Search Results (104)

Background: Obesity is a growing public health concern in Italy, with prevalence reaching 21.6% in 2022, particularly among the elderly. To address this issue, the ObeCare project was implemented to promote obesity prevention and awareness through community pharmacies. This study aimed to evaluate obesity-related knowledge, lifestyle behaviors, and risk perception among participants engaged in the ObeCare project. Methods: A survey was administered to individuals >18 years old across Italian pharmacies involved in the ObeCare initiative by trained pharmacists. A validated questionnaire assessed obesity-related knowledge, risk perception, lifestyle behaviors, demographics, clinical conditions, and Body Mass Index (BMI). A multinomial logistic regression was implemented to identify predictors of overweight and obesity. Results: Obesity was more prevalent among men, older adults, and those with multiple comorbidities. Healthier lifestyle and greater health knowledge were significantly associated with having a normal BMI, whereas low lifestyle scores (OR 13; 95% CI 2.96–57.85) and the presence of multiple comorbidities (OR 14.79; 95% CI 8.00–27.36) were strong predictors of obesity. Individuals with obesity exhibited lower knowledge (OR 1.55; 95% CI 1.02–2.37) and risk perception. Conclusions: This study highlights the significance of lifestyle habits, knowledge, and risk perception, which will be helpful in the prevention and management of obesity. These findings support community-based education and targeted interventions, especially for high-risk groups such as men, retirees, and residents of Southern Italy. Full article

Owner-led self-medication for companion animals is a growing global practice; however, empirical data from Japan remain limited. Framing medication safety within a One Health perspective, this study aimed to characterize Japanese pet owners’ use of over-the-counter (OTC) drugs and identify possibilities for pharmacists to support rational self-medication. A cross-sectional 13-item online survey was administered to 500 owners in Japan between 30 May and 2 June 2025. Data on owner demographics, willingness to consult pharmacists, veterinary visit behavior, and OTC purchasing practices were summarized. Many owners were receptive to pharmacy support; 65% wished to consult a pharmacist, and 6.8% had already done so. Overall, 15.2% reported using OTCs drugs, primarily for treatment or prevention and prioritized perceived effectiveness and safety when selecting products. Some owners managed mild pet illnesses at home, citing perceived mildness and cost as reasons for not visiting a veterinary clinic. There is an unmet demand for accessible expert counseling at the point of purchase. Leveraging community pharmacies linked with pet specialty pharmacies as first-contact hubs could promote appropriate self-medication; doing so would require veterinary-specific training, establishing a formal credential for veterinary pharmacists, and defining pharmacist–veterinarian communication to ensure safe and effective use. Full article

Background: Diabetes Mellitus (DM) represents a significant public health challenge in Pakistan, with a high prevalence exacerbated by various socio-demographic, clinical, and environmental factors. Community pharmacies offer an accessible setting for managing chronic diseases, yet the combined influence of these factors on diabetes control within Pakistani community settings remains underexplored. Objective: This study aimed to assess the impact of socio-demographic, environmental, and clinical factors on diabetes control among patients attending community pharmacies in Lahore, Pakistan. Methods: A cross-sectional study was conducted involving 321 patients with type 2 diabetes recruited from community pharmacies across three regions of Lahore. A structured questionnaire, developed based on international guidelines, was used to collect data on socio-demographic characteristics, clinical history, lifestyle behaviors, and environmental factors. Diabetes control was categorized as controlled, partially controlled, or uncontrolled. Data were analyzed using descriptive statistics, chi-square tests, and multiple logistic regression in SPSS version 26.0. Results: Key socio-demographic predictors of better diabetes control included higher education levels (AOR = 1.317–2.338, p ≤ 0.006) and non-obese status (AOR = 1.057, p = 0.006). Significant clinical and lifestyle predictors were treatment adherence (AOR = 1.287, p < 0.001), regular physical activity (AOR = 1.387, p < 0.001), healthy dietary patterns (AOR = 1.317, p < 0.001), and longer duration of diabetes (>5 years, AOR = 1.277, p = 0.008). Conversely, a family history of diabetes (AOR = 1.967, p < 0.001) and the presence of comorbidities were associated with poorer control. Rural residence showed lower odds of good diabetes control (AOR = 0.857, p = 0.001). Smoking status was also influential, with ex-smokers demonstrating better control than current smokers. Conclusions: Diabetes control is multifactorial, strongly influenced by education, residence, obesity, lifestyle behaviors, and treatment adherence. Interventions targeting modifiable risk factors through patient education, lifestyle counseling, and personalized care are essential to improve diabetes outcomes in community settings. These findings underscore the critical role of community pharmacists in providing holistic diabetes management. Full article

Background: Falls in older adults are a leading cause of morbidity, particularly when compounded by polypharmacy. There is mixed evidence of the efficacy of medicine reviews, but there is little work exploring this in the ambulance setting. A new referral pathway enabling ambulance staff to connect patients to primary care pharmacists aimed to address this. This study explored staff and patient experiences with the pathway and its potential to improve medication safety after a fall. Methods: A mixed-method service evaluation was conducted to assess the implementation and impact of this pathway. Routine data from an ambulance trust and pharmacist proformas were used to address objectives relating to referral rates, clinical appropriateness, and fall recurrence. Patient and staff stakeholder perspectives were gathered through two cross-sectional surveys designed to explore emotional, behavioral, and practical responses to the intervention. Quantitative data were analyzed descriptively and using ordinal logistic regression where appropriate. Free-text responses were analyzed thematically. Results: Between May 2019 and March 2020, referrals were initiated for 775 older adults after ambulance attendance for a fall, with pharmacists completing medicine reviews on 340 patients. Survey data revealed improvements in patients’ emotional responses to their medicines. Ambulance clinicians identified patient disclosure, stockpiling, and the presence of expired medicines as key indicators of poor medicines management and valued the ability to refer patients. Conclusions: Overall, referral to the pathway demonstrates a marginal improvement in recontact rates in the short-term but does not necessarily represent an improvement in overall patient safety. The cost of such an intervention and patient expectations need further exploration to prove efficacy and patient satisfaction. Full article

Background: A point prevalence survey conducted at Singapore General Hospital in 2021 showed 48% of inpatients on antibiotics. We hypothesize that a mobile application, transforming complex antibiotic prescribing information into a succinct and individualized resource, will empower healthcare professionals and improve antibiotic prescriptions. Hence, we developed ABxSG using the behavioral design thinking approach (BDTA) to ensure positive user experience and sustained engagement. We aim to evaluate the impact of ABxSG on the proportion of inpatients on antibiotics, antibiotic appropriateness, and the number of antibiotic-related interventions by pharmacists. Methods: ABxSG was launched in March 2023. An interrupted time series analysis was conducted to evaluate its impact on the above outcomes measured using data collected from October 2021 to September 2024. There were 18 data points pre- and post-ABxSG. Results: Following the ABxSG launch, there was an immediate reduction in the proportion of inpatients on antibiotics by 1.66% (p < 0.01), followed by a sustained reduction of 3.12% at 18 months (p < 0.01). Piperacillin-tazobactam appropriateness increased by 2.76% at 1 month (p = 0.11) and further increased by 7.09% at 18 months (p < 0.05). Similarly, ceftriaxone appropriateness increased by 5.74% (p < 0.05) at 1 month and remained above pre-ABxSG levels. There was a significant increase in the number of pharmacist-led interventions for dosing optimization, with 96 more interventions/month at 18 months (p = 0.14). Conclusion: Antimicrobial stewardship teams must remain agile, embrace innovations, and adopt digital technologies to engage and empower clinicians. ABxSG reduced the proportion of inpatients on antibiotics and improved antibiotic prescriptions. The incorporation of BDTA in ABxSG, strong hospital leader support, and strategic planning to promote adoption led to its success. Full article

Emerging research has shown that pharmacist-led comprehensive medication management (CMM) can be an effective strategy for controlling hypertension. A synthesis of the evidence on the overall effects of CMM on clinical, quality, and economic outcomes could help inform and contribute to improvements in programming and practice. Presently, such a synthesis is limited in the literature. To address this gap, we conducted a scoping review of CMM effects on these outcomes, organized by 4 domains: therapeutic, humanistic, safety and economic. Using predefined search terms for articles on studies published between 2010 and 2024, we performed a literature search utilizing these terms to search the MEDLINE, Cochrane Library and CINAHL databases. For each of the identified studies, we applied a multi-stage screening process to extract data, chart results, and synthesize findings. The process took into account methodology of study design, patient population involved, CMM implementation, relevance of outcomes to clinical improvement, and factors that were deemed relevant to study selection. In total, 49 experimental, observational, and simulation-based studies were included in the scoping review. The synthesis focused on outcomes most frequently reported and those rigorously evaluated by the studies in the review. They included clinical measures of blood pressure reduction and control, frequency and duration of healthcare visits, and changes in medication therapy regimen and medication adherence. Overall, CMM interventions were found to have significantly favorable effects on systolic blood pressure reduction, hypertension control, and medication changes. Other outcomes, which showed positive effects, included self-reported patient experience and behaviors, emergency department visits, hospitalizations, mortality, and program costs and related savings from implementing a CMM program. Some results, however, were mixed. For example, a number of studies reported outcomes data without significance testing and many generally lacked consistent characterization of their programming and implementation processes. Future research and practice evaluations should include these elements in their documentation. Furthermore, a more consistent approach to implementing CMM in the field may lead to better support of program delivery fidelity, helping to optimize CMM, moving it from demonstrated efficacy to intervention effectiveness in the real world. Full article

Background/Objectives: Hispanics living in the United States have higher rates of diagnosis and mortality from certain kinds of cancers, including human papillomavirus (HPV)-related cancers. HPV vaccines can prevent 90% of HPV-associated cancers. Methods: The purpose of this study was to recruit a sample of Hispanic parents to investigate trusted sources of HPV vaccine information. An online survey was used to collect data from Hispanic parents who reported having children between the ages of 11 and 17. Results: Parents of children 11–17 years of age (n = 203, M_age = (38, SD = 6.97; female 85.1%) were included. The top five trusted sources of HPV vaccine information were medical doctors (95.1%), registered nurses (54.2%), the CDC (47.8%), the WHO (45.3%), and pharmacists (25.6%). The two least trusted sources were the president of the U.S. (7.9%) and religious leaders (3%). Hierarchical linear regression models revealed that HPV vaccine acceptance was associated with trusting registered nurses (p < 0.001) and the CDC (p = 0.026) in recommending the HPV vaccine. Importantly, the family-held belief that vaccines cause autism was strongly correlated with personal beliefs that vaccines cause autism (r = 0.58; p < 0.001). Conclusions: Findings from this study have clinical implications for the development of interventions and health communication strategies that leverage trusted sources of information including medical doctors and registered nurses to encourage preventive health behaviors. Additionally, our findings support that pharmacists should be included in these interventions as they are often an underused resource and are trusted by their patients for vaccine information. 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

Background and Objectives: Investigating the adherence to antihypertensive medication and identifying patients with low adherence allows targeted interventions to improve therapeutic outcomes. Artificial intelligence (AI) offers advanced tools for analyzing medication adherence data. This study aimed to develop and validate several predictive models for non-adherence, using patient-reported data collected via a structured questionnaire. Materials and Methods: A cross-sectional, multi-center study was conducted on 3095 hypertensive patients from community pharmacies. A structured questionnaire was administered, collecting data on sociodemographic factors, medical history, self-monitoring behaviors, and informational exposure, alongside medication adherence measured using the Romanian-translated and validated ARMS (Adherence to Refills and Medications Scale). Five machine learning models were developed to predict non-adherence, defined by ARMS quartile-based thresholds. The models included Logistic Regression, Random Forest, and boosting algorithms (CatBoost, LightGBM, and XGBoost). Models were evaluated based on their ability to stratify patients according to adherence risk. Results: A total of 79.13% of respondents had an ARMS Score ≥ 15, indicating a high prevalence of suboptimal adherence. Better adherence was statistically associated (adjusted for age and sex) with more frequent blood pressure self-monitoring, a reduced salt intake, fewer daily supplements, more frequent reading of medication leaflets, and the receipt of specific information from pharmacists. Among the ML models, CatBoost achieved the highest ROC AUC Scores across the non-adherence classifications, although none exceeded 0.75. Conclusions: Several machine learning models were developed and validated to estimate levels of medication non-adherence. While the performance was moderate, the results demonstrate the potential of AI in identifying and stratifying patients by adherence profiles. Notably, to our knowledge, this study represents the first application of permutation and SHapley Additive exPlanations feature importance in combination with probability-based adherence stratification, offering a novel framework for predictive adherence modelling. Full article

Background: Due to their participation in patient care, pharmacists frequently face various ethical decisions that must be made. Every day, pharmacists encounter ethical challenges in any pharmaceutical workplace. This study aims to assess the attitude and awareness among pharmacy students and pharmacists regarding general and professional ethics. Methods: This study was cross-sectional, using an interview-based questionnaire. Pharmacy students from Yarmouk University volunteered to approach other pharmacy students and pharmacists to complete the questionnaire using a convenient sampling method. Results: A total of 1737 pharmacy students and pharmacists participated in this study. Among the 691 participants who are currently practicing pharmacists, 549 (79.4%) reported working in a community pharmacy. About half of the pharmacy students (53.6%) had studied a course in ethics, while 110 (15.9%) of the pharmacists had not. While students and pharmacists have shown significantly different attitudes, less than 20% of the participants demonstrated a high level of awareness regarding the pharmacy code of ethics. On the other hand, more than 60% of pharmacy students and practicing pharmacists concurred that they might permit others to carry out the duties of a pharmacist. Surprisingly, the data revealed that student pharmacists performed better than practicing pharmacists, highlighting that students appreciate the principles of professionalism and that exposure to a work environment can help modulate negative behavior and beliefs. Conclusions: These findings underscore the need for ongoing ethical education and training for both pharmacy students and practicing pharmacists to ensure that everyone in the field upholds a high standard of moral behavior in patient care. Full article

Background/Objectives: Antimicrobial resistance (AMR) is a growing global health threat, requiring an approach that integrates human, animal, and environmental health. Public awareness and responsible antibiotic use are key to combating AMR. This study examines the knowledge, attitudes, and practices related to antibiotic use among the general population in Serbia, exploring their impact on antimicrobial stewardship efforts. Methods: A cross-sectional study was conducted in December 2022 using a three-stage stratified random sample of the Serbian population. The Eurobarometer questionnaire was utilized with permission from the European Commission. Statistical analyses included multivariate ordinal logistic regression to identify predictors of desirable attitudes and behaviors related to antibiotic use. Results: Almost two-thirds of respondents (61.6%) reported not receiving any advice on rational antibiotic use, underscoring the need for education of the general population and raising awareness. A Higher Antibiotic Knowledge Score was associated with a 60% greater likelihood of favorable attitudes and a 21% greater likelihood of rational antibiotic use. Pharmacists were identified as the primary source of antibiotic-related information for the general population in Serbia, but there is limited public interest and awareness of antibiotic use in animals, as well as of the bans on using antibiotics to stimulate growth in farm animals within the EU. Conclusions: Through targeted educational interventions, strengthening interdisciplinary collaboration and AMR control measures is necessary for human and veterinary medicine. Although pharmacists are the primary source of information about antibiotics for the population in Serbia, collaboration with physicians and their empowerment should be introduced to strengthen antimicrobial stewardship further. Full article

Objective: This study assessed hospital pharmacists’ awareness, attitudes, and behaviors regarding adverse drug reaction (ADR) reporting and explored cognitive factors shaping hospital pharmacists’ intentions to report ADRs, using the theory of planned behavior (TPB) as a framework. Methods: A cross-sectional survey was conducted among hospital pharmacists from various regions of Saudi Arabia. Data were collected on their intentions to report ADRs to the national pharmacovigilance center (NPC), along with their attitudes, subjective norms, and perceived behavioral control related to ADR reporting. Descriptive statistics summarized the data, while multivariate logistic regression analyzed the influence of TPB constructs on reporting intentions. Results: A total of 141 hospital pharmacists participated in the study. While 86.5% of them were aware of the Saudi NPC, only 30% had reported ADRs in the past year. A strong intention to report ADRs was observed in 56% of the hospital pharmacists. Additionally, 53% exhibited a highly positive attitude, 57% perceived strong social norms, 52.5% reported high perceived behavioral control, and 63.8% expressed a strong moral obligation to report ADRs. Subjective norms and moral obligation emerged as significant predictors of the hospital pharmacists’ intention to report ADRs, according to the TPB constructs. Conclusions: While awareness of the Saudi NPC among hospital pharmacists was high, ADR reporting rates were low. Enhancing education, addressing barriers, and leveraging moral and normative drivers may strengthen pharmacovigilance practices and improve ADR reporting adherence among hospital pharmacists, ultimately fostering safer healthcare delivery. Full article

In the United States, 41.6% of all pregnancies are unintended. This disproportionately affects women 20 to 24 years old. The high rate of unintended pregnancy among college students is associated with a lack of or incomplete formal education on reproductive health in grade and high school. The purpose of this study was to evaluate the outcomes of health education seminars designed to reduce reproductive health knowledge gaps among college-aged students and increase their safe sex behavior (health protection/prevention). Student pharmacists offered eighteen one-hour health education programs on fertility, contraception, and emergency contraception to college student attendees via live and Zoom-based presentations. Pre- and post-program quizzes, a post-program performance evaluation, and a post-program behavior change survey were completed anonymously. The response rate was 94.8% (n = 153 attendees). Post-program quiz scores (84%) were significantly higher than pre-program quiz scores (56%, p ≤ 0.001). The greatest increases in knowledge were about sperm survival, correct condom use, and fertility windows. The two-month follow-up survey responses revealed more confidence with birth control decisions, increased awareness of emergency contraception items, increased safe sex behaviors, and increased condom usage. Students reported that the seminars were helpful for preventing future unintended pregnancies. Reproductive health knowledge gaps can be minimized, and some self-reported safe sex behaviors can be improved with health education programs implemented at a university. Full article

Background: The prevalence of chronic kidney disease (CKD) is rising, increasing demand for renal replacement therapy (RRT). Community pharmacies, as accessible healthcare hubs, can play a pivotal role in CKD prevention. This study aimed to develop care models for community pharmacies to optimize medication use, encourage behavior modification, and promote self-management among at-risk individuals. Methods: Conducted between June 2017 and July 2018, this study utilized an action research approach. Microalbuminuria was assessed using urine dipsticks, and pharmacists applied behavioral change and self-management support (SMS) strategies to slow CKD progression. Participants were categorized by albuminuria levels and enrolled in pharmacist-led care programs, with follow-up assessments at weeks 0 and 12. Results: Of 521 participants screened, 57% tested positive for albuminuria. For these individuals, serum creatinine testing and referrals to primary care were initiated. Self-management behavior assessment (S1) scores significantly improved (p = 0.024). Key factors associated with urine albumin levels included age < 60 years (OR = 0.44), diabetes (OR = 3.69), hypertension (OR = 2.01), BMI < 27.5 kg/m² (OR = 0.42), eGFR ≥ 60 mL/min/1.73 m² (OR = 3.34), lower systolic (OR = 0.55) and diastolic blood pressure (OR = 0.34), and fasting plasma glucose < 126 mg/dL (OR = 0.29). Conclusions: Community pharmacist-led albuminuria screening effectively supports CKD prevention and enhances self-awareness within communities. Full article

Background/Objectives: Medication adherence is essential for effective healthcare, significantly influencing treatment success and overall health outcomes. However, there is limited understanding of how healthcare professionals in Saudi Arabia manage and support medication adherence. This study aims to examine physicians’ and pharmacists’ approaches to managing medication adherence in Saudi Arabia by examining the methods used for adherence assessment, interventions to enhance adherence, and the challenges faced. Methods: A cross-sectional study was conducted over nine months using a self-administered online questionnaire. The study targeted physicians and pharmacists actively working in Saudi Arabia. The questionnaire was distributed through professional networks to ensure a broad and representative sample. Results: A total of 397 healthcare professionals met the inclusion criteria, comprising 81.1% pharmacists and 18.9% physicians. Direct patient inquiry was the most common assessment method, frequently or always used by 81.3% of physicians and 57.1% of pharmacists. Treatment response evaluation was similarly frequent (89.3% of physicians and 56.2% of pharmacists). Standardized tools, such as the Morisky Medication Adherence Scale, were underutilized (14.7%). Adherence-enhancing interventions focused on patient education, and their use was reported by 89.3% of physicians and 74.2% of pharmacists as frequent or always. Written information was more commonly used by pharmacists (65.8%) than physicians (45.3%). Barriers included excessive workloads and short consultation times (59.9%), absence of effective systems for tracking adherence (51.9%), lack of reliable tools for assessing adherence (48.9%), and insufficient training in behavioral interventions (48.1%). Conclusions: This study reveals significant differences in medication adherence management practices between physicians and pharmacists in Saudi Arabia, emphasizing their distinct roles. Key barriers, including excessive workload, limited consultation time, and inadequate tracking systems, hinder the adoption of evidence-based tools. Tailored interventions, enhanced interprofessional collaboration, and systemic support are essential to address these challenges and improve adherence management, ultimately enhancing patient outcomes. Full article