Pharmacy

12 pages, 4072 KB

Open AccessArticle

Pharmacy-Inspection Outcomes in Great Britain: An Analysis of Regulatory Compliance and the Impact of Vaccination Service Provision

by Cosmika Goswami, Yoni Carmel, Rosalind Gittins and Gazala Akram

Pharmacy 2026, 14(4), 107; https://doi.org/10.3390/pharmacy14040107 - 14 Jul 2026

Abstract

Community pharmacies provide vaccinations through nationally commissioned or private services. In Great Britain, pharmacies are regulated by the General Pharmaceutical Council (GPhC) and inspected for compliance against the 26 Standards for registered pharmacies. GPhC inspection outcomes between 2022 and 2024 were examined for [...] Read more.

Community pharmacies provide vaccinations through nationally commissioned or private services. In Great Britain, pharmacies are regulated by the General Pharmaceutical Council (GPhC) and inspected for compliance against the 26 Standards for registered pharmacies. GPhC inspection outcomes between 2022 and 2024 were examined for differences between pharmacies offering vaccination services and those who did not. Inspection data from 2197 pharmacies, consisting of 1918 (87.3%) ‘brick-and-mortar’ pharmacies and 279 (12.7%) ‘other’ types (predominantly online pharmacies) were analysed. In total, 1922 (87.5%) pharmacies met all 26 Standards. Pharmacies providing vaccinations demonstrated higher compliance with Standards relating to governance, service delivery, and suitability of premises. Independent single-owner pharmacies and independent pharmacy chains were more likely to not meet standards. A gradient effect was observed across pharmacy-ownership categories, with progressively higher odds of inspection failure as the ownership model size decreased. Analysis of inspector comments identified three key factors influencing inspection performance: governance and organisational oversight; suitability of the physical environment; and staff competence and training. Strengthening governance structures, workforce development and infrastructure support, particularly in smaller independent pharmacies, may improve consistency in regulatory compliance, and support safe, high-quality delivery of vaccination services from community pharmacies. Full article

(This article belongs to the Special Issue The Evolving Role of the Pharmacist in Improving Vaccination Uptake)

► Show Figures

Figure 1

11 pages, 215 KB

Open AccessArticle

The Labor Supply of Full-Time and Part-Time Pharmacists in the U.S.

by Ioana Popovici, Manuel J. Carvajal and Rawan Alkhamisi

Pharmacy 2026, 14(4), 106; https://doi.org/10.3390/pharmacy14040106 - 11 Jul 2026

Abstract

The U.S. pharmacist workforce has undergone significant growth and demographic changes, particularly increased female participation and part-time employment. However, limited evidence exists on how labor supply behavior varies by gender and employment status. This study used a nationally representative sample of 12,064 pharmacists [...] Read more.

The U.S. pharmacist workforce has undergone significant growth and demographic changes, particularly increased female participation and part-time employment. However, limited evidence exists on how labor supply behavior varies by gender and employment status. This study used a nationally representative sample of 12,064 pharmacists from the 2019–2022 American Community Survey (ACS) to examine heterogeneity in labor supply decisions. Ordinary Least Squares (OLS) regression models were estimated separately by employment status (full-time versus part-time) and gender. The dependent variable was the number of hours worked. Independent variables included wage rate, age, marital status, number of children, and race/ethnicity. Findings showed that women were more than twice as likely to work part-time as men and minority pharmacists were largely underrepresented in the study sample relative to nonminority pharmacists. Gender gaps in wages, hours worked, and demographic and family characteristics also differed markedly between full-time and part-time pharmacists. Finally, findings lent support to the contention than women are more likely to work fewer hours than men as they are expected to spend more hours at home raising children. Understanding how individual characteristics shape pharmacists’ labor supply, and how these relationships differ by gender and employment status, is essential for workforce planning and healthcare human resources policy. Full article

(This article belongs to the Special Issue Pharmacist Workforce Challenges and Solutions: Perspectives from Research and Practice)

12 pages, 342 KB

Open AccessArticle

Applying Cognitive Load Theory to Improve Instructional Efficiency and Learner Experience in Current Good Manufacturing Practices Training for Pharmacists

by Russell D. Wilson, Paroma Arefin and Sujit S. Sansgiry

Pharmacy 2026, 14(4), 105; https://doi.org/10.3390/pharmacy14040105 - 9 Jul 2026

Abstract

Current Good Manufacturing Practice (cGMP) training is federally mandated for pharmaceutical manufacturing personnel and plays a critical role in ensuring product quality and patient safety. Despite extensive evidence supporting Cognitive Load Theory (CLT) and Mayer’s Cognitive Theory of Multimedia Learning (CTML), their application [...] Read more.

Current Good Manufacturing Practice (cGMP) training is federally mandated for pharmaceutical manufacturing personnel and plays a critical role in ensuring product quality and patient safety. Despite extensive evidence supporting Cognitive Load Theory (CLT) and Mayer’s Cognitive Theory of Multimedia Learning (CTML), their application to cGMP training has not been evaluated. This study examined whether a CLT/CTML-informed cGMP video training strategy could improve instructional efficiency and learner experience among pharmacists. A randomized repeated-measures crossover study was conducted among 49 pharmacists. Participants completed both an enhanced CLT/CTML-informed training strategy and a standard training strategy in randomized order. Instructional efficiency, calculated from learner performance and perceived mental effort, and learner experience outcomes were assessed using paired-samples t-tests. Compared with the standard training strategy, the CLT/CTML-enhanced strategy resulted in higher assessment scores (78% vs. 72%, p = 0.04), lower perceived mental effort (2.4 vs. 3.5, p < 0.001), and greater instructional efficiency (0.50 vs. −0.50, p < 0.001). Learner experience ratings, including satisfaction, perceived knowledge gain, and likelihood of future recommendation, also improved significantly (all p < 0.001). Applying CLT and CTML principles to cGMP video training significantly improved instructional efficiency and learner experience, supporting theory-informed instructional design as a practical approach for complex regulatory education. Full article

(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)

► Show Figures

Figure 1

18 pages, 358 KB

Open AccessArticle

Boosting Pharmacy Foundational Science Education Through Game-Based Learning and Active Engagement Strategies

by Maria Victoria Tejada-Simón

Pharmacy 2026, 14(4), 104; https://doi.org/10.3390/pharmacy14040104 - 9 Jul 2026

Abstract

Background: Game-based learning (GBL) and active engagement strategies have shown promise in health professions education; however, their application in foundational basic science courses, which serve as critical academic gatekeepers in professional pharmacy programs, remains underexplored. Objective: This study evaluated the effect of a [...] Read more.

Background: Game-based learning (GBL) and active engagement strategies have shown promise in health professions education; however, their application in foundational basic science courses, which serve as critical academic gatekeepers in professional pharmacy programs, remains underexplored. Objective: This study evaluated the effect of a multimodal suite of faculty-developed, web-based GBL activities and active engagement strategies on academic performance, learning management system (LMS) engagement, and student perceptions in a required first-year (P1) pharmacy biochemistry course. Methods: A cross-sectional, descriptive study was conducted with 117 P1 pharmacy students. Game-based activities (including Jeopardy, Rapid Fire, and Crossword Puzzle games) were developed using WiscOnline and deployed via Blackboard alongside pre-class activities, a Workbook, and a Padlet discussion board. Engagement was measured via LMS access metrics, academic performance via examination scores, and perceptions via an end-of-semester anonymous Poll Everywhere survey. Results: The cohort achieved a mean examination score of 81.59%, with 83.8% earning a passing grade. A positive association was observed between game access frequency and grade group performance (R² = 0.8241), though individual-level correlations did not reach statistical significance. Student perceptions were overwhelmingly positive, with over 90% of respondents agreeing that GBL activities were enjoyable, facilitated learning, and provided valuable practice opportunities. Conclusions: Low-cost, faculty-developed GBL tools can be successfully integrated into foundational pharmacy science courses, yielding high engagement and positive student perceptions. These findings underscore the importance of extending active learning research to foundational basic science courses and offer a replicable model for health professions programs seeking to enhance student engagement at this critical curricular stage. Full article

(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)

► Show Figures

Figure 1

23 pages, 310 KB

Open AccessPerspective

A Portable, Patient-Possessed Health Record: Architecture for Care Coordination as an Alternative to Centralized Data Aggregation

by Richard Henry Parrish II

Pharmacy 2026, 14(4), 103; https://doi.org/10.3390/pharmacy14040103 - 8 Jul 2026

Abstract

The fragmentation of clinical information across health systems, community pharmacies, and specialty providers continues to undermine medication safety and emergency care, particularly when patients are unconscious or otherwise unable to communicate their history. The dominant response to this fragmentation has been the construction [...] Read more.

The fragmentation of clinical information across health systems, community pharmacies, and specialty providers continues to undermine medication safety and emergency care, particularly when patients are unconscious or otherwise unable to communicate their history. The dominant response to this fragmentation has been the construction of a centralized data infrastructure—health information exchanges, prescription drug monitoring programs (PDMPs), and federated electronic health record (EHR) networks—that aggregates clinical information into institutional databases that are queryable by providers, insurers, regulators, and, in many jurisdictions, law enforcement. This article argues that the same care-coordination problems can be addressed through an architecturally different approach in which the patient, not the institution, holds the integrative artifact. The proposed design, here labeled the Guardian Card (a conceptual architecture, not a commercial product), pairs an HL7 Fast Healthcare Interoperability Resources (FHIR) clinical payload with the SMART Health Cards verifiable-credential framework and a dual-modality (QR code plus near-field communication) physical carrier. After describing the technical architecture, hardware options, and a five-phase deployment roadmap, the design is situated within the surveillance-critical scholarship that has documented PDMP function creep, third-party doctrine erosion, racial disparities in algorithmic prescribing oversight, and the surveillance-instrumentarian repackaging of nominally de-identified prescription data. The Guardian Card is offered as one operational implementation of a patient-controlled medication-record architecture, with community pharmacy and long-term post-acute care, where the Pharmacist eCare Plan integration is most feasible as a recommended first-deployment venue. Full article

(This article belongs to the Special Issue Advancing Pharmacy Practice: Innovations and Expanding Horizons)

27 pages, 7708 KB

Open AccessSystematic Review

Impact of Pharmacist-Led Interventions on Patient Outcomes in Gulf Cooperation Council Countries: A Systematic Review and Meta-Analysis

by Saleh Alghamdi

Pharmacy 2026, 14(4), 102; https://doi.org/10.3390/pharmacy14040102 - 6 Jul 2026

Abstract

Background: Pharmacist-led interventions in Gulf Cooperation Council (GCC) countries have been increasingly studied, yet their overall effectiveness across clinical and healthcare outcomes remains incompletely defined. To address this gap, a systematic review and meta-analysis of randomized controlled trials and quasi-experimental studies published between [...] Read more.

Background: Pharmacist-led interventions in Gulf Cooperation Council (GCC) countries have been increasingly studied, yet their overall effectiveness across clinical and healthcare outcomes remains incompletely defined. To address this gap, a systematic review and meta-analysis of randomized controlled trials and quasi-experimental studies published between 2000 and 2025 was conducted, following PRISMA 2020 and Cochrane standards. Methods: Searches of PubMed/MEDLINE, Scopus, Web of Science, and CENTRAL identified 437 records, of which 20 studies met the inclusion criteria; 13 contributed meta-analyzable data as randomized controlled trials and seven as quasi-experimental studies. Results: Pooled random-effects estimates favored pharmacist-led care for HbA1c, fasting glucose, low-density lipoprotein cholesterol, diastolic blood pressure, and medication knowledge, although these estimates carried substantial, largely unexplained heterogeneity and were rated as low to very low certainty under GRADE. The effects on systolic blood pressure, total cholesterol, triglycerides, high-density lipoprotein cholesterol, unplanned healthcare use, and antimicrobial utilization were favorable but not statistically significant. Quasi-experimental studies consistently demonstrated reductions in mortality and readmissions, though hospital and ICU length of stay remained variable. Risk of bias was judged as some concerns for randomized trials and moderate to serious for quasi-experimental studies, with substantial heterogeneity observed across blood pressure and lipid outcomes. Conclusions: Overall, pharmacist-led interventions in GCC settings were associated with improvements in glycemic control and LDL cholesterol, with additional benefits in mortality and readmissions, although the certainty of evidence was low to very low, owing to substantial heterogeneity and the predominance of non-randomized designs for the inpatient outcomes. These findings underscore the need for standardized intervention models and outcome measures. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

► Show Figures

Figure 1

7 pages, 543 KB

Open AccessArticle

Sublingual Tropicamide Eye Drops for the Management of Clozapine-Induced Hypersalivation: A Case Series of Seven Patients

by Seshadri Sekhar Chatterjee, Soumitra Das and Adesh Agrawal

Pharmacy 2026, 14(4), 101; https://doi.org/10.3390/pharmacy14040101 - 4 Jul 2026

Abstract

Clozapine-induced hypersalivation (CIH) affects 30–80% of patients on clozapine and is a major contributor of non-adherence. Current managements, largely based on systemic anticholinergics, can worsen other clozapine-related side effects. Here sublingual tropicamide 1% eye drops can be a low-cost alternative worth evaluating. We [...] Read more.

Clozapine-induced hypersalivation (CIH) affects 30–80% of patients on clozapine and is a major contributor of non-adherence. Current managements, largely based on systemic anticholinergics, can worsen other clozapine-related side effects. Here sublingual tropicamide 1% eye drops can be a low-cost alternative worth evaluating. We report a case series of seven patients with schizophrenia treated with sublingual tropicamide 1% ophthalmic solution (4–8 drops/day) for CIH. Treatment response was assessed by patient-reported percentage reduction in salivation. All seven patients reported improvement (25–80%). One patient reported a transient bitter taste; no systemic anticholinergic effects occurred. Sublingual tropicamide was associated with patient-reported improvement in CIH and was well tolerated in this small, uncontrolled series. Its short duration of action and local administration may offer practical advantages over systemic anticholinergics, though the mechanism remains unproven. Randomised trials with validated outcome measures are needed to establish its efficacy and safety. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

► Show Figures

Figure 1

16 pages, 1117 KB

Open AccessArticle

Pharmacists’ Management of Urinary Tract Infection Symptoms in Community Pharmacy: Counseling Practices and Attitudes Toward Antibiotic Therapy

by Aleksandar Jovanović, Radmila Veličković Radovanović, Ivana Tadić, Milica Drobac, Bojana Vidović, Dragana Pavlović, Marina Odalović and Dušanka Krajnović

Pharmacy 2026, 14(4), 100; https://doi.org/10.3390/pharmacy14040100 - 3 Jul 2026

Abstract

Background/Objectives: Pharmacists play a key role in managing urinary tract infection (UTI) symptoms by providing medications, self-care advice, and over-the-counter treatments, while referring patients to a doctor when necessary. This study aimed to examine the practices of community pharmacists in managing UTI [...] Read more.

Background/Objectives: Pharmacists play a key role in managing urinary tract infection (UTI) symptoms by providing medications, self-care advice, and over-the-counter treatments, while referring patients to a doctor when necessary. This study aimed to examine the practices of community pharmacists in managing UTI symptoms and to gain insight into their attitudes toward antibiotic use for this condition. Methods: A cross-sectional study was conducted among community pharmacists in Serbia using a previously validated online questionnaire, assessed for content and face validity and pilot-tested among pharmacists. Results: A total of 430 community pharmacists participated in the study. Patients more often consulted pharmacists before visiting a doctor than after (median 5 vs. 3 per week; p < 0.001). For uncomplicated UTIs, pharmacists primarily recommended increased fluid intake (92.8%), herbal teas (94.7%), and food supplements (85.6%), whereas for complicated UTIs, most referred patients to a doctor (95.4%). Attitudes, perceived competence, and support for over-the-counter antibiotic availability were significantly associated with gender, years of experience, and specialization. Pharmacists who agreed that antibiotics are the most effective treatment for uncomplicated urinary tract infections were more likely to refer patients to a doctor (p < 0.01). Conclusions: Pharmacists are frequently consulted for UTI management and emphasize non-antibiotic approaches for uncomplicated cases. Their attitudes influence counseling practices, highlighting the need for standardized UTI counseling services, antimicrobial stewardship education, and structured communication training to support appropriate antibiotic use. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

► Show Figures

Graphical abstract

15 pages, 481 KB

Open AccessReview

Pharmacy Students’ Perception of E-Learning During the COVID-19 Pandemic Across the League of Arab States: A Regional Scoping Review

by Haroon Malak, Madeeha Mirza, Stephen F. Gambescia and Basil H. Aboul-Enein

Pharmacy 2026, 14(4), 99; https://doi.org/10.3390/pharmacy14040099 - 3 Jul 2026

Abstract

The COVID-19 pandemic compelled higher education to resort to e-learning, posing new challenges to the teaching/learning of pharmacy students worldwide. While digital learning provided flexibility, diverse technological infrastructure and institutional availability of resources greatly influenced the student experience. This scoping review aims to [...] Read more.

The COVID-19 pandemic compelled higher education to resort to e-learning, posing new challenges to the teaching/learning of pharmacy students worldwide. While digital learning provided flexibility, diverse technological infrastructure and institutional availability of resources greatly influenced the student experience. This scoping review aims to assess the perceptions relating to the pivot to e-learning among pharmacy students in the League of Arab States due to the COVID-19 pandemic and how the shift affected student engagement, learning outcomes, and institutional preparedness. Following PRISMA-ScR guidelines, a comprehensive search across ten databases was conducted to identify relevant studies published between January 2020 and December 2025. Forty studies satisfied the inclusion criteria. Pharmacy students in this region responded to the transition to e-learning in diverse ways. While most appreciated the convenience of online modalities, several challenges were consistently enumerated. These were limited technological infrastructure, reduced interpersonal interaction, and disruption of hands-on practical training. Blended learning approaches were largely favored, particularly for their ability to marry online theoretical instruction with face-to-face experiential learning. Reliability and validity issues of internet-based tests were felt by both faculty and students. Stress and mental health problems among students surfaced. Student complaints in general depicted pharmacy education’s need for pedagogic reform, better infrastructure, and student mental health services during e-learning. Areas identified from this review are instructional technology infrastructure improvement, adopting a blended learning strategy, and the need to consider the mental health of students learning at a distance. Full article

(This article belongs to the Collection New Insights into Pharmacy Teaching and Learning during COVID-19)

► Show Figures

Figure 1

19 pages, 566 KB

Open AccessSystematic Review

Coordinated Primary-Care Access in Rural and Suburban Alberta, with a Contextual Comparison to Rural Wyoming: A Systematic Review and Narrative Synthesis of Community Pharmacist–Family Physician Care Models

by Tomasz Karczewski, Jennifer M. L. Stephens, Dawid Karczewski, Sahar Feizizadeh, Dhwani Dixit and Mihaela Olsen

Pharmacy 2026, 14(4), 98; https://doi.org/10.3390/pharmacy14040098 - 2 Jul 2026

Abstract

Background/Objectives: Primary-care access in Alberta, Canada, is shaped by geography, attachment, timeliness, continuity, and local service capacity. Rural communities may face travel burden, workforce fragility, and intermittent services, whereas suburban communities may have nearby facilities but still experience delayed access, low attachment, and [...] Read more.

Background/Objectives: Primary-care access in Alberta, Canada, is shaped by geography, attachment, timeliness, continuity, and local service capacity. Rural communities may face travel burden, workforce fragility, and intermittent services, whereas suburban communities may have nearby facilities but still experience delayed access, low attachment, and fragmented episodic care. Rural Wyoming has some similar geographic and workforce constraints, although the jurisdictions differ in financing, regulation, and pharmacist scope. This systematic review and narrative synthesis examined evidence on coordinated community pharmacist–family physician care in rural and suburban Alberta and considered, separately, the contextual relevance of the findings to rural Wyoming and comparable frontier settings. Methods: We searched PubMed/MEDLINE, Embase, Scopus, CINAHL, and the Cochrane Library using controlled vocabulary and free-text terms to identify English-language peer-reviewed studies and practice-relevant evidence published from 1 January 2010 to 19 April 2026. Two authors screened titles/abstracts and full texts and resolved decisions by consensus. Methodological appraisal used design-appropriate Critical Appraisal Skills Programme criteria, and outcome-level certainty was considered using GRADE domains. Results: Thirty-four eligible peer-reviewed or practice-evaluation records were included in the narrative synthesis, and seven official contextual or methodological sources supported jurisdictional interpretation. Evidence was strongest for hypertension, cardiovascular risk reduction, medication management, and chronic disease monitoring. No included study directly compared the same intervention in Alberta and Wyoming; evidence for emergency-department effects and equivalent effectiveness across settings was limited. Conclusions: Coordinated pharmacist–family physician care may extend access to selected medication-related and chronic disease services when supported by documentation, referral, follow-up, and red-flag protocols. Application to Wyoming should be treated as a context-dependent proposition requiring local adaptation and prospective evaluation, not as demonstrated transferability or a substitute for physician-led longitudinal primary care. Full article

(This article belongs to the Special Issue Advances in Rural Pharmacy Practice)

► Show Figures

Graphical abstract

11 pages, 205 KB

Open AccessArticle

Skills Developed by Student Pharmacists Completing a Research Project in the Doctor of Pharmacy Program

by David R. Axon, Becka Eckert, Alyx Meilinger, Maren Steffen, Haylee Bingham, Justin Pacheco, Houston Swann and Kayleen Tubbs

Pharmacy 2026, 14(4), 97; https://doi.org/10.3390/pharmacy14040097 - 2 Jul 2026

Abstract

Objective: To explore fourth-year student pharmacists’ perspectives of the skills they develop by completing a research project in the pharmacy curriculum at one United States College of Pharmacy. Methods: Semi-structured interviews were conducted with a sample of fourth-year student pharmacists until thematic saturation [...] Read more.

Objective: To explore fourth-year student pharmacists’ perspectives of the skills they develop by completing a research project in the pharmacy curriculum at one United States College of Pharmacy. Methods: Semi-structured interviews were conducted with a sample of fourth-year student pharmacists until thematic saturation was achieved. Interviews were recorded and transcribed verbatim. Thematic analysis was conducted to identify main themes. All records were reviewed by two researchers, and consensus was sought at each step of the analysis. Results: Eleven interviews were conducted. Three themes related to skills developed by students while completing a research project were apparent from the final reconciled code list: Theme 1—critical analysis skills; Theme 2—residency preparedness skills; and Theme 3—interpersonal skills. Critical analysis skills helped students review the literature and appropriately translate the findings into clinical settings. Residency preparedness skills described how students perceived completing a research project would prepare them for a residency program. Interpersonal skills were inter-related and consisted of collaboration, communication, conflict resolution, leadership, and project management skills. Conclusions: These study findings should be considered by curriculum committees as changes to the pharmacy program are considered. Future research is suggested to explore other perspectives of the research process. Full article

(This article belongs to the Special Issue Advancing Pharmacy Education: Integrating Science and Clinical Practice)

16 pages, 1205 KB

Open AccessReview

Automated Processes and Artificial Intelligence in Generating Candidates for Oncology Drug Repurposing: Three-Year Scoping Review of Data

by Antonio Ivanov, Ines Hababa-Ivanova, Savina Elitova, Svetoslav Stoev and Violeta Getova-Kolarova

Pharmacy 2026, 14(4), 96; https://doi.org/10.3390/pharmacy14040096 - 1 Jul 2026

Abstract

Oncology conditions are increasingly defined by their molecular profiles, and drug repurposing exploits this new evidence to identify new therapeutic uses of authorized/investigational medicinal products outside their original indication(s). This scoping review mapped original research published between January 2022 and December 2024 to [...] Read more.

Oncology conditions are increasingly defined by their molecular profiles, and drug repurposing exploits this new evidence to identify new therapeutic uses of authorized/investigational medicinal products outside their original indication(s). This scoping review mapped original research published between January 2022 and December 2024 to determine the impact of automated processes and artificial intelligence in generating oncology candidates for drug repositioning, and 42 individual projects met the eligibility criteria and were analyzed. The included studies demonstrate extensive use of computational approaches for candidate prioritization, large-scale data integration, and hypothesis generation in oncology drug repurposing, creating opportunities for positive impact on efficiency. The included projects most commonly were target-oriented and disease-oriented and used multiple databases and computational validation procedures, while experimental and clinical validation were less frequently reported. The available open-access literature suggests substantial activity in China and India, which can support the notion that digitalization represents an important instrument in healthcare systems of low- and middle-income countries but should be interpreted cautiously. While the search was limited to PubMed and open-access English-language publications, we identified a relatively small number of drug-oriented projects, the importance of providing publicly accessible source code to reduce development costs, and the predominant role of academic institutions. Full article

(This article belongs to the Special Issue Drug Repurposing: Strengthening Outcomes of Existing Pharmaceuticals to Shift Emerging Health Challenges)

► Show Figures

Figure 1

17 pages, 1249 KB

Open AccessArticle

Experiential Learning Through Editorial Practice: The Panamacani Initiative in Pharmacy Education

by Gustavo A. Hernández-Fuentes, Iván Delgado-Enciso, Alejandra E. Hernández-Rangel, Jesús E. Castrejón-Antonio, Héctor R. Galván-Salazar, Janet Diaz-Martinez, Nibardo Cobian-Gutiérrez, José Guzmán-Esquivel, Alicia Olvera-Montejano, Carmen Meza-Robles, Alberto M. Ramírez-Montes, Fabian Rojas-Larios, Gabriel Ceja-Espíritu and Daniel A. Montes-Galindo

Pharmacy 2026, 14(4), 95; https://doi.org/10.3390/pharmacy14040095 - 1 Jul 2026

Abstract

Science communication is increasingly recognized as a key component of higher education; however, its integration into disciplinary training remains limited, particularly in pharmaceutical sciences. This study analyzes the Panamacani initiative as an institutional science communication initiative embedded within pharmacy education, based on editorial [...] Read more.

Science communication is increasingly recognized as a key component of higher education; however, its integration into disciplinary training remains limited, particularly in pharmaceutical sciences. This study analyzes the Panamacani initiative as an institutional science communication initiative embedded within pharmacy education, based on editorial practice within the Pharmaceutical Chemist Biologist program at the Universidad de Colima, Mexico. A descriptive institutional case study was conducted using data from the first five issues (2023–2025), comprising 58 published contributions. Institutional participation, authorship profiles, and audience engagement were evaluated through descriptive statistics and editorial records. Results showed that 70.7% of contributions originated from the host institution, while 29.3% involved external institutions, indicating progressive expansion. Undergraduate students accounted for 44.8% of authorship, with a gradual increase in participation from postgraduate students and researchers. External contributions reached up to 50% in one issue, suggesting increased visibility beyond the host institution. Article visibility totaled approximately 1500 views, with applied health topics receiving the highest level of audience attention. These findings suggest that editorial-based initiatives may provide opportunities for student participation in science communication, peer review, and knowledge dissemination. However, the present study did not directly evaluate educational outcomes or competency development. This model may represent a scalable framework for integrating science communication activities into pharmacy education while fostering public engagement with science. Full article

(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)

► Show Figures

Graphical abstract

12 pages, 291 KB

Open AccessArticle

“The Most High-Risk People Are Given the Most High-Risk Drugs in the Most High-Risk Way”: Experiences of Treating Problematic Over-the-Counter and Prescription-Only Medication Use in Substance Misuse Services

by Rosalind Gittins, Roya Vaziri and Ian Maidment

Pharmacy 2026, 14(4), 94; https://doi.org/10.3390/pharmacy14040094 - 27 Jun 2026

Abstract

Misuse of over-the-counter (OTC) and prescription-only medicines (POMs) is increasingly recognised as a public health and medicine-safety concern. Although specialist substance misuse services (SMS) increasingly support people affected by OTC/POM misuse, little is known about how SMS staff perceive the characteristics, challenges, and [...] Read more.

Misuse of over-the-counter (OTC) and prescription-only medicines (POMs) is increasingly recognised as a public health and medicine-safety concern. Although specialist substance misuse services (SMS) increasingly support people affected by OTC/POM misuse, little is known about how SMS staff perceive the characteristics, challenges, and treatment needs of this population. This study explored the experiences of SMS staff to address this evidence gap and inform pharmacy practice and service development. Confidential semi-structured interviews were conducted with staff across five community adult English SMS. Audio recordings were transcribed verbatim and analysed thematically using NVivo^®. Twenty interviews with varied professionals achieved data saturation. Three overarching themes emerged: (1) characteristics of OTC/POM misuse; (2) staff-perceived patterns among people who misuse OTC/POM; and (3) negative experiences and concerns. Dependence on orally administered opioids (particularly codeine-containing products), benzodiazepines and gabapentinoids predominated. Polypharmacy including illicit substance use was also reported. Withdrawal symptoms frequently perpetuated misuse, and abrupt supply cessation created additional risks. Routine enquiry about OTC/POM misuse and provision of tailored harm-reduction interventions are essential. The findings suggest that pharmacists may have an important role in early identification of problematic OTC/POM use, harm-reduction interventions, medicine review and facilitating referral into appropriate treatment pathways. Further research should examine whether dedicated OTC/POM pathways are required and explore differences in demographic and treatment needs across medicine types. Full article

(This article belongs to the Special Issue Pharmacists’ Roles in the Identification, Prevention and Treatment of Substance Use Disorders)

► Show Figures

Figure 1

14 pages, 827 KB

Open AccessArticle

Exploring Community Pharmacists’ Knowledge of Voluntary Assisted Dying and Authorised Disposal in Australia

by Michelle Gyr, Heather Brown, Victoria Crisp, Milan du Plooy, Noora Al Hasooni, Natalia Popowicz, Liza Seubert and Tanya Burgess

Pharmacy 2026, 14(4), 93; https://doi.org/10.3390/pharmacy14040093 - 26 Jun 2026

Abstract

Background: Voluntary Assisted Dying (VAD) legislation in Western Australia (WA) introduced new responsibilities for community pharmacists, including the safe disposal of unused VAD substances. Pharmacists may receive VAD-related enquiries; however, their preparedness, including their knowledge of VAD, remains largely unexplored. Aim: To explore [...] Read more.

Background: Voluntary Assisted Dying (VAD) legislation in Western Australia (WA) introduced new responsibilities for community pharmacists, including the safe disposal of unused VAD substances. Pharmacists may receive VAD-related enquiries; however, their preparedness, including their knowledge of VAD, remains largely unexplored. Aim: To explore Western Australian community pharmacists’ knowledge of VAD and their role as Authorised Disposers under the Voluntary Assisted Dying Act 2019 (WA). Methods: Community pharmacists in WA were invited to participate in an anonymous, online survey consisting of multiple choice and open-ended questions. Results: Of 143 respondents, 76% were aware that VAD is an end-of-life option; despite this, 64% were uncertain about its relevance to their role. Almost one-third had received VAD-related enquiries. Of these, 40% could not provide information, with half attributing this to insufficient knowledge. Among those yet to receive a VAD-related enquiry (n = 115), 75% felt ‘not confident’ to respond, with 76% attributing this to lack of knowledge. A total of 63% of participants were unaware that they may be requested to perform authorised disposal. Uncertainty surrounding the process and the legal and ethical aspects were frequently mentioned. Conclusion: WA Community pharmacists demonstrate awareness of VAD legislation but have gaps in knowledge, particularly regarding authorised disposal. Further training and resources are essential. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

► Show Figures

Figure 1

16 pages, 625 KB

Open AccessReview

The Evolution of Pharmacist Administered Vaccinations in Australia: A Narrative Review of Legislation and Regulatory Documents

by Shambel Nigussie Amare, Kwang Choon Yee, Myra Leung, Mark Naunton, Abbey Wilson, Annika Rooney, Omar Gannash and Mary Bushell

Pharmacy 2026, 14(4), 92; https://doi.org/10.3390/pharmacy14040092 - 26 Jun 2026

Abstract

Background: Since 2014, all Australian jurisdictions have progressively amended legislation to authorise pharmacists to administer vaccines, evolving from restricted pilots to an essential public health pillar. Objective: This review analyses the longitudinal evolution of pharmacist-administered vaccinations (PAVs), documenting changes in authorised [...] Read more.

Background: Since 2014, all Australian jurisdictions have progressively amended legislation to authorise pharmacists to administer vaccines, evolving from restricted pilots to an essential public health pillar. Objective: This review analyses the longitudinal evolution of pharmacist-administered vaccinations (PAVs), documenting changes in authorised vaccines, age eligibility, and regulatory frameworks across all Australian jurisdictions. Methods: A retrospective review of Australian jurisdictional legislation, regulations, and policy documents was undertaken. Searches included official legislative registers, Government Gazettes, Health Department protocols, and professional guidance published by Pharmaceutical Society of Australia (PSA) and The Pharmacy Guild of Australia between 2014 to 2026. Documents were independently reviewed by five authors, followed by secondary verification and consensus-based adjudication to resolve discrepancies and confirm findings. Results: PAVs scope was expanded from a single influenza pilot in 2014 to include over 21 vaccine-preventable diseases by 2026. The COVID-19 pandemic catalysed rapid reform, leading to the standardisation of age eligibility (largely ≥5 years). A landmark milestone occurred in 2025 when South Australia enabled pharmacists to administer any vaccine within their professional scope. Conclusion: Legislative reforms have significantly enhanced vaccine accessibility. However, jurisdictional fragmentation persists. National harmonisation, using a competency-based model similar to South Australia, is recommended to streamline delivery and optimise public health outcomes. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

► Show Figures

Figure 1

9 pages, 534 KB

Open AccessArticle

Sodium-Glucose Co-Transporter 2 Inhibitors and Hyperkalemia-Related Discontinuation of Renin-Angiotensin-Aldosterone System Inhibitors During Mineralocorticoid Receptor Antagonist Therapy: A Real-World Cohort Study

by Abdullah Hashim Almalki, Nourah Abdulaziz Alorainan, Muhjah Abdulhakim Bukhari, Fahad Ali Dokhaikh, Salma Mohamed Abbas Quqandi, Reyan Hatem Merdad and Laila Fahad Sadagah

Pharmacy 2026, 14(4), 91; https://doi.org/10.3390/pharmacy14040091 - 26 Jun 2026

Abstract

Background: Hyperkalemia (HK) is a common complication of renin-angiotensin-aldosterone system inhibitor (RAASi) therapy, and the risk is often increased by concomitant use of a mineralocorticoid receptor antagonist (MRA). The effect of SGLT2i co-prescription on this risk in routine clinical practice remains incompletely understood. [...] Read more.

Background: Hyperkalemia (HK) is a common complication of renin-angiotensin-aldosterone system inhibitor (RAASi) therapy, and the risk is often increased by concomitant use of a mineralocorticoid receptor antagonist (MRA). The effect of SGLT2i co-prescription on this risk in routine clinical practice remains incompletely understood. Methods: This is a secondary analysis of a published retrospective cohort of 905 adult RAASi users attending outpatient clinics at King Abdulaziz Medical City, Jeddah, Saudi Arabia (IRB: NRJ22J/279/11), followed for a median of 28 months. Patients were classified as RAASi alone (n = 723) or RAASi plus MRA (n = 182). Beta-blockers and digoxin were excluded from the exposure definition. Effect modification by SGLT2i was assessed using logistic regression with a multiplicative interaction term. Results: MRA addition was associated with significantly higher rates of any HK (48.4% vs. 28.9%; RR 1.67, 95% CI 1.38–2.02, p < 0.001) and moderate-to-severe HK (13.7% vs. 6.9%; RR 1.99, 95% CI 1.26–3.12, p = 0.003). Overall, RAASi discontinuation rates were similar between groups. SGLT2i co-prescription significantly modified the association between MRA use and HK-driven RAASi discontinuation (interaction p = 0.004): among patients without SGLT2i, MRA addition was associated with a more than 5-fold increase in HK-driven discontinuation (21.1% vs. 4.1%; RR 5.11, p = 0.001), whereas no significant excess risk was observed among SGLT2i users (1.8% vs. 4.2%; RR 0.44, 95% CI 0.12–1.57, p = 0.190), although this subgroup estimate was imprecise. CKD (aOR 2.16, 95% CI 1.56–2.99) and age ≥ 75 years (aOR 1.64, 95% CI 1.04–2.58) were the strongest independent predictors of HK. Conclusions: MRA addition to RAASi substantially increases HK burden, and SGLT2i co-prescription appears to protect against HK-driven RAASi discontinuation in combined RAASi–MRA-treated patients. In patients with established indications for SGLT2i, co-prescription may confer the additional benefit of preserving RAASi continuity in the setting of MRA combination therapy. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

► Show Figures

Figure 1

12 pages, 1381 KB

Open AccessArticle

Performance, Determinants, and Acceptability of a Clinical Pharmacy Assessment in Hospital Pharmacy Education

by Sébastien Chanoine, Quentin Perrier, Elisa Vitale, Arnaud Tanty, Benoît Allenet and Pierrick Bedouch

Pharmacy 2026, 14(4), 90; https://doi.org/10.3390/pharmacy14040090 - 24 Jun 2026

Abstract

Background: Pharmacy students in France complete an equivalent six-month full-time hospital placement during the fifth year of their university curriculum. At our school, it includes a clinical pharmacy within a medical ward, with daily supervision by a clinical pharmacist and a pharmacy resident. [...] Read more.

Background: Pharmacy students in France complete an equivalent six-month full-time hospital placement during the fifth year of their university curriculum. At our school, it includes a clinical pharmacy within a medical ward, with daily supervision by a clinical pharmacist and a pharmacy resident. This training has been strengthened by the introduction of a workplace-based formative assessment conducted at the end of the clinical pharmacy rotation, alongside weekly clinical case discussions at the school, culminating in an end-of-year oral assessment. Objective: To assess the performance, determinants, and acceptability of this assessment model. Methods: We conducted a retrospective, single-center study over ten academic years (2013–2023). The evaluation combined three complementary components: the workplace-based clinical assessment based on real patient interactions, the case-based oral assessment, and students’ satisfaction. Results: Nearly one thousand students were included. Students’ performances remained stable over time. Higher scores were observed among students with prior clinical experience and those enrolled in hospital-focused training pathways. Student satisfaction was high, particularly in settings with direct pharmaceutical supervision, which was strongly associated with improved perceived learning, engagement, and supervision quality. Conclusions: Beyond performance measurement, this model appears to foster clinical reasoning, professional development, and student engagement, suggesting its relevance for competency-based pharmacy education. Full article

(This article belongs to the Special Issue Advancing Pharmacy Education: Integrating Science and Clinical Practice)

► Show Figures

Figure 1

14 pages, 768 KB

Open AccessArticle

Cumulative Anticholinergic Burden and Risk of Delirium Among Older Adults with Alzheimer’s Disease

by Ashna Talwar, Jeffrey Sherer, Susan Abughosh, Satabdi Chatterjee and Rajender R. Aparasu

Pharmacy 2026, 14(4), 89; https://doi.org/10.3390/pharmacy14040089 - 23 Jun 2026

Abstract

Delirium is a transient neuropsychiatric condition that is a severe and prevalent condition affecting 2.6 million older adults each year. Alzheimer’s disease (AD) and anticholinergic medication use are risk factors for delirium. This study evaluated the association between cumulative anticholinergic burden (CAB) and [...] Read more.

Delirium is a transient neuropsychiatric condition that is a severe and prevalent condition affecting 2.6 million older adults each year. Alzheimer’s disease (AD) and anticholinergic medication use are risk factors for delirium. This study evaluated the association between cumulative anticholinergic burden (CAB) and risk of delirium among older adults with AD initiating cholinesterase inhibitors (ChEIs). This retrospective cohort study used 2013–2017 Medicare claims data, and included adults 65 years and older with AD who initiated any of the ChEIs (donepezil, rivastigmine, and galantamine) after a 12-month washout period. CAB, as the primary exposure, was measured on the index date and calculated as the monthly total standardized daily dose of anticholinergic medications. A multivariable Cox proportional hazards regression model with inverse probability of treatment weighting (IPTW) generated using generalized boosted models was used to evaluate the risk of delirium associated with the CAB. This study identified 143,320 older adults with AD who initiated ChEIs. Most patients were in the low/no burden (62.73%) group, followed by high burden (21.12%) and moderate burden (16.14%). Overall, delirium diagnosis was observed in 19.11% of the cohort. The Cox regression model with IPTW found that moderate (aHR, 1.56; 95% CI, 1.52–1.61; p < 0.0001) and high CAB (aHR, 1.45; 95% CI, 1.42–1.49; p < 0.0001) were associated with an increased risk of delirium compared to low/no burden. Among older adults with AD initiating ChEIs, moderate and high CAB were associated with an increased risk of delirium compared with low/no CAB. These findings highlight the need to carefully reduce the CAB, especially dose and duration, along with utilizing anticholinergic alternatives in older adults with AD. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

► Show Figures

Graphical abstract

Journal Description

Pharmacy

Latest Articles

Journal Menu

Journal Browser

Highly Accessed Articles

Latest Books

E-Mail Alert

News

Topics

Conferences

Special Issues

Topical Collections

Further Information

Guidelines

MDPI Initiatives

Follow MDPI