Exploratory research in clinical and social pharmacy最新文献

{"title":"The triple burden: A systematic review and meta-analysis of essential medicine availability, price, and affordability across Ethiopian health facilities","authors":"Tsegaye Melaku,&nbsp;Dula Dessalegn,&nbsp;Mestawet Getachew","doi":"10.1016/j.rcsop.2025.100674","DOIUrl":"10.1016/j.rcsop.2025.100674","url":null,"abstract":"<div><h3>Background</h3><div>Access to essential medicines is a fundamental component of achieving universal health coverage, as outlined by the World Health Organization's(WHO) framework. Despite various efforts to improve access to essential medicines, there remains a gap in comprehensive data regarding their availability, price, and affordability at health facilities in Ethiopia. This systematic review and meta-analysis aimed to assess the pooled estimates of availability, price, and affordability of generic essential medicines at health facilities in Ethiopia.</div></div><div><h3>Methods</h3><div>We conducted a complete search of electronic databases (PubMed/MEDLINE, EMBASE, Science Direct, Web of Science, Scopus, African Index Medicus, AJOL, Google Scholar, and Organization repositories such as the Ministry of Health, Ethiopian Pharmaceuticals Supply Service) to find relevant articles on the topic from inception to August 2025. Data was analyzed using STATA version 18.0. Random-effect model meta-analysis and descriptive statistics were performed to determine the pooled availability and affordability, respectively. Statistical significance was considered at a <em>p</em>-value less than 0.05.</div></div><div><h3>Results</h3><div>A total of 46 studies, encompassing data from 2302 health facilities, were included in the final analysis. The overall mean availability of essential medicines was 63.89 % (± 19.48 SD). In public health facilities, the pooled availability was 64 % (95 % CI: 58 %–70 %), while in private facilities it was lower at 54 % (95 % CI: 42 %–66 %). The pooled proportion of unaffordable medicines was 62 % (95 % CI: 45 %–79 %). Analysis of the Median Price Ratios (MPRs) revealed that, in public health facilities, MPRs ranged from 0.55 to 5.21, with an overall median (IQR) of 1.45 (1.26–2.31). In private health facilities, MPRs ranged from 0.88 to 11.17, with a higher overall median (IQR) of 3.66 (2.12–4.10), reflecting greater price variability and reduced affordability in the private sector.</div></div><div><h3>Conclusion</h3><div>The availability of generic essential medicines in Ethiopia was below the WHO target of 80 % in both public and private health facilities. Prices of these medicines were higher than international reference prices, with significant variations across sectors. About two-thirds of the evaluated medicines were unaffordable. Addressing these challenges will require coordinated efforts, including policy refinement, supply chain improvements, and context-specific interventions, to progressively enhance equitable access to essential medicines across all sectors.</div><div><strong>Systematic review registration number:</strong> PROSPERO CRD420251137000.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100674"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating genetic insights into pain management and opioid use optimization in chronic pain and substance abuse populations","authors":"Ammar Abdulrahman Jairoun ,&nbsp;Sabaa Saleh Al-Hemyari ,&nbsp;Moyad Shahwan ,&nbsp;Abeer M. Al-Ghananeem ,&nbsp;Ghala Rashid Alnuaimi ,&nbsp;Thantrira Porntaveetus","doi":"10.1016/j.rcsop.2025.100684","DOIUrl":"10.1016/j.rcsop.2025.100684","url":null,"abstract":"","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100684"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145680939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting career-related decisions within the contemporary pharmacy workforce in Australia","authors":"Jocelyn Bussing,&nbsp;Lorraine Smith,&nbsp;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":"2025-12-01","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}

{"title":"Impact of electronic prescribing on medication changes in users of multidose drug dispensing","authors":"Anette Vik Josendal ,&nbsp;Trine Strand Bergmo","doi":"10.1016/j.rcsop.2025.100667","DOIUrl":"10.1016/j.rcsop.2025.100667","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the number and type of prescription modifications after introducing e-prescribing for multidose drug dispensing (MDD) users.</div></div><div><h3>Methods</h3><div>A longitudinal study using dispensing records from the main MDD supplier in Norway from June 2012 to August 2023. The study included 1522 MDD users with complete data from 24 weeks before and 24 weeks after the implementation. The main outcome measures were the number and type of prescription modifications.</div></div><div><h3>Results</h3><div>In total, there was a 175 % increase in the frequency of prescription modifications, with 15.9 % of patients experiencing prescription alterations every two weeks, compared to 5.7 % before the intervention. Modifications were categorized into administrative and treatment changes. Administrative changes increased by 300 %, while treatment changes (including newly prescribed medications, discontinued medications, and dose adjustments) increased by 60 %. The proportion of patients with no prescription modifications throughout the 24 weeks decreased from 58.1 % to 26.2 % following the implementation of e-prescribing.</div></div><div><h3>Conclusion</h3><div>Transitioning to an e-prescribing system is associated with more frequent modifications to patients' prescriptions. More frequent treatment changes can potentially improve medication safety and accuracy of the medication lists, but the major increase in administrative changes can also increase the workload of involved health care personnel.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100667"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appropriateness of empiric antibiotic therapy for community-acquired pneumonia: A multicenter cross-sectional study","authors":"Deema Rahme ,&nbsp;Hania Nakkash Chmaisse ,&nbsp;Pascale Salameh","doi":"10.1016/j.rcsop.2025.100669","DOIUrl":"10.1016/j.rcsop.2025.100669","url":null,"abstract":"<div><h3>Background</h3><div>Community-acquired pneumonia (CAP) remains a major public health concern, with appropriate empiric antibiotic therapy critical to improving patient outcomes and combating antimicrobial resistance (AMR). Despite the availability of national guidelines, adherence among physicians in Lebanon was previously unclear.</div></div><div><h3>Objective</h3><div>To evaluate the appropriateness of empiric antibiotic prescribing for hospitalized CAP patients in Lebanon and identify factors associated with non-compliance with national guidelines.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted in five Lebanese hospitals across various regions. Medical records of 380 adult CAP patients were reviewed. Empiric antibiotic regimens were evaluated for compliance with national CAP guidelines based on drug selection, dosage, route, and duration. Multivariate logistic regression was used to identify predictors of inappropriate prescribing.</div></div><div><h3>Results</h3><div>Only 38.9 % of patients received fully guideline-concordant empiric therapy. Inappropriate prescribing was significantly associated with physician rank (residents: aOR = 29.13, <em>p</em> = 0.001), geographic region (South Lebanon: aOR = 7.78, <em>p</em> = 0.028), and antibiotic class (β-lactam plus respiratory fluoroquinolones: aOR = 19.18, <em>p</em> &lt; 0.001). Clinical factors such as systemic inflammatory response syndrome and elevated serum creatinine were also linked to inappropriate use.</div></div><div><h3>Conclusion</h3><div>Non-compliance with national CAP treatment guidelines is widespread in Lebanese hospitals and driven by physician experience, geographic disparities, and misalignment in antibiotic selection. Strengthening antimicrobial stewardship programs, regional training, and clinical decision support is essential to improve adherence and reduce AMR risk.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100669"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design and evaluation of a comprehensive training program for hospital-based clinical pharmacists - various, active, and work-integrated learning","authors":"Marianne Lea ,&nbsp;Elin Trapnes ,&nbsp;Hanne Steen ,&nbsp;Nina Bjerketveit Ødegaard","doi":"10.1016/j.rcsop.2025.100677","DOIUrl":"10.1016/j.rcsop.2025.100677","url":null,"abstract":"<div><h3>Background</h3><div>Medication reconciliation and -reviews are not emphasized in the pharmacy curriculums in Norway and graduated pharmacists are at novice level. Therefore, a postgraduate training program for hospital-based clinical pharmacists was developed. The aim of this paper is to describe the program design and evaluation of the last four years (2021–2024).</div></div><div><h3>Method</h3><div>The training program, established in 2012, used Southern Sweden's training in Integrated Medicines Management as inspiration. Experienced clinical pharmacists in Norway have further developed and improved the program. The training program comprises i) a three-day in-class and skill training course in a simulation lab ii) eight days in a hospital ward performing medication reconciliations and - reviews under individual supervision from a clinical supervisor, i.e. an experienced clinical pharmacist, and iii) independently conducted medication reconciliations and –reviews presented to the supervisor for feedback and reflection.</div></div><div><h3>Results</h3><div>Of 46 participants in the last four years, 39 (85 %) completed a questionnaire. Participants scored their overall satisfaction with a median of 6 (range 4–6) on a scale from 1 to 6. Participants highlighted the way the course is organized and facilitated by skilled lecturers, active learning with feedback, peer learning, and work relevance as positive factors.</div></div><div><h3>Conclusion</h3><div>A comprehensive work-integrated training program with various and active learning methods that can be used as a template in settings where pharmacists graduate at novice level in medication reconciliation and -reviews has been developed. The program is appreciated by participants, seems to improve their professional confidence, and could ensure standardised high quality clinical pharmacy services.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100677"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The short medication adherence scale (SMAS-7): Development and psychometric validation in a general population sample","authors":"Fouad Sakr ,&nbsp;Mariam Dabbous ,&nbsp;Jihan Safwan ,&nbsp;Mohamad Rahal ,&nbsp;Pascale Salameh","doi":"10.1016/j.rcsop.2025.100676","DOIUrl":"10.1016/j.rcsop.2025.100676","url":null,"abstract":"<div><h3>Background</h3><div>Medication adherence is essential for treatment success across both chronic and acute conditions. However, concise, multidimensional, and broadly applicable validated tools to measure medication adherence remain scarce.</div></div><div><h3>Objectives</h3><div>This study primarily aimed to develop and validate the Short Medication Adherence Scale (SMAS-7) and, secondarily, to assess adherence levels and related factors in a general adult population.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted among Lebanese adults aged ≥18 years from the general population. Individuals who declined follow-up contact for the test-retest phase were excluded. The 7-item SMAS-7, developed from the LMAS-14, was administered electronically in Arabic using an online questionnaire. Exploratory and confirmatory factor analyses (EFA and CFA) were performed on two random subsamples to assess factorial structure and model fit. Internal consistency (Cronbach's α, McDonald's ω), test-retest reliability (ICC), and construct and criterion validity were evaluated. Multivariable logistic regression identified predictors of adherence using a ROC curve-derived SMAS-7 cut-off score.</div></div><div><h3>Results</h3><div>A total of 501 participants were included in the study. EFA revealed a 3-factor structure, psychological, economic, and behavioral domains, supported by KMO = 0.830 and significant Bartlett's test (<em>P</em> &lt; 0.001). CFA confirmed the structure with excellent fit (χ²/df = 1.757, CFI = 0.992, TLI = 0.985, RMSEA = 0.055, SRMR = 0.020). The SMAS-7 demonstrated high internal consistency (α = 0.889, ω = 0.945) and test-retest reliability (ICC = 0.779). Criterion validity was excellent (AUC = 0.985; sensitivity = 91.2 %; specificity = 96.0 %). Suboptimal adherence was observed in 52.3 % of participants. Significant predictors of adherence included gender (<em>P</em> = 0.030), region (<em>P</em> = 0.014), financial well-being (<em>P</em> = 0.002), chronic illness (<em>P</em> = 0.009), communication barriers (<em>P</em> = 0.013), and patient perception (<em>P</em> = 0.029).</div></div><div><h3>Conclusion</h3><div>The SMAS-7 demonstrated strong preliminary psychometric properties in this initial validation study. It offers a valuable resource for researchers, clinicians, and policymakers seeking to monitor and enhance adherence behaviors. While these findings are encouraging, further studies in diverse populations and clinical settings are required to confirm its external validity and generalizability. The findings revealed suboptimal adherence and underscored the multifaceted nature of its predictors, highlighting the need for targeted, multidimensional interventions.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100676"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An international portrait of pharmacists' professional role identities: A Q-methodology innovative study","authors":"Kaitlyn E. Watson ,&nbsp;Theresa J. Schindel ,&nbsp;Sherly Meilianti ,&nbsp;Ross T. Tsuyuki ,&nbsp;Yazid N. Al Hamarneh","doi":"10.1016/j.rcsop.2025.100616","DOIUrl":"10.1016/j.rcsop.2025.100616","url":null,"abstract":"<div><h3>Background</h3><div>Professional identities shape who pharmacists are, what they do, and what they stand for as professionals. Novel research methodologies have potential to illuminate pharmacists' professional identity and roles in new and innovative ways. This study aimed to explore international pharmacists' identity through reflection on their professional roles.</div></div><div><h3>Methods</h3><div>Q Methodology, which uses quantitative techniques to systematically study subjectivity, was used to allow for an in-depth analysis of professional identity. The participants were self-identified pharmacists working in patient-facing roles who attended the International Pharmaceutical Federation (FIP) Congress in Brisbane, Australia, from September 24–28, 2023. They completed Q methodology online activities to sort the Q-Set within a fixed quasi-normal distribution grid.</div></div><div><h3>Results</h3><div>Twenty participants completed the Q-Sort activity. Participants came from 10 countries (five of the six World Health Organization regions), two thirds identified as women and approximately one third practiced in hospital and community pharmacy settings, respectively. Three factor arrays are described, which explain 52 % of the variance; Factor 1: Pharmacists as autonomous healthcare providers AND clinical team members; Factor 2: Pharmacists as healthcare providers for individual patients; and Factor 3: Pharmacists as managers first, then healthcare providers.</div></div><div><h3>Conclusion</h3><div>This study offers a new perspective, revealing how various roles may converge to form a pharmacist's professional role identity: for example, autonomous healthcare providers AND clinical team members AND patient-focused practitioners AND leaders mindful of management responsibilities. Viewing the Q Methodology with a systems thinking lens illuminates pharmacists' professional identities as neither a mere sum of the roles and services they provide, nor represented by a singular aspect of their professional work. Recognizing the complexity of the pharmacists' identities as individuals helps to break free from the cognitive dissonance that has plagued the profession suggesting that professional identity is represented by singular or often competing roles as the scope of pharmacy practice evolves.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100616"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parent perspectives on a pharmacist-disseminated vaping educational tool for vaping prevention","authors":"Olufunmilola Abraham ,&nbsp;Virginia Quach ,&nbsp;Jenny S. Li","doi":"10.1016/j.rcsop.2025.100615","DOIUrl":"10.1016/j.rcsop.2025.100615","url":null,"abstract":"<div><h3>Background</h3><div>Adolescent e-cigarette use is a major public health issue which can lead to respiratory damage and mental health problems. However, there is a lack of reliable educational resources for adolescents and parents. A vaping educational tool can educate parents about e-cigarettes and support discussions with their children. Pharmacists can leverage their accessibility to integrate educating families about vaping within their practice. This study aimed to explore parent perspectives on adolescent vaping, a pharmacist-led vaping educational tool, and pharmacists' potential role in vaping intervention and prevention.</div></div><div><h3>Methods</h3><div>Parents of adolescents were recruited for virtual semi-structured interviews on vaping knowledge, opinions on pharmacist vaping intervention, and feedback on the Pharmacist-led <em>E</em>-cigarette and Vaping Educational Resource (pH-EVER). Interviews were analyzed on Dedoose software with inductive thematic analysis.</div></div><div><h3>Results</h3><div>Interviews from 46 parents led to five primary themes: vaping knowledge, exposure, and opinions; pH-EVER availability, feedback and usage; parental and school role in vaping intervention; receptiveness to learning about vaping; and pharmacist role in vaping intervention. Most participants expressed that they had limited vaping knowledge but were aware of some health consequences. Participants found the Ph-EVER to be useful for starting conversations with family. Many participants trusted and respected pharmacists to receive education from them. The Ph-EVER was described as important with potential use to inform and initiate conversations with adolescents on e-cigarette risks.</div></div><div><h3>Conclusion</h3><div>Parent participants found the Ph-EVER to be a helpful educational tool that can be disseminated in public settings with further need to explore integration into pharmacy practice.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100615"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not so great expectations: The role of price and name information in the nocebo effect","authors":"Kiarne Humphreys ,&nbsp;Michelle Lin ,&nbsp;Kirsten Barnes ,&nbsp;Yasmin Hasan ,&nbsp;Ashwin Vignaraja ,&nbsp;Kritika Sarna ,&nbsp;Andrew L. Geers ,&nbsp;Kate Faasse","doi":"10.1016/j.rcsop.2025.100630","DOIUrl":"10.1016/j.rcsop.2025.100630","url":null,"abstract":"<div><h3>Background</h3><div>The perception of taking a generic medication can result in reduced efficacy and increased side effects, despite equivalence to brand name medications under double blind conditions. It may be that cues typically associated with generics, including lower price and more complex name, exacerbate negative expectations and cause nocebo effects.</div></div><div><h3>Methods</h3><div>Healthy participants (<em>N</em> = 196) were randomised to receive sham-oxytocin nasal spray associated with either a generic (complex name, low price; <em>n</em> = 66) or brand (simple name, high price; <em>n</em> = 68) cue, or to no treatment control (<em>n</em> = 62). Participants were informed that oxytocin could enhance trust and cooperation, but might cause side effects of headache, nausea, vomiting, rapid heartbeat, feeling faint or light-headed, and skin itching or rash. Treatment-related side effects were assessed at baseline, and after 3 days of sham-oxytocin use.</div></div><div><h3>Results</h3><div>Nocebo effects were observed across sham-treated participants relative to control (<em>p</em> = .015; <em>d</em> = 0.28). Association with a generic relative to branded cue significantly enhanced nocebo effects (<em>p</em> = .042; <em>d</em> = 0.36). Negative expectations mediated the observed nocebo and branding effects.</div></div><div><h3>Conclusions</h3><div>Cues associated with generic medications can exacerbate nocebo effects and these findings may explain clinical observations of increased side effects from generic medications. Results have important implications for medical care, and interventions to mitigate nocebo effects from generic medications are needed.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100630"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580915","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}