Pharmacy

15 pages, 752 KB

Open AccessArticle

Beyond the Counter: Assessing NSAIDs Dispensing and Use Among Community Pharmacies in Saudi Arabia’s Eastern Region: A Cross-Sectional Study

by Mohamed A. Albekery, Helal F Hetta, Shatha A. Almikhlal, Aisha Y. Alfraih, Nora Aldhuhayyan, Zahra Alarbsh, Abdulrahman Abdullah Alnijadi, Monther Alsultan and Abdullah Al Hamid

Pharmacy 2026, 14(5), 123; https://doi.org/10.3390/pharmacy14050123 - 20 Aug 2026

Abstract

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for pain, inflammation, and fever. Although many NSAIDs are available without a prescription, inappropriate use may increase the risk of renal, gastrointestinal, and cardiovascular complications. This study evaluated NSAID dispensing patterns and potential risk practices [...] Read more.

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for pain, inflammation, and fever. Although many NSAIDs are available without a prescription, inappropriate use may increase the risk of renal, gastrointestinal, and cardiovascular complications. This study evaluated NSAID dispensing patterns and potential risk practices in community pharmacies in the Eastern Province of Saudi Arabia. Methods: A cross-sectional study was conducted in 90 community pharmacies across Al-Ahsa, Al-Dammam, and Jubail Industrial City between February and March 2025. Data on demographics, NSAID type, indication, dosage, frequency, duration, and concomitant medication use were collected and analyzed descriptively. Results: Among the 171 documented NSAID dispensing cases, 98 (57.3%) occurred without a prescription, whereas 73 (42.7%) involved prescription-based dispensing. Ibuprofen (62%) and diclofenac (36.3%) were the most commonly dispensed agents, with oral tablets being the preferred formulation (76.6%). Most documented treatment durations were short (3–7 days) with once- or twice-daily dosing. Common documented indications included dental conditions, pain, and inflammation, although the indication was not specified in 57.3% of cases. At least one potential interaction was identified in 11(7.8%, 95% CI 4.4–13.4%) of the 141 cases with concomitant medication use, corresponding to 13 (5.9%, 95% CI 3.5–9.9%) potential interaction pairs. Conclusions: Frequent non-prescription NSAID dispensing, incomplete documentation, and potentially clinically relevant drug interactions highlight the need to strengthen medication review, documentation, public awareness, regulatory oversight, and pharmacist counseling in community pharmacy practice. Full article

(This article belongs to the Topic Optimization of Drug Utilization and Medication Adherence)

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13 pages, 2924 KB

Open AccessArticle

Safe Handover or Lost in Transition?—A Retrospective Evaluation of Pharmacist Referrals to Primary Care Following Hospital Discharge

by Katarina Wickman, Cecilia Lenander, Gabriella Caleres and Sara Modig

Pharmacy 2026, 14(5), 122; https://doi.org/10.3390/pharmacy14050122 - 20 Aug 2026

Abstract

The medication-related problems identified by clinical pharmacists during hospitalisation may be better addressed after patient discharge and recovery from acute illness. This approach enables follow-up and may reduce the risks associated with multiple medication changes. However, inadequate information transfer at discharge is a [...] Read more.

The medication-related problems identified by clinical pharmacists during hospitalisation may be better addressed after patient discharge and recovery from acute illness. This approach enables follow-up and may reduce the risks associated with multiple medication changes. However, inadequate information transfer at discharge is a recognised patient safety risk. Referral-based communication between clinical pharmacists and general practitioners (GPs) is a novel procedure in southern Sweden. This retrospective observational study aimed to describe the patient population, medication-related problems, their clinical relevance, and resulting GP actions. Data were collected from pharmacist referrals and electronic medical records between Q4 2021 and Q4 2023. Medication-related problems were categorised, recommendations were assessed for clinical relevance, and follow-up within six months after discharge was analysed to determine whether GPs accepted the recommendations. Forty patients with 58 medication-related problems were included. Women accounted for 70% of the patients, the median age was 79.5 years, and 75% had extensive polypharmacy. Adherence problems were most common (22%). Overall, 98% of the recommendations were considered clinically relevant. Of the 48 assessable recommendations, 77% were implemented in primary care. No statistical association between clinical relevance and implementation was detected (odds ratio 2.27, p = 0.247, CI 0.57–9.04). Pharmacist referrals at discharge may support information transfer and provide clinically relevant recommendations that improve medication safety. Full article

(This article belongs to the Special Issue Innovations and Systems Approaches to Medication Safety in Pharmacy Practice)

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10 pages, 297 KB

Open AccessArticle

A Novel Fixed-Dose Activated Prothrombin Complex Concentrate Regimen for Warfarin-Associated Hemorrhages: A Retrospective Cohort Comparison of Two Regimens

by Francisco Ibarra, Jr., Evan Cheng and Benjamin Falkenstein

Pharmacy 2026, 14(5), 121; https://doi.org/10.3390/pharmacy14050121 - 19 Aug 2026

Abstract

The optimal fixed-dose strategy for managing warfarin-associated hemorrhages remains unknown and few studies have evaluated the use of Factor VIII Inhibitor Bypass Activity (FEIBA). This retrospective cohort study’s primary efficacy outcome was the percentage of patients who achieved a post-FEIBA INR ≤ 1.5 [...] Read more.

The optimal fixed-dose strategy for managing warfarin-associated hemorrhages remains unknown and few studies have evaluated the use of Factor VIII Inhibitor Bypass Activity (FEIBA). This retrospective cohort study’s primary efficacy outcome was the percentage of patients who achieved a post-FEIBA INR ≤ 1.5 following receipt of the old and new dosing regimens. In the old group patients received 500 or 1000 units for an INR < 5 or ≥5, respectively. In the new group patients received 1000, 1500, or 2000 units for an INR < 5, 5–9.9, or ≥10, respectively. Eighteen patients were included in each group. The median (IQR) pre-FEIBA INR in the old and new groups was 6.1 (3.1–12.9) and 5.3 (3.4–13.0), respectively [difference: −0.8 (95 CI%, −7.2 to 6.5)]. The median (IQR) post-FEIBA INR in the old and new groups was 1.6 (1.4–2.1) and 1.4 (1.2–1.5), respectively [difference: −0.2 (95% CI: −0.6 to 0.0)]. A post-FEIBA INR ≤ 1.5 was achieved in 14 (78%) patients in the new group and 9 (50%) patients in the old group (relative risk: 1.56; 95% CI, 0.91 to 2.7; p = 0.16). The post-FEIBA INR values in the patients who did not achieve a post-FEIBA INR ≤ 1.5 in the new group were 1.6, 1.6, 1.8, and 2.4. Among patients with a baseline INR ≥ 10, significantly more patients in the new group achieved a post-FEIBA INR ≤ 1.5 compared to the old group (86% vs. 17%, respectively). These findings suggest that the new FEIBA dosing regimen may improve INR reversal compared with the previous regimen, particularly among patients with a baseline INR ≥ 10, but larger studies are needed to confirm this observation. Full article

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

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15 pages, 1438 KB

Open AccessArticle

A Retrospective Cohort Study to Optimize Piperacillin/Tazobactam Dosing in Routine Intensive-Care Patients via a Newly Designed Clinical Pharmacy Service Including TDM- and Algorithm-Based Recommendations

by Johanna Dicken, Daniel Dönisch, Jan Hensen, Olaf Zube and Thilo Bertsche

Pharmacy 2026, 14(5), 120; https://doi.org/10.3390/pharmacy14050120 - 17 Aug 2026

Abstract

Background: Therapeutic drug monitoring (TDM) for piperacillin/tazobactam has become established in intensive care. TDM should be used in a structured approach to optimize dosing. We evaluated a newly designed TDM- and algorithm-based clinical-pharmacy-service to determine whether it is appropriate for optimization. Methods: We [...] Read more.

Background: Therapeutic drug monitoring (TDM) for piperacillin/tazobactam has become established in intensive care. TDM should be used in a structured approach to optimize dosing. We evaluated a newly designed TDM- and algorithm-based clinical-pharmacy-service to determine whether it is appropriate for optimization. Methods: We developed a clinical pharmacy service providing algorithmic recommendations for optimizing piperacillin/tazobactam dosing based on piperacillin TDM. After implementing the clinical pharmacy service, we evaluated the treatment of intensive-care patients with piperacillin/tazobactam in terms of achieving the minimum-inhibitory-concentration-(MIC)-related target concentration at the following four time points: t1, t2, t3, and t4 (1–4 working days after piperacillin/tazobactam therapy was started). Results: A total of 132 patients (including 36% women), median age 78 years, received piperacillin/tazobactam therapy. Sepsis or septic shock was the most common indication (43%), while a pulmonary focus was most frequent (40%). From 132 patients (t1), 19% had “too low piperacillin concentrations”, 20% “appropriate concentrations”, and 61% “too high concentrations”. After recommendations were given (acceptance rate 100%) the corresponding numbers from 93 remaining patients (t2) were 16%, 35%, and 48%, from 49 patients (t3) 8%, 53%, and 39% and from 29 patients (t4) 38%, 45%, and 17%. In (t1), dose reduction was the main recommendation (49%). The number of patients with “appropriate concentrations” increased in one comparison (t1–t2: n.s.; t1–t3: p = 0.0013; t1–t4: n.s.; Bonferroni-corrected McNemar test), while “too high concentrations” decreased (t1–t2: p = 0.0080; t1–t3: p = 0.0056; t1–t4: p = 0.0095). “too low concentrations” were not influenced (t1–t2: n.s.; t1–t3: n.s.; t1–t4: n.s.). Conclusions: Inappropriate piperacillin plasma concentrations were common. A TDM- and algorithm-based clinical-pharmacy-service especially decreased the number of overdosed patients in routine practice. Full article

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11 pages, 931 KB

Open AccessArticle

The Implementation and One-Year Evaluation of a Pre-Admission Pharmacist for Obstetric Admissions

by Bridget Clark, Nabeelah Mukadam, Tamara Lebedevs and Stephanie Wai Khuan Teoh

Pharmacy 2026, 14(5), 119; https://doi.org/10.3390/pharmacy14050119 - 17 Aug 2026

Abstract

(1) Objective: This study aims to evaluate the pre-admission clinic (PAC) pharmacist for high-risk obstetric patients’ admissions on medication management processes, workflow efficiency, and staff satisfaction. (2) Methods: Data collected over a 12-month period, from March 2025 to February 2026, were analysed. Data [...] Read more.

(1) Objective: This study aims to evaluate the pre-admission clinic (PAC) pharmacist for high-risk obstetric patients’ admissions on medication management processes, workflow efficiency, and staff satisfaction. (2) Methods: Data collected over a 12-month period, from March 2025 to February 2026, were analysed. Data collected included clinic type, patient attendance, mode of pharmacist review, and follow-up requirements. Multidisciplinary healthcare professionals were invited to complete a satisfaction survey to identify themes relating to service value, workflow impact, and opportunities for improvement. (3) Results: A total of 1039 interviews with obstetric patients, equating to an average of 19.98 interviews per week. A total of 999 patients were involved in the 1039 interviews held, 40/999 (4%) patients required additional follow-up telephone interview and 14 patients (14/999, 1.4%) required in-person interview for interpreter services, detailed discussion or hearing impairment. Thirty-two staff responded to a survey and demonstrated a consistent trend across anaesthetists, nursing and midwifery staff, and pharmacists. All respondents either agreed or strongly agreed that a PAC pharmacist in the obstetric setting was valuable and beneficial to clinical workflow and medication management processes, and that they were satisfied with the PAC pharmacy service. (4) Conclusions: The PAC pharmacist demonstrated a positive impact on medication management for obstetric patients within the pre-admission setting. Full article

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

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13 pages, 943 KB

Open AccessArticle

Patterns and Safety-Related Aspects of Antidepressant and Anxiolytic Use Among Healthcare Students and University Staff at a Brazilian Public University: A Cross-Sectional Study

by Núbia Vieira Alves, Geórgia Almeida Sant’Ana, Jorge Fernando Carrozza, Gabriela Moraes Oliveira, Carlos Ferreira Santos and Adriana Maria Calvo

Pharmacy 2026, 14(5), 118; https://doi.org/10.3390/pharmacy14050118 - 13 Aug 2026

Abstract

Background/Objectives: The use of antidepressants and anxiolytics has increased worldwide, raising concerns about treatment patterns, medication safety, and rational use. This study aimed to characterize the frequency, utilization patterns, and safety-related aspects of antidepressant and anxiolytic use among healthcare students and university staff [...] Read more.

Background/Objectives: The use of antidepressants and anxiolytics has increased worldwide, raising concerns about treatment patterns, medication safety, and rational use. This study aimed to characterize the frequency, utilization patterns, and safety-related aspects of antidepressant and anxiolytic use among healthcare students and university staff at a Brazilian public university. Methods: A cross-sectional study was conducted between September 2024 and June 2025 using an online questionnaire administered to students and staff at the University of São Paulo, Brazil. Descriptive statistics and multivariable logistic regression were applied to characterize medication utilization patterns and evaluate factors associated with antidepressant and/or anxiolytic use. Results: Among the 300 participants, 167 (55.7%) reported antidepressant and/or anxiolytic use during the previous six months. Most users reported treatment for more than one year (59.9%), anxiety as the primary indication (68.3%), and prescription by a healthcare professional (93.4%). A total of 203 medications were reported, with selective serotonin reuptake inhibitors being the most common pharmacological class (42.4%). Among users, 99 (59.3%) reported at least one self-reported adverse effect, most commonly excessive drowsiness, reduced libido/sexual dysfunction, dry mouth, headache, and nausea. No statistically significant independent associations were identified between antidepressant and/or anxiolytic use and the evaluated sociodemographic characteristics. Conclusions: Antidepressant and anxiolytic use was frequently reported and was characterized by predominantly long-term, professionally prescribed treatment and frequent self-reported adverse effects. These findings may inform institutional strategies to improve access to mental healthcare while promoting the rational and safe use of psychotropic medications within university settings. Full article

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13 pages, 1366 KB

Open AccessArticle

Frequency and Profiles of Drug Combinations Constituting the Triple Whammy in Japan: An Analysis of a Patient Estimation Database

by Mari Maese, Nozomi Ito, Haruka Shiokawa, Shingo Kondo, Yuko Okamoto, Hiroki Iwata, Shunsuke Urushibata and Katsunori Yamaura

Pharmacy 2026, 14(5), 117; https://doi.org/10.3390/pharmacy14050117 - 8 Aug 2026

Abstract

“Triple whammy” prescriptions, combining non-steroidal anti-inflammatory drugs (NSAIDs), renin–angiotensin system (RAS) inhibitors, and diuretics, increase acute kidney injury (AKI) risk. To clarify the frequency and profiles of these prescriptions and identify vulnerable populations, we analyzed the AHI partners database to estimate the number [...] Read more.

“Triple whammy” prescriptions, combining non-steroidal anti-inflammatory drugs (NSAIDs), renin–angiotensin system (RAS) inhibitors, and diuretics, increase acute kidney injury (AKI) risk. To clarify the frequency and profiles of these prescriptions and identify vulnerable populations, we analyzed the AHI partners database to estimate the number of individuals prescribed these three drug classes. In the single-agent analysis, loxoprofen was the most commonly prescribed NSAID (66.3%), olmesartan (19.4%) and telmisartan (15.9%) were the predominant RAS inhibitors, and furosemide (19.6%) and spironolactone (16.0%) were the most frequently used diuretics. Dual-drug combinations showed patterns consistent with the single-agent results for NSAIDs and diuretics. By contrast, sacubitril/valsartan was the most common RAS inhibitor when combined with diuretics, frequently utilized for heart failure management. In triple whammy prescriptions, NSAIDs and diuretics patterns mirrored those of single-agents. The annual number of triple whammy prescriptions showed a statistically significant downward trend over the study period by the Mann–Kendall trend test (p = 0.048). Notably, sacubitril/valsartan was the leading RAS inhibitor (46/199 patients, 23%), showing a higher proportion than its single-agent use (7.4%). Heart failure patients prescribed these two causative drugs are highly vulnerable to “triple whammy” prescriptions. Awareness of inadvertent NSAID additions is warranted to mitigate potential AKI risks. Full article

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13 pages, 1362 KB

Open AccessArticle

Medicine Inventories and Practices of Self-Medication in Households of Medical and Pharmacy Students at the University of Rijeka, Croatia: A Cross-Sectional Study with Implications for Healthcare Professions Education

by Vedrana Aljinović-Vučić and Jasenka Mršić-Pelčić

Pharmacy 2026, 14(5), 116; https://doi.org/10.3390/pharmacy14050116 - 7 Aug 2026

Abstract

Background/Objectives: Self-medication and keeping medicine inventory in households are common practices, even among healthcare professionals and healthcare professions students. Despite their knowledge of appropriate medicine use and storage, these practices are not always responsible and may pose health risks. This study aimed to [...] Read more.

Background/Objectives: Self-medication and keeping medicine inventory in households are common practices, even among healthcare professionals and healthcare professions students. Despite their knowledge of appropriate medicine use and storage, these practices are not always responsible and may pose health risks. This study aimed to describe self-medication practices, contents of home pharmacies, and habits of keeping medicine inventories in households of medical and pharmacy students at the Faculty of Medicine, University of Rijeka. Methods: In this cross-sectional study conducted in 2025, 60 third-year medical and pharmacy students interviewed members of their households regarding contents of home pharmacies and self-medication practices and compiled inventories of medicines kept at home. Results: Of the participating students, 70.0% were female. Healthcare professionals (physicians or pharmacists) were present in 23.3% of households. Medicines were stored in a designated location (“home pharmacy”) in 65.0% of households, whereas only one household reported having no medicines. Expired medicines and/or medicines with an unknown purpose were found in 41.6% of households. No household reported that medicines were accessible to children younger than 14 years. Inventories of stored medicines were obtained from 54 households (90.0%). Analgesics and antipyretics were present in 92.6% of households and were used for self-medication in 96.0% of them. Cough and cold preparations were found in 35.2% of households and used for self-medication in 94.7%. Antibiotics were present in 31.5% of households and used for self-medication in 52.9%, while anxiolytics were found in 16.7% of households and used for self-medication in 33.3%. Conclusions: Stocking medicine supplies and practicing self-medication are common among households of third-year medical and pharmacy students at the Faculty of Medicine, University of Rijeka. Analgesics and antipyretics were the most frequently stored medicines used for self-medication. The presence of expired medicines and the self-medication of prescription-only medicines highlight the need for greater emphasis on responsible self-medication, safe medicine storage, and rational medicine use within healthcare professions education. Full article

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

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14 pages, 247 KB

Open AccessArticle

Integration and Outcomes of Entrustable Professional Activities Performed by PharmD Trainees at Hospital Practice Sites

by Tania Bayoud, Sarah Alghanem, Fajer Al-Sejari, Mai Alhazami and Pierre Moreau

Pharmacy 2026, 14(5), 115; https://doi.org/10.3390/pharmacy14050115 - 6 Aug 2026

Abstract

Objectives: Our primary objectives were to evaluate the integration and impact of Entrustable Professional Activities (EPAs) within a competency-based add-on PharmD curriculum and to describe the types and frequency of EPAs performed by PharmD trainees as an assessment tool during their placements at [...] Read more.

Objectives: Our primary objectives were to evaluate the integration and impact of Entrustable Professional Activities (EPAs) within a competency-based add-on PharmD curriculum and to describe the types and frequency of EPAs performed by PharmD trainees as an assessment tool during their placements at secondary and tertiary care practice sites. A secondary objective was to report, categorize, and quantify patients’ drug therapy problems (DTPs) with the rate of recommendations’ acceptance by preceptors. Methods: A descriptive study for 2437 EPAs (concerning 1295 patients) was performed by 56 PharmD trainees during their experiential training year from January 2018 to November 2021. Results: The most frequent EPA performed by trainees was Medication Therapy Management (MTM) (718; 29.5%), followed by Medication Reconciliation (MedRec) (636; 26.1%), prescription/order review (546; 22.4%), and medication counseling (284; 11.7%). A total of 1224 DTPs were encountered through MTM, MedRec, and prescription/order reviews, with “drug not indicated” being the most common DTP (16.7%). Anti-infectives (25.1%), cardiovascular (21.8%), endocrine (12.5%), and gastrointestinal (12.1%) agents made up most of the 1612 medicines involved in medication-related DTPs. The majority of interventions were accepted by preceptors (91%). The rejection rate was 3.6%, owing primarily to medical expertise, clinical judgment, and the personal opinion of preceptors. Patients’ age (older adults), gender (females), and admission type (newly admitted patients) were associated with a higher risk of experiencing DTPs. Conclusions: Our findings demonstrate that incorporating EPA-based practice and assessment into pharmacy training can ensure graduates are not only knowledgeable but also trusted to perform essential tasks independently, ultimately optimizing the safety and quality of patient care. Full article

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

12 pages, 208 KB

Open AccessArticle

Building Tobacco Treatment Capacity and Sustainability: A Qualitative Study on Implementation of Community Pharmacy Technicians as Community Health Workers

by Cindy V. Valencia, Robin L. Corelli, Shin-Ping Tu, Melissa M. Gosdin and Elisa K. Tong

Pharmacy 2026, 14(5), 114; https://doi.org/10.3390/pharmacy14050114 - 3 Aug 2026

Abstract

Community pharmacies are increasingly providing health care services like tobacco treatment and disease-related management but need sustainable models for implementation. As several state Medicaid programs reimburse for community health worker (CHW) services, one promising model is to have pharmacy technicians engage with patients [...] Read more.

Community pharmacies are increasingly providing health care services like tobacco treatment and disease-related management but need sustainable models for implementation. As several state Medicaid programs reimburse for community health worker (CHW) services, one promising model is to have pharmacy technicians engage with patients as designated CHWs. This qualitative study interviewed staff in seven California pharmacies about their experience with and perspectives on implementing community pharmacy technicians as CHWs. Guided by implementation science frameworks, data were hand-coded and analyzed iteratively using thematic analysis. Relative advantage and compatibility of CHWs was high across all pharmacies. Pharmacy culture aligned with CHW values, and CHW integration helped formalize the work that pharmacy staff were already doing. Challenges included the complexity of billing and obtaining payment for services provided. Despite these barriers, pharmacies successfully integrated and expanded their CHW services, ranging from social service connections to tobacco treatment or disease-related management education. Pharmacy peer networks, health plan champions and patient outcome improvements accelerated diffusion. Community pharmacies provide a trusted setting for delivering both CHW education and extending health care services, but broad implementation will need health plans to improve policy and procedure with guidance specifically for the pharmacy context that helps overcome administrative barriers. Full article

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

15 pages, 435 KB

Open AccessReview

The Risks to Patients Associated with Using Artificial Intelligence Tools in Pharmacy Practice: A Scoping Review

by Tracy Zhang, Minh-Hien Le, Noah Zlotnik, Amanda Yee, Anjali Patodia and Zubin Austin

Pharmacy 2026, 14(5), 113; https://doi.org/10.3390/pharmacy14050113 - 3 Aug 2026

Abstract

Artificial intelligence (AI) tools are being used in pharmacy practice in a variety of ways, such as enhancing the safety and efficiency of dispensing, compounding medications and helping pharmacists identify drug–drug interactions. The further development and use of these innovative technologies will be [...] Read more.

Artificial intelligence (AI) tools are being used in pharmacy practice in a variety of ways, such as enhancing the safety and efficiency of dispensing, compounding medications and helping pharmacists identify drug–drug interactions. The further development and use of these innovative technologies will be necessary to ensure patients can continue to access high-quality care amidst a growing health human resource crisis. However, in the field of pharmacy practice, little is known about actual or potential risks these tools pose to patients. A scoping review was conducted to map these risks. A database search of Ovid Medline, Ovid Embase, Ebsco CINAHL, and Web of Science, and a grey literature search were conducted. Three major potential risks were described in the literature: inaccuracies associated with AI outputs, privacy and data security concerns, and risks associated with algorithmic bias. Despite these potential risks, there is still a large gap in the literature regarding the study of risks of AI in pharmacy practice. While characterizing all risks associated with this rapidly changing technology may be impossible, further exploration of risk, perhaps using novel approaches to understanding risk itself, is warranted if these technologies are to be adopted responsibly and used safely. Full article

(This article belongs to the Special Issue AI Use in Pharmacy and Pharmacy Education)

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19 pages, 5504 KB

Open AccessArticle

“It’s Worth Its Weight in Gold”: Patient Reported Experience Measures of a National NHS-Funded Community Pharmacy-Based Common Ailments Service

by Efi Mantzourani, David McRae, Egerton Hunter, Grace Naylor, Emma Hinks, Andrew Evans and Rebecca Cannings-John

Pharmacy 2026, 14(5), 112; https://doi.org/10.3390/pharmacy14050112 - 3 Aug 2026

Abstract

The NHS-funded Common Ailments Service (CAS) in Wales enables community pharmacists to manage 28 common ailments by providing advice and/or medication free of charge without the need for patients to book an appointment. The aim of this study was to evaluate the patient [...] Read more.

The NHS-funded Common Ailments Service (CAS) in Wales enables community pharmacists to manage 28 common ailments by providing advice and/or medication free of charge without the need for patients to book an appointment. The aim of this study was to evaluate the patient experience of the CAS using patient reported experience measures (PREMs) and determine the feasibility of digital data capture collected directly from patients through a pharmacist-led manual recruitment model. The study used prospective, primary data collected through an online survey accessible via a Quick Response code and census recruitment. A total of 3660 surveys were included in the analysis, completed between 27 October 2025 and 31 March 2026. Overall experience was rated as excellent by 95.1% of participants. A theory-based framework analysis of 1499 free-text comments across the six domains of healthcare quality confirmed the high standard of care provision, primarily influenced by consultation quality, convenience, accessibility, and short waiting times. It also identified targeted areas for improvement, such as the need for seamless referrals from other areas of primary care and consistent availability of the service across all pharmacies. While digital PREMs captured high-quality insights, the pharmacist-led recruitment model reached a “feasibility ceiling”, with an overall response rate of 3.2%. Full article

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

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23 pages, 538 KB

Open AccessCommunication

Embedding Resilience Activities Across an Undergraduate Pharmacy Degree: An Educational Improvement Initiative and Cross-Sectional Evaluation

by Abdullah Al-Juhaishi, Nilushi Karunaratne, Annie Chen-Chen, Anisha Kaur Sandhu, Kirsten Galbraith and Betty Exintaris

Pharmacy 2026, 14(5), 111; https://doi.org/10.3390/pharmacy14050111 - 3 Aug 2026

Abstract

Resilience, the capacity to recover from adversity, manage stress, and maintain well-being, is vital for pharmacy students to manage academic stress, clinical challenges, and future professional demands. Despite its recognised importance, pharmacy curricula often lack structured resilience education. This pilot study aimed to [...] Read more.

Resilience, the capacity to recover from adversity, manage stress, and maintain well-being, is vital for pharmacy students to manage academic stress, clinical challenges, and future professional demands. Despite its recognised importance, pharmacy curricula often lack structured resilience education. This pilot study aimed to design, implement, and evaluate resilience-focused activities within Monash University’s Bachelor of Pharmacy (Hons)/Master of Pharmacy program. This study employed a descriptive cross-sectional educational evaluation design using a single post-intervention survey to explore student perceptions following participation in curriculum-integrated resilience activities within the Skills Coaching program. Sessions used reflective frameworks and interactive small-group activities facilitated by staff and pharmacists across the Australian and Malaysian campuses. In 2022, 1061 students participated, with feedback response rates between 26 and 40%. Students reported perceived improvements in their understanding of resilience following participation in the sessions. Likert-scale responses indicated improved understanding of resilience and highlighted strong engagement with case discussions and reflective exercises. Findings from this pilot inform curriculum refinement, assessment design, and faculty development to support sustainable integration of resilience education in pharmacy programs. This work also supports the lead author’s doctoral research to develop a comprehensive resilience curriculum for undergraduate pharmacy education. Full article

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

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13 pages, 435 KB

Open AccessArticle

Management of Acute Sore Throat in Community Pharmacies: Insights from a Survey of Italian Pharmacists

by Rachele Aspesi, Paolo Levantino, Giulia Ciancarella, Andrea Nacci, Pietro Tasegian and Diego Maria Michele Fornasari

Pharmacy 2026, 14(5), 110; https://doi.org/10.3390/pharmacy14050110 - 25 Jul 2026

Abstract

Background: Acute sore throat (pharyngitis) accounts for 10–30% of ambulatory visits annually. Bacterial etiology, primarily Group A Streptococcus, is confirmed in only 20–34% of cases, and inappropriate antibiotic administration remains frequent, contributing to antimicrobial resistance. Community pharmacists play a key role in [...] Read more.

Background: Acute sore throat (pharyngitis) accounts for 10–30% of ambulatory visits annually. Bacterial etiology, primarily Group A Streptococcus, is confirmed in only 20–34% of cases, and inappropriate antibiotic administration remains frequent, contributing to antimicrobial resistance. Community pharmacists play a key role in symptomatic management and stewardship, but real-world practices remain underexplored. Methods: A 16-item online questionnaire surveyed 629 Italian community pharmacists via professional networks, covering demographics, diagnostic tools, symptom assessment, treatment preferences, and follow-up. Responses were analyzed using descriptive statistics and interpreted within a multidisciplinary expert framework. Results: Italian community pharmacists (n = 629), predominantly mid-career and experienced individuals, prioritize targeted symptom questioning (flu-like signs (59.96%), fever (48.73%), pain intensity (49.64%)) and medical referral over formal diagnostic tools like the Centor criteria (unused in 53.66% of cases). A total of 46.74% report performing a Strep A test in fewer than 20% of patients. Topical sprays (83.33%) and lozenges (44.69%), especially containing flurbiprofen (94.19%), dominate recommendations, followed by systemic analgesics (45.79%). For mild cases, anti-inflammatory/analgesic sprays/lozenges (35.42%) and antiseptic lozenges (35.61%) dominate, while in severe cases, drugs with anti-inflammatory or analgesic effects are often preferred (72.47%). Most pharmacists request a follow-up (73.22%). Conclusions: Italian community pharmacists report a predominantly topical-first approach focused on symptomatic treatment and referral when appropriate. Diagnostic gaps and inconsistent follow-up represent actionable targets. The findings inform training outputs prioritizing simplified triage, expanded symptom checklists, spray/lozenge optimization, and 3–5-day call-backs. This work aims to promote pharmacists’ antimicrobial stewardship to reduce antibiotic use while enhancing patient-centred sore throat care in Italy’s pharmacy network. Full article

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

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19 pages, 343 KB

Open AccessArticle

An Underused Competence: Clinical Pharmacists’ Experiences of Writing Referrals in Transitions of Care

by Katarina Wickman, Sara Modig, Cecilia Lenander and Gabriella Caleres

Pharmacy 2026, 14(5), 109; https://doi.org/10.3390/pharmacy14050109 - 23 Jul 2026

Cited by 1

Abstract

Older people are at increased risk of medication-related problems, which may be identified by clinical pharmacists during hospital medication reviews. Some problems are better managed in primary care, where follow-up is possible. Medication-related communication by pharmacists may improve information transfer in care transitions, [...] Read more.

Older people are at increased risk of medication-related problems, which may be identified by clinical pharmacists during hospital medication reviews. Some problems are better managed in primary care, where follow-up is possible. Medication-related communication by pharmacists may improve information transfer in care transitions, but this practice remains uncommon in Sweden. This qualitative study explored clinical pharmacists’ experiences and perceptions of writing referrals to primary care. Data were collected through four focus groups and three supplementary interviews with 19 clinical pharmacists from hospitals and primary care, and analysed using qualitative content analysis. Eleven participants had experience writing referrals, although none did so regularly. Four categories emerged: role of the pharmacist, current work procedures, pharmacist–physician relationship and facilitating factors. Pharmacists believe they can contribute to patient safety through involvement in transitions of care. An overall concept of an underused competence permeated the categories. Referrals identifying medication-related problems are hindered by limited pharmacist integration into the healthcare team and limited continuity. Writing referrals was considered a new procedure requiring collaboration with unfamiliar partners. Organisational changes, including increased pharmacist continuity and clearer pharmacist roles, are needed to implement referral practices. Further research is needed to evaluate effects on medication treatment and patient outcomes. Full article

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16 pages, 351 KB

Open AccessSystematic Review

Factors Influencing Phenoconversion in CYP-Mediated Drug Metabolism: A Scoping Review

by Sierra Scodellaro, Stefanie Triantafilou and Iris Cohn

Pharmacy 2026, 14(4), 108; https://doi.org/10.3390/pharmacy14040108 - 16 Jul 2026

Abstract

Pharmacogenetics (PGx) aims to optimize drug therapy by predicting medication response based on genetic variation in drug-metabolizing enzymes. However, observed drug metabolism may differ from genotype-predicted metabolizer status given external or acquired influences. This phenomenon is known as phenoconversion. As PGx testing becomes [...] Read more.

Pharmacogenetics (PGx) aims to optimize drug therapy by predicting medication response based on genetic variation in drug-metabolizing enzymes. However, observed drug metabolism may differ from genotype-predicted metabolizer status given external or acquired influences. This phenomenon is known as phenoconversion. As PGx testing becomes increasingly integrated into clinical care, understanding the contributing factors of phenoconversion is important for interpreting test results and guiding treatment. This scoping review aimed to categorize reported contributors of phenoconversion affecting CYP2D6, CYP2C19, and CYP3A4 metabolism. A structured literature search was conducted across Ovid MEDLINE^®, Embase Classic + Embase, EBM Reviews, and Clarivate Web of Science. Records were screened using predefined inclusion and exclusion criteria, and data were extracted from eligible studies describing factors associated with metabolic activity inconsistent with genotype-predicted phenotypes. From 6008 records identified, 43 studies met the inclusion criteria. Reported contributors clustered into pharmacological factors, including drug–drug and drug–drug–gene interactions, clinical factors such as inflammation, physiological and demographic factors including pregnancy and age-related changes, and environmental influences such as smoking. Pharmacological contributors were most frequently studied, whereas environmental and demographic influences were less well characterized. These findings highlight the multifactorial nature of phenoconversion and underscore the need for further investigations to support phenoconversion integration into PGx-informed clinical decision-making. Full article

(This article belongs to the Special Issue Personalized Pharmacy and Pharmaceutics: Advancing Precision Medicine Within Contemporary Pharmaceutical Science and Practice)

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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)

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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)

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