Pharmacy

20 pages, 813 KiB

Open AccessReview

The Role of Pharmacists in Delivering Pharmaceutical Services to Breast Cancer Patients in Clinical and Community Settings: A Scoping Review

by Yuyao Pei, Ruoxin Huang, Feng Chang, Yuanhui Hu, Sarah Versteeg and Yufen Zheng

Pharmacy 2025, 13(4), 97; https://doi.org/10.3390/pharmacy13040097 - 21 Jul 2025

Abstract

(1) Background: Patient-centered care for individuals with breast cancer requires multidisciplinary cooperation to ensure the appropriate use of medication and prevent medication-related problems. Pharmaceutical care has been associated with improved adherence in breast cancer management, a factor linked to patient outcomes and mortality. [...] Read more.

(1) Background: Patient-centered care for individuals with breast cancer requires multidisciplinary cooperation to ensure the appropriate use of medication and prevent medication-related problems. Pharmaceutical care has been associated with improved adherence in breast cancer management, a factor linked to patient outcomes and mortality. This study aims to summarize and explore the provision and utilization of pharmaceutical services for breast cancer patients by pharmacists. (2) Methods: A scoping review was performed to assess the pharmacist’s role in providing pharmaceutical services for patients with breast cancer. A comprehensive review of four databases (PubMed, Ovid Embase, Ovid International Pharmaceutical Abstracts, and Scopus) was completed between 1 January 2012 and 8 April 2025 according to PRISMA-ScR framework. (3) Results: A total of 46 articles met the inclusion criteria, which included RCTs, observatory studies, cohort studies, and reviews. Findings suggest that both clinical and community pharmacists play an important role in prevention, management, and education for breast cancer patients. (4) Conclusions: Pharmacists can improve health outcomes by providing pharmaceutical service in breast cancer care. Optimizing interventions, expanding services, and evaluating long-term cost-effectiveness is needed in the future. Full article

► Show Figures

Figure 1

16 pages, 647 KiB

Open AccessArticle

Medical Cannabis Use and Healthcare Utilization Among Patients with Chronic Pain: A Causal Inference Analysis Using TMLE

by Mitchell L. Doucette, Emily Fisher, Junella Chin and Panagiota Kitsantas

Pharmacy 2025, 13(4), 96; https://doi.org/10.3390/pharmacy13040096 - 15 Jul 2025

Abstract

Introduction: Chronic pain affects approximately 20% of U.S. adults, imposing significant burdens on individuals and healthcare systems. Medical cannabis has emerged as a potential therapy, yet its impact on healthcare utilization remains unclear. Methods: This retrospective cohort study analyzed administrative data from a [...] Read more.

Introduction: Chronic pain affects approximately 20% of U.S. adults, imposing significant burdens on individuals and healthcare systems. Medical cannabis has emerged as a potential therapy, yet its impact on healthcare utilization remains unclear. Methods: This retrospective cohort study analyzed administrative data from a telehealth platform providing medical cannabis certifications across 36 U.S. states. Patients were classified as cannabis-exposed if they had used cannabis in the past year, while unexposed patients had no prior cannabis use. Outcomes included self-reported urgent care visits, emergency department (ED) visits, hospitalizations, and quality of life (QoL), measured using the CDC’s Healthy Days measure. Targeted Maximum Likelihood Estimation with SuperLearner estimated causal effects, adjusting for numerous covariates. Results: Medical cannabis users exhibited significantly lower healthcare utilization. Specifically, exposure was associated with a 2.0 percentage point reduction in urgent care visits (95% CI: −0.036, −0.004), a 3.2 percentage point reduction in ED visits (95% CI: −0.051, −0.012) and fewer unhealthy days per month (−3.52 days, 95% CI: −4.28, −2.76). Hospitalization rates trended lower but were not statistically significant. Covariate balance and propensity score overlap indicated well-fitting models. Conclusions: Medical cannabis use was associated with reduced healthcare utilization and improved self-reported QoL among chronic pain patients. Full article

► Show Figures

Figure 1

17 pages, 271 KiB

Open AccessReview

The Role of Pharmacists in Identifying and Preventing Drug-Related Problems in PCOS Management

by Hristina Lebanova, Vesselina Yanachkova and Svetoslav Stoev

Pharmacy 2025, 13(4), 95; https://doi.org/10.3390/pharmacy13040095 - 11 Jul 2025

Abstract

Polycystic ovary syndrome (PCOS) is an endocrine disorder prevalent in women of reproductive age, often requiring complex pharmacological management. The heterogeneity of the syndrome and the use of on- and off-label therapeutic agents—ranging from insulin sensitizers and ovulation inducers to oral contraceptives and [...] Read more.

Polycystic ovary syndrome (PCOS) is an endocrine disorder prevalent in women of reproductive age, often requiring complex pharmacological management. The heterogeneity of the syndrome and the use of on- and off-label therapeutic agents—ranging from insulin sensitizers and ovulation inducers to oral contraceptives and herbal supplements—pose significant challenges, including adverse effects, drug interactions, and poor adherence. This narrative review explores the role of pharmacists in identifying and mitigating drug-related problems (DRPs) associated with PCOS therapy. Through thematic synthesis of the current literature, the study highlights common DRPs such as suboptimal drug selection, inappropriate dosing, prolonged therapy duration, and treatment-related safety concerns. It underscores the value of pharmacists’ interventions in enhancing medication adherence, optimizing therapeutic regimens, providing patient education, and monitoring adverse events. A structured, patient-level pharmaceutical care model is proposed, emphasizing personalized assessment, interdisciplinary collaboration, and continuous follow-up. The integration of clinical pharmacists into PCOS care teams has the potential to improve treatment effectiveness, patient satisfaction, and long-term health outcomes. Pharmacists’ contributions are especially critical given the widespread use of off-label therapies and supplements with variable evidence of benefit. Tailored pharmaceutical care can thus bridge the existing gaps in PCOS management and enhance the quality of life for the affected individuals. Full article

(This article belongs to the Special Issue Women's Special Issue Series: Pharmacy and Pharmacists)

17 pages, 222 KiB

Open AccessArticle

Enhancing the Role of Community Pharmacists in Medication Safety: A Qualitative Study of Voices from the Frontline

by Annesha White, Erika L. Thompson, Solyi Kim, Janice A. Osei, Kimberly G. Fulda and Yan Xiao

Pharmacy 2025, 13(4), 94; https://doi.org/10.3390/pharmacy13040094 - 9 Jul 2025

Abstract

Preventable adverse drug events (ADEs) remain a significant threat in community settings, a challenge that is critical in community pharmacy settings where continuity of care and healthcare access can be limited. This qualitative study explored the perspectives of 13 community pharmacists through focus [...] Read more.

Preventable adverse drug events (ADEs) remain a significant threat in community settings, a challenge that is critical in community pharmacy settings where continuity of care and healthcare access can be limited. This qualitative study explored the perspectives of 13 community pharmacists through focus groups and interviews to identify barriers and propose solutions to enhance their role in patient care. Pharmacists emphasized their critical position in ensuring safe medication use, particularly for older adults managing multiple chronic conditions. Key findings revealed five themes: (1) defining medication safety as minimizing risk and empowering patients; (2) characteristics of the “perfect patient,” including medication awareness and proactive engagement; (3) the pharmacist’s role in detecting and resolving medication-related problems; (4) systemic barriers such as time constraints, lack of access to patient records, insufficient privacy, and undervaluation of pharmacists’ roles; and (5) proposed solutions including private counseling areas, increased staffing, integrated electronic health records, and legislative recognition of pharmacists as healthcare providers. Strengthening collaboration with physicians and empowering patients through education were also highlighted as key strategies. These findings underscore the need for systemic changes—especially in light of lessons learned during the pandemic—to support pharmacists in delivering comprehensive medication management and improving patient safety. Full article

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

10 pages, 190 KiB

Open AccessArticle

Type II Diabetes Mellitus and COVID-19: Exploring Insulin Management in Patients from Family Medicine Clinics

by Chinemerem Opara, Annesha White, Kimberly G. Fulda, Somer Blair, Clare Aduwari, Nihitha Nukala and Yan Xiao

Pharmacy 2025, 13(4), 93; https://doi.org/10.3390/pharmacy13040093 - 4 Jul 2025

Abstract

The COVID-19 pandemic disrupted routine care for individuals with type 2 diabetes mellitus (T2DM), raising concerns about its impact on glycemic control and medication management. This study evaluated the relationship between insulin use and glycemic control among T2DM patients during the pandemic. A [...] Read more.

The COVID-19 pandemic disrupted routine care for individuals with type 2 diabetes mellitus (T2DM), raising concerns about its impact on glycemic control and medication management. This study evaluated the relationship between insulin use and glycemic control among T2DM patients during the pandemic. A retrospective analysis was conducted using deidentified clinical and prescription data from two family medicine clinics, comparing data from the pre-COVID-19 period (1 March 2019–13 March 2020) and during the COVID-19 pandemic (14 March 2020–31 March 2021). Patients included had at least two A1c values before the COVID and one during the COVID. A1c control was defined as less than 8%. Among 992 patients, 238 experienced a change in A1c status: 128 improved and 110 worsened. Mean A1c remained stable at 8.2 across both periods. A majority of patients who improved were using insulin during the COVID-19 era, although some discontinued insulin at some point during the study period. These findings suggest that consistent insulin therapy may have helped maintain glycemic control despite healthcare disruptions. This study highlights the importance of sustained medication management and suggests that integrating telehealth and pharmacist-led care could support diabetes control during future healthcare system challenges. Full article

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

13 pages, 327 KiB

Open AccessArticle

Polysubstance Use and Social Sequelae in Women of Reproductive Age with Recent Marijuana Use

by Sean Hyungwoo Kim, Hua Min, Hong Xue and Panagiota Kitsantas

Pharmacy 2025, 13(4), 92; https://doi.org/10.3390/pharmacy13040092 - 2 Jul 2025

Abstract

Polysubstance use (PSU) involving marijuana among women of reproductive age (WRA) is linked to psychosocial harm, yet research on the combined effects of marijuana with stimulants, opioids, tobacco, and binge drinking remains limited. The purpose of this study was to assess the prevalence [...] Read more.

Polysubstance use (PSU) involving marijuana among women of reproductive age (WRA) is linked to psychosocial harm, yet research on the combined effects of marijuana with stimulants, opioids, tobacco, and binge drinking remains limited. The purpose of this study was to assess the prevalence of PSU in WRA with past month MJ use and examine the association between PSU status and social sequelae, including getting in trouble with the law, relationship difficulty with others, and lower achievement in job or educational settings, in this group of women. We used data from the United States 2015–2019 National Survey on Drug Use and Health, which included 11,895 non-institutionalized WRA (18–44 years old) with reported use of MJ in the past month. Descriptive statistics, chi-squared tests, and multivariable logistic regression analyses were conducted to describe the sample and assess associations between PSU and social sequelae. Nearly 4.5% of the women who used MJ in the past month had experienced social sequelae regardless of PSU status. Women who used three or more substances along with MJ had the highest adjusted odds (AOR = 3.18, 95% CI 1.90, 5.31) of social sequelae relative to monosubstance MJ users. Concurrent use of multiple substances significantly increased the likelihood of social sequelae among women MJ users. Full article

► Show Figures

Figure 1

12 pages, 715 KiB

Open AccessArticle

Visual Thinking to Explore “Relational Pharmacology”: Systemic Maps for Managing Non-Selective Antidepressants in Cardiovascular Prevention

by Irene García-Domínguez, Azahara Rodríguez-Luna and Manuel Machuca

Pharmacy 2025, 13(4), 91; https://doi.org/10.3390/pharmacy13040091 - 27 Jun 2025

Abstract

Relational pharmacology introduces an innovative approach using visual thinking to understand how drugs interact with multiple body systems, addressing the limitations of the traditional “reductionist approach”. While conventional pharmacology focuses on individual drug effects, it struggles with the complexities of polypharmacy, where multiple [...] Read more.

Relational pharmacology introduces an innovative approach using visual thinking to understand how drugs interact with multiple body systems, addressing the limitations of the traditional “reductionist approach”. While conventional pharmacology focuses on individual drug effects, it struggles with the complexities of polypharmacy, where multiple medications interact via shared metabolic pathways. This article highlights integrating systemic maps into educational methodologies to empower students in identifying and assessing medication risks. By visualizing the body and drug therapy as interconnected systems, students can better understand complex pharmacological interactions beyond linear frameworks. This approach enables active learning and real-life case analysis, such as cardiovascular prevention with non-selective antidepressants, where multiple drug interactions must be considered. It also fosters global health education by promoting the exchange of effective teaching practices and addressing challenges in healthcare training. Systemic maps prepare students for clinical decision-making by enhancing their ability to manage risks and complex cases effectively. Full article

► Show Figures

Figure 1

15 pages, 988 KiB

Open AccessReview

Historical Process, Status and Future Development of Pharmacovigilance Systems in Chinese Medicine

by Xue Wang, Yinfeng Wang, Xiaomeng Zhang, Bing Zhang and Zhijian Lin

Pharmacy 2025, 13(4), 90; https://doi.org/10.3390/pharmacy13040090 - 26 Jun 2025

Abstract

The definition of pharmacovigilance was first proposed in the 1970s to safeguard public health and the safety of drug use, and to improve the quality of life of patients. China’s traditional medicine has also always contained the idea of vigilance for the safe [...] Read more.

The definition of pharmacovigilance was first proposed in the 1970s to safeguard public health and the safety of drug use, and to improve the quality of life of patients. China’s traditional medicine has also always contained the idea of vigilance for the safe use of medicines in the process of development. In this article, we will discuss the origin and development of the idea of pharmacovigilance in China, the establishment of a realistic system, and the current status of pharmacovigilance construction, and look forward to the development of pharmacovigilance in the future. Full article

► Show Figures

Figure 1

16 pages, 735 KiB

Open AccessSystematic Review

Clinical Outcomes of Pharmacist Involvement in Cardiac Arrest and Trauma Resuscitations: A Scoping Review

by Harshita Patel, Myles Wee, Aaron M. Tejani and Anthony Lau

Pharmacy 2025, 13(4), 89; https://doi.org/10.3390/pharmacy13040089 - 24 Jun 2025

Abstract

Background: The role of clinical pharmacists in the emergency department continues to gain recognition, particularly during cardiac and trauma resuscitations. However, their contributions to patient outcomes remain unclear. The objective of this scoping review with narrative synthesis was to determine the impact of [...] Read more.

Background: The role of clinical pharmacists in the emergency department continues to gain recognition, particularly during cardiac and trauma resuscitations. However, their contributions to patient outcomes remain unclear. The objective of this scoping review with narrative synthesis was to determine the impact of pharmacists on medication and patient outcomes during cardiac and trauma resuscitations and to identify barriers to integration. Methods: A literature search of databases in September 2024 identified randomized and non-randomized control trials, evaluating the impact of pharmacists’ involvement in cardiac or trauma resuscitations. Excluded were studies on acute stroke, acute hemorrhage, and sepsis. Data were extracted and analyzed for primary (e.g., medication errors and Advanced Cardiovascular Life Support [ACLS] compliance) and secondary outcomes (e.g., pharmacists’ education and training). Results: Of the 560 records screened, 26 records were included in the final analysis. Due to heterogeneity, quantitative analysis was not feasible. Among primary outcomes, ACLS guideline compliance and medication errors were commonly reported; mortality and length of stay were less commonly reported. ACLS certification improved pharmacists’ confidence in their tasks. Pharmacists’ presence also correlated with reduced healthcare costs. Conclusions: Our analysis suggests that the involvement of pharmacists in the context of emergency cardiac or trauma resuscitations may benefit direct patient outcomes and indirect outcomes. Full article

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

► Show Figures

Figure 1

15 pages, 322 KiB

Open AccessArticle

Pharmacists’ Perceptions of 3D Printing and Bioprinting as Part of Personalized Pharmacy: A Cross-Sectional Pilot Study in Bulgaria

by Anna Mihaylova, Antoniya Yaneva, Dobromira Shopova, Petya Kasnakova, Stanislava Harizanova, Nikoleta Parahuleva, Rumyana Etova, Ekaterina Raykova, Mariya Semerdzhieva and Desislava Bakova

Pharmacy 2025, 13(3), 88; https://doi.org/10.3390/pharmacy13030088 - 19 Jun 2025

Abstract

Advances in pharmaceutical technology have positioned 3D printing and bioprinting as promising tools for developing personalized drug therapies. These innovations may redefine compounding practices by enabling precise, patient-specific drug formulations. Evaluating pharmacists’ readiness to adopt such technologies is therefore becoming increasingly important. Aim: [...] Read more.

Advances in pharmaceutical technology have positioned 3D printing and bioprinting as promising tools for developing personalized drug therapies. These innovations may redefine compounding practices by enabling precise, patient-specific drug formulations. Evaluating pharmacists’ readiness to adopt such technologies is therefore becoming increasingly important. Aim: The aim of this study is to investigate pharmacists’ knowledge, attitudes, and perceived barriers regarding the application of 3D printing and bioprinting technologies, as well as their perspectives on the regulation and implementation of these technologies in the context of personalized pharmacy. Materials and Methods: A custom-designed questionnaire was developed for the purposes of this pilot study, based on a review of the existing literature and informed by expert consultation to ensure conceptual relevance and clarity. The survey was conducted between September and December 2024. The data collection instrument comprises three main sections: (1) sociodemographic and professional characteristics, (2) knowledge regarding the applications of 3D printing and bioprinting in pharmacy, and (3) attitudes toward the regulatory framework and implementation of these technologies. Results: A total of 353 respondents participated, and 65.5% of them (n = 231) correctly distinguished between the concepts of “3D printing” and “bioprinting.” More than 25% (n = 88) were uncertain, and 8.5% (n = 30) were unable to differentiate between the two. Regarding the perceived benefits of personalized pharmacy, 83% (n = 293) of participants identified “the creation of personalized medications tailored to individual needs” as the main advantage, while 66% (n = 233) highlighted the “optimization of drug concentration to enhance therapeutic efficacy and minimize toxicity and adverse effects.” Approximately 60% (n = 210) of the pharmacists surveyed believed that the introduction of 3D-bioprinted pharmaceuticals would have a positive impact on the on-site preparation of customized drug formulations in community and hospital pharmacies. Lack of regulatory guidance and unresolved ethical concerns were identified as primary barriers. Notably, over 40% (n = 142) of respondents expressed concern that patients could be subjected to treatment approaches resembling “laboratory experimentation.” Nearly 90% (n = 317) of participants recognized the need for specialized training and expressed a willingness to engage in such educational initiatives. Conclusions: Three-dimensional printing and bioprinting technologies are considered cutting-edge instruments that may contribute to the advancement of pharmaceutical practice and industry, particularly in the field of personalized medicine. However, respondents’ views suggest that successful integration may require improved pharmacist awareness and targeted educational initiatives, along with the development and adaptation of appropriate regulatory frameworks to accommodate these novel technologies in drug design and compounding. Full article

► Show Figures

Figure 1

12 pages, 219 KiB

Open AccessArticle

Pharmacists’ Experiences on Adverse Drug Reactions in Saudi Arabia: A Cross-Sectional Study

by Dalal Salem Bakheit Aldossari, Naeema Taha Alshalaan, Khuloud Salem Alshammari, Fatima Ahmed Lubbad, Mudhi Ratyan Alanazi, Neamah Ahmed Lubbad, Nada Suliman Fahad Alessa and Sheraz Ali

Pharmacy 2025, 13(3), 87; https://doi.org/10.3390/pharmacy13030087 - 19 Jun 2025

Abstract

Background and objectives: As part of Vision 2030, Saudi Arabia aims to strengthen its healthcare system by enhancing efficiency, reducing medical errors, and ensuring drug safety. Evidence on pharmacists’ experiences with adverse drug reactions (ADRs) in daily practice remains limited. Gaining insight into [...] Read more.

Background and objectives: As part of Vision 2030, Saudi Arabia aims to strengthen its healthcare system by enhancing efficiency, reducing medical errors, and ensuring drug safety. Evidence on pharmacists’ experiences with adverse drug reactions (ADRs) in daily practice remains limited. Gaining insight into their perspectives is essential for improving patient safety and optimizing pharmaceutical care. Therefore, we aimed to assess pharmacists’ ability to identify ADRs in daily practice and the subsequent actions taken upon identification. Methods: Between July and August 2024, an email-based invitation was sent to randomly selected registered community and hospital pharmacists in Saudi Arabia to participate in the study, which employed a piloted questionnaire. Results: The study involved 305 pharmacists, including 169 hospital/clinical pharmacists (HCPs, 55.4%) and 136 community pharmacists (CPs, 44.6%). A majority (n = 251, 82.3%) indicated direct patient encounters, while 67.2% (n = 205) reported observing suspected ADRs in the preceding 12 months. Most respondents filed ADR reports to the Saudi Food and Drug Administration/National Pharmacovigilance Centre (HCP = 103, CP = 60) and hospital drug information centers (HCP = 89, CP = 64), with online forms being the favored mode (HCP = 122, CP = 96). Awareness of ADR reporting procedures was reported by 128 HCPs and 80 CPs. Conclusions: More than two-thirds of participants reported having participated in ADR reporting, with greater adherence observed in hospital settings. Pharmacists predominantly depend on the Saudi Food and Drug Administration/National Pharmacovigilance Centre and hospital drug information centers for reporting, with a preference for online submission methods. Targeted educational interventions addressing gaps in knowledge, reporting procedures, and form complexity could improve ADR reporting practices. These findings support the need for structured training and policy measures to strengthen pharmacovigilance system. Full article

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

14 pages, 732 KiB

Open AccessArticle

Application of Fuzzy AHP for Medication Decision Making in Iron-Chelating Medications for Thalassemia

by Saeed Barzegari, Hosein Rostamian, Ehsan Firoozi-Majd and Ibrahim Arpaci

Pharmacy 2025, 13(3), 86; https://doi.org/10.3390/pharmacy13030086 - 15 Jun 2025

Abstract

Iron overload is a significant concern for patients with thalassemia and often necessitates the use of iron-chelating agents to mitigate the associated complications. Selecting the most appropriate chelation therapy from the available options is a complex decision for healthcare professionals. To support this [...] Read more.

Iron overload is a significant concern for patients with thalassemia and often necessitates the use of iron-chelating agents to mitigate the associated complications. Selecting the most appropriate chelation therapy from the available options is a complex decision for healthcare professionals. To support this decision-making process, this study investigates the application of the “Fuzzy Analytic Hierarchy Process” (FAHP) for medication selection in thalassemia patients requiring iron-chelation therapy. In this study, 20 hematologists participated, and matrices related to the FAHP model were used to evaluate three primary iron chelators: deferoxamine, deferasirox, and deferiprone. The results revealed that deferiprone was the most effective choice, while deferasirox outperformed the others in terms of cost and patient satisfaction. Notably, deferoxamine exhibits the highest rate of side effects, followed by deferiprone and deferasirox. The results obtained from the FAHP analysis indicated a consensus among experts and highlighted deferasirox as the optimal choice for treating chronic iron overload in thalassemia patients. The study demonstrates the practical applicability of the FAHP methodology in guiding informed decisions for iron-chelation therapy. It provides insights to help healthcare professionals optimize treatment strategies for patients with thalassemia. Full article

► Show Figures

Figure 1

12 pages, 836 KiB

Open AccessArticle

Insulin Glargine Biosimilar Prescribing and Cost Trends in the United Kingdom’s Primary Care from 2020 to 2024

by Murtada Alsaif and Zoë Blumer

Pharmacy 2025, 13(3), 85; https://doi.org/10.3390/pharmacy13030085 - 14 Jun 2025

Abstract

Background/Objectives: Long-acting insulin glargine (iGlar) has been available as a biosimilar since 2014 in the UK. We reviewed previous prescribing to evaluate if the anticipated cost savings with biosimilars were realized with iGlar. Methods: This study investigated prescribing patterns of long-acting iGlar (100 [...] Read more.

Background/Objectives: Long-acting insulin glargine (iGlar) has been available as a biosimilar since 2014 in the UK. We reviewed previous prescribing to evaluate if the anticipated cost savings with biosimilars were realized with iGlar. Methods: This study investigated prescribing patterns of long-acting iGlar (100 units/mL) in cartridges and pre-filled pens from 2020 to 2024 across primary care organizations in England, Northern Ireland, Scotland, and Wales. Results: iGlar prescribing declined in all of the four nations. From 2020 to 2024, the total prescribed quantity of biosimilars persistently increased in all countries, reaching 24% in England, 5% in Northern Ireland, 24% in Scotland, and 11% in Wales, all in 2024. Consequently, the proportion of Lantus prescriptions (as quantity) decreased but continued to exceed that of all available iGlar products combined in all countries in all years analyzed. By 2024, Lantus was also priced lower than the most common biosimilar, Abasaglar, across all nations. Conclusions: The introduction of biosimilars does not automatically result in altered prescribing practices, though we show that the most commonly prescribed iGlar was also the least expensive product at the end of the analysis period. At launch and for several years after, biosimilars failed to gain strong utilization, despite cost advantages, highlighting the need for active switching policies and prescriber engagement. Full article

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

► Show Figures

Figure 1

10 pages, 510 KiB

Open AccessArticle

Real-World Experience of L-Glutamine in Sickle Cell Disease: A Retrospective Observational Study

by Shouq Turkistani, Atika AlHarbi, Mansoor Khan, Aeshah AlAzmi, Sultan Almutairi, Naglla Elimam and Sultan Alotaibi

Pharmacy 2025, 13(3), 84; https://doi.org/10.3390/pharmacy13030084 - 13 Jun 2025

Abstract

Sickle cell disease (SCD) affects millions globally, with approximately 0.26% of the Saudi population impacted. Despite standard treatments, patients frequently experience vaso-occlusive crises (VOCs). This retrospective observational study evaluated the real-world effectiveness of L-glutamine (Endari^®) in reducing SCD-related complications in the [...] Read more.

Sickle cell disease (SCD) affects millions globally, with approximately 0.26% of the Saudi population impacted. Despite standard treatments, patients frequently experience vaso-occlusive crises (VOCs). This retrospective observational study evaluated the real-world effectiveness of L-glutamine (Endari^®) in reducing SCD-related complications in the Saudi population, where data remain limited. Patients aged five and older who received L-glutamine from June 2019 to June 2023 were included. The primary endpoint was VOC frequency through week 48. Descriptive statistics and paired t-tests compared outcomes before and after treatment. Fifteen patients (median age 12 years, 53% female) met the inclusion criteria; all were on maximum tolerated hydroxyurea. Eleven completed 48 weeks, showing a median VOC reduction from 4 to 3 (p = 0.44). Hospital stay duration remained unchanged (median 7 days, p = 0.72). Laboratory parameters were largely stable, except for a 61.9% increase in reticulocyte count (p = 0.03). The estimated annual treatment cost exceeded SAR 2 million (USD ~547,840). L-glutamine did not produce statistically significant improvements in VOC frequency, though numerical trends were observed. Given the small sample size and limited statistical power, the findings are exploratory. Larger, well-powered, multicenter studies are needed to confirm L-glutamine’s potential benefits in this population. Full article

► Show Figures

Figure 1

10 pages, 312 KiB

Open AccessArticle

Real-World Evidence Assessing the Safety of Administering Intravenous Rituximab Biosimilar in the First Cycle and Subcutaneous Rituximab in Subsequent Cycles in B-Cell Lymphoma Patients

by Tamather Almandeel, Mansoor Ahmed Khan, Ashwag Algethami, Mashael S. Alaboud, Munirah A. Alkathiri, Mohammed Aseeri, Ahmed Absi, Mubarak Almansour and Abdullah Alotaibi

Pharmacy 2025, 13(3), 83; https://doi.org/10.3390/pharmacy13030083 - 11 Jun 2025

Abstract

Background: Biosimilar versions of rituximab have similar safety and efficacy as the reference product across all indications based on the extrapolation principle. Our organization replaced intravenous (IV) rituximab (Mabthera) with IV rituximab (Truxima-Biosimilar) in 2021. Hence, our practice changed to providing first cycles [...] Read more.

Background: Biosimilar versions of rituximab have similar safety and efficacy as the reference product across all indications based on the extrapolation principle. Our organization replaced intravenous (IV) rituximab (Mabthera) with IV rituximab (Truxima-Biosimilar) in 2021. Hence, our practice changed to providing first cycles of IV rituximab (Truxima-Biosimilar) instead of rituximab (Mabthera), and if the first cycle was completed without severe infusion-related reactions (IRRs), then subsequent cycles were given with subcutaneous (SC) rituximab as per institutional guidelines. However, the safety of this approach has not been evaluated. Methods: A retrospective study was conducted at the Princess Nourah Oncology Center in Saudi Arabia. The primary objective was to assess IRRs after using IV rituximab (Truxima-Biosimilar) in the first cycle followed by SC rituximab in subsequent cycles. Results: Of the 71 patients reviewed, 35 patients met the eligibility criteria. Only one (3%) patient developed an IRR. However, it was a Grade 1 IRR, as per CTCAE.V5, and the patient was able to complete the remaining IV infusion successfully. Hence, all patients transitioned from IV rituximab biosimilar to SC rituximab Mabthera. Conclusions: This real-world study demonstrates that transitioning from IV rituximab biosimilar to SC Mabthera is a well-tolerated and safe practice, confirming the extrapolation principle of biosimilars. Full article

► Show Figures

Figure 1

11 pages, 237 KiB

Open AccessArticle

Potentially Inappropriate Medication Use Among Older Adults with Cognitive Impairment and Dementia Attending Primary Care-Based Memory Clinics

by Rishabh Sharma, Linda Lee, Feng Chang and Tejal Patel

Pharmacy 2025, 13(3), 82; https://doi.org/10.3390/pharmacy13030082 - 7 Jun 2025

Abstract

Potentially inappropriate medications (PIMs) increase the risk of adverse drug reactions, hospitalizations, and worsened health outcomes in older adults, particularly those with cognitive impairment (CI) or dementia. This study was designed to compare the Beers Criteria^® 2023 and the Screening Tool of [...] Read more.

Potentially inappropriate medications (PIMs) increase the risk of adverse drug reactions, hospitalizations, and worsened health outcomes in older adults, particularly those with cognitive impairment (CI) or dementia. This study was designed to compare the Beers Criteria^® 2023 and the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) Criteria 2023 to determine which identifies a higher prevalence of PIMs in older adults with CI or dementia attending primary care-based memory clinics. PIMs were identified with the use of the updated Beers Criteria^® 2023 and STOPP Criteria 2023, from electronic medical records of study participants from January to August 2023. The study identified PIMs and analyzed associated risk factors using bivariate logistic regression. Of 44 older adults, 47.7% (n = 21) were detected with one PIM based on Beers Criteria^® 2023, and 27.2% (n = 12) were identified with at least one PIM using STOPP criteria. Using the updated Beers Criteria^® 2023 and STOPP Criteria 2023, the study identified 50 PIMs (averaging 0.9 PIMs per participant) based on Beers Criteria^® and 31 PIMs (averaging 0.6 PIMs per participant) based on STOPP Criteria, respectively. Bivariate logistic regression revealed a significant association between having nine or more comorbidities and PIMs according to Beers Criteria^® (odds ratio (OR) = 8.4, 95% confidence interval (CIn) = 1.27–55.39, p = 0.027). This study highlights the high prevalence of PIMs among older adults with CI or dementia, emphasizing the need for regular medication reviews. Implementing both criteria can enhance medication management and improve patient safety in this vulnerable population. Full article

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

20 pages, 657 KiB

Open AccessArticle

Jamaican Community Pharmacists-Determined Barriers to Availability of Smoking Cessation Aids

by Aleena Langlay, Jeanine Abrons and Andrea Daly

Pharmacy 2025, 13(3), 81; https://doi.org/10.3390/pharmacy13030081 - 5 Jun 2025

Abstract

Objectives: To determine the willingness of Jamaican pharmacists to stock and dispense smoking cessation aids and determine barriers to selling products. Design: A descriptive study that utilized pharmacist-completed surveys. The participants received a sectionalized survey and a structured questionnaire tool. Data collection took [...] Read more.

Objectives: To determine the willingness of Jamaican pharmacists to stock and dispense smoking cessation aids and determine barriers to selling products. Design: A descriptive study that utilized pharmacist-completed surveys. The participants received a sectionalized survey and a structured questionnaire tool. Data collection took place over six weeks. Setting: Pharmacists practicing in pharmacies registered by the Pharmacy Council of Jamaica (PCJ) Participants: A total of fifty-seven registered community pharmacists. Results: Most pharmacies (87.7%) do not stock smoking cessation aids. The most identifiable products were nicotine patches/nicotine gum. Pharmacists’ barriers to selling were cost (42%), lack of knowledge of the process of obtaining cessation aids (27.3%), and low demand from patients/clients (22.7%). Most pharmacists (86%) were willing to stock cessation aids. Of the total product requests, 61.2% were lodged by persons 26–50 years old. The stocking of products was not independent of location (p < 0.005). Conclusion: The barriers to the availability of smoking cessation aids, once adequately addressed, could positively enhance the achievement of smoking cessation practices. Full article

► Show Figures

Figure 1

14 pages, 229 KiB

Open AccessArticle

Qualitative Analysis of Test-to-Treat Benefits and Barriers for Pharmacists in Rural Washington State

by Bradley Brown, Megan Undeberg, Angela Stewart and Kimberly McKeirnan

Pharmacy 2025, 13(3), 80; https://doi.org/10.3390/pharmacy13030080 - 3 Jun 2025

Abstract

Background: Rural communities in the United States experience significant barriers in accessing healthcare, including inadequate numbers of providers and local healthcare facilities. These barriers are exacerbated during seasons with high rates of respiratory diseases when rural clinics and providers may be overwhelmed. When [...] Read more.

Background: Rural communities in the United States experience significant barriers in accessing healthcare, including inadequate numbers of providers and local healthcare facilities. These barriers are exacerbated during seasons with high rates of respiratory diseases when rural clinics and providers may be overwhelmed. When mild, many of these respiratory diseases may be managed effectively in alternate settings, including community pharmacies. Investigators interviewed pharmacists in Washington State to explore the capacity of pharmacists and pharmacies to provide test-to-treat services for COVID-19, influenza, and strep throat. Methods: A qualitative study design was used to conduct key informant interviews with pharmacists who precepted student pharmacists from a local university. Twenty interviews were conducted, transcribed, and qualitatively evaluated to identify themes. The 5 A’s of Access were utilized as a theoretical framework. This framework describes five domains of access, including affordability, availability, accessibility, accommodation, and acceptability. Results: Qualitative analysis identified several themes that described the benefits of offering test-to-treat services in rural communities, such as reducing geographical barriers to accessing care, reducing wait times for patients, and reducing the number of patients seeking higher levels of care for basic treatments. Barriers to offering test-to-treat services identified by pharmacist participants included difficulties with receiving payment for services, challenges with adequate staffing, and the lack of awareness among many people in rural communities that pharmacies offer test-to-treat services. Conclusions: Rural communities experience challenges with the limited capacity of healthcare providers to meet the needs of patients in their communities. The results of this qualitative analysis may be useful to pharmacists in U.S. states where collaborative drug therapy agreements or collaborative practice agreements allow the provision of test-to-treat services. By providing test-to-treat services, pharmacists can increase access to care for rural patients and alleviate the burden of offering these services from other healthcare providers. Full article

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

17 pages, 563 KiB

Open AccessArticle

Knowledge, Attitudes, and Practices Toward Self-Medication Among Pharmacy Undergraduates in Penang, Malaysia: A Cross-Sectional Study

by Bayan F. Ababneh, Hisham Z. Aljamal and Rabia Hussain

Pharmacy 2025, 13(3), 79; https://doi.org/10.3390/pharmacy13030079 - 2 Jun 2025

Abstract

Background: Self-medication is the use of medicinal products to treat self-diagnosed disorders or symptoms without the prescription or supervision of a healthcare professional. There is a lack of data about self-medication knowledge, attitudes, and practices among pharmacy undergraduates in Malaysia. This study assessed [...] Read more.

Background: Self-medication is the use of medicinal products to treat self-diagnosed disorders or symptoms without the prescription or supervision of a healthcare professional. There is a lack of data about self-medication knowledge, attitudes, and practices among pharmacy undergraduates in Malaysia. This study assessed the knowledge, attitudes, and practices among undergraduate pharmacy students in Penang regarding self-medication. Method: A descriptive cross-sectional study was conducted using a self-administered, web-based survey (Google Forms), which was completed and responded to by 203 undergraduate pharmacy students from Penang, Malaysia, between October and December 2023. Descriptive statistics were used to summarize the socio-demographic characteristics of the participants. Associations between the socio-demographic characteristics of the participants and the knowledge, attitudes, and practices regarding self-medication were assessed using a chi-square test. Regression analyses were carried out to determine whether the socio-demographic characteristics of the participants were associated with practices of self-medication. Results: A total of 203 of the undergraduate pharmacy students completed the questionnaire. More than half of the participants’ age ranged between 19 and 21 years old, the majority were females (77.3%), and 31.5% of the participants had family members employed in the healthcare sector. Most respondents showed good knowledge in a variety of domains: 97.5% acknowledged the potential for drug interaction with other medications, indicating a high awareness of proper self-medication practices. A positive attitude was found regarding participants’ attitudes toward self-medication, and 65.5% practiced self-medication, primarily for treating minor illnesses (75.9%). Common conditions included fever (83.3%), cough/cold/flu (76.8%), and headache (71.4%). Reasons for not self-medicating included the absence of illness (20.2%), lack of knowledge/prior experience (19.2%), and fear of using the wrong medication (18.7%). Only academic year level was the predictor of practicing self-medication within the last six months among the participants. Conclusions: Generally, the participants possessed good knowledge and positive attitudes toward self-medication. The study revealed no significant associations between demographic characteristics and knowledge or attitudes. Insights from this research contribute to understanding self-medication practices among pharmacy students in Penang, informing potential interventions to promote responsible self-medication practices. Full article

► Show Figures

Figure 1

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