Search Results (303)

People living in rural communities are typically underserved by public transportation services and face challenges in accessing healthcare, jobs, stores, and other destinations. Understanding the lived experiences of people who use public transportation in rural communities can help to inform a more equitable transportation system. This qualitative study gathered the perspectives of community health center employees about the public bus system for Hawai‘i Island, a rural county in the United States. Using a community-engaged research approach, the evaluation team interviewed 10 employees through either in-person small group interviews or online individual interviews between April and July 2023. Transcripts were coded and analyzed using a thematic analysis approach. While all study participants were selected for their interest in commuting to work by bus, most believed the bus was not a reliable or convenient option. Participants shared their experiences about not being able to rely on the bus schedule, feeling unsafe while walking to bus stops or waiting for the bus, and other barriers to using the bus system. Participants also shared their insights about how a reliable bus system would benefit community health center patients who needed transportation to more than just their medical appointments, but also to places like pharmacies, laboratory services, and grocery stores. These findings can be used to initiate discussions around the ways that community health centers can further address transportation as a social determinant of health and inform transportation providers about how to best plan and invest in transportation infrastructure and services to meet the needs of rural populations. Full article

Introduction: During pharmaceutical care, community pharmacists play a crucial role by carrying out interventions aimed at preventing, detecting, and resolving drug-related problems (DRPs) and negative outcomes associated with medication (NOM), simultaneously enhancing patients’ knowledge about their treatments. The chronic use of Benzodiazepines (BZDs) is known to be associated with risks such as tolerance, dependence, and cognitive impairment. Furthermore, the combined use of BZDs with other medications or alcohol may expose patients to significant drug interactions. Objectives: This study aimed to characterize and describe the clinical profile of patients using BZDs, to evaluate the extent of polypharmacy and potential drug interactions, to investigate their level of knowledge regarding BZD treatment, and ultimately, to propose evidence-based interventions from the community pharmacy to contribute to improving patient safety and minimizing risks associated with BZD use. Method: A cross-sectional, descriptive study was conducted in a single community pharmacy in Gran Canaria (Canary Islands, Spain). The study population comprised 125 adult patients with active BZD prescriptions. Data collection was performed through pharmacist–patient structured interviews using a questionnaire that included sociodemographic, clinical, and BZD knowledge variables. Results: Lormetazepam and alprazolam were the BZDs most frequently prescribed and dispensed. Potential drug interactions with other medications were detected in 38.4% of BZD users. Notably, 61.5% of patients using BZDs also reported the concurrent use of opioid analgesics, with tramadol being the most common opioid (48.1% of BZD users were also treated with tramadol). Statistically significant differences were observed between patients with and without BZD and other drug interactions in several adverse outcome variables, including the risk of falls (p = 0.003), cognitive impairment (p = 0.047), and urinary incontinence (p = 0.016). Existing BZD dependence is detected in 25% and 22.1% of cases, respectively. Patients’ knowledge of their BZD treatment revealed critical gaps, which are identified as a challenge and a clear opportunity for intervention through pharmaceutical care services. Conclusions: The findings underscore the essential and proactive role of community pharmacists in identifying and managing drug interactions, as well as in supporting deprescribing strategies through collaborative and interprofessional care models. Full article

Background: Telepharmacy consultations (TPCs) became a routine element of pharmacy operations. However, there is limited data available on local pharmacy customer feedback related to TPC. Methods: A customer survey was developed seeking feedback on TPC. The pharmacy customers were invited to complete the survey in two local pharmacies in Germany. The survey and corresponding informed consent form were approved by the Ethics Committee. Results: In total, 178 pharmacy customers were enrolled (median age 41–50 years). From those, 37% agreed when asked whether they were generally interested in TPC. A total of 37% had the nearest pharmacy 5–15 min from their home. A total of 42% visited their pharmacy quarterly. A total of 36% used technical devices in median 1–2 h per days. A total of 33% classified their own digital skills at least as sufficient. A total of 59% would use their smartphone as a potential device for TPC. A total of 83% rated it as (slightly) important that the pharmacist providing TPC can be heard clearly. A total of 76% each (strongly) agreed that an argument for TPC would include limited mobility or pandemic/quarantine. A total of 33% (strongly) agreed that a key argument against TPC were technical requirements. A total of 75% considered situations of immobility to be the most important future perspective for TPC. Conclusions: Many pharmacy customers see TPC as an opportunity, e.g., in cases of limited mobility or during pandemic or quarantine. However, the use of appropriate technology can be a limiting factor. Full article

Background: Community pharmacies are increasingly delivering structured services to support chronic disease management, such as Multidose Drug Dispensing (MDD). This strategy can improve adherence and safety, but evidence of its economic feasibility in Portuguese pharmacies remains limited. Objective: To estimate the cost of implementing and operating an MDD system in a community pharmacy, informing reimbursement models and policy. Methods: A micro-costing approach assessed fixed and variable expenses for serving polymedicated elderly patients. Costs were calculated in euros (2024/2025) and expressed per working day based on 253 annual preparation days. Results: First-year costs totaled €70,985.68, including €8184.00 for setup, €21,579.00 for supplies, and €41,222.68 for staff salaries. The daily operating cost was €280.58, with labour representing the major expense. A break-even analysis indicated sustainability with around 700 users at €10/month. Conclusion: Although requiring significant initial investment, MDD can become financially viable through scaling, workflow efficiency, and supportive reimbursement strategies. Full article

(1) Background: Medication shortages have become increasingly common in the UK. However, there is limited evidence regarding the experiences of people with epilepsy and their caregivers during these shortages. The aim of this study is to explore the extent and impact of ASM shortages on people with epilepsy and their caregivers across the UK. (2) Methods: A cross-sectional online survey was distributed between January and April, 2024 by epilepsy charities. Participants included people with epilepsy and caregivers. The survey collected demographic information, types of ASM respondents were prescribed, experiences of shortages, and the impact of shortages. Data were analysed descriptively, and subgroup analyses were conducted by medication type. (3) Results: A total of 1549 responded, of whom 1312 were people with epilepsy and their carers who were included in the analysis with a mean age of 43 years. A total of 941 respondents (71.7%) reported difficulty obtaining their prescribed ASM in the past year. Shortages were most frequently reported for sodium valproate (60.8%), lamotrigine (65.2%), carbamazepine (92.6%), clobazam (82.6%), topiramate (81.5%), zonisamide (74.0%), levetiracetam (62.8%), lacosamide (71.0%), and brivaracetam (70.5%). A total of 529 (40.4%) of the participants reported that stress and/or anxiety caused by medication shortages was associated with recurrent seizures. We did not ask whether patients missed medications because of these difficulties. (4) Conclusions: ASM shortages are a widespread issue for people with epilepsy in the UK, leading to treatment disruptions and psychological distress. Addressing supply change limitations and identifying effective approaches to preventing the substitution of ASMs brands by clinicians may potentially reduce this problem. Full article

Background: In June 2024, urinary tract infections (UTIs) were added to the list of conditions that could be treated by community pharmacists providing the national Common Ailments Service in Wales. The aim of this study was to describe patient-reported experiences of UTI management by pharmacists. Methods: A positivist research paradigm was selected, with data collection through a survey. Results: In total, 309 surveys were received between 29 June 2024 and 14 July 2025. Patients rated their experience using a scale of 1 (very poor) to 10 (excellent), with a median score of 10 (IQR = 10 to 10, range 6 to 10). High satisfaction was independent of age and provision of antibiotics, with the same median and IQR and a similar range between the groups who received and did not receive antibiotics (7–10 and 6–10, respectively). Of the 309 respondents, 297 (96.1%) stated that the next time they had a UTI, they would return to the pharmacy instead of trying to see a GP, and 253 (81.9%) that they understood why antibiotics are not always recommended. Conclusions: Community pharmacists managed patient expectations, improved patient confidence in managing current symptoms and provided information on self-care strategies for preventing future infections, demonstrating their valuable role in health promotion and antimicrobial stewardship. Full article

In order to reach and maintain hepatitis C virus (HCV) elimination goals, it is imperative to reach marginalized people who do not engage with traditional testing and treatment. Peer-led interventions are effective in engaging such individuals. Studies have demonstrated community pharmacy as a low-threshold setting for HCV testing, but pharmacy teams’ competing demands are a barrier to maximizing potential. This pilot project aimed to assess whether a pharmacy-based peer-led model of HCV testing was implementable, deliverable, able to engage marginalized people, and overcome pharmacy staff constraints. We implemented a peer-led HCV testing service in one community pharmacy in the Midlands, England, providing four focused phases of testing, totalling 198 h, over two years. In total, 591 tests for antibodies or RNA were undertaken, identifying 24 active infections. Subsequent phases retested 20%, 16%, and 11% of those tested in combined preceding phases. In response to feedback, phases 3 and 4 included health screening (blood pressure, cholesterol, diabetes, and nurse-performed Fibroscans^®). We demonstrate engagement and the ability to identify and refer those with abnormal results to appropriate healthcare. This pilot shows that peer-led testing in the pharmacy setting can be implemented and warrants further scale up and evaluation. Full article

Pharmaceutical care in European countries is at various stages of development. Although the problem of occupational burnout affects many professions, it is particularly relevant among healthcare workers, such as pharmacists. Studies assessing pharmacists’ life satisfaction and factors influencing the level of occupational burnout play an important role in social pharmacy. Therefore, the present study aimed to evaluate the impact of providing pharmaceutical care on the professional life satisfaction of pharmacists in Poland. This study was conducted as an anonymous online survey. It included pharmacists who are members of the professional self-government in Poland. A custom-designed questionnaire was used for data collection, and 91 completed questionnaires were obtained. The respondents were divided into four groups according to their professional experience: up to 5 years, 6–10 years, 11–20 years, and over 20 years. In response to questions regarding job satisfaction and the willingness to provide pharmaceutical care, the respondents gave affirmative answers. Pharmacists in Poland have a positive perception of the impact of pharmaceutical care on the prestige of their profession. Currently, the pharmaceutical care services most commonly provided are those financed by the State; however, pharmacists are willing to engage in such activities and expect an expansion of the scope of reimbursed services. Consequently, pharmacists express dissatisfaction with the current stage of pharmaceutical care implementation in Poland. Those who provide pharmaceutical care feel more appreciated in their profession, do not experience psychological strain, do not feel uncomfortable when communicating with patients, and are not afraid of the responsibility associated with providing such services. Nevertheless, they consider it an additional workload in their professional duties. Full article

The recent shift from in-person to digital pharmacy services is transforming how patients interact with their pharmacists but has the potential to disadvantage older adults (aged ≥ 65) who often face barriers when using technology. This study aimed to assess digital inequalities affecting medication access among older adults. A Spanish-language questionnaire was developed and psychometrically validated, revealing a two-factor latent structure comprising: (1) Technology Use, and (2) Medication Access. Item discrimination analysis confirmed that all significantly differentiated between those that used technology to facilitate their medication access and those that did not (p < 0.001). Participants with higher education reported greater income levels (p < 0.001), and income was in turn related to both internet access and digital skills. Age played a key role in perceptions of technology. Participants who considered technology helpful were younger ($\overline{x}$ = 72.9) than those who did not ($\overline{x}$ = 76.6; p = 0.001). There was no significant relationship between perceived technological usefulness and reporting not being able to acquire medications because of technological barriers (p = 0.788). This newly created and validated questionnaire identified gaps related to digital pharmacy services and may be a useful tool in future clinical, community, and investigative contexts. Full article

Background: In some countries, community pharmacists provide advanced services to people with diabetes that improve glycaemic control and cardiovascular risk. This study aims to describe the cardiovascular risk profile of people with diabetes attending community pharmacy in Ireland. Methods: Data collection for this descriptive, observational, cross-sectional study took place in 10 pharmacies, in four Irish counties between July 2018 and October 2019. Participants were aged ≥18 years, with type 1 or type 2 diabetes, attending a participating pharmacy and were dispensed oral diabetes medicines, insulin, or devices for monitoring glycaemic control. Participants were asked about their demographics, medical history, and cardiovascular risk factors. Current medications were identified from dispensing software. Results: Data were available for 106 participants; 70 (66.0%) were male and 36 (34.0%) were female. The median age was 66.0 [56.5: 72.0] years. Of these, 90 (84.9%) had type 2 diabetes. Hypertension and dyslipidaemia were reported by 60 (56.6%) and 59 (55.7%) participants, respectively. Twenty-one participants (19.8%) were current smokers, 31 (29.2%) followed no specific diet, and 44 (41.5%) did not undertake exercise. Oral diabetes medication was prescribed to 85 (80.2%) and insulin was prescribed to 29 (27.4%) participants. Where an antihypertensive was prescribed, 21 participants (19.8%) achieved the systolic blood pressure on-treatment goal of ≤130 mmHg and 34 (32.1%) achieved the diastolic blood pressure on-treatment goal of <80 mmHg. Conclusions: Study participants demonstrated a high rate of characteristics associated with increased cardiovascular risk, including non-achievement of target blood pressure, smoking, and lack of exercise. A community pharmacist-led intervention aimed at potentially improving cardiovascular risk factors in people with diabetes warrants further study in an Irish setting. Full article

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

Berberine, a natural isoquinoline alkaloid, has been shown to improve glycemic control, lipid metabolism, and blood pressure regulation. However, its poor bioavailability has limited widespread clinical use. ToBeRock^® is a self-emulsifying formulation designed to enhance the bioaccessibility of berberine. This retrospective, real-world pilot study conducted through community pharmacies with pharmaceutical care services aimed to evaluate the metabolic and hemodynamic effects of ToBeRock^® in adults with impaired fasting glucose (IFG). Sixty adults with IFG (FPG 100–125 mg/dL) were enrolled through territorial pharmacies offering pharmaceutical services. Patients were retrospectively grouped into two cohorts: a Low-Dose Group (ToBeRock^® 1 capsule/day) and a High-Dose Group (ToBeRock^® 2 capsules/day). Capillary blood sampling and in-pharmacy blood pressure measurements were recorded at baseline (T0), 4 weeks (T1), and 8 weeks (T2). Evaluated parameters included fasting glucose, HbA1c, lipid profile (total cholesterol, LDL, HDL, triglycerides), systolic and diastolic blood pressure (SBP/DBP), and oxidative stress markers (FORT, FORD). Both cohorts showed statistically significant reductions in fasting glucose (p < 0.001), LDL (p = 0.036 Low-Dose/p = 0.039 High-Dose), and triglycerides (p = 0.012/0.009) after 8 weeks of treatment. The High-Dose Group experienced a greater improvement in HbA1c (−0.26%, p = 0.041) and a mild but statistically significant increase in HDL (p = 0.049). Improvements in oxidative balance were observed with significant reductions in FORT (p = 0.019/0.011), increases in FORD (p = 0.033/0.008), and a favorable shift in the REDOX index (p = 0.012/0.006). Systolic blood pressure decreased by −6.3 mmHg in the Low-Dose Group (p = 0.031) and −7.6 mmHg in the High-Dose Group (p = 0.048), while diastolic pressure dropped by −3.9 mmHg (p = 0.044) and −4.2 mmHg (p = 0.051), respectively. This real-world, retrospective analysis highlights the potential clinical benefit of ToBeRock^® in improving glycemic, lipid, oxidative, and hemodynamic profiles. The High-Dose Group demonstrated more consistent and significant results, supporting the dose-responsive efficacy of the bioavailable formulation and the value of pharmacy-based monitoring of nutraceutical interventions. Full article

Routine collection of Patient-Reported Outcomes (PROs) can enhance patient–pharmacist communication and identify medication-related concerns. This study aims to explore the influence of RxTalk™, an electronic PRO tool, on patients’ attributes and the dynamics of communication. Secondary aims include describing patients’ experiences with RxTalk™ and identifying suggestions for improvements. This study is part of a pilot randomized controlled trial in which patients used RxTalk™ in the pharmacy while being observed before they spoke with the pharmacist. Patients’ interactions with pharmacists were tape-recorded and analyzed, and patients were interviewed within one week. We integrated data from RxTalk™, patient observations, taped encounters, and interviews to provide a thicker description of patients’ experiences with RxTalk™ and its impact on their communication. A total of 70% of patients found RxTalk™ easy to use, and 59% perceived RxTalk™ as very useful to extremely useful. Triangulated findings show that RxTalk™ met patients’ social and informational needs, improved their communication skills, and cultivated a sense of privacy to share concerns. Furthermore, RxTalk™ validated the appropriateness of reporting any health concerns, not simply medication concerns. As patients had a positive experience with RxTalk™, pharmacists should consider integrating PRO tools into their daily services to improve patient interactions and quality of care. Full article

The common border between Bulgaria and North Macedonia, alongside the regulatory requirements stemming from Bulgaria’s membership in the European Union, provide grounds for comparing the legislative environment in both countries. This article presents a comparative case study of the regulatory frameworks governing community pharmacies in Bulgaria and North Macedonia. The aim of this study is to examine the specific features of current legislation related to the operation of community pharmacies, and to identify similarities, differences, and gaps in the organizational structure of pharmacy services, the population’s access to pharmaceutical care, and the qualification requirements for personnel working in community pharmacies. Bulgaria has been a member of the European Union since 2007, while the Republic of North Macedonia has had official EU candidate status since 2005. This provides a basis for comparing the regulatory frameworks of an EU and a non-EU system within the same regional context. In both countries, the overall pharmacy-to-population ratio exceeds the European average (3.3 pharmacies per 10,000 inhabitants), indicating sufficient availability. However, pharmacies are predominantly concentrated in major urban areas. In Bulgaria, challenges remain in ensuring access to pharmaceutical services in smaller and rural settlements, while in North Macedonia, the provision of such services is better ensured. The findings of this case study may be particularly relevant for countries undergoing health system reforms or EU harmonization processes. Full article

Background: Since the current increase in antimicrobial resistance globally, parasitic infectious diseases have become a greater public health crisis than ever before and an absolute priority. The Egyptian community pharmacist, as a health care provider and advisor, has a potential role to play in deworming. Objective: To evaluate the outcomes of community pharmacist-led deworming-related counseling services. Methods: A prospective randomized controlled study was conducted in Damanhur, Behera, Egypt. The intervention group received community pharmacy counseling, and the control group received the usual care. Both groups were monitored for 12 months for recurrence evaluation. Results: A total of 173 patients were included, of whom 96 (55.5%) received patient counseling. The types of infection included Oxyuris (44.5%), Entamoeba histolytica (28.9%), Ascaris (8.7%), Entamoeba Cyst (8.7%), Giardiasis (4.6%), Schistosomiasis (2.9%), and pinworm (1.7%). A total of 119 participants (68.8%) reported a need for dose repetition. Personal hygiene practices were reported by 71 participants (41%). Recurrence of infection was observed in 101 cases (58.4%). Patient counseling was significantly associated with lower recurrence rates and higher rates of personal hygiene application (p < 0.001). Multivariate logistic regression analysis revealed that patient counseling and personal hygiene measures were the only significant predictors of infection recurrence rate. Conclusions: Community pharmacists’ deworming-related counseling had positive behavioral and clinical outcomes. Full article