Pub Date : 2025-06-19DOI: 10.1016/j.rcsop.2025.100626
Bei Huang
Emergency department (ED) length of stay (EDLOS) refers to the waiting time experienced by patients at various stages of the ED. It serves as an indicator of ED overcrowding. Prolonged EDLOS can lead to delays in assessment and care, negatively impacting patient satisfaction, and is associated with a poor prognosis. ED overcrowding may result in higher rates of medical errors, adverse events, and mortality. The crude mortality rate for patients with EDLOS <6 h was significantly lower than for those with EDLOS of 12–24 h and > 24 h. Multiple factors influence EDLOS before admission, including limited medical resources and a high volume of non-emergency cases. Hospitals should develop personalized strategies to reduce EDLOS by analyzing patient volumes and resource demands. In this narrative review, measures involving alternatives to ward admission from the ED such as an emergency fast track (FT), an emergency short-stay ward (ESSW)/emergency short-stay unit (ESSU), and an acute medical unit (AMU)/acute medical admissions unit (AMAU), are summarized, aiming to serve as a reference for shortening EDLOS, improving emergency care efficiency, and optimizing service quality.
{"title":"Shortening emergency department length of stay: Fast track, short-stay unit and acute medical unit","authors":"Bei Huang","doi":"10.1016/j.rcsop.2025.100626","DOIUrl":"10.1016/j.rcsop.2025.100626","url":null,"abstract":"<div><div>Emergency department (ED) length of stay (EDLOS) refers to the waiting time experienced by patients at various stages of the ED. It serves as an indicator of ED overcrowding. Prolonged EDLOS can lead to delays in assessment and care, negatively impacting patient satisfaction, and is associated with a poor prognosis. ED overcrowding may result in higher rates of medical errors, adverse events, and mortality. The crude mortality rate for patients with EDLOS <6 h was significantly lower than for those with EDLOS of 12–24 h and > 24 h. Multiple factors influence EDLOS before admission, including limited medical resources and a high volume of non-emergency cases. Hospitals should develop personalized strategies to reduce EDLOS by analyzing patient volumes and resource demands. In this narrative review, measures involving alternatives to ward admission from the ED such as an emergency fast track (FT), an emergency short-stay ward (ESSW)/emergency short-stay unit (ESSU), and an acute medical unit (AMU)/acute medical admissions unit (AMAU), are summarized, aiming to serve as a reference for shortening EDLOS, improving emergency care efficiency, and optimizing service quality.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100626"},"PeriodicalIF":1.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490641","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 : 2025-06-13DOI: 10.1016/j.rcsop.2025.100624
Mohammed Misbah Ul Haq, Mohammed Ansar, Aieman Siddiqua, Mohd Mudaseer
This case report describes a unique and severe instance of Stevens-Johnson syndrome (SJS) triggered by a combination of phenytoin, levetiracetam, glimepiride, and metformin in a patient with type 2 diabetes. SJS is a serious condition that affects the skin and mucous membranes and is often induced by various medications. The report underscores the critical importance of promptly identifying and managing SJS, as well as the need for careful monitoring of patients on multiple drugs, especially those with prior drug allergies. It also adds valuable insights to the existing literature on drug-induced SJS, emphasizing the role of a multidisciplinary approach in improving patient care and outcomes.
{"title":"Stevens-Johnson syndrome triggered by phenytoin in a patient with type 2 diabetes and seizures","authors":"Mohammed Misbah Ul Haq, Mohammed Ansar, Aieman Siddiqua, Mohd Mudaseer","doi":"10.1016/j.rcsop.2025.100624","DOIUrl":"10.1016/j.rcsop.2025.100624","url":null,"abstract":"<div><div>This case report describes a unique and severe instance of Stevens-Johnson syndrome (SJS) triggered by a combination of phenytoin, levetiracetam, glimepiride, and metformin in a patient with type 2 diabetes. SJS is a serious condition that affects the skin and mucous membranes and is often induced by various medications. The report underscores the critical importance of promptly identifying and managing SJS, as well as the need for careful monitoring of patients on multiple drugs, especially those with prior drug allergies. It also adds valuable insights to the existing literature on drug-induced SJS, emphasizing the role of a multidisciplinary approach in improving patient care and outcomes.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100624"},"PeriodicalIF":1.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588039","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 : 2025-06-11DOI: 10.1016/j.rcsop.2025.100623
Tristan Coppes , Hetty Prins , Kees A. van Amerongen , Teun van Gelder , Ellen S. Koster , Marcel L. Bouvy
Background
Certain high-risk medication, such as diuretics, should be temporarily adjusted during sick days (diarrhoea, vomiting or fever) to reduce the risk of adverse drug events. Guidelines refer to this as ‘sick day guidance’. Prior research has shown limited awareness among pharmacy staff of these recommendations.
Objective
This study assessed how community pharmacies in the Netherlands address a simulated self-care inquiry related to diarrhoea from a 71-year-old patient with diabetes.
Methods
Three trained simulated informal caregivers visited community pharmacies unannounced to seek an antidiarrheal product for a 71-year-old family member with diabetes and high-risk medication. Data were collected through a data collection form with audio recording.
Results
A total of 64 pharmacies were visited. Current comorbidities and medications were identified in 59 % (38/64) of the pharmacies. Sixteen out of 64 pharmacies (25 %) provided sick day guidance either through temporary medication adjustment or GP referral. In more than 80 % of the pharmacies, a pharmaceutical product was dispensed, most often loperamide. The pharmacies that did not identify current comorbidities and medications (n = 26), did not provide sick day guidance nor referred to the GP.
Conclusions
Sick day guidance was applied in one in four cases. Identifying current comorbidities and medications is essential for providing sick day guidance.
{"title":"Using simulated patient methodology to assess sick day guidance in community pharmacy: The case of an elderly patient with diabetes","authors":"Tristan Coppes , Hetty Prins , Kees A. van Amerongen , Teun van Gelder , Ellen S. Koster , Marcel L. Bouvy","doi":"10.1016/j.rcsop.2025.100623","DOIUrl":"10.1016/j.rcsop.2025.100623","url":null,"abstract":"<div><h3>Background</h3><div>Certain high-risk medication, such as diuretics, should be temporarily adjusted during sick days (diarrhoea, vomiting or fever) to reduce the risk of adverse drug events. Guidelines refer to this as ‘sick day guidance’. Prior research has shown limited awareness among pharmacy staff of these recommendations.</div></div><div><h3>Objective</h3><div>This study assessed how community pharmacies in the Netherlands address a simulated self-care inquiry related to diarrhoea from a 71-year-old patient with diabetes.</div></div><div><h3>Methods</h3><div>Three trained simulated informal caregivers visited community pharmacies unannounced to seek an antidiarrheal product for a 71-year-old family member with diabetes and high-risk medication. Data were collected through a data collection form with audio recording.</div></div><div><h3>Results</h3><div>A total of 64 pharmacies were visited. Current comorbidities and medications were identified in 59 % (38/64) of the pharmacies. Sixteen out of 64 pharmacies (25 %) provided sick day guidance either through temporary medication adjustment or GP referral. In more than 80 % of the pharmacies, a pharmaceutical product was dispensed, most often loperamide. The pharmacies that did not identify current comorbidities and medications (<em>n</em> = 26), did not provide sick day guidance nor referred to the GP.</div></div><div><h3>Conclusions</h3><div>Sick day guidance was applied in one in four cases. Identifying current comorbidities and medications is essential for providing sick day guidance.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100623"},"PeriodicalIF":1.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296823","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 : 2025-06-08DOI: 10.1016/j.rcsop.2025.100618
Saba Dangpiaei, Mohammad A. Al-Mamun
Background
Gabapentinoid, including Gabapentin and Pregabalin, are commonly used for approved and off-label health conditions, but their misuse with opioid among individuals with substance use disorder (SUD) increases the risk of respiratory depression and death. Thus, we investigated the impact of SUD on different health outcomes among the Gabapentinoid users in the U.S.
Methods
We used Medical Expenditure Panel Survey data (2015 to 2021) to identify Gabapentinoid users and categorized them into SUD and Non-SUD groups. The primary aim was to investigate the association between SUD and health related quality of life measured through physical component score (PCS) and mental component score (MCS) while secondary aim was to compare healthcare utilization between these groups. The prescription trends and related costs were also examined.
Results
Total 164 Gabapentinoid users had SUD who had lower MCS compared to the Non-SUD group (β = −3.83 [−6.24, −1.41], p = 0.002). Additionally, SUD was associated with a higher number of outpatient visits (β = 0.35 [0.02, 0.68], p = 0.04). The SUD group incurred higher total expenditure ($10,671.4, SE = 970.6) compared to the Non-SUD group ($9166.7, SE = 714.7). Gabapentinoid use increased from 2015 to 2021, with Pregabalin prescriptions rising from 0.98 % to 2.24 % and Gabapentin from 4.37 % to 10.16 %. Among users with SUD, common co-prescriptions included Tramadol (46.59 %), Oxycodone (35.62 %), and Lorazepam (34.78 %).
Conclusion
Our results suggest the critical need to monitor and assess the Gabapentinoid prescription among individuals with SUD, further warrant to develop and implement new policies and guidelines at both federal and state levels in the U.S.
{"title":"Evaluating health-related quality of life and health resource utilization among Gabapentinoid users with substance use disorder in the US: Trends, co-prescriptions, and cost analysis","authors":"Saba Dangpiaei, Mohammad A. Al-Mamun","doi":"10.1016/j.rcsop.2025.100618","DOIUrl":"10.1016/j.rcsop.2025.100618","url":null,"abstract":"<div><h3>Background</h3><div>Gabapentinoid, including Gabapentin and Pregabalin, are commonly used for approved and off-label health conditions, but their misuse with opioid among individuals with substance use disorder (SUD) increases the risk of respiratory depression and death. Thus, we investigated the impact of SUD on different health outcomes among the Gabapentinoid users in the U.S.</div></div><div><h3>Methods</h3><div>We used Medical Expenditure Panel Survey data (2015 to 2021) to identify Gabapentinoid users and categorized them into SUD and Non-SUD groups. The primary aim was to investigate the association between SUD and health related quality of life measured through physical component score (PCS) and mental component score (MCS) while secondary aim was to compare healthcare utilization between these groups. The prescription trends and related costs were also examined.</div></div><div><h3>Results</h3><div>Total 164 Gabapentinoid users had SUD who had lower MCS compared to the Non-SUD group (β = −3.83 [−6.24, −1.41], <em>p</em> = 0.002). Additionally, SUD was associated with a higher number of outpatient visits (β = 0.35 [0.02, 0.68], <em>p</em> = 0.04). The SUD group incurred higher total expenditure ($10,671.4, SE = 970.6) compared to the Non-SUD group ($9166.7, SE = 714.7). Gabapentinoid use increased from 2015 to 2021, with Pregabalin prescriptions rising from 0.98 % to 2.24 % and Gabapentin from 4.37 % to 10.16 %. Among users with SUD, common co-prescriptions included Tramadol (46.59 %), Oxycodone (35.62 %), and Lorazepam (34.78 %).</div></div><div><h3>Conclusion</h3><div>Our results suggest the critical need to monitor and assess the Gabapentinoid prescription among individuals with SUD, further warrant to develop and implement new policies and guidelines at both federal and state levels in the U.S.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100618"},"PeriodicalIF":1.8,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291478","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 : 2025-06-08DOI: 10.1016/j.rcsop.2025.100621
Frederick Sundram , Amy Hai Yan Chan , Joanne C. Lin , Retina Rimal , Timothy F. Chen , Jane L. Sheridan
Background
Community pharmacists (CPs) play a valuable role in the provision of mental healthcare in primary care settings; however, CPs may not be comfortable or confident doing so. Mental health literacy (MHL) of CPs and consumers, alongside factors in community pharmacies may contribute to this.
Objective
The aims of this study were to explore how MHL may affect the provision and receipt of mental healthcare in community pharmacies, and the perceived barriers and facilitators for CPs in providing mental healthcare.
Methods
Participants were recruited from a sample of respondents to a prior national survey of MHL in CPs. Thirteen CPs with a mean age of 40 years, comprising participants from both independent and chain pharmacies were recruited. Individual, semi-structured interviews were conducted, followed by professional transcription and thematic analysis.
Results
Analysis revealed five main themes describing factors related to MHL and also the provision of mental healthcare services in community pharmacies: 1) Complexities in the understanding of and recognition and management of mental illness; 2) Attitudes and experiences of CPs in supporting mental health needs; 3) Prevention and management of mental illness needing a collaborative approach; 4) Opportunities and challenges within community pharmacies to support mental healthcare needs; and 5) Preparedness and willingness of CPs to provide mental healthcare.
Conclusions
CPs identified several MHL-related factors that could affect mental healthcare delivery by CPs and consumers receiving care. CPs also described several ways to enhance preparedness to deliver mental healthcare in community pharmacies including working collaboratively with other healthcare providers.
{"title":"A qualitative study of community pharmacists in New Zealand: mental health literacy and the barriers and facilitators to providing and receiving mental healthcare in community pharmacies","authors":"Frederick Sundram , Amy Hai Yan Chan , Joanne C. Lin , Retina Rimal , Timothy F. Chen , Jane L. Sheridan","doi":"10.1016/j.rcsop.2025.100621","DOIUrl":"10.1016/j.rcsop.2025.100621","url":null,"abstract":"<div><h3>Background</h3><div>Community pharmacists (CPs) play a valuable role in the provision of mental healthcare in primary care settings; however, CPs may not be comfortable or confident doing so. Mental health literacy (MHL) of CPs and consumers, alongside factors in community pharmacies may contribute to this.</div></div><div><h3>Objective</h3><div>The aims of this study were to explore how MHL may affect the provision and receipt of mental healthcare in community pharmacies, and the perceived barriers and facilitators for CPs in providing mental healthcare.</div></div><div><h3>Methods</h3><div>Participants were recruited from a sample of respondents to a prior national survey of MHL in CPs. Thirteen CPs with a mean age of 40 years, comprising participants from both independent and chain pharmacies were recruited. Individual, semi-structured interviews were conducted, followed by professional transcription and thematic analysis.</div></div><div><h3>Results</h3><div>Analysis revealed five main themes describing factors related to MHL and also the provision of mental healthcare services in community pharmacies: 1) Complexities in the understanding of and recognition and management of mental illness; 2) Attitudes and experiences of CPs in supporting mental health needs; 3) Prevention and management of mental illness needing a collaborative approach; 4) Opportunities and challenges within community pharmacies to support mental healthcare needs; and 5) Preparedness and willingness of CPs to provide mental healthcare.</div></div><div><h3>Conclusions</h3><div>CPs identified several MHL-related factors that could affect mental healthcare delivery by CPs and consumers receiving care. CPs also described several ways to enhance preparedness to deliver mental healthcare in community pharmacies including working collaboratively with other healthcare providers.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100621"},"PeriodicalIF":1.8,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280370","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}
Using generics became an established practice. Studies about dispensing practices of generic controlled substances are scarce.
Objective
We investigated dispensing practices of generic controlled substances compared to non-controlled substances, challenges community pharmacists face when substituting them, and how they can be better supported.
Methods
A mixed-methods approach was employed. We descriptively analyzed prescribing and dispensing rates of originals and generics of controlled and non-controlled substances. Ten community pharmacists were interviewed to investigate challenges and support options.
Results
Seven hundred eight prescriptions were included in the data analysis. Physicians prescribed 54 % (167/307) of originals for controlled substances and 50 % (202/401) of originals for non-controlled substances (p > 0.05). A total of 37 % (62/167) of prescriptions for original controlled substances were substituted with generics in community pharmacies in contrast to 74 % (149/202) of prescriptions for original non-controlled substances (p < 0.001). Challenges mentioned by the interviewees included gaining trust in the context of generic controlled substance use, meeting patients' needs, and legal regulations. They named support measures, such as patient education by physicians, and reduction of the administrative workload.
Conclusion
The analysis revealed a significantly lower substitution rate for controlled substances compared to non-controlled substances in pharmacies. Yet, physicians showed similar prescribing rates of originals and generics. The findings support the need to strengthen the collaboration between healthcare providers, and to improve education as well as awareness to ensure adequate patient care when substituting generic controlled substances.
{"title":"A mixed-methods study investigating the potential and challenges of generic substitution of controlled substances in community pharmacies","authors":"I.M. Keller , J.M. Alexa , M.W. Meier , S.S. Allemann","doi":"10.1016/j.rcsop.2025.100622","DOIUrl":"10.1016/j.rcsop.2025.100622","url":null,"abstract":"<div><h3>Background</h3><div>Using generics became an established practice. Studies about dispensing practices of generic controlled substances are scarce.</div></div><div><h3>Objective</h3><div>We investigated dispensing practices of generic controlled substances compared to non-controlled substances, challenges community pharmacists face when substituting them, and how they can be better supported.</div></div><div><h3>Methods</h3><div>A mixed-methods approach was employed. We descriptively analyzed prescribing and dispensing rates of originals and generics of controlled and non-controlled substances. Ten community pharmacists were interviewed to investigate challenges and support options.</div></div><div><h3>Results</h3><div>Seven hundred eight prescriptions were included in the data analysis. Physicians prescribed 54 % (167/307) of originals for controlled substances and 50 % (202/401) of originals for non-controlled substances (<em>p</em> > 0.05). A total of 37 % (62/167) of prescriptions for original controlled substances were substituted with generics in community pharmacies in contrast to 74 % (149/202) of prescriptions for original non-controlled substances (<em>p</em> < 0.001). Challenges mentioned by the interviewees included gaining trust in the context of generic controlled substance use, meeting patients' needs, and legal regulations. They named support measures, such as patient education by physicians, and reduction of the administrative workload.</div></div><div><h3>Conclusion</h3><div>The analysis revealed a significantly lower substitution rate for controlled substances compared to non-controlled substances in pharmacies. Yet, physicians showed similar prescribing rates of originals and generics. The findings support the need to strengthen the collaboration between healthcare providers, and to improve education as well as awareness to ensure adequate patient care when substituting generic controlled substances.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100622"},"PeriodicalIF":1.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280371","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 : 2025-06-03DOI: 10.1016/j.rcsop.2025.100620
Sundos Q. Al-Ebrahim , Ahmad El Ouweini , Fatima Boura , Heba M. Abu Tayyem , Rami Diab , Omar Adas , Nemah Awwad , Maisam Tobeh , Fatima A.L. Salame , Sara A.L. Jabi , Ghattas Abu Dawoud , Hamzah Alzubaidi , Jeff Harrison , Timothy F. Chen , Mohammed A. Mohammed
Background
The Medication-Related Burden Quality of Life (MRB-QoL) Arabic version is a 31-item valid and reliable measure of medication burden on functioning and well-being in people with long-term conditions.
Aim
To evaluate the feasibility of using the Arabic MRB-QoL tool in clinical pharmacist-led medicines optimisation services in United Arab Emirates (UAE) hospitals.
Method
This non-randomised, non-controlled, feasibility study was conducted in 4 UAE hospitals, utilising a mixed-methods approach. The clinical utility of the MRB-QoL Arabic was evaluated, covering various aspects of feasibility, including acceptability, usability, benefits, facilitators, and barriers to its implementation in practice. The study comprised 3 stages: providing training for clinical pharmacists (CPs) and nurses, implementing the Arabic MRB-QoL tool, and the System Usability Scale (SUS) survey and semi-structured interviews with CPs. The usability and perceived benefits were evaluated using qualitative interviews and a Qualtrics survey. The perceived acceptability, barriers, and facilitators were explored through analysis of the interviews.
Results
Ten CPs implemented the Arabic MRB-QoL tool during routine medication reviews for 227 admitted patients. Thematic analysis of the interview transcripts identified key themes that highlighted the acceptability, usability, benefits, as well as facilitators, and barriers the CPs faced in implementing the tool in their routine clinical practice. In addition, the SUS survey showed an average score of 82.2, indicating excellent usability of the tool in facilitating medicines optimisation services.
Conclusions
This study confirmed the clinical utility of the MRB-QoL Arabic in pharmacist-led medicines optimisation services in UAE hospitals, highlighting preliminary evidence of its acceptability, usability, and benefits, as well as facilitators and barriers to implementation. By promoting patient-centred medicines optimisation, the Arabic MRB-QoL tool has the potential to help healthcare providers gain insights into patients' experiences with medicines and the key dimensions of medication burden patients encounter, optimise medicines regimens, and improve patients' quality of life.
{"title":"Clinical utility of the Arabic medication-related burden quality of life (MRB-QoL) tool in hospital-based medicines optimisation services: A mixed methods feasibility study","authors":"Sundos Q. Al-Ebrahim , Ahmad El Ouweini , Fatima Boura , Heba M. Abu Tayyem , Rami Diab , Omar Adas , Nemah Awwad , Maisam Tobeh , Fatima A.L. Salame , Sara A.L. Jabi , Ghattas Abu Dawoud , Hamzah Alzubaidi , Jeff Harrison , Timothy F. Chen , Mohammed A. Mohammed","doi":"10.1016/j.rcsop.2025.100620","DOIUrl":"10.1016/j.rcsop.2025.100620","url":null,"abstract":"<div><h3>Background</h3><div>The Medication-Related Burden Quality of Life (MRB-QoL) Arabic version is a 31-item valid and reliable measure of medication burden on functioning and well-being in people with long-term conditions.</div></div><div><h3>Aim</h3><div>To evaluate the feasibility of using the Arabic MRB-QoL tool in clinical pharmacist-led medicines optimisation services in United Arab Emirates (UAE) hospitals.</div></div><div><h3>Method</h3><div>This non-randomised, non-controlled, feasibility study was conducted in 4 UAE hospitals, utilising a mixed-methods approach. The clinical utility of the MRB-QoL Arabic was evaluated, covering various aspects of feasibility, including acceptability, usability, benefits, facilitators, and barriers to its implementation in practice. The study comprised 3 stages: providing training for clinical pharmacists (CPs) and nurses, implementing the Arabic MRB-QoL tool, and the System Usability Scale (SUS) survey and semi-structured interviews with CPs. The usability and perceived benefits were evaluated using qualitative interviews and a Qualtrics survey. The perceived acceptability, barriers, and facilitators were explored through analysis of the interviews.</div></div><div><h3>Results</h3><div>Ten CPs implemented the Arabic MRB-QoL tool during routine medication reviews for 227 admitted patients. Thematic analysis of the interview transcripts identified key themes that highlighted the acceptability, usability, benefits, as well as facilitators, and barriers the CPs faced in implementing the tool in their routine clinical practice. In addition, the SUS survey showed an average score of 82.2, indicating excellent usability of the tool in facilitating medicines optimisation services.</div></div><div><h3>Conclusions</h3><div>This study confirmed the clinical utility of the MRB-QoL Arabic in pharmacist-led medicines optimisation services in UAE hospitals, highlighting preliminary evidence of its acceptability, usability, and benefits, as well as facilitators and barriers to implementation. By promoting patient-centred medicines optimisation, the Arabic MRB-QoL tool has the potential to help healthcare providers gain insights into patients' experiences with medicines and the key dimensions of medication burden patients encounter, optimise medicines regimens, and improve patients' quality of life.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100620"},"PeriodicalIF":1.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261768","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 : 2025-05-31DOI: 10.1016/j.rcsop.2025.100619
Alison D. Hooper , Jodie Marquez , Beata Bajorek , Joyce M. Cooper , David Newby
Background
Pharmacists are accessible, trusted healthcare professionals who are well-positioned to contribute to Sport and Exercise Medicine (SEM), yet their roles remain underutilised. Previous research using the Capability, Opportunity, Motivation-Behaviour (COMB) model identified behavioural barriers and enablers influencing pharmacists' engagement in SEM and collaboration with physiotherapists.
Objective
To design a theory-informed intervention toolkit to enhance pharmacists' engagement in SEM and support pharmacist–physiotherapist collaboration, using the Behaviour Change Wheel (BCW) framework.
Methods
A structured, three-stage intervention mapping approach guided by the BCW was used. This included: (i) understanding behaviour and identifying influencing factors using COM-B analysis; (ii) identifying appropriate intervention functions and supporting policy categories; and (iii) selecting Behaviour Change Techniques (BCTs) and preferred modes of delivery based on the APEASE criteria.
Results
Pharmacists' engagement in SEM is influenced by multiple barriers, including unclear role definitions, limited training and systemic constraints such as time and remuneration. Key enablers include pharmacists' medicines expertise, accessibility and motivation to collaborate. Six intervention functions and five policy categories were identified as suitable. Fifteen BCTs (e.g., goal setting, social support, prompts/cues) were selected to inform intervention content and delivery strategies, with various modes of delivery proposed.
Conclusion
The BCW framework provided a structured method for developing an intervention toolkit aimed at enhancing pharmacists' engagement in SEM and collaboration with physiotherapists. The resulting strategies address key behavioural determinants and offer a foundation for future implementation. However, as the study focused on intervention design rather than implementation, further research is needed to assess the feasibility and real-world impact of the proposed strategies.
{"title":"Enhancing pharmacists' engagement and collaboration in sport and exercise medicine: An intervention mapping study using the behaviour change wheel","authors":"Alison D. Hooper , Jodie Marquez , Beata Bajorek , Joyce M. Cooper , David Newby","doi":"10.1016/j.rcsop.2025.100619","DOIUrl":"10.1016/j.rcsop.2025.100619","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacists are accessible, trusted healthcare professionals who are well-positioned to contribute to Sport and Exercise Medicine (SEM), yet their roles remain underutilised. Previous research using the Capability, Opportunity, Motivation-Behaviour (COM<img>B) model identified behavioural barriers and enablers influencing pharmacists' engagement in SEM and collaboration with physiotherapists.</div></div><div><h3>Objective</h3><div>To design a theory-informed intervention toolkit to enhance pharmacists' engagement in SEM and support pharmacist–physiotherapist collaboration, using the Behaviour Change Wheel (BCW) framework.</div></div><div><h3>Methods</h3><div>A structured, three-stage intervention mapping approach guided by the BCW was used. This included: (i) understanding behaviour and identifying influencing factors using COM-B analysis; (ii) identifying appropriate intervention functions and supporting policy categories; and (iii) selecting Behaviour Change Techniques (BCTs) and preferred modes of delivery based on the APEASE criteria.</div></div><div><h3>Results</h3><div>Pharmacists' engagement in SEM is influenced by multiple barriers, including unclear role definitions, limited training and systemic constraints such as time and remuneration. Key enablers include pharmacists' medicines expertise, accessibility and motivation to collaborate. Six intervention functions and five policy categories were identified as suitable. Fifteen BCTs (e.g., goal setting, social support, prompts/cues) were selected to inform intervention content and delivery strategies, with various modes of delivery proposed.</div></div><div><h3>Conclusion</h3><div>The BCW framework provided a structured method for developing an intervention toolkit aimed at enhancing pharmacists' engagement in SEM and collaboration with physiotherapists. The resulting strategies address key behavioural determinants and offer a foundation for future implementation. However, as the study focused on intervention design rather than implementation, further research is needed to assess the feasibility and real-world impact of the proposed strategies.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100619"},"PeriodicalIF":1.8,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240304","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 : 2025-05-27DOI: 10.1016/j.rcsop.2025.100617
Safaa Badi , Sara Zainelabdein Suliman , Rayan Almahdi , Mohammed A. Aldomah , Habab Khalid Elkheir , Mohamed Izham Mohamed Ibrahim , Mohamed H. Ahmed
Background
Diabetes affects various body systems, increasing the risk of complications.
Objectives
This study assessed the impact of clinical pharmacist-associated education on diabetes self-care practices and glycemic control in Sudanese individuals with Type 2 Diabetes Mellitus (T2DM).
Design and methods
This quasi-experimental study with no control group recruited 110 adults with T2DM from a diabetes clinic over 12 months using simple random sampling. We collected data through interviews and calls. Participants received 12 educational videos covering diabetes management. The intervention was video-based and delivered over 5 months. We analyzed data using SPSS version 28.
Results
The mean age of participants was 56.2 ± 10.3 years. Self-care practices significantly improved over time. Fasting blood glucose (FBG) levels decreased by 16.7 mg/dL at 6 months (p = 0.009) and 41.9 mg/dL at 12 months (p < 0.001). Two-hour postprandial glucose levels dropped by 18.7 mg/dL at 6 months (p = 0.006) and 61.8 mg/dL at 12 months (p < 0.001). HbA1c levels decreased by 1 % at6 months (p < 0.001) and 1.9 % at 12 months (p < 0.001). The effect size (Cohen's d) was increased from 0.26 at 6 months to 0.74 at 12 months. Similarly, it was increased for 2hrsPPG from 0.2 at 6 months to 0.74 at 12 months. For HbA1c, it was increased from 0.62 at 6 months to 1.25 at 12 months, indicating clinically meaningful improvement in long-term glycemic control following the pharmacist intervention. LDL decreased by 9.2 mg/dL at 12 months (p < 0.001), and HDL increased by 5.5 mg/dL at 12 months (p = 0.002). Changes in BUN and serum creatinine were insignificant.
Conclusion
Clinical pharmacist education improved diabetes self-care practices and metabolic outcomes, including glycemic control and lipid profiles, demonstrating its role in achieving therapeutic goals for patients with T2DM.
{"title":"Impact of clinical pharmacist video-based education on self-care and glycemic control in Sudanese adults with type 2 diabetes: A pre-post interventional study","authors":"Safaa Badi , Sara Zainelabdein Suliman , Rayan Almahdi , Mohammed A. Aldomah , Habab Khalid Elkheir , Mohamed Izham Mohamed Ibrahim , Mohamed H. Ahmed","doi":"10.1016/j.rcsop.2025.100617","DOIUrl":"10.1016/j.rcsop.2025.100617","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes affects various body systems, increasing the risk of complications.</div></div><div><h3>Objectives</h3><div>This study assessed the impact of clinical pharmacist-associated education on diabetes self-care practices and glycemic control in Sudanese individuals with Type 2 Diabetes Mellitus (T2DM).</div></div><div><h3>Design and methods</h3><div>This quasi-experimental study with no control group recruited 110 adults with T2DM from a diabetes clinic over 12 months using simple random sampling. We collected data through interviews and calls. Participants received 12 educational videos covering diabetes management. The intervention was video-based and delivered over 5 months. We analyzed data using SPSS version 28.</div></div><div><h3>Results</h3><div>The mean age of participants was 56.2 ± 10.3 years. Self-care practices significantly improved over time. Fasting blood glucose (FBG) levels decreased by 16.7 mg/dL at 6 months (<em>p</em> = 0.009) and 41.9 mg/dL at 12 months (<em>p</em> < 0.001). Two-hour postprandial glucose levels dropped by 18.7 mg/dL at 6 months (<em>p</em> = 0.006) and 61.8 mg/dL at 12 months (<em>p</em> < 0.001). HbA1c levels decreased by 1 % at6 months (<em>p</em> < 0.001) and 1.9 % at 12 months (<em>p</em> < 0.001). The effect size (Cohen's d) was increased from 0.26 at 6 months to 0.74 at 12 months. Similarly, it was increased for 2hrsPPG from 0.2 at 6 months to 0.74 at 12 months. For HbA1c, it was increased from 0.62 at 6 months to 1.25 at 12 months, indicating clinically meaningful improvement in long-term glycemic control following the pharmacist intervention. LDL decreased by 9.2 mg/dL at 12 months (<em>p</em> < 0.001), and HDL increased by 5.5 mg/dL at 12 months (<em>p</em> = 0.002). Changes in BUN and serum creatinine were insignificant.</div></div><div><h3>Conclusion</h3><div>Clinical pharmacist education improved diabetes self-care practices and metabolic outcomes, including glycemic control and lipid profiles, demonstrating its role in achieving therapeutic goals for patients with T2DM.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100617"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205237","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 : 2025-05-26DOI: 10.1016/j.rcsop.2025.100616
Kaitlyn E. Watson , Theresa J. Schindel , Sherly Meilianti , Ross T. Tsuyuki , Yazid N. Al Hamarneh
Background
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.
Methods
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.
Results
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.
Conclusion
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.
{"title":"An international portrait of pharmacists' professional role identities: A Q-methodology innovative study","authors":"Kaitlyn E. Watson , Theresa J. Schindel , Sherly Meilianti , Ross T. Tsuyuki , 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":"2025-05-26","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}
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