Search Results (76)

Background and Objectives: The improper disposal of expired and unused medications (EUM) poses significant environmental and health risks. Discarding EUM in household trash or drains leads to accidental poisoning, illegal trade, and ecosystem contamination. These persistent compounds often resist wastewater treatment, disrupting ecological balance and contributing to antimicrobial resistance, thereby increasing morbidity and mortality rates. This study aims to analyze the knowledge, attitudes and practices (KAP) and related factors of the Mexican population regarding the disposal of EUM. Methods: A cross-sectional, descriptive, and correlational study was conducted via an online survey of adults (18+) from October 2021 to October 2024. Results: Among 6080 participants (95.4% aged 18–59; 65.8% women), a medium level of KAP was observed. Notably, 51.5% did not use specialized disposal containers, only 15.5% knew container locations, and 30.5% correctly identified expiration dates. Significant associations emerged: lower education levels correlated with poorer disposal knowledge, while health-related backgrounds and postgraduate studies linked to positive attitudes and adequate practices. Ordinal logistic regression revealed that being elderly, belonging to a high socioeconomic class, having lower education levels, and lacking health-related studies were significantly associated with poor KAP regarding EUM disposal. Conclusions: Inadequate pharmaceutical disposal in Mexico compromises environmental and public health. Addressing this requires reinforced regulations, professionalized pharmacies, and a comprehensive approach to bridge knowledge gaps. Integrating digital tools—like real-time mapping and QR labeling—with accessible take-back schemes is vital in mitigating hazards and uphold the One Health triad. Full article

Treatment adherence can improve the prognosis of severe mental illnesses. Self-report questionnaires are the main tools to measure it. However, a new assessment method has emerged: the electronic prescription system. This enables us to verify whether patients have collected their medication from the pharmacy, providing an objective measure of adherence. The ADHERA study aims to: (1) Compare digital self-report questionnaires with the electronic prescription system. (2) Identify factors associated with non-adherence. (3) Evaluate the effectiveness of an adherence-promoting intervention. This intervention will consist of the identification of patients with poor adherence and a subsequent program of psychoeducation led by clinical psychologists. Adherence will be reassessed six months later to evaluate the intervention’s effectiveness. By identifying key sociodemographic and clinical factors associated with non-adherence, this project will inform targeted interventions to support patients with schizophrenia and bipolar disorder. Furthermore, the psychoeducational telehealth program may represent an effective, scalable, and patient-centered strategy to improve long-term treatment adherence and clinical outcomes. If successful, this model could be implemented in other regions and chronic conditions, contributing to a more efficient and patient-focused healthcare system. Full article

Diabetes mellitus is a growing global health challenge, and digital health technologies offer new opportunities to support self-management. Mobile applications can benefit both patients and healthcare professionals; however, awareness and integration of these tools into community pharmacy practice remain limited. As accessible frontline providers, pharmacists are well positioned to promote digital health, yet their readiness and engagement require further investigation. A cross-sectional survey was conducted among community pharmacists in Serbia using a structured questionnaire. Developed through a consensus-based process, the instrument assessed pharmacists’ awareness, attitudes, and experiences with digital health technologies, focusing on mobile applications for diabetes self-management. Only 15.8% of pharmacists were aware of such applications, and 2.4% reported receiving relevant training. Higher digital health technology literacy was associated with greater awareness, confidence, and preference for digital learning. Most participants supported expanding pharmacists’ roles in advising patients on digital tools and expressed interest in structured education and official guidance. These findings indicate limited awareness and training in mobile health applications among community pharmacists. Enhancing digital competencies through targeted education and structured guidance may facilitate greater integration of digital tools into routine pharmacy practice and strengthen pharmacists’ roles in chronic disease management. Full article

This study analyses the educational and social impact of a series of innovative teaching projects developed at the Museum of the History of Pharmacy of the University of Seville. The initiatives—including historical video documentaries, the “student guides” programme, and the digital outreach project “Voices that Empower”—explore the pedagogical potential of scientific heritage as a learning tool and as a medium for public communication. Through experiential and service-learning methodologies, these projects have enhanced students’ communication skills, critical thinking, and awareness of cultural and gender dimensions within pharmaceutical studies. The results demonstrate that the integration of audiovisual production, museum-based learning, and digital storytelling fosters meaningful engagement between the university and society, while also revitalising the historical and humanistic dimensions of pharmacy. Furthermore, the inclusion of a gender perspective in the “Voices that Empower” initiative contributes to the visibility of women in STEM and highlights the museum as a space for empowerment and social transformation. This work concludes that university museums can act as strategic platforms for innovation in higher education, combining heritage preservation, teaching excellence, and civic outreach to promote a more inclusive and sustainable scientific culture. Full article

Pharmacy-based point-of-care (POC) services have evolved from pilot initiatives to an essential component of decentralized healthcare delivery. These services—ranging from rapid infectious-disease screening to chronic-disease monitoring—improve access, reduce diagnostic delays and empower pharmacists as front-line healthcare providers. The present paper is an updated, in-depth review of the evolution of pharmacy POC services worldwide, combined with the analysis of the regulatory and educational frameworks supporting implementation, technological drivers such as biosensors, mobile health and artificial intelligence and in-depth socioeconomic considerations. Benefits for patients, pharmacies and healthcare systems are contrasted with challenges including variable reimbursement, uneven regulatory oversight and workforce preparedness. Full article

This study aimed to develop a typology of consumers based on their behavior in the areas of sustainable consumption and digitalization in the pharmaceutical market. The analysis considered factors including (i) Schwartz’s universal values, (ii) demographic, and (iii) socioeconomic determinants. The study was based on a survey conducted on a sample of Polish adults (n = 1247) between April and July 2024, using a computer-assisted web interviewing method via SurveyMonkey^®. In the area of sustainability, the most frequently observed behaviors included: (i) packing purchased medicinal products into a personal bag, (ii) for medicinal products with short expiration dates owing to their origin, purchasing only the quantities that meet current needs without stockpiling, and (iii) for regularly used medicinal products, choosing larger packages. Whereas, in the area of digitalization, purchasing at an online pharmacy allows for (i) saving time and (ii) saving money, while also (iii) providing greater privacy. Importantly, the presence of four types of consumers was demonstrated, i.e., Sustainable-Active (20%), Digital-Adept (29%), Sustainable-Digital-Uninterested (21%), and Sustainable-Digital-Addicted (29%). In conclusion, within the pharmaceutical market, sustainability and digitalization are reflected in consumer behavior to varying degrees across consumer types, influenced by personal values. Full article

Background/Objectives: Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for pain management but pose gastrointestinal (GI) and cardiovascular (CV) risks, particularly during long-term use. This study evaluated NSAID-prescribing patterns and the appropriateness of gastroprotective co-therapy among patients with varying GI and CV risk profiles. Methods: An observational, cross-sectional study was conducted in the outpatient pharmacy department over six months (March 2023 to August 2023) at a public secondary care facility. Data pertaining to patient demographics, NSAIDs prescription, and GI/CV risks were collected and reviewed from electronic health records. Descriptive statistics, chi-square tests, and logistic regression were performed. Results: A total of 1005 prescriptions containing 2051 NSAIDs were analyzed. Selective COX-2 inhibitors and non-selective NSAIDs were the most frequently prescribed. Only 42.1% of patients received proton-pump inhibitors despite guideline recommendations. Non-selective NSAIDs were significantly associated with CV history and GI risk (p < 0.0001). Logistic regression showed age, gender, CV history, and GI risk significantly influenced NSAID selection. Notably, non-selective NSAIDs continued to be prescribed among moderate- and high-GI-risk patients. Conclusions: Suboptimal adherence to guideline-recommended gastroprotective strategies was evident, particularly among high-risk patients. Comprehensive GI and CV risk assessment and the rational use of gastroprotective co-therapy are essential. Integrating evidence-based digital tools may enhance safer NSAID prescribing in routine practice. Full article

Each year, over 1 million people in the United States die from diabetes and cardiovascular diseases (CVDs). These largely preventable chronic conditions also create a financial burden on patients, payers, and healthcare systems. The popularity of GLP-1-based management of cardiometabolic conditions can escalate healthcare spending, while incentivizing digitization of semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro), and others using the “prescription drug use-related software” (PDURS) framework. In this article, we highlight opportunities to advance digital-first interventions and metformin-enhanced digital therapeutics (DTx) for the primary prevention of diabetes and CVDs. Metformin is a low-cost antidiabetic medication that is effective in preventing diabetes and cardiovascular adverse events. Concurrently, digital health technologies for managing chronic conditions, e.g., Dario Health, Omada Health, and WellDoc, enable digital-first and drug + digital combination therapies for prediabetes and those at risk for CVDs. We describe incentives for advancing Affordable Primary Prevention (APP), suggesting that nonprofit healthcare systems, such as Kaiser Permanente, Intermountain Health or Ascension Health, payers such as Cigna and Aetna/CVS Health, or private equity investors can leverage their venture funds to support development of metformin-enhanced DTx. In conclusion, (1) the PDURS framework can accelerate innovation of preventive medicine by bridging precision digital interventions with low-cost generic drugs, and (2) integrating healthy behaviors with pharmacotherapies is essential for the financially sustainable prevention of lifestyle-related chronic diseases. 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

Medication non-adherence remains a major challenge in healthcare systems worldwide, with significant implications for patient outcomes and healthcare costs. This study explored the perceptions and practices of Key Opinion Creators (KOCs) in Kosovo regarding medication adherence. Using a qualitative approach, 15 participants representing hospitals, pharmacies, academia, pharmaceutical companies, insurance, and professional associations were surveyed through open-ended questionnaires. Findings reveal the absence of clear national policies or guidelines dedicated to adherence, limited monitoring systems, and insufficient institutional support. While KOCs recognize healthcare professionals’ (HPs) role in patient education, counseling, and monitoring, they also stressed that their engagement is often fragmented and lacks standardized reporting mechanisms. Technology and innovation were identified as promising tools to improve adherence, but their application is limited by inadequate infrastructure and resources. Key barriers include a lack of guidelines, financial and human resource constraints, low patient education, and disparities across demographic groups. The study highlights the urgent need for coordinated policies, stronger inter-professional collaboration, targeted interventions, and integration of digital health solutions to strengthen medication adherence practices in Kosovo. Full article

Background/Objectives: Occlusal analysis is an important component of oral rehabilitation with a determining role in the prognosis of restorations. Over time, several qualitative and quantitative occlusal analysis methods have been proposed, starting with occlusion wax up to the most advanced digital systems. The objective of the present study was to evaluate and compare the data obtained through dental occlusion analysis using the Medit i700 and Exocad Elefsina v3.2 in a group of subjects, in order to establish the reliability or compatibility between the two occlusal analysis systems. Methods: The study was conducted on 20 subjects, aged between 24 and 53 years, who presented in the Dental Prosthetics Clinic of the University of Medicine and Pharmacy of Craiova. Digital impressions were acquired using the Medit Link v.3.3.6 intraoral scanner, and the digital files were subsequently uploaded from the Medit i700 into the Medit Occlusion Analyzer application and the Dental CAD Exocad software. For the analysis of occlusion in dynamics, mandibular movements and data acquisition, positions of edge-to-edge in protrusion, edge-to-edge in right laterotrusion and edge-to-edge in left laterotrusion were recorded, using the corresponding print screens. The 2D occlusal contact images generated by the two software programs were converted into .jpeg format and subsequently imported into Adobe Photoshop CS6 (2021) for comparative analysis. The data were statistically processed for each software used and the obtained data were subsequently compared. Results: The occlusal surfaces recorded with the Medit Occlusion Analyzer application represent 94% of the occlusal surfaces recorded with the Exocad software for the maxilla and 90% of the occlusal surfaces recorded for the mandible. In maximum intercuspation, the highest values were recorded by the Medit i700 software, whereas in edge-to-edge protrusion and both right and left edge-to-edge laterotrusion positions, the highest values were reported by the Exocad software. The discrepancy between maxillary and mandibular values arises from the conversion of the data from a three-dimensional to a two-dimensional format during image processing. Conclusions: The occlusal areas recorded by the DentalCAD Exocad software show higher values than those provided by the Medit Link software with the Medit Occlusion Analyzer application. The differences in recorded values, in the case of the digital flow of prosthetic restorations, require the intervention of the dentist to perform clinical adjustments to optimize occlusal relationships after the fabrication and cementation of restorations. Full article

Background/Objectives: Diabetes mellitus is a major global health concern requiring both preventive strategies and patient-centered clinical management. This study evaluated knowledge, lifestyle behaviors, treatment adherence and the use of digital tools among Romanian patients with diabetes in a real-world setting. Methods: A cross-sectional observational study was conducted on 100 patients recruited from community pharmacies in Iași, Romania. Data were collected using a structured 27-item questionnaire addressing demographics, disease management, adherence, lifestyle factors, and complications. Results: Most participants had type 2 diabetes. Engagement in healthy behaviors was suboptimal, with low levels of daily physical activity and limited routine glucose monitoring. Complications and treatment-related side effects were frequent, reflecting a high disease burden. Treatment adherence was significantly higher among younger patients, those with type 1 diabetes and individuals who had set long-term health goals. The use of digital technologies was low overall but more common in younger participants. Conclusions: This study identifies critical gaps in lifestyle practices, adherence and technology uptake among Romanian patients with diabetes. These findings carry important clinical implications, as poor adherence and limited self-management are closely linked to complications and higher healthcare spending. The findings suggest that patient education, integrating validated digital tools and enhancing the role of community healthcare providers could support better adherence and reduce long-term complications. 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: The implementation of electronic prescriptions in Bulgaria since 2023 provides new opportunities for real-world data analysis of prescribing practices and medication adherence particularly for chronic diseases such as diabetes. Objective: To evaluate prescribing patterns medication adherence and National Health Insurance Fund (NHIF) coverage in patients with diabetes across three major Bulgarian regions using 6-month electronic prescription (e-prescription) data from January to June 2024. Materials and Methods: Data were collected from community pharmacies in Sofia, Plovdiv, and Dobrich and Stara Zagora. Prescriptions were categorized by diabetes type (type 1 or type 2), therapy class (traditional vs. innovative), refill frequency, and NHIF reimbursement. Adherence was estimated using refill frequency and the Proportion of Days Covered (PDC) method. Results: A total of 1071 prescriptions were analyzed. In Sofia, type 1 patients (n = 13) had high rates of adherence (mean: 6.5 refills; 54% refill-based adherence), while type 2 patients (n = 138) showed more variability (mean: 4.55 refills; 27.5% with PDC ≥ 80%). Innovative therapies (e.g., DPP-4, SGLT2 inhibitors) were more frequently used in Sofia, reflected by higher NHIF reimbursement costs. In contrast, Dobrich, Stara Zagora, and Plovdiv predominantly relied on traditional medications (e.g., metformin, sulfonylureas) with lower adherence and limited use of innovative therapies. Conclusions: E-prescription data provides valuable insights into real-world diabetes management and shows substantial regional differences in adherence and treatment intensity. In the bigger cities there is better adherence and access to modern therapies, while smaller regions are slower in adopting these treatments. These findings support the need for national policies to ensure equitable access to innovative therapies and enhanced digital support for chronic disease management. From clinical practice point of view adherence follow-up is a key for treatment success and healthcare decision-making. Full article

Background/Objectives: Geographical variations in outcomes and oral anticoagulant (OAC) initiation among patients with nonvalvular atrial fibrillation (NVAF) in the United States (US) have been characterized; however, regional effects on OAC persistence are unknown. The study described variation in persistence with OACs among patients with NVAF across different US regions. Methods: The Komodo Healthcare Map was used to evaluate adult patients with NVAF, elevated stroke risk, and ≥1 pharmacy claim for an OAC between 1 January 2015 and 31 August 2022. Patients initiating treatment with an OAC (treatment-naïve) and having ≥12 months continuous enrollment were included. Persistence rates were assessed at 6, 9, 12 and 18 months among OAC- and direct OAC (DOAC)-naïve patients by 3-digit zip codes. Results: Of the 260,001 (Northeast = 72,507, Midwest = 59,979, South = 83,880, West = 42,778, Other/Unknown = 857) OAC-naïve patients identified, 82.2% were DOAC-naïve while 17.8% initiated warfarin. Mean follow-up time was 1101 (median = 964) and 1073 days (median = 938) in OAC and DOAC cohorts, respectively, while mean time to discontinuation was 342 (median = 190) and 329 days (median = 181), respectively. At 12 months, persistence rates ranged from 40.3% to 78.8% for OAC-naïve patients and 40.6% to 81.4% for DOAC-naïve patients. Average OAC and DOAC 12-month persistence rates were highest in the Northeast (63.5% and 63.7%, respectively) and lowest in the South (57.1% and 56.9%, respectively). Conclusions: Variations in 12-month persistence were consistent with existing evidence on geographic variation in NVAF-related disease burden and treatment initiation. Understanding geographic trends in prescribing patterns may provide insights into differences in treatment persistence that are relevant for clinicians seeking to address real-world barriers to care. Full article