Pharmacy

Pharmacy practice is expanding into clinical, digital, and ethically sensitive areas, yet professional support may not translate into implementation. Building on previous studies in point-of-care testing (POCT), artificial intelligence (AI), and assisted suicide, this exploratory convergent mixed-methods study used a purpose-designed symposium workshop focused on responsible implementation. Participants completed an anonymous 15-item questionnaire and submitted anonymous online barrier entries during the workshop. Of 45 returned questionnaires, 42 met the predefined completeness criterion for inferential analyses; 186 barrier entries were analyzed using structured qualitative content analysis. POCT showed high perceived capability, relevance, support, and willingness, while barriers centered on resources and economic viability. AI was considered highly relevant, but perceived capability was lower and concerns focused on reliability, regulation, accountability, and uncritical use. Pharmacist involvement in assisted suicide was broadly supported, while perceived capability was lower and barriers spanned ethical, organizational, legal, communicative, and emotional domains. These field-specific patterns were heuristically summarized as endorsement-capacity, capability-governance, and support-preparedness gaps. The labels are descriptive, non-validated summaries rather than participant-level mismatches. The findings suggest that professional support alone is an insufficient indicator of implementation readiness, as each activity was characterized by a distinct combination of capability, organizational capacity, and governance or support needs. Full article

Non-steroidal anti-inflammatory drugs (NSAIDs) have been among the most frequently prescribed medications worldwide for several decades. Ongoing vigilance regarding their potential adverse effects on the gastrointestinal tract and kidneys remains critical. Over the past twenty years, accumulating evidence has indicated an increased cardiovascular (CV) risk associated with NSAID use, posing a significant challenge for both patients and healthcare providers. This issue has prompted the US Food and Drug Administration (FDA) to issue explicit warnings concerning NSAID use. Recent data and comparative analyses of existing publications provide a basis for critically re-evaluating the association between NSAID use and potential CV risk, particularly when NSAIDs are administered for approved indications such as the treatment of pain and inflammation in patients with arthritis. The debate regarding the CV safety of NSAIDs centers on establishing causality. It is necessary to determine whether NSAIDs directly induce CV risks by initiating new pathological processes or act as modulators that influence the severity of pre-existing susceptibilities. The evidence presented in this review supports the view that NSAIDs do not create new CV risks but reduce CV incidents in patients with inflammatory pathologies such as arthritis. Conversely, NSAIDs have been observed to slightly increase CV risk when used at inappropriate high doses or in patients without inflammatory pain, such as those with Alzheimer’s disease or other vulnerable populations. This perspective shifts the focus from causality to context-based risk management. The distinction between risk generation and risk modulation is proposed as a framework for the rational use of NSAIDs. The potential for NSAIDs to exacerbate pre-existing CV risk is dependent on the context of morbidity, and is low when used for anti-inflammatory indications in populations with the highest benefit, i.e., those with inflammatory morbidities. A general condemnation of NSAIDs keeps relevant patient populations from the only anti-inflammatory analgetic pharmacotherapy so far available. Full article

Artificial intelligence (AI) is entering medication-use and drug-development workflows, but the AI-specific capabilities needed for pharmacist workforce readiness remain poorly characterized. This pilot environmental scan and qualitative content analysis examined publicly accessible United States employment advertisements covering 1 January 2023 through 10 August 2026. Thirty-four distinct candidate requisitions were audited; 31 met operational criteria. Ten explicitly required AI-related work and formed the primary analytic sample, while 21 AI-enabling informatics, electronic-health-record, automation, analytics, and clinical-decision-support roles were retained as contextual comparators. AI-explicit employers sought pharmacists or PharmD-eligible professionals to evaluate model-generated clinical content, correct unsafe reasoning, construct prompts and cases, curate datasets and reference answers, verify claims, apply structured evaluation frameworks, validate dosing and pharmacokinetic reasoning, provide iterative model feedback, and implement AI-enabled clinical-pharmacology use cases. These activities were synthesized into five AI workforce-readiness competencies: AI-output evaluation and validation; AI systems and workflow literacy; prompt and evaluation-task design; AI performance assessment and improvement; and responsible AI implementation and governance. The framework distinguishes these AI-specific capabilities from the pharmacotherapy, medication-safety, evidence-appraisal, and quantitative expertise required to exercise them safely. These preliminary workforce signals support staged curricular development while requiring larger prospective and stakeholder-validated studies. Full article

The opioid epidemic continues to be a major public health crisis in the United States, and nalmefene has recently emerged as an alternative opioid overdose reversal agent. However, little is known about pharmacists’ awareness and beliefs regarding nalmefene use and distribution. Therefore, the purpose of this study was to assess Alabama pharmacists’ knowledge, perceptions, and behavioral intentions related to nalmefene. This study used a cross-sectional survey design. Practicing pharmacists in the state of Alabama were eligible to participate, and were recruited through the Alabama Board of Pharmacy email listserv. An anonymous online survey was distributed via email, and respondents were eligible to enter a lottery for one of five $100 electronic gift cards. The survey instrument was developed by the investigators, adapted from prior overdose reversal literature and informed by the Theory of Planned Behavior. Primary outcome measures included: knowledge of nalmefene (12 items); perceived barriers regarding nalmefene stocking and recommendations (19 items); and Theory of Planned Behavior concepts including attitudes (15 items), subjective norms (perceived social support) (six items), perceived behavioral control (confidence in ability to stock or recommend nalmefene) (11 items), and behavioral intentions surrounding nalmefene stocking and recommendations (13 items). Outcomes were measured via multiple-choice (objective knowledge) and Likert-type scale (1 = strongly disagree, 5 = strongly agree) questions. Differences in mean scale scores across pharmacy setting (pharmacists employed in inpatient versus outpatient settings), community pharmacy type (chain vs. independent), and geographic location (rural vs. urban) were analyzed using two-sided Mann–Whitney U tests for non-parametric data or t-tests for parametric data, as appropriate. Multiple linear regression analyses examined associations between TPB constructs and pharmacists’ intentions to stock or recommend nalmefene over the next six months. All data were analyzed using SPSS statistical software version 29 with an alpha of 0.05. There were 119 pharmacist respondents (n = 25 inpatient, n = 94 outpatient). The majority were female (68.1%), White (94.1%), and worked in community settings (35.3% independent, 10.9% corporate, 10.1% big-box, 5.0% grocery). Median age was 42 years (IQR: 36–51). Awareness of nalmefene was low: only 39.5% had heard of it and 5.9% had seen it in practice. Inpatient versus outpatient pharmacists reported higher subjective norms external to the workplace (median [IQR]: 3.00 [2.33, 3.58] vs. 2.33 [1.67, 3.00]; p = 0.004) as well as subjective knowledge (mean [SD]: 2.96 [0.94] vs. 2.55 [0.74]; p = 0.023), while outpatient versus inpatient pharmacists reported higher perceived barriers related to fiscal/logistical concerns (mean [SD]: 3.45 [0.59] vs. 3.07 [0.66]; p = 0.009). Among community pharmacists, stocking and procurement confidence was higher among independent versus chain pharmacists (3.75 [3.00–4.17] vs. 3.17 [2.67–3.92]; p = 0.026). Furthermore, external workplace norms among urban pharmacists were higher than among rural pharmacists (2.50 [2.00–3.00] vs. 2.33 [1.67, 2.67]; p = 0.027), while stocking and procurement confidence was higher among rural than urban pharmacists (3.83 [2.83–4.50] vs. 3.17 [2.67–4.00]; p = 0.034). In adjusted reduced regression models, perceived behavioral control regarding nalmefene stocking and procurement (B = 0.189, 95% CI: 0.049, 0.329; p = 0.009), subjective norms external to the workplace (B = 0.232, 95% CI: 0.047, 0.418; p = 0.015), and interprofessional recommendation attitudes (B = 0.237, 95% CI: 0.037, 0.437; p = 0.021) positively predicted nalmefene implementation intentions. These findings suggest practice-setting differences that could be further explored for optimal implementation of nalmefene distribution and access, and highlight the need for targeted education, interprofessional collaboration, procurement guidance, and workflow tools to improve pharmacist preparedness for nalmefene services. Full article

Background: Patients often must change their behaviors to prevent and mitigate the impact of chronic disease, yet deciding to begin and adhere to these changes can be challenging. Motivational interviewing (MI), a patient-centered communication approach, has been utilized by pharmacists to support patients in making these changes. Thus, this systematic review aimed to describe the outcomes of MI interventions by pharmacists and student pharmacists. Methods: Using PRISMA methodology and registered in PROSPERO (CRD42024546509), PubMed, CINAHL, and Web of Science were searched for articles matching the study objective (pharmacists, motivational interviewing, and patient outcomes) from January 2014 to April 2024. Two reviewers independently screened titles, abstracts, and full texts. Data from included articles were extracted, synthesized categorically, and underwent quality assessment using the Mixed Methods Assessment Test. Results: Out of 356 identified articles, 45 were included. Randomized controlled trial designs implemented in ambulatory care or community pharmacies in the Global North were most common. Studies most frequently addressed diabetes, hypertension, and smoking cessation. Overall, MI interventions were associated with positive or neutral outcomes, with no studies reporting worsened results. Conditions such as hypertension and lipidemia and the need for nicotine cessation had positive outcomes, while diabetes and cardiovascular conditions contained both positive and neutral outcomes. Conclusions: Given its low implementation burden, MI represents a potential strategy for pharmacists and student pharmacists to improve patient outcomes, though future research should evaluate intervention fidelity and expand settings studied. Full article

Attendance format may be associated with the learning-support effects of preparatory courses for the National Examination for Pharmacists (NEP). This retrospective observational study examined associations of self-selected attendance format with course-period learning gain and subsequent NEP performance in a four-month HyFlex course for sixth-year pharmacy students. Students received the same course content and examinations and were classified into face-to-face (F2F), live online (LO), or mixed (MIX) attendance groups. Course-period learning gain was defined as the difference in examination score percentage between the post-course and pre-course examinations. The F2F group showed greater learning gain than the LO and MIX groups. Although the NEP pass rate was higher in the F2F group, the difference among groups did not reach statistical significance in the primary analysis (p = 0.086). Similar findings were observed in a sensitivity analysis. In conclusion, F2F attendance was associated with greater course-period learning gain than LO or MIX attendance. However, this advantage was not clearly reflected in NEP outcomes, indicating that course-period learning gain alone may not fully explain final examination performance and continued post-course support may be needed. Because the attendance format was self-selected, these findings should not be interpreted as evidence of a causal effect. Full article

This study evaluates the implementation and associated 30-day outcomes of the “Medication Code” (MC), a secondary prevention bundle for drug-related problems (DRPs), implemented at the Consorci Sanitari de Terrassa (CST), an integrated healthcare organization in Catalonia. The bundle, which combines medication reconciliation, structured medication review, and coordinated communication with primary care, was previously shown to reduce 30-day readmissions in a randomized trial at a large tertiary hospital. Between May 2024 and December 2025, 185 patients attending the emergency department (ED) at CST for a DRP received the secondary prevention intervention bundle. The study assesses the association between implementation of the recommendations and 30-day outcomes, not the effect of the MC bundle itself. Treatment optimization proposals were implemented in 72.4% of patients, either at discharge or during primary care follow-up, supported by a multiprofessional integrated team of pharmacists and primary care practitioners. Implementation of the pharmacotherapeutic proposals was associated with an absolut risk reduction of 30-day ED revisits and DRP-related readmissions. These findings are consistent with previous observations from the original MC program. However, because all included patients received the intervention bundle and outcomes were compared according to implementation status, the study cannot estimate the effectiveness of the MC bundle itself. Full article

Background: Abdominal pain is one of the most common complaints in community pharmacy, yet how individuals define it, which symptoms they associate with it, and how they manage it through self-care remains poorly characterized. Objective: This study aimed to investigate individual perceptions, definitions, and self-care behaviors related to abdominal pain among adults attending Italian community pharmacies and to explore healthcare-seeking behaviors and needs. Methods: A cross-sectional observational survey was conducted among adults attending community pharmacies across Italy. Eligible participants were aged ≥18 years and provided consent for data processing; individuals with cognitive or language barriers were excluded. Thirty-three SIFAC clinical pharmacists administered an expert-reviewed 18-item digital questionnaire (October–December 2025), covering pain perception, healthcare needs, and self-care behaviors. Data were analyzed descriptively. Results: 406 pharmacy customers were enrolled (66.7% female; mean age 44.3 years). Over 93% reported at least one episode in the previous 12 months. The term was applied heterogeneously across localizations, symptom profiles, and attributed causes. The pharmacist was the preferred professional for mild-to-moderate episodes (29.9%) and high-intensity episodes without alarm signs (40.2%). Conversely, the physician was most frequently consulted for high-intensity episodes with alarm signs (53.4%) and first-time episodes (16.1%). Self-medication was reported by 89.4%, with probiotics and intestinal flora products (57.4%), antispasmodics (43.8%), and antacids and gastric acid suppressants (32.5%) most commonly used. Despite this, 55.3% expressed insecurity about autonomous management. Conclusions: The findings indicate that community pharmacists represent an important point of contact in the initial management of abdominal pain among pharmacy customers. The heterogeneous symptom profiles, widespread use of self-medication, and uncertainty reported by many respondents about autonomous management support the potential value of structured symptom assessment, personalized counselling, and clear guidance on when medical evaluation is warranted. Full article

Community pharmacists play an increasingly important role in the care of transgender individuals receiving gender-affirming hormone therapy (GAHT). However, the content of structured pharmaceutical consultations tailored to this population has not yet been clearly defined. This systematic review aimed to identify therapeutic issues relevant to community pharmacy practice in order to inform the development of structured pharmaceutical consultations. A systematic literature review was conducted in accordance with the PRISMA 2020 Statement. The review question was structured using the PICo framework, with transgender individuals as the population, treatment-related issues associated with GAHT as the phenomenon of interest, and community pharmacy practice as the context. Electronic searches of Medline, Google Scholar, and APA PsycINFO were performed on 17 July 2024. Studies involving transgender adolescents or adults receiving GAHT and reporting therapeutic effects, adverse events, monitoring requirements, or medication-related issues were eligible. Two reviewers independently screened the studies and extracted data using a standardized form. Owing to the heterogeneity of study designs, the findings were synthesized narratively according to therapeutic domains relevant to community pharmacy practice. Among 755 screened records, 116 articles met the inclusion criteria. Seven therapeutic domains relevant to pharmacist-led consultations were identified: cardiovascular and cardiometabolic effects, dermatologic effects, gynecologic effects, musculoskeletal effects, biological and pharmacological effects, psychiatric effects, and other adverse effects or specific clinical situations. The evidence highlighted treatment-specific monitoring needs, medication-related risks, fertility and contraceptive considerations, laboratory monitoring requirements, drug–drug interactions, and mental health outcomes. Community pharmacists may contribute to the monitoring and optimization of GAHT, adverse effect management, patient education, fertility and contraceptive counseling, pharmacovigilance, and interdisciplinary collaboration within the scope of their professional practice. These findings provide an evidence-informed basis for the future development of structured pharmaceutical consultations tailored to transgender individuals. Full article

Objective: Colleges of pharmacy have begun offering pre-matriculation programs to refresh and strengthen pharmacy students’ basic math skills. Although previous survey-based research showed that many institutions offer a pre-matriculation program, it remains unclear whether such information is publicly available to prospective pharmacy students. In this study, we conducted a comprehensive review of pharmacy school websites to identify pharmacy schools that publicly describe their pre-matriculation programs. Methods: The official websites of the Accreditation Council for Pharmacy Education pharmacy schools were searched for information on pre-matriculation programs. Results: Out of 142 pharmacy schools, 20 (14%) of those schools were found to describe their pre-matriculation program on their website. Ten of those 20 programs reported that their pre-matriculation program includes a section that teaches calculations. Only one school described a positive impact on student performance in a calculations course. The timing, length, and format of the 20 programs varied. Conclusions: Only a small proportion of U.S. pharmacy schools (14%) publicly disclose the presence of a pre-matriculation program on their institutional websites. Most of the programs do not report outcomes or evidence of impact. Future work should focus on developing calculation-focused pre-matriculation programs and evaluating their effectiveness, while also improving the visibility and availability of information about these programs on institutional websites. Full article

Chronic kidney disease (CKD) affects more than 10% of the global population and represents one of the leading causes of mortality. This study aimed to assess the pharmacotherapy of hospitalized patients aged ≥ 65 years with CKD, focusing on the prevalence of polypharmacy, potentially inappropriate medications (PIMs), potentially clinically significant drug–drug interactions (DDIs), the use of renal-risk drugs (RRDs). A prospective observational study was conducted at the Department of Nephrology and Dialysis of University Hospital Dubrava, including 100 participants. A clinical pharmacist obtained the Best Possible Medication History (BPMH) within 24 h of hospital admission. A total of 1324 comorbidities were recorded (median 12 per patient), along with 985 prescribed medications. Polypharmacy (5–9 drugs) was observed in 43% of patients, while excessive polypharmacy (≥10 drugs) was present in 48%. A total of 258 PIMs were identified, with 89% of patients having at least one PIM (mean 2.6 per patient). Nearly 94% of patients had significantly impaired renal function (G3–G5), and 82% were exposed to inappropriately prescribed RRDs. Contraindicated medications based on renal function were identified in 62% of patients, while 52% had at least one medication prescribed at an unadjusted dose. A total of 1097 potentially clinically significant DDIs were identified, with a mean of 10.9 interactions per patient. The results indicate a high prevalence of polypharmacy, PIMs, potentially clinically significant DDIs and inappropriately prescribed RRDs among older hospitalized patients with CKD, increasing the risk of adverse events and unfavorable treatment outcomes. The findings highlight the importance of the 24 h period following hospital admission as an early opportunity for identifying medication-related problems and optimizing pharmacotherapy in highly vulnerable patients, such as elderly patients with CKD. The study also emphasizes the importance of early involvement of a clinical pharmacist in the pharmacotherapy review and obtaining the BPMH. Full article

Introduction: The development of technology to support medication management and adherence among older adults is rising. Many of these technologies offer diverse features, which add complexity when making a choice. Evidence-based decision aids can inform decision-making in such situations. To inform the development of such a decision aid, it is necessary to review the literature on the development and validation of decision aids that impact medication adherence. Therefore, this study aims to review the available literature on digital decision aids that examine the impact on medication adherence and investigate their features, development, and validation processes. Methods: Adopting the Arksey and O’Malley scoping review framework, a comprehensive search was conducted using PubMed, Embase, CINAHL, IPA and Scopus, using four key concepts: medication adherence, decision aids/tools, older adults, and software/technology. Eligibility criteria included studies that enrolled older adults with a mean/median age of 65 years, published protocols for studies that supported decision-making, published in the English language, and examined and reported the development and/or validation and/or evaluation of digital decision aids. Results: Our search identified 3526 records. After removing 947 duplicates, 2579 records underwent title and abstract screening, of which 726 proceeded to full-text screening. Following full-text screening, one research protocol met all eligibility criteria and was included in the review. An additional 16 systematic reviews were examined to identify potentially relevant studies from their reference lists; however, none of the studies identified through this supplementary screening met the eligibility criteria. Conclusion: The limited number of eligible studies shows a substantial gap in the literature on the development and validation of digital decision aids that support medication adherence among older adults. Further research in this field is needed to develop and validate evidence-based and user-centered digital decision aids for this population. Full article

Background: Health professional training is inherently challenging, with elevated rates of burnout, stress, and diminished well-being. Dedicating curricular time to well-being education may build awareness and skills to help students navigate these demands. Methods: A 10-week well-being elective was designed and implemented for health professional students. Participants in the intervention group were predominantly pharmacy students. This pilot feasibility study used a pre- and post-intervention survey design with a comparison group. Course evaluation, self-reported confidence, knowledge, skills, and attitudes about well-being practices, and measures of empathy, compassion, stress, social support, and burnout were assessed [n = 29 intervention, n = 24 comparison]. Results: Students in the elective reported high satisfaction in the course and significantly greater improvements than those in the comparison group in confidence applying wellness strategies in their personal and academic lives, identifying mental health and wellness resources, preparing nourishing meals, showing up authentically, using mindfulness, practicing self-compassion, as well as in frequency of reflecting on wellness, practicing mindfulness and self-compassion, and applying wellness strategies (all p < 0.05). Prioritization of wellness and feelings of social connection also improved significantly more than in the comparison group. At 6-week delayed follow-up, participants reported significantly greater increases in confidence in preparing nourishing meals, showing up authentically, applying mindfulness, as well as in frequency of mindfulness practice, reflection on wellness, and greater gains in social connection (all p < 0.05). No significant between-group differences were observed on the validated measures of empathy, burnout, or self-compassion. Conclusions: A novel well-being elective designed for health professional students significantly improved select well-being-promoting behaviors and emotional connectedness among participating students. Scalable curricula may bolster student well-being and foster community in demanding academic environments. Full article

The Japanese label specifies suvorexant 20 mg once nightly for adults and 15 mg once nightly for older adults, but dose selection has not been characterized across all doses. We conducted a single-center retrospective drug-utilization study of outpatient prescriptions and inpatient medication orders at a Japanese university hospital during 2023–2025. Dose and prescription-date age were reconstructed, and patient-cluster bootstrap confidence intervals addressed repeated prescriptions. Among 3755 records, 15 mg accounted for 68.4%, 20 mg for 29.9%, and 10 mg and other calculable doses each for 0.9%. Of 3685 age-classifiable 15/20 mg records, 2529 were concordant with the operational age-based framework (68.6%; 95% CI 62.5–74.2). Non-concordance predominantly comprised 15 mg in patients younger than 65 years (841/1646; 51.1%); 20 mg in patients aged 65 years or older occurred in 315/2039 records (15.4%). Concordance was 65.0% in outpatient and 73.8% in inpatient records. Full-dose retention revealed uncommon 7.5- and 30-mg selections that a binary analysis would omit. Together, these findings provide a descriptive, single-center, full-dose, age- and setting-stratified basis for medication-use evaluation and targeted contextual review. Full article

This study explored pharmacy students’ lived experiences of mental health support structures at a University in South Africa. A qualitative phenomenological design was employed, with data collected through semi-structured interviews (n = 20) and document analysis of institutional mental health resources (2020–2024). Thematic analysis revealed five interrelated themes: awareness and visibility of support; barriers to access and utilization; institutional responses to mental health crises; cultural and contextual misalignment; and informal support and coping strategies. Although formal support services were available, students experienced them as fragmented, reactive, and insufficiently integrated into academic life. Barriers to access included long waiting times, stigma, and concerns about confidentiality. Institutional responses to crises were perceived as academically focused, with limited psychological follow-up. Students relied heavily on informal networks, including peers, family, and spirituality. These findings highlight a disconnect between institutional provision and student experience, underscoring the need for more integrated, culturally responsive, and student-centred approaches to mental health support within pharmacy education. Full article

In Ontario, Canada, pharmacists and pharmacy technicians who have completed an approved injection training program are authorized to administer vaccines against 16 vaccine-preventable diseases, with other vaccines requiring an order from a physician or nurse practitioner authorizing their administration to a patient. Authorization to administer vaccines is separate from authorization to dispense vaccines. Some of these vaccines can be dispensed without a prescription, while others require a prescription for the pharmacist to be able to dispense the vaccine and/or to be able to bill the cost of the vaccine to a private insurance plan. Currently, Ontario pharmacists do not have authorization to prescribe any vaccines, whether it be for dispensing or insurance billing purposes. This article describes current practice in Ontario related to vaccine accessibility, summarizes vaccine-prescribing scope of practice adopted by other Canadian provinces and territories, and describes the potential benefits of expanding the pharmacist scope of practice in Ontario to include the prescribing of vaccines. Full article

Objectives: This study aimed to assess pharmacy students’ curricular exposure to deprescribing, their attitudes and preparedness to perform core deprescribing steps, and their understanding of interprofessional roles in the deprescribing process. Methods: A cross-sectional online survey that included undergraduate pharmacy students in their fifth or sixth year of study, who were enrolled in Saudi universities during the academic year 2025/2026. A 43-item self-administered validated questionnaire was used. The independent-samples t-test was used to examine differences in attitudes and preparedness among participants via SPSS 27. Results: In total, 367 students from 23 universities participated in the study; 54.0% were female, and 62.1% were in their fifth year. Familiarity with the term ‘deprescribing’ was reported by 55.3% of participants. Participants demonstrated highly positive attitudes toward the benefits of deprescribing, moderate toward misconceptions, and low toward barriers, with mean percentage scores of 85.08%, 66.50%, and 41.93%, respectively. Participants indicated moderately positive perceptions toward the non-experiential curriculum preparedness to identify and practice deprescribing and self-perception of the ability to perform core deprescribing steps, with mean percentage scores of 70.2% and 77.24%, respectively. Statistically significant differences were observed in the perception of curriculum preparedness by gender (p = 0.038), familiarity with the term deprescribing (p < 0.001), and exposure to deprescribing in the required pharmacy curriculum (p < 0.001). Participants perceived clinical pharmacists as having the greatest role across most stages of the deprescribing process. Conclusions: Undergraduate pharmacy students in Saudi Arabia recognize the value of deprescribing but have limited curricular exposure and moderate perceived preparedness to deprescribe. Full article

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

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