Pharmacy

11 pages, 1477 KB

Open AccessCommentary

Pharmacotherapy of Demodex-Associated Blepharitis: Current Trends and Future Perspectives

by Aleksandra Czępińska-Myszura, Małgorzata Maria Kozioł and Beata Rymgayłło-Jankowska

Pharmacy 2025, 13(5), 148; https://doi.org/10.3390/pharmacy13050148 - 15 Oct 2025

Demodex-associated blepharitis (DAB) is a common condition in our society. Patients report not only uncomfortable and bothersome symptoms but also decreased self-esteem and confidence. Because of its nonspecific signs, pharmacists are often the first healthcare professionals patients consult. What is most concerning [...] Read more.

Demodex-associated blepharitis (DAB) is a common condition in our society. Patients report not only uncomfortable and bothersome symptoms but also decreased self-esteem and confidence. Because of its nonspecific signs, pharmacists are often the first healthcare professionals patients consult. What is most concerning is that DAB can cause serious complications within the eye, such as dry eye syndrome, corneal scarring, or recurrent styes and chalazia. Therefore, we aimed to compile both standard and innovative therapies and compare their effectiveness and safety. As shown, standard methods remain the recommended approach. Alongside antiparasitic agents such as metronidazole or ivermectin, education and improved eyelid hygiene are crucial. However, in recent years, promising new treatments for Demodex blepharitis have emerged, such as Lotilaner Ophthalmic Solution 0.25%, which has shown positive results in clinical trials. Mechanical techniques, including Intense Pulsed Light (IPL) therapy and eyelid peeling procedures such as Blepharoexfoliation, have also demonstrated promise. Due to the notable effects of tea tree oil, studies have explored the lethal effects of other essential oils, such as sage, peppermint, and bergamot oils. These are just a few of the interesting examples discussed in this paper. Full article

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Graphical abstract

17 pages, 2417 KB

Open AccessArticle

From Peak to Plunge: A Multi-Database Analysis of State-Level Disparities in Hydromorphone Use in the US

by Krisha S. Patel, Leana J. Pande, Kenneth L. McCall and Brian J. Piper

Pharmacy 2025, 13(5), 147; https://doi.org/10.3390/pharmacy13050147 - 13 Oct 2025

Abstract

Background: Hydromorphone is a semi-synthetic opioid agonist and a hydrogenated ketone of morphine. This study examined hydromorphone use in the United States (US) using three databases. Methods: The distribution of hydromorphone in the US (in grams) was provided by the US Drug Enforcement [...] Read more.

Background: Hydromorphone is a semi-synthetic opioid agonist and a hydrogenated ketone of morphine. This study examined hydromorphone use in the United States (US) using three databases. Methods: The distribution of hydromorphone in the US (in grams) was provided by the US Drug Enforcement Administration’s Automated Reports and Consolidated Orders System (ARCOS) by state, zip code, and business type (pharmacies, hospitals, providers, etc.). Hydromorphone prescription claims were also examined using the Medicaid and Medicare Part D programs from 2010 to 2023. Results: Hydromorphone increased by +30.6% by 2013, followed by a decrease of −55.9% by 2023 in ARCOS. Medicaid prescriptions increased by +39.6% by 2015 and decreased by −48.9% by 2023. Medicare Part D claims increased by +8.5% by 2015 and decreased by −31.9% by 2023. There were also pronounced regional disparities in hydromorphone use identified in ARCOS (158.7-fold), Medicaid (17.5-fold), and Medicare Part D (13.7-fold). Conclusions: Hydromorphone use in the US has decreased substantially from 2010 to 2023. Additionally, these findings highlight considerable regional disparities, which may inform targeted opioid stewardship initiatives and guide policymakers to ensure safe and equitable opioid prescribing practices. Full article

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16 pages, 583 KB

Open AccessArticle

Pharmacy Staff Experiences and Needs During Second Dispense of Driving-Impairing Medicines: A Qualitative Study

by Karin Benning, Liset van Dijk, Johan (Han) J. De Gier and Sander D. Borgsteede

Pharmacy 2025, 13(5), 146; https://doi.org/10.3390/pharmacy13050146 - 9 Oct 2025

Abstract

Driving-impairing medicines (DIMs) are associated with an increased risk of traffic accidents. While Dutch pharmacy staff are expected to counsel patients at the first and second dispense of DIMs, current practice suggests that second-dispense consultations are underutilized. This study explored pharmacy staff’s experiences [...] Read more.

Driving-impairing medicines (DIMs) are associated with an increased risk of traffic accidents. While Dutch pharmacy staff are expected to counsel patients at the first and second dispense of DIMs, current practice suggests that second-dispense consultations are underutilized. This study explored pharmacy staff’s experiences and perceived barriers in addressing driving impairment during the second dispense. Qualitative, semi-structured interviews were performed with 17 staff members in community pharmacies across the Netherlands. Transcripts were coded using thematic analysis in Atlas.ti, applying both deductive and inductive coding strategies to explore current practices and improvement needs. Participants reported that they provided detailed information on medication use, side effects, and driving impairment during the first dispense. In contrast, driving fitness was only discussed during the second dispense when patients initiated the topic, which rarely happened. Barriers to discuss DIMs included time constraints, a lack of protocols or prompts in pharmacy software, limited privacy, and patients’ reluctance to communicate about this topic. Many pharmacy technicians relied on closed questioning and observed a lack of patient initiative. Facilitators included strong patient relationships, access to medical records, and a desire for training in consultation skills. Pharmacy staff expressed the need for improved protocols, better ICT (Information and Communication Technology) integration, and targeted communication tools to support safe use of DIMs. In conclusion, second-dispense consultations for DIMs are underused and can support patients in safer medication use. Improved implementation will lead to better-informed choices about medicines and driving, and strengthen the pharmacy’s contribution to traffic safety. Full article

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

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15 pages, 699 KB

Open AccessArticle

Knowledge, Attitude, Practice, and Barriers Toward Pharmacovigilance Among Pharmaceutical Sales and Marketing Personnel in Saudi Arabia: A Cross-Sectional Study

by Muath A. Alsalloum, Mohammed A. Almutairi, Saud M. Alsahali and Waleed M. Altowayan

Pharmacy 2025, 13(5), 145; https://doi.org/10.3390/pharmacy13050145 - 9 Oct 2025

Abstract

Sales and marketing personnel are among the most knowledgeable individuals regarding the safety of the medications they promote. No previous work has assessed pharmaceutical sales and marketing personnel’s knowledge, attitude, practice (KAP), and barriers toward pharmacovigilance (PV) in Saudi Arabia; therefore, the present [...] Read more.

Sales and marketing personnel are among the most knowledgeable individuals regarding the safety of the medications they promote. No previous work has assessed pharmaceutical sales and marketing personnel’s knowledge, attitude, practice (KAP), and barriers toward pharmacovigilance (PV) in Saudi Arabia; therefore, the present study aimed to assess these aspects and to scrutinize their associations with the subjects’ baseline characteristics. A validated questionnaire comprising five sections (baseline characteristics, knowledge, attitude, practice, and barriers) was disseminated via email networks and social media platforms between 18 March and 31 May 2025. All employees working in the sales and marketing departments of pharmaceutical companies in Saudi Arabia were eligible to participate. Participants’ responses were categorized as good or poor knowledge, positive or negative attitude, good or poor practice, and challenging or non-challenging work environment, based on the cumulative score in each respective section, using a 60% cutoff. A total of 400 participants completed the survey. Of these, about one-third (37.3%) had 2–4 years of professional experience and two-thirds (63%) were employed by multinational companies. Overall, 57% and 83.5% had good knowledge and positive attitude, respectively. The work environment was considered non-challenging by 92.8% of participants, and 61% reported good practice. We noted that holding a non-pharmacy degree was a significant predictor of poor knowledge and a challenging work environment. Additionally, employment in a local company was significantly associated with poor knowledge and practice. Pharmaceutical sales and marketing personnel in Saudi Arabia demonstrated acceptable levels of KAP and reported few barriers toward PV, with an opportunity for improvement. Full article

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18 pages, 311 KB

Open AccessArticle

Anticholinergic and Sedative Medication Burden in Croatian Older Adults: EuroAgeism Cohort Findings

by Margita Držaić, Iva Bužančić, Ingrid Kummer, Andrea Bošković, Dragan Glavaš, Maja Ortner Hadžiabdić, Jovana Brkić and Daniela Fialová

Pharmacy 2025, 13(5), 144; https://doi.org/10.3390/pharmacy13050144 - 6 Oct 2025

Abstract

Use of anticholinergic and sedative medications is potentially inappropriate in older adults due to associated adverse effects, including impaired cognitive and physical function. This study evaluated anticholinergic and sedative burden in Croatian community-dwelling older adults using the Drug Burden Index (DBI) and examined [...] Read more.

Use of anticholinergic and sedative medications is potentially inappropriate in older adults due to associated adverse effects, including impaired cognitive and physical function. This study evaluated anticholinergic and sedative burden in Croatian community-dwelling older adults using the Drug Burden Index (DBI) and examined its association with self-reported health and healthcare utilization over 12 months. This observational, cross-sectional study, part of the EuroAgeism H2020 ESR 7 project, included conveniently sampled adults ≥ 65 years from community pharmacies in three Croatian regions. Data were collected using a standardized research questionnaire. DBI was used to quantify exposure to anticholinergic and sedative medications. Multivariate regression analyses examined associations between DBI and health outcomes, using logistic regression for binary outcomes and linear regression for self-reported health. Among 388 participants (63.7% female, median age 73), most had multimorbidity (median five diagnoses) and polypharmacy (63.9%), while 57% used at least one DBI medication—most commonly diazepam (15.5%) and tramadol (14.7%). High DBI (≥1) independently predicted more emergency department (ED) visits (OR = 2.45) and worse self-rated health (B = −0.26), but not hospitalization. High DBI in older adults was associated with more ED visits and poorer self-rated health, highlighting the need for targeted interventions to reduce anticholinergic and sedative use in this vulnerable population. Full article

13 pages, 966 KB

Open AccessArticle

Impact of Pharmacist Interventions in a Portuguese Hospital: A Study Using the CLEO Multidimensional Tool

by Sofia Silva, Mafalda Jesus, Sandra Faria, Sara Machado and Manuel Morgado

Pharmacy 2025, 13(5), 143; https://doi.org/10.3390/pharmacy13050143 - 5 Oct 2025

Abstract

(1) Background: Pharmacist interventions are key to optimizing medication therapy and improving patient outcomes. The CLEO multidimensional tool assesses the clinical, economic, and organizational impact of these interventions, though its use in Portuguese hospital settings is limited. This study explored the predicted impact [...] Read more.

(1) Background: Pharmacist interventions are key to optimizing medication therapy and improving patient outcomes. The CLEO multidimensional tool assesses the clinical, economic, and organizational impact of these interventions, though its use in Portuguese hospital settings is limited. This study explored the predicted impact of pharmacist interventions in the Oncology Department of a Portuguese hospital, using CLEO to quantify their potential contribution to patient care and healthcare system efficiency;(2) Methods: A retrospective observational study was conducted at the hospital’s Oncology Outpatient Pharmacy between April and December 2024. Data from 144 pharmacist interventions were analyzed, focusing on drug-related problems, corrective actions, and CLEO scores. Descriptive statistics were used for data analysis; (3) Results: The most frequent drug-related problems were incorrect administration frequency (57.6%), drug interactions (22.2%), and incorrect dosing (10.4%). Nearly half of the interventions (47.2%) resulted in prescription corrections. CLEO analysis demonstrated a predicted positive clinical impact (80% of interventions scored 1C–3C), potential economic benefits (40.3% scored 1E), and organizational improvements (79.9% scored 1O), especially in lung, breast, and colorectal cancer treatments; (4) Conclusions: Pharmacist interventions were predicted to be associated with improvements in clinical, economic, and organizational outcomes in oncology care. These findings suggest that systematic documentation and evaluation of interventions using CLEO may enhance patient safety and healthcare efficiency, although further multicenter and prospective studies are needed to confirm these observations. Full article

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Graphical abstract

11 pages, 250 KB

Open AccessArticle

Outcomes of Structured Medication Reviews for Selected Patients in the English National Health Service

by Michael Wilcock, Marco Motta and Chris Burgin

Pharmacy 2025, 13(5), 142; https://doi.org/10.3390/pharmacy13050142 - 1 Oct 2025

Abstract

Structured medication reviews are now a common part of primary care practice, but little information is available on the outcomes of these reviews. We incentivised practices to submit a report via MS Forms supplying information from and the outcomes of the reviews of [...] Read more.

Structured medication reviews are now a common part of primary care practice, but little information is available on the outcomes of these reviews. We incentivised practices to submit a report via MS Forms supplying information from and the outcomes of the reviews of two cohorts of patients (those prescribed potentially addictive medication and those on problematic polypharmacy), as defined in the Primary Care Networks Contract Directed Enhanced Service. Submissions were analysed in Microsoft Excel. By the end of March 2025, 2858 reports were received from 48 of 55 eligible practices, reviewing a total of 34,531 prescribed items, with a mean of 12.1 items reviewed per structured medication review. Results indicated a preference amongst patients for the remote delivery of reviews, though changes to prescribed medication were more common following face-to-face contact. A total of 2706 changes to prescribed medication were made at a mean rate of 0.9 per structured medication review, with pain management being the most common British National Formulary category altered, though this may be because of the cohorts chosen. The most common change across all reviews was the discontinuation of a prescribed item. In reviews for the potentially addictive medication cohort, a reduction was proposed and accepted in 43.5% of cases. Additional interventions, which took place in 83.9% of reviews, were also captured. Full article

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

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16 pages, 997 KB

Open AccessArticle

Community Health Empowerment Through Clinical Pharmacy: A Single-Arm, Post-Intervention-Only Pilot Implementation Evaluation

by Clipper F. Young, Casey Shubrook, Cherry Myung, Andrea Rigby and Shirley M. T. Wong

Pharmacy 2025, 13(5), 141; https://doi.org/10.3390/pharmacy13050141 - 1 Oct 2025

Abstract

Background: The Pharm2Home Initiative’s Community Health Arm adopts a health-equitable approach to chronic disease education and medication therapy management (MTM). We serve senior residents of Solano County, California, who live in affordable housing and have limited financial resources. Aim: This evaluation assesses the [...] Read more.

Background: The Pharm2Home Initiative’s Community Health Arm adopts a health-equitable approach to chronic disease education and medication therapy management (MTM). We serve senior residents of Solano County, California, who live in affordable housing and have limited financial resources. Aim: This evaluation assesses the uptake of chronic disease management recommendations provided by clinical pharmacists during MTM sessions at community events. Methods: The program engaged clinical pharmacists to provide tailored education and healthcare interventions in senior housing facilities. The goal was to empower seniors to manage their health effectively. The sessions covered various topics, including expired or duplicated medications, incorrect medication use, consultations on medication management, immunizations, and lifestyle adjustments. Results: Over an 18-month period, from January 2022 to August 2023, the program involved 65 participants across ten community health events. These events provided approximately 65 h of direct intervention. Many participants reported significant improvements in understanding their treatment plans and navigating their health needs more confidently. Feedback from 60 seniors after the sessions indicated that 88% felt much better informed about their medications, and 75% expressed that their concerns were addressed extremely well. Conclusions: These outcomes demonstrate the importance of clinical pharmacist-led interventions in improving seniors’ medication use and chronic disease management. The initiative’s approach advocates for integrating clinical pharmacists into community health settings, suggesting a scalable model for enhancing person-centered care. However, further studies are necessary to assess the long-term impacts of these interventions and explore their effectiveness across diverse age groups and more complex conditions. Full article

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

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9 pages, 421 KB

Open AccessCase Report

Possible Drug–Radiopharmaceutical Interaction in ^99mTc-Sestamibi Parathyroid Imaging

by Tracia-Gay Kennedy-Dixon, Mellanie-Anne Didier, Keisha Allen-Dougan, Peter Glegg and Maxine Gossell-Williams

Pharmacy 2025, 13(5), 140; https://doi.org/10.3390/pharmacy13050140 - 1 Oct 2025

Abstract

Drug–radiopharmaceutical interactions can significantly alter radiotracer biodistribution, complicating diagnostic accuracy. This case report describes a 64-year-old male who underwent a Technetium-99m-methoxyisobutyl isonitrile (^99mTc-MIBI) parathyroid scan for suspected primary hyperparathyroidism. Initially, the patient was asked to discontinue his medications for his chronic [...] Read more.

Drug–radiopharmaceutical interactions can significantly alter radiotracer biodistribution, complicating diagnostic accuracy. This case report describes a 64-year-old male who underwent a Technetium-99m-methoxyisobutyl isonitrile (^99mTc-MIBI) parathyroid scan for suspected primary hyperparathyroidism. Initially, the patient was asked to discontinue his medications for his chronic illnesses for 24 h prior to the scan. However, the images revealed significantly reduced counts/tracer uptake in the thyroid, parathyroid and cardiac tissues in both the early and delayed phases. After a detailed review of his medication profile, it was postulated that there were potential interactions involving multiple P-glycoprotein (P-gp) substrates with specific emphasis on amlodipine, atorvastatin and telmisartan. The patient was advised to discontinue all medications for 72 h prior to the date of a repeat scan which was scheduled for two weeks after his initial scan. The repeat scan successfully detected a small focus of marked tracer retention in the left inferior parathyroid bed, suggestive of a small parathyroid adenoma. Post-surgery, the focus identified on the scan was removed and histologically confirmed to be a parathyroid adenoma. This is the first report of its kind among nuclear medicine patients in Jamaica. It highlights the importance of reviewing medication history prior to nuclear imaging, particularly when using radiotracers affected by P-gp mechanisms. This is crucial for mitigating against false-negative results, thus ensuring accurate diagnosis and appropriate clinical management. Full article

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

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13 pages, 846 KB

Open AccessArticle

Primary Care Pharmacy Competencies of Graduates from a Community-Focused Curriculum: Self- and Co-Worker Assessments

by Kritsanee Saramunee, Chakravudh Srirawatra, Pathinya Buaban, Surasak Chaiyasong and Wiraphol Phimarn

Pharmacy 2025, 13(5), 139; https://doi.org/10.3390/pharmacy13050139 - 1 Oct 2025

Abstract

Primary Care Pharmacy (PCP) plays a vital role in healthcare systems. This study evaluated the competencies of pharmacy graduates from a community-focused curriculum, emphasizing their skills and personal traits. A structured questionnaire assessed four domains: general characteristics (11 items), PCP skills (16 items: [...] Read more.

Primary Care Pharmacy (PCP) plays a vital role in healthcare systems. This study evaluated the competencies of pharmacy graduates from a community-focused curriculum, emphasizing their skills and personal traits. A structured questionnaire assessed four domains: general characteristics (11 items), PCP skills (16 items: 13 home visit and 3 community engagement skills), PCP personal traits (7 items), and readiness for PCP practice. Two sets of questionnaires were distributed in 2018 to recent pharmacy graduates: one for self-assessment and the other for evaluation by supervisors or co-workers. A 5-point scale (1 = least competent, 5 = most competent) was used. Co-workers gave higher scores than the graduates themselves. In home visit skills, “providing medicine advice” scored highest (4.4 ± 0.6 by graduates; 4.5 ± 0.2 by co-workers), while “performing essential physical exams” scored the lowest (3.5 ± 0.7). For co-workers, the lowest score was “working with a multidisciplinary team” (3.9 ± 0.9). Among community engagement skills, “solving health-related problems” rated highest (3.4 ± 0.7), and “identifying community health needs” rated lowest (3.2 ± 0.7). “Being friendly” and “responsibility” were top-rated personal traits by graduates and co-workers, respectively. The lowest was “coordinating with local organizations.” Graduates showed strong PCP traits and home visit skills but moderate community engagement. Community-based exposure is recommended to enhance these competencies. Full article

(This article belongs to the Special Issue Advances in Experiential Learning in Pharmacy)

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19 pages, 619 KB

Open AccessArticle

Factors, Attitudes, and Prevalence of Self-Medication Among Pregnant Women: A Cross-Sectional Study in Saudi Arabia

by Alla Alhumaid, Noha Alhumaid, Khalid Alkhurayji, Abdallah Alsuhaimi, Fawaz Modahi, Noor Almanidi, Abdullah Almutairi, Abdullah Alanazi and Nayif Modahi

Pharmacy 2025, 13(5), 138; https://doi.org/10.3390/pharmacy13050138 - 1 Oct 2025

Abstract

Background: Self-medication (SM) among women during pregnancy poses a critical risk to maternal health, and SM is still commonly practiced in Saudi Arabia. Therefore, this study aims to assess the factors, attitudes, and prevalence of SM among pregnant women in the Ministry of [...] Read more.

Background: Self-medication (SM) among women during pregnancy poses a critical risk to maternal health, and SM is still commonly practiced in Saudi Arabia. Therefore, this study aims to assess the factors, attitudes, and prevalence of SM among pregnant women in the Ministry of Health (MOH) First Health Cluster. Methods: A cross-sectional design was used among 400 pregnant women who received care at primary, secondary, and tertiary healthcare levels. A structured tool was adopted and modified based on the literature review, expert and focus group interviews, and the experiences of the target participants. The dependent variables included history of illness, access to healthcare services, medication usage, and perception of SM, while the independent variables included socioeconomic status. Statistical Package for the Social Sciences (SPSS), Version 25 was used for analysis. Results: The prevalence of SM was 36.5%. Cough syrup and antipyretics were the most commonly used medications, while hair problems and weight loss were the most frequently reported reasons for SM. The primary sources of information guiding SM behavior were prior prescriptions and previous experience. Education level, occupation, age, number of pregnancies, and miscarriage history were all significantly associated with SM (p < 0.05). Conclusions: SM was found to be frequent among pregnant women in the First Health Cluster, highlighting the need for educational interventions and regulatory measures to reduce unsafe practices and improve maternal health. Full article

(This article belongs to the Special Issue Pharmacy Practice for Women’s/Reproductive Health)

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20 pages, 261 KB

Open AccessArticle

Drug–Drug Interaction Management Among Pharmacists in Jordan: A National Comparative Survey

by Derar H. Abdel-Qader, Khalid Awad Al-Kubaisi, Esra’ Taybeh, Nadia Al Mazrouei, Rana Ibrahim and Abdullah Albassam

Pharmacy 2025, 13(5), 137; https://doi.org/10.3390/pharmacy13050137 - 28 Sep 2025

Abstract

Introduction: Drug–drug interactions (DDI) are a major, preventable cause of patient harm, a challenge amplified in Jordan by rising polypharmacy and documented high rates of medication errors. To date, no study in Jordan has systematically compared hospital and community pharmacists. This study [...] Read more.

Introduction: Drug–drug interactions (DDI) are a major, preventable cause of patient harm, a challenge amplified in Jordan by rising polypharmacy and documented high rates of medication errors. To date, no study in Jordan has systematically compared hospital and community pharmacists. This study aimed to conduct the first national, comparative assessment of DDI management among these two cadres. Materials and Methods: A national, cross-sectional study was conducted with 380 licensed pharmacists (175 hospitals, 205 community) recruited via proportionate stratified random sampling. A validated online questionnaire assessed demographics, objective DDI knowledge, professional attitudes, practices, and barriers. Multivariable logistic regression was used to identify independent predictors of high knowledge and optimal practice. All collected data were coded, cleaned, and analyzed using the Statistical Package for the Social Sciences (SPSS V28.0). Results: Hospital pharmacists achieved significantly higher mean objective knowledge scores than community pharmacists (10.3 vs. 8.1 out of 15, p < 0.001), a gap particularly wide for interactions involving high-risk OTC medications. The primary barrier for community pharmacists was a lack of access to patient data (85.4%), contrasting with high workload and physician resistance in hospitals. Optimal practice was independently predicted by higher knowledge (AOR = 1.25), a hospital practice setting (AOR = 3.65), and was inhibited by perceived physician resistance (AOR = 0.45). Conclusions: Jordanian hospital and community pharmacists operate in distinct worlds of knowledge and practice. A tailored, dual-pronged national strategy is essential. For hospitals, interventions should target interprofessional dynamics. For community pharmacies, health policy reform to provide access to integrated patient data is the most urgent priority. These findings highlight a globally relevant challenge of practice-setting disparities, offering a model for other nations to develop tailored, context-specific interventions to improve medication safety. Full article

15 pages, 437 KB

Open AccessArticle

Knowledge, Attitudes and Behaviours Towards Alcohol Consumption and Cardiovascular Health Among Healthcare Students of South Asian Heritage in the UK: A Qualitative Study

by Jeevan Singh, Samira Osman, Sarah Baig, Yousuf Murad and Zahraa Jalal

Pharmacy 2025, 13(5), 136; https://doi.org/10.3390/pharmacy13050136 - 18 Sep 2025

Abstract

Background: Cardiovascular disease is a leading cause of mortality in England, with South Asians estimated to have a higher risk of CVD development compared to the general population. Harmful drinking is a key risk factor for cardiovascular disease, but little is known about [...] Read more.

Background: Cardiovascular disease is a leading cause of mortality in England, with South Asians estimated to have a higher risk of CVD development compared to the general population. Harmful drinking is a key risk factor for cardiovascular disease, but little is known about drinking behaviours among South Asians, especially those aged 18–25. Objectives: The objectives of this study were (i) to investigate the knowledge of the cardiovascular effects of harmful drinking among young South Asians aged 18–25, and (ii) to explore the perceptions of young South Asians towards the role of the pharmacist in supporting individuals with alcohol-related harm. Methods: Qualitative, in depth, face-to-face, semi-structured interviews were conducted with ten young South Asians, around 30 min in length. The interviews were audio recorded, transcribed verbatim and then thematically analysed. Results: Four superordinate themes emerged: (1) Culture Clash; (2) The Great Escape; (3) Cardiovascular Confusion; and (4) The Ambiguous Pharmacist. These themes highlighted a dichotomy between the drinking behaviours among different South Asian communities, a lack of knowledge regarding the cardiovascular consequences of harmful drinking and mixed views regarding pharmacists’ role in supporting dependence. Participants acknowledged the prevalence of poor cardiovascular health among British South Asians, citing various types of dysfunction and possible causes; however, the effect of drinking specifically was not understood. Most participants would refer a young person struggling with dependence to a pharmacist and would be receptive to discussing drinking with one. However, few commented on any role outside of signposting to other services or healthcare providers. Conclusions: Greater cardiovascular health promotion is needed among South Asians, with an emphasis on the link between excess alcohol consumption and cardiovascular dysfunction. Furthermore, pharmacists must do more to promote greater awareness of the different ways in which alcohol dependence can be supported within the community to encourage young people seeking harm reduction to utilise those services as needed. Full article

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

11 pages, 959 KB

Open AccessArticle

Perceived Knowledge and Confidence of Beta-Lactam Allergy Management Among Pharmacy Students on Advanced Pharmacy Practice Experiences

by Jamie L. Wagner, David R. Oliver, Bruce M. Jones, Kayla R. Stover, Misha T. Watts, Wesley D. Kufel, Lena McDowell, Edoabasi U. McGee, T. Lynn Stevenson and Christopher M. Bland

Pharmacy 2025, 13(5), 135; https://doi.org/10.3390/pharmacy13050135 - 18 Sep 2025

Abstract

Pharmacist engagement in allergy clarification has demonstrated increased appropriate antibiotic use. The purpose of this study was to determine the knowledge and confidence of pharmacy students in their final professional year regarding beta-lactam (BL) allergies. Students from 5 schools of pharmacy participated in [...] Read more.

Pharmacist engagement in allergy clarification has demonstrated increased appropriate antibiotic use. The purpose of this study was to determine the knowledge and confidence of pharmacy students in their final professional year regarding beta-lactam (BL) allergies. Students from 5 schools of pharmacy participated in a 22-question survey pertaining to experience with drug allergies, knowledge of BL allergies, and confidence regarding BL allergy management. Data were summarized among all respondents and further analyzed by infectious disease (ID) interest. A total of 160/521 students responded to the survey (31%). Most students (73%) had no course dedicated to drug allergies; however, 84% indicated the topic was taught within the curriculum. Students with an ID interest had a higher perceived knowledge regarding the details of penicillin skin testing (62% vs. 32%), clinical implications of penicillin skin test results (87% vs. 70%), and the principles behind a graded and direct penicillin challenge (64% vs. 41%). These students were more confident in educating patients about a perceived penicillin allergy (34% vs. 15%). Perceived knowledge and confidence of BL allergies were low, especially in high-level interventions. Targeted training in beta-lactam allergy recognition and management within the curriculum should be considered to improve upon these findings. Full article

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

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11 pages, 3593 KB

Open AccessArticle

A Revised Mixed-Approach Rubric for the Quality of Academic Posters

by Michael J. Peeters, Megan A. Kaun and Kimberly A. Schmude

Pharmacy 2025, 13(5), 134; https://doi.org/10.3390/pharmacy13050134 - 17 Sep 2025

Abstract

The quality of posters at pharmacy conferences can vary. We created a mixed-approach rubric (MAR) for poster quality. Evidence from multiple sources (systematic review, further analysis of rater scores, verbal feedback from raters) showed the need to slightly modify that MAR, which we [...] Read more.

The quality of posters at pharmacy conferences can vary. We created a mixed-approach rubric (MAR) for poster quality. Evidence from multiple sources (systematic review, further analysis of rater scores, verbal feedback from raters) showed the need to slightly modify that MAR, which we accomplished. Our objectives here were to re-evaluate scoring using this revised MAR (rMAR) and to further examine the attributes of lower-quality versus higher-quality posters. Two faculty raters independently scored each poster using the rMAR for recent posters presented at a pharmacy education conference. The Rasch Measurement Model provided psychometric evidence and poster-quality measures. These measures were then linear-regressed with attributes of logical sequencing, QR-code presence/use, submission abstract presence, and wordiness. Moreover, Traditional vs. Contemporary poster formats were compared. Raters scored 642 posters (267 from 2023, 375 from 2024). The Rasch Measurement Model showed a distinct separation of posters into lower quality versus higher quality. The rMAR’s rating scale continued to function well (like the original MAR had) among multiple raters. Poster-quality measures were significantly positive when linearly regressed with logical sequencing, QR-code presence/use, absence of submission abstract, and decreased wordiness. Moreover, Contemporary poster formats (either Persky-style or Billboard-style) were higher quality on average than Traditional poster formats. This evidence-based rMAR showed a helpful validation of poster-quality scores. Regression confirmed findings from the initial MAR (before revision), and choice of poster format proved a notable decision affecting poster quality. Full article

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13 pages, 236 KB

Open AccessArticle

Developing a Theoretically Informed Strategy to Enhance Pharmacist-Led Deprescribing in Care Homes for Older People

by Linda Birt, David Wright, David P. Alldred, Christine M. Bond, Richard Holland, Carmel Hughes and Sion Scott

Pharmacy 2025, 13(5), 133; https://doi.org/10.3390/pharmacy13050133 - 16 Sep 2025

Abstract

Polypharmacy is prevalent in older people residing in care homes. Deprescribing, reducing or stopping harmful or unnecessary medicines, leads to improvements in patient- and health-system-orientated outcomes. This study identified the barriers and enablers to pharmacists proactively deprescribing in United Kingdon care homes. It [...] Read more.

Polypharmacy is prevalent in older people residing in care homes. Deprescribing, reducing or stopping harmful or unnecessary medicines, leads to improvements in patient- and health-system-orientated outcomes. This study identified the barriers and enablers to pharmacists proactively deprescribing in United Kingdon care homes. It draws on methods from behavioural science. Twenty-nine participants who had previously taken part in a deprescribing randomised control trial (sixteen pharmacists, six primary care doctors, and seven care home managers) were interviewed. Data were mapped to the Theoretical Domains Framework to understand pharmacists’ deprescribing behaviour. Barriers were deprescribing seen as risky and perceived resistance to deprescribing by residents, their families, and care home staff. Enablers were seeing benefits from deprescribing, part of a pharmacists’ role, and endorsement from a doctor. Ways to change pharmacist behaviour were identified from a suite of behaviour change techniques (BCT). Using a modified Nominal Group Technique, 15 staff (six pharmacists, five primary care doctors, and four care home managers) naïve to deprescribing interventions completed an online survey to assess the feasibility and acceptability of implementing the 27 BCTs. Seven BCTs achieved a more that 80% consensus on all implementation criteria. In a consensus workshop, the staff group discussed practical ways the BCTs might work in primary care practice. Fourteen UK policy and practice leaders worked with the researchers to develop recommendations from the consensus workshop into a policy briefing. In conclusion, this study provides detail on using a theory-informed approach to translate research into policy to inform deprescribing practices. Full article

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

10 pages, 206 KB

Open AccessArticle

Scaffolded Medication Therapy Management in a Pharmacy Skills Laboratory: A Structured Approach to Skill Development

by Kimberley J. Begley, Molly C. Goessling, Tara M. Eickhoff and Timothy P. Ivers

Pharmacy 2025, 13(5), 132; https://doi.org/10.3390/pharmacy13050132 - 15 Sep 2025

Abstract

Pharmacists are increasingly expected to deliver medication therapy management (MTM) services, yet many pharmacy students report insufficient confidence and preparedness in executing these complex tasks. This study evaluated a scaffolded MTM instructional series integrated into a second-year pharmacy skills laboratory, aiming to enhance [...] Read more.

Pharmacists are increasingly expected to deliver medication therapy management (MTM) services, yet many pharmacy students report insufficient confidence and preparedness in executing these complex tasks. This study evaluated a scaffolded MTM instructional series integrated into a second-year pharmacy skills laboratory, aiming to enhance student competence through progressive, structured learning. A mixed-methods design assessed changes in self-reported confidence, performance-based outcomes, and reflective insights among 154 students across three educational tracks. The 14-week intervention included sequential activities such as medication history interviews, drug-related problem (DRP) identification, care plan development, and comprehensive MTM simulations. Pre- and post-intervention surveys revealed statistically significant improvements in all 18 confidence domains, with the greatest gains in therapeutic recommendations and prescriber communication. Effect sizes ranged from small to very large (Cohen’s d 0.33–1.05), indicating gains that were both statistically reliable and educationally meaningful. Performance assessments showed consistent proficiency across MTM components, with average scores ranging from 90% to 96%. Qualitative reflections reinforced these findings, highlighting growth in communication, individualized patient care, and professional identity formation. The scaffolded approach aligns with accreditation standards and instructional design theory, offering a model for pharmacy curricula. Despite limitations such as lack of a comparator group and potential response bias, the study demonstrates that scaffolded MTM instruction effectively supports skill acquisition and confidence, preparing students for real-world clinical practice. Full article

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

15 pages, 218 KB

Open AccessArticle

Pharmacist Dispensing of Mifepristone: Evaluation of Knowledge and Support Before and After a Continuing Education Course

by Natalie Morris, Alexa Orosz, M. Antonia Biggs, Sally Rafie and Daniel Grossman

Pharmacy 2025, 13(5), 131; https://doi.org/10.3390/pharmacy13050131 - 15 Sep 2025

Abstract

Medication abortion with mifepristone and misoprostol is a safe and effective method for ending a pregnancy. Pharmacy dispensing of mifepristone was approved by the U.S. Food and Drug Administration in 2023, but educational opportunities for pharmacists were nonexistent. We designed a 1 h [...] Read more.

Medication abortion with mifepristone and misoprostol is a safe and effective method for ending a pregnancy. Pharmacy dispensing of mifepristone was approved by the U.S. Food and Drug Administration in 2023, but educational opportunities for pharmacists were nonexistent. We designed a 1 h continuing education course on medication abortion for pharmacists, which was offered in a live-webinar or recorded-video format over 3 years. It included key medication abortion topics, including medications, patient counseling, relevant policies, and implementing pharmacy dispensing. Using a prepost design, we administered online surveys to participants prior to and after completing the course to assess changes in overall medication abortion knowledge score (six items, Cronbach’s alpha = 0.76) and support for pharmacist dispensing of medication abortion (one Likert-scaled item). During the study period, 279 students and pharmacists took the course, of which 148 completed both the pre- and post-course questionnaires. Adjusted regression analyses demonstrated significant increases in knowledge scores and support for pharmacist dispensing of medication abortion post-course; most thought dispensing mifepristone would be very (21.6%) or somewhat easy (38.5%) to implement, and 75% indicated a willingness to dispense mifepristone if allowed. These findings suggest that video-based education on medication abortion is an effective tool for enhancing pharmacists’ knowledge and support for medication abortion, which could increase access to reproductive health care. Full article

(This article belongs to the Special Issue Pharmacy Practice for Women’s/Reproductive Health)

20 pages, 11681 KB

Open AccessArticle

Pharmacist-Led Prescribing in Austria: A Mixed-Methods Study on Clinical Readiness and Legal Frameworks

by Olaf Rose, Clarissa Egel, Johanna Pachmayr and Stephanie Clemens

Pharmacy 2025, 13(5), 130; https://doi.org/10.3390/pharmacy13050130 - 8 Sep 2025

Abstract

In Austria, community pharmacists may dispense prescription-only drugs in exceptional emergency cases. Hospital pharmacists are permitted to adapt or discontinue therapy with prior physician approval. This mixed-methods study explores how Austrian pharmacists interpret and apply these frameworks, their readiness for expanded roles, and [...] Read more.

In Austria, community pharmacists may dispense prescription-only drugs in exceptional emergency cases. Hospital pharmacists are permitted to adapt or discontinue therapy with prior physician approval. This mixed-methods study explores how Austrian pharmacists interpret and apply these frameworks, their readiness for expanded roles, and the systemic conditions required to support broader clinical engagement. A cross-sectional design was used with two online surveys targeting community and hospital pharmacists. Additionally, 15 semi-structured interviews were conducted (ten community, five hospital pharmacists). Quantitative data were analyzed descriptively; qualitative data were examined using Mayring’s content analysis. Data integration followed a triangulation design via mixed-methods matrices. A total of 238 community and 53 hospital pharmacists responded. Findings show that community pharmacists frequently apply clinical judgment in urgent situations and navigate regulatory grey zones. Over 88% support expanded roles, particularly in continuing contraceptives, managing chronic diseases, and treating infections using point-of-care testing. Hospital pharmacists report limited implementation of their framework, hindered by institutional inertia, staffing shortages, and poor access to patient data. Confidence in clinical pharmacotherapy decisions was limited. Targeted training and policy support are essential. Full article

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