pharmacists (22.82, <em>p</em> = 0.0034). No difference existed between managerial (25.44) and non-managerial pharmacists (25.11, <em>p</em> = 0.5962). Spearman correlations showed significant negative associations between PSS scores and difficulty providing quality care (ρ = −0.47, <em>p</em> < 0.0001) and unsafe conditions perceptions (ρ = −0.51, p < 0.0001). Patient care measures correlated positively (ρ = 0.71, p < 0.0001).</div></div><div><h3>Conclusion</h3><div>Stress significantly impacts community pharmacists' ability to provide quality care.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100641"},"PeriodicalIF":1.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144781012","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 : 2025-07-22DOI: 10.1016/j.rcsop.2025.100637
Reko Ravela , Timi Aaltonen , Marja Airaksinen , Alan Lyles
Background
Since 1984, Finland has used storage obligations for essential medicines, requiring manufacturers and importers to maintain storage of certain medicines. This study aimed to investigate whether this type of obligatory storage system for human medicines is effective in preventing and mitigating medicine shortages.
Methods
This is a retrospective register study, utilizing open data from Finnish, Norwegian, and Swedish national medicines authorities. We compared the proportion and median durations of shortages between medicines with and without storage obligations within Finland, and the proportion of shortages across Finland, Sweden, and Norway.
Results
A total of 1910 shortage notifications met the inclusion criteria for the analysis of shortages within Finland. Medicines not subject to storage obligations experienced between 1.8 and 2.3 times more shortages during the study period compared to those covered by storage obligations. Additionally, the median duration of short-term shortages (lasting less than 21 days) was shorter for medicines that are subject to storage obligations.
The inter-country analysis included 1230 shortage notifications from Sweden, 1075 from Norway, and 1369 from Finland. In comparison to Finland, shortages of products equivalent to those subject to storage obligations were 2.5 times more common in Sweden, where no storage obligations are in place, and 2.4 times more common in Norway, where storage obligations are more limited.
Conclusions
Our findings suggest that storage obligations for essential human medicines are associated with a lower frequency of shortages. This evidence provides support for other nations considering taking similar policy measures to reduce such shortages.
{"title":"Can a national storage obligation for medicines prevent shortages? Evidence from the Finnish experience","authors":"Reko Ravela , Timi Aaltonen , Marja Airaksinen , Alan Lyles","doi":"10.1016/j.rcsop.2025.100637","DOIUrl":"10.1016/j.rcsop.2025.100637","url":null,"abstract":"<div><h3>Background</h3><div>Since 1984, Finland has used storage obligations for essential medicines, requiring manufacturers and importers to maintain storage of certain medicines. This study aimed to investigate whether this type of obligatory storage system for human medicines is effective in preventing and mitigating medicine shortages.</div></div><div><h3>Methods</h3><div>This is a retrospective register study, utilizing open data from Finnish, Norwegian, and Swedish national medicines authorities. We compared the proportion and median durations of shortages between medicines with and without storage obligations within Finland, and the proportion of shortages across Finland, Sweden, and Norway.</div></div><div><h3>Results</h3><div>A total of 1910 shortage notifications met the inclusion criteria for the analysis of shortages within Finland. Medicines not subject to storage obligations experienced between 1.8 and 2.3 times more shortages during the study period compared to those covered by storage obligations. Additionally, the median duration of short-term shortages (lasting less than 21 days) was shorter for medicines that are subject to storage obligations.</div><div>The inter-country analysis included 1230 shortage notifications from Sweden, 1075 from Norway, and 1369 from Finland. In comparison to Finland, shortages of products equivalent to those subject to storage obligations were 2.5 times more common in Sweden, where no storage obligations are in place, and 2.4 times more common in Norway, where storage obligations are more limited.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that storage obligations for essential human medicines are associated with a lower frequency of shortages. This evidence provides support for other nations considering taking similar policy measures to reduce such shortages.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100637"},"PeriodicalIF":1.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723532","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 increased prevalence of cardiovascular disease (CVD) and associated risk factors like hypertension, type 2 diabetes, dyslipideamia, and obesity underscores the need for proactive screening. Given the insidious progression of these conditions, early detection is paramount. The Screening and Testing Programme for Pharmacy Students (STEPPS) is a pharmacy student-led, work-based learning initiative at the University of the Witwatersrand that provides preventive cardiovascular risk screening to university staff and students.
Aim
To identify the occurrence of underlying and uncontrolled risk factors for cardiovascular disease from a convenience sample of participants who attended the STEPPS screening events at the University of the Witwatersrand in year 2022. The study further determined whether the referral of the identified participants led to a diagnosis and intervention.
Methodology
A cross-sectional study was conducted in a screening event called STEPPS at the University of the Witwatersrand. A convenience sample of university staff and students aged 18 years and older who voluntarily participated was included. Fourth-year pharmacy students conducted screenings, including blood pressure, blood glucose, cholesterol, and anthropometric measurements. Participants with abnormal results were referred for further care, and follow-up was conducted via telephone interviews several months later. Quantitative data were analysed using descriptive and inferential statistics in STATA® 18.0.
Results
There was a self-reported occurrence of hypertension (6.5 %), diabetes (2.09 %), dyslipideamia (2.87 %), and obesity (3.91 %). Elevated readings were observed among 136 (18.25 %) participants for blood pressure, 13 (2.83 %) participants for blood glucose and, 50 (11.36 %) participants for blood cholesterol. Among the CVD-related referrals based on abnormal screening results (33 participants), 75 % complied. Of these, 35 % exhibited significant findings, including newly diagnosed cases (43 %), disease escalation (29 %) and lifestyle modifications (29 %). Among follow-up participants, 16 (80 %) participants reported undergoing interventions post-screening.
Conclusion
The student-led initiative effectively identified the occurrences of undiagnosed and uncontrolled cases at the university with 80 % of referrals leading to a medical intervention.
{"title":"Identification and follow up of cardiovascular disease risk factors among participants at a pharmacy student-led screening program","authors":"Umara Bibi Qureshi , Dineo Mpanya , Razeeya Khan , Muhammed Vally , Ané Orchard","doi":"10.1016/j.rcsop.2025.100636","DOIUrl":"10.1016/j.rcsop.2025.100636","url":null,"abstract":"<div><h3>Background</h3><div>The increased prevalence of cardiovascular disease (CVD) and associated risk factors like hypertension, type 2 diabetes, dyslipideamia, and obesity underscores the need for proactive screening. Given the insidious progression of these conditions, early detection is paramount. The Screening and Testing Programme for Pharmacy Students (STEPPS) is a pharmacy student-led, work-based learning initiative at the University of the Witwatersrand that provides preventive cardiovascular risk screening to university staff and students.</div></div><div><h3>Aim</h3><div>To identify the occurrence of underlying and uncontrolled risk factors for cardiovascular disease from a convenience sample of participants who attended the STEPPS screening events at the University of the Witwatersrand in year 2022. The study further determined whether the referral of the identified participants led to a diagnosis and intervention.</div></div><div><h3>Methodology</h3><div>A cross-sectional study was conducted in a screening event called STEPPS at the University of the Witwatersrand. A convenience sample of university staff and students aged 18 years and older who voluntarily participated was included. Fourth-year pharmacy students conducted screenings, including blood pressure, blood glucose, cholesterol, and anthropometric measurements. Participants with abnormal results were referred for further care, and follow-up was conducted via telephone interviews several months later. Quantitative data were analysed using descriptive and inferential statistics in STATA® 18.0.</div></div><div><h3>Results</h3><div>There was a self-reported occurrence of hypertension (6.5 %), diabetes (2.09 %), dyslipideamia (2.87 %), and obesity (3.91 %). Elevated readings were observed among 136 (18.25 %) participants for blood pressure, 13 (2.83 %) participants for blood glucose and, 50 (11.36 %) participants for blood cholesterol. Among the CVD-related referrals based on abnormal screening results (33 participants), 75 % complied. Of these, 35 % exhibited significant findings, including newly diagnosed cases (43 %), disease escalation (29 %) and lifestyle modifications (29 %). Among follow-up participants, 16 (80 %) participants reported undergoing interventions post-screening.</div></div><div><h3>Conclusion</h3><div>The student-led initiative effectively identified the occurrences of undiagnosed and uncontrolled cases at the university with 80 % of referrals leading to a medical intervention.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100636"},"PeriodicalIF":1.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722572","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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