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}
Although medication is important for children with Attention Deficit Hyperactivity Disorder (ADHD), medication adherence is low among parents. One of the key factors affecting medication adherence and disorder management is health literacy.
Objective
This study aimed to assess the effectiveness of an educational program for parents of children with ADHD in improving medication adherence and health literacy.
Methods
An educational program was developed that covered four main topics: general disorder information, treatment, parenting based on emotional needs, and basic health information. A total of 191 parents were screened and assigned 108 eligible participants to either the intervention group (n = 74) or the control group (n = 35). The intervention group received a two-month educational program delivered via messenger application, while the control group received general counseling. Medication adherence and health literacy were measured before and after the intervention. t-test, ANOVA, ANCOVA, and chi-square test were used to compare group differences.
Results
Post-intervention, the intervention group showed significantly higher medication adherence (6.87 ± 1.36) than the control group (5.46 ± 1.45). The intervention group also demonstrated higher health literacy scores (82.34 ± 6.96) than the control group (72.15 ± 6.52). Covariance analysis revealed significant improvements in health literacy (F = 162.73, p < 0.001, eta squared = 0.657) and medication adherence (F = 40.41, p < 0.001, eta squared = 0.322) scores. A significant difference was found in medication adherence improvement based on economic status (p = 0.037) in the intervention group. However, no significant differences in medication adherence and health literacy were observed based on parental gender, education level, or insurance status.
Conclusion
The educational program showed improvement in medication adherence and health literacy among parents of children with ADHD.
背景：虽然药物治疗对患有注意缺陷多动障碍（ADHD）的儿童很重要，但家长的药物依从性很低。影响药物依从性和障碍管理的关键因素之一是健康素养。目的本研究旨在评估ADHD儿童家长教育计划在提高药物依从性和健康素养方面的有效性。方法制定了一个教育计划，包括四个主要主题：一般障碍信息、治疗、基于情感需求的养育和基本健康信息。共筛选了191名家长，并将108名符合条件的参与者分配到干预组（n = 74）和对照组（n = 35）。干预组通过信使应用程序接受为期两个月的教育计划，而对照组接受一般咨询。在干预前后测量药物依从性和健康素养。采用t检验、ANOVA、ANCOVA、卡方检验比较组间差异。结果干预后，干预组患者的药物依从性（6.87±1.36）明显高于对照组（5.46±1.45）。干预组健康素养得分（82.34±6.96）高于对照组（72.15±6.52）。协方差分析显示健康素养显著提高(F = 162.73, p <；0.001， eta平方= 0.657)和药物依从性(F = 40.41, p <；0.001， eta平方= 0.322)分数。干预组经济状况对药物依从性的改善差异有统计学意义（p = 0.037）。然而，在药物依从性和健康素养方面，没有观察到基于父母性别、教育水平或保险状况的显著差异。结论该教育方案提高了ADHD患儿家长的药物依从性和健康素养。
{"title":"Improved medication adherence and health literacy in parents of children with ADHD: Effects of a targeted educational program","authors":"Nafiseh Valaei Sharif , Peivand Ghasemzadeh , Niayesh Mohebbi , Sogand Ghasemzadeh","doi":"10.1016/j.rcsop.2025.100634","DOIUrl":"10.1016/j.rcsop.2025.100634","url":null,"abstract":"<div><h3>Background</h3><div>Although medication is important for children with Attention Deficit Hyperactivity Disorder (ADHD), medication adherence is low among parents. One of the key factors affecting medication adherence and disorder management is health literacy.</div></div><div><h3>Objective</h3><div>This study aimed to assess the effectiveness of an educational program for parents of children with ADHD in improving medication adherence and health literacy.</div></div><div><h3>Methods</h3><div>An educational program was developed that covered four main topics: general disorder information, treatment, parenting based on emotional needs, and basic health information. A total of 191 parents were screened and assigned 108 eligible participants to either the intervention group (<em>n</em> = 74) or the control group (<em>n</em> = 35). The intervention group received a two-month educational program delivered via messenger application, while the control group received general counseling. Medication adherence and health literacy were measured before and after the intervention. <em>t</em>-test, ANOVA, ANCOVA, and chi-square test were used to compare group differences.</div></div><div><h3>Results</h3><div>Post-intervention, the intervention group showed significantly higher medication adherence (6.87 ± 1.36) than the control group (5.46 ± 1.45). The intervention group also demonstrated higher health literacy scores (82.34 ± 6.96) than the control group (72.15 ± 6.52). Covariance analysis revealed significant improvements in health literacy (F = 162.73, <em>p</em> < 0.001, eta squared = 0.657) and medication adherence (F = 40.41, p < 0.001, eta squared = 0.322) scores. A significant difference was found in medication adherence improvement based on economic status (<em>p</em> = 0.037) in the intervention group. However, no significant differences in medication adherence and health literacy were observed based on parental gender, education level, or insurance status.</div></div><div><h3>Conclusion</h3><div>The educational program showed improvement in medication adherence and health literacy among parents of children with ADHD.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100634"},"PeriodicalIF":1.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656294","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}
Japanese pharmacists aim to improve efficiency and communication by simplifying work processes and developing protocols. While assistants and robots have been shown to improve drug dispensing, reports on the efficiency of pharmacies with automated dispensing systems are limited. This study explores factors affecting pharmacist efficiency in dispensing.
Methods
77Daily reports from our hospital pharmacy (December 1, 2020–November 30, 2021) were retrospectively analyzed. The primary outcome was the mean duration of drug dispensing. Multiple regression analyses identified factors affecting dispensing time. Strategies to address these factors were implemented, and outcomes were evaluated using data from December 1, 2021–November 30, 2022.
Results
Univariate analysis identified that the prescription/pharmacist ratio, number of one-dose package (ODP) prescriptions, and powdered drugs significantly influenced dispensing time. Multivariate analysis confirmed that the prescription/pharmacist ratio (p < 0.001), ODP prescriptions (p < 0.001), and powdered drugs (p = 0.02) were key factors. A higher number of ODP prescriptions generally increased dispensing time. After implementing a new strategy for checking ODP, mean dispensing time decreased from 20.0 ± 4.0 to 18.5 ± 3.6 min (p < 0.001), and the percentage of tasks completed in under 20 min increased from 56.3 % to 73.6 % (p < 0.001). Dispensing times were reduced without changing staffing levels by reallocating tasks.
Conclusions
Optimizing the ODP verification workflow enhances dispensing efficiency without increasing pharmacist workload, highlighting the importance of prioritizing ODP prescriptions and implementing support tools for final checks, while further multicenter studies are needed to confirm these findings across diverse settings.
{"title":"Streamlining one-dose package-handling process improves operational efficiency when dispensing drugs: A retrospective study","authors":"Takahiro Kato , Miki Kato , Kazuyo Nagashiba , Masayuki Takeuchi , Masafumi Onishi","doi":"10.1016/j.rcsop.2025.100635","DOIUrl":"10.1016/j.rcsop.2025.100635","url":null,"abstract":"<div><h3>Background</h3><div>Japanese pharmacists aim to improve efficiency and communication by simplifying work processes and developing protocols. While assistants and robots have been shown to improve drug dispensing, reports on the efficiency of pharmacies with automated dispensing systems are limited. This study explores factors affecting pharmacist efficiency in dispensing.</div></div><div><h3>Methods</h3><div>77Daily reports from our hospital pharmacy (December 1, 2020–November 30, 2021) were retrospectively analyzed. The primary outcome was the mean duration of drug dispensing. Multiple regression analyses identified factors affecting dispensing time. Strategies to address these factors were implemented, and outcomes were evaluated using data from December 1, 2021–November 30, 2022.</div></div><div><h3>Results</h3><div>Univariate analysis identified that the prescription/pharmacist ratio, number of one-dose package (ODP) prescriptions, and powdered drugs significantly influenced dispensing time. Multivariate analysis confirmed that the prescription/pharmacist ratio (<em>p</em> < 0.001), ODP prescriptions (p < 0.001), and powdered drugs (<em>p</em> = 0.02) were key factors. A higher number of ODP prescriptions generally increased dispensing time. After implementing a new strategy for checking ODP, mean dispensing time decreased from 20.0 ± 4.0 to 18.5 ± 3.6 min (p < 0.001), and the percentage of tasks completed in under 20 min increased from 56.3 % to 73.6 % (p < 0.001). Dispensing times were reduced without changing staffing levels by reallocating tasks.</div></div><div><h3>Conclusions</h3><div>Optimizing the ODP verification workflow enhances dispensing efficiency without increasing pharmacist workload, highlighting the importance of prioritizing ODP prescriptions and implementing support tools for final checks, while further multicenter studies are needed to confirm these findings across diverse settings.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100635"},"PeriodicalIF":1.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614678","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 : 2025-07-05DOI: 10.1016/j.rcsop.2025.100631
Dan Zhao, Jie Wang, Mengting Sun, Tao Wu, Yingxin Peng
Background
Medication errors and delays in drug dispensing are persistent challenges in traditional pharmacy systems. Automated Dispensing Cabinets (ADCs) were introduced at the study hospital in July 2022 to improve medication safety and efficiency. However, the initial implementation phase revealed several issues, including prolonged medication retrieval times, suboptimal cabinet layout, system interface limitations, and inconsistent user operations. These challenges highlighted the need for further system optimization using a structured improvement approach.
Objective
This study aims to implement an inpatient pharmacy management system based on Six Sigma methodology and compare its effectiveness with TPS in terms of medication convenience and error reduction.
Methods
Starting in July 2022, an intelligent pharmacy management model was implemented in inpatient wards, centered around ADCs and guided by the Six Sigma methodology. Comprehensive improvements were made to address issues such as baseline medication management inefficiencies and delays in retrieving medications for temporary orders. The study compared various metrics, including the time required for retrieving medications for temporary orders, medication administration time, medication error rates before after one month of implementing the intelligent system and nurses' satisfaction with the intelligent system.
Results
Compared with the pre-implementation phase, the intelligent system significantly reduced the time required for nurses to retrieve medications and execute orders (P < 0.05). The rates of medication retrieval and administration errors also decreased (P < 0.05). A majority of nurses (86.96 %) reported that the intelligent system improved work efficiency, 92.40 % found it easier to retrieve medications during emergencies, and 97.82 % expressed high satisfaction with the system.
Conclusion
The application of an intelligent inpatient pharmacy management system based on the Six Sigma methodology effectively reduced the time nurses needed to retrieve medications, enhanced overall nurse satisfaction, lowered error rates caused by human factors.
{"title":"Implementing six sigma management to shorten the time of taking medicine from intelligent medicine cabinet in inpatient ward","authors":"Dan Zhao, Jie Wang, Mengting Sun, Tao Wu, Yingxin Peng","doi":"10.1016/j.rcsop.2025.100631","DOIUrl":"10.1016/j.rcsop.2025.100631","url":null,"abstract":"<div><h3>Background</h3><div>Medication errors and delays in drug dispensing are persistent challenges in traditional pharmacy systems. Automated Dispensing Cabinets (ADCs) were introduced at the study hospital in July 2022 to improve medication safety and efficiency. However, the initial implementation phase revealed several issues, including prolonged medication retrieval times, suboptimal cabinet layout, system interface limitations, and inconsistent user operations. These challenges highlighted the need for further system optimization using a structured improvement approach.</div></div><div><h3>Objective</h3><div>This study aims to implement an inpatient pharmacy management system based on Six Sigma methodology and compare its effectiveness with TPS in terms of medication convenience and error reduction.</div></div><div><h3>Methods</h3><div>Starting in July 2022, an intelligent pharmacy management model was implemented in inpatient wards, centered around ADCs and guided by the Six Sigma methodology. Comprehensive improvements were made to address issues such as baseline medication management inefficiencies and delays in retrieving medications for temporary orders. The study compared various metrics, including the time required for retrieving medications for temporary orders, medication administration time, medication error rates before after one month of implementing the intelligent system and nurses' satisfaction with the intelligent system.</div></div><div><h3>Results</h3><div>Compared with the pre-implementation phase, the intelligent system significantly reduced the time required for nurses to retrieve medications and execute orders (<em>P</em> < 0.05). The rates of medication retrieval and administration errors also decreased (P < 0.05). A majority of nurses (86.96 %) reported that the intelligent system improved work efficiency, 92.40 % found it easier to retrieve medications during emergencies, and 97.82 % expressed high satisfaction with the system.</div></div><div><h3>Conclusion</h3><div>The application of an intelligent inpatient pharmacy management system based on the Six Sigma methodology effectively reduced the time nurses needed to retrieve medications, enhanced overall nurse satisfaction, lowered error rates caused by human factors.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100631"},"PeriodicalIF":1.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614679","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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