Search Results (465)

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: Pharmacy technicians are increasingly involved in immunization services, enhancing vaccine accessibility and reducing pharmacies’ workload. This scoping review aims to (1) provide a comprehensive overview of pharmacy technicians’ involvement in immunization services across various healthcare settings and countries, and (2) conduct a comparative analysis of training curricula for pharmacy technicians on immunization. Methods: A scoping review was conducted following the Arksey and O’Malley framework. A comprehensive search of the PubMed and Scopus databases was performed using keywords and MeSH terms such as “pharmacy technician(s)”, “immunization”, “vaccination”, “role”, and “involvement”. Studies included assessed pharmacy technicians’ roles in vaccine administration, training, and public health outcomes. Descriptive and thematic analyses were used to synthesize the findings. In addition, a supplementary analysis of immunization training curricula was conducted, reviewing programs from different countries to identify similarities, differences, and gaps in course structure, content, and delivery formats. Lastly, a comprehensive toolkit was developed, offering guidelines intended to facilitate the implementation of immunization training programs. Results: A total of 35 articles met the inclusion criteria, primarily from the United States of America (n = 30), Canada (n = 2), Ethiopia (n = 1), Denmark (n = 1) and United Kingdom (n = 1). The findings indicate that pharmacy technicians contribute significantly to vaccine administration, patient education, and workflow optimization, particularly in community pharmacies. The COVID-19 pandemic accelerated their involvement in immunization programs. Key challenges include regulatory barriers, a lack of standardized training, and resistance from other healthcare professionals. Facilitators include legislative support (e.g., the PREP Act), structured training programs, and collaborative pharmacist–technician models. Conclusions: Pharmacy technicians can play a vital role in expanding immunization services, improving vaccine uptake, and reducing pharmacist workload. Addressing regulatory inconsistencies, enhancing training, and fostering interprofessional collaboration are crucial for their effective integration of immunization programs. Since immunization by pharmacy technicians is not yet allowed in many EU countries, this review will provide a foundational basis to address their potential to support the healthcare workforce and improve access to immunization services. Full article

Background/Objectives: Pharmacists are highly accessible healthcare providers who have frequent, repeated contact with diverse patient populations. They are poised to offer expanded and comprehensive healthcare, including mental health services. One potential barrier to this is a lack of knowledge, confidence, or training in mental health, which may be overcome with a program like Mental Health First Aid (MHFA) training. The aim of this systematic review and meta-analysis is to fill this gap in knowledge by critically evaluating all studies of MHFA training for pharmacists or pharmacy students that report on knowledge, attitudes, or self-efficacy outcomes. Methods: A systematic review was performed to identify all relevant studies. Data was extracted and a random-effects meta-analysis was performed for knowledge and attitudes/self-efficacy outcomes, respectively. Subgroup analyses were performed based on survey question type, geographic location, and population studied. Results: Overall, MHFA training significantly increased pharmacists’ and pharmacy students’ knowledge (Hedges’ g = 0.228) and combined attitudinal/self-efficacy measures (Hedges’ g = 0.376). Subgroup analyses based on question type, study quality, design, population studied, and location showed similar, significant effects. Conclusions: MHFA training appears to have significant effects on pharmacist and pharmacy student knowledge, attitudes, and self-efficacy. Future work should establish the durability of these effects. Full article

Chronic diseases are a leading cause of death worldwide and have a significant negative impact on public health, overall well-being, national economies, and the long-term sustainability of already burdened health systems. In addressing some of the current health challenges, the contribution of pharmacists and community pharmacies is of particular significance. Pharmacists play a vital role in the medication use process, enhancing the efficacy of pharmacological interventions and facilitating the delivery of health services. Community pharmacies occupy a key position within the healthcare system, acting as a primary point of contact with the public and frequently representing the most accessible healthcare facility for patients. In recent times, community pharmacies have undergone a process of adaptation, shifting from a narrow focus on the dispensing of medications towards a more comprehensive approach that is patient-centered and incorporates a range of healthcare services, while also prioritizing the quality of the services provided. This work aims to explore the role of pharmacists in the provision of pharmaceutical services in three countries with distinct healthcare systems, examining how these services operate, the requirements for their delivery, the associated remuneration structures, and the extent of out-of-pocket costs for patients—ultimately analyzing their impact on health outcomes. Full article

Pharmacist-led transitions of care (TOC) services decrease preventable hospital readmission. TOC service implementation assessment can inform translation to real-world settings. The purpose of this study was to evaluate the implementation of a TOC service for patients with multiple admissions at a regional hospital using the RE-AIM framework. In this quasi-experimental, non-randomized study, individuals with ≥2 recent hospitalizations received pharmacist-led discharge medication reconciliation and counseling, management of drug-related problems, post-discharge telephonic visits, and social support. The reach, effectiveness, implementation, and maintenance RE-AIM dimensions were assessed using patient and service records. Outcomes included 30-day readmission rates for individuals completing ≥1 outpatient pharmacist visit (intervention) versus those unreachable in the outpatient setting (comparison), completed interventions, implementation features, and service adaptations. Chi-square and Fisher’s exact tests were used for comparison of categorical variables and the t-test was used for continuous variables. From February 2022 to August 2023, 72.7% of the 66 service participants participated in the intervention (reach). Additionally, 30-day readmission was 22.9% (intervention) versus 55.6% (comparison; p = 0.01). In total, 2279 interventions were documented (effectiveness). The service was adapted (implementation) and expanded to include additional populations (maintenance) to enhance sustainability. Based on RE-AIM evaluation, the pharmacist-led TOC intervention appears to be a sustainable solution for addressing readmission in multivisit patients. Full article

(1) Background: Patient-centered care for individuals with breast cancer requires multidisciplinary cooperation to ensure the appropriate use of medication and prevent medication-related problems. Pharmaceutical care has been associated with improved adherence in breast cancer management, a factor linked to patient outcomes and mortality. This study aims to summarize and explore the provision and utilization of pharmaceutical services for breast cancer patients by pharmacists. (2) Methods: A scoping review was performed to assess the pharmacist’s role in providing pharmaceutical services for patients with breast cancer. A comprehensive review of four databases (PubMed, Ovid Embase, Ovid International Pharmaceutical Abstracts, and Scopus) was completed between 1 January 2012 and 8 April 2025 according to PRISMA-ScR framework. (3) Results: A total of 46 articles met the inclusion criteria, which included RCTs, observatory studies, cohort studies, and reviews. Findings suggest that both clinical and community pharmacists play an important role in prevention, management, and education for breast cancer patients. (4) Conclusions: Pharmacists can improve health outcomes by providing pharmaceutical service in breast cancer care. Optimizing interventions, expanding services, and evaluating long-term cost-effectiveness is needed in the future. Full article

Background: Pneumococcal vaccination rates in the United States (US) remain suboptimal, especially for adults aged 19 to 64 with high-risk medical conditions. Community-pharmacy-based immunization services increase vaccine access, particularly in rural areas. This study describes the provision of pneumococcal immunization services, assesses the processes used to identify and confirm patient eligibility, and determines barriers to immunization services in rural community pharmacies. Methods: A cross-sectional survey was emailed to members of the Rural Research Alliance of Community Pharmacies, located in the southeastern US. The survey assessed which pneumococcal vaccines were offered, age groups, prescription requirements, and how patient eligibility was determined. In addition, participants were asked to rate a series of patient-related and organizational barriers to pneumococcal vaccination. Results: Ninety-four pharmacies completed the survey, with most (96.8%) offering pneumococcal vaccines, most commonly PCV20 (95.6%). Most pharmacies vaccinated patients upon request (98.9%) or when patients presented with a prescription (82.4%), but few proactively contacted patients to schedule the vaccination (17.6%). Pharmacists most often administered pneumococcal vaccines to patients aged 65 and older and used patient age and immunization information systems to identify eligible patients. The most common patient-related barrier was the patient’s belief that they do not need the vaccine. The most common organizational barriers were inadequate reimbursements for vaccine administration and vaccine products. Conclusions: Pneumococcal vaccinations are commonly offered in rural community pharmacies, which play an important role in immunization access. With recent guideline changes to the age-based recommendation, there is an opportunity to optimize strategies to increase vaccine uptake. Full article

Background: The project ‘Multicenter Renal Pharmacist Group—Implementation of Pharmaceutical Care for Patients with Renal Impairment at four Non-University Hospitals in Germany’ started in the beginning of 2020 with the goal to establish high-quality pharmaceutical care to improve patient safety for hospitalized patients with renal impairment at German non-university hospitals. Pharmaceutical service quality should be optimized by intense and effective intraprofessional collaboration within the network. Methods: Over a period of two years (2020–2022), we implemented renal pharmacists (RPs) for patients with renal impairment (RI) at four non-university hospitals in Germany (Starnberg Hospital, Rudolf Virchow Hospital Glauchau, Catholic Hospital in the Märkisch District (KKiMK), and Hospital Sindelfingen-Boeblingen). The RPs conducted medication analyses identifying renal-drug-related problems (rDRPs) two to five days a week. The rDRPs, including recommendations to solve them, were forwarded to the attending physicians via written consultations or personally during ward rounds. The RPs were mentored by a renal pharmacist expert from LMU Munich and formed a multicentered team with close collaboration. Data about the RP service were collected and were retrospectively evaluated. Results: During the two-year project period, a total of 3924 patients from various disciplines were visited across all four locations. In total, 1425 patients (36.3%; with a range from 22.7 to 56.4% between hospitals) received one or more interventions by RPs concerning 2454 rDRPs (a median of one to three rDRPs per patient). In cooperation with the physicians, 77.6 to 88.2% of the rDRPs were solved. The most common causes were ‘dosage too high’ and ‘contraindication’. Conclusion: The implementation of pharmaceutical care for patients with renal impairment at four non-university hospitals in Germany increased appropriate prescribing by physicians. The multicenter team proved to be an excellent support for the newly established services. Full article

Background: This study evaluates one of the five regions of the state of Rio de Janeiro, Brazil, as part of a broader research project examining users’ perceptions of the Unified Health System (SUS), which has already generated publications in previous phases. The aim was to assess users’ perceptions of the SUS regarding access to and the quality of public health services, including pharmaceutical services, in the Metropolitan Region of Rio de Janeiro State. Method: A cross-sectional study was conducted between January and August 2024 with 200 participants, using a 66-item survey addressing access to and the quality of SUS services, appointment scheduling, medication acquisition, and the pharmacist’s role. Associations between variables were investigated using the Pearson Chi-Square Test in R software. Results: Frequent SUS users rated access as very good/good (p = 0.002) and overall quality as very good/good (p = 0.045). Reported challenges included the need for improved infrastructure (48.5%), better professional qualifications (30.6%), and easier access to medicines (16.8%). Higher ratings were given by those who used the SUS more frequently, and, in general, there was a tendency for participants with lower socioeconomic conditions to provide more favorable assessments of access to public health services (p = 0.024). Conclusions: A universal health system should cover diverse regions with unique needs. However, 49.4% of participants stated they never received information on how to store their medicines, and 42.3% reported never encountering a pharmacist in public pharmacies. Further ongoing studies assessing user perceptions are essential to ensure users play a central role in health decision-making, contributing to the system’s strengthening and improvement. Full article

Background: Rural communities in the United States experience significant barriers in accessing healthcare, including inadequate numbers of providers and local healthcare facilities. These barriers are exacerbated during seasons with high rates of respiratory diseases when rural clinics and providers may be overwhelmed. When mild, many of these respiratory diseases may be managed effectively in alternate settings, including community pharmacies. Investigators interviewed pharmacists in Washington State to explore the capacity of pharmacists and pharmacies to provide test-to-treat services for COVID-19, influenza, and strep throat. Methods: A qualitative study design was used to conduct key informant interviews with pharmacists who precepted student pharmacists from a local university. Twenty interviews were conducted, transcribed, and qualitatively evaluated to identify themes. The 5 A’s of Access were utilized as a theoretical framework. This framework describes five domains of access, including affordability, availability, accessibility, accommodation, and acceptability. Results: Qualitative analysis identified several themes that described the benefits of offering test-to-treat services in rural communities, such as reducing geographical barriers to accessing care, reducing wait times for patients, and reducing the number of patients seeking higher levels of care for basic treatments. Barriers to offering test-to-treat services identified by pharmacist participants included difficulties with receiving payment for services, challenges with adequate staffing, and the lack of awareness among many people in rural communities that pharmacies offer test-to-treat services. Conclusions: Rural communities experience challenges with the limited capacity of healthcare providers to meet the needs of patients in their communities. The results of this qualitative analysis may be useful to pharmacists in U.S. states where collaborative drug therapy agreements or collaborative practice agreements allow the provision of test-to-treat services. By providing test-to-treat services, pharmacists can increase access to care for rural patients and alleviate the burden of offering these services from other healthcare providers. Full article

Accessing essential healthcare services presents a challenge for consumers living in rural and remote communities, leading to higher rates of chronic disease and poorer health outcomes. Community pharmacists are well positioned to address this lack of access; thus, this study aimed to explore the perceptions of rural and remote consumers and pharmacists with respect to community pharmacists expanding their services in these communities. Qualitative, semi-structured interviews were undertaken with consumers and pharmacists recruited from community pharmacies in the far north, north west, and central west Queensland. The Consolidated Framework for Implementation Research guided question development, with the responses deductively coded and thematically analysed. Thirteen pharmacists and twenty-three consumers were interviewed, with both groups citing the benefit of reduced wait times. Key barriers were pharmacist workload, time constraints, inadequate infrastructure, and limited consumer awareness of services. Pharmacists highlighted the need for better reimbursement models and professional collaboration, while consumers valued accessibility and convenience but were concerned about the costs of services. This study has highlighted the benefits of expanded pharmacy services as perceived by the key stakeholders: consumers and pharmacists. However, future research investigating a larger sample in more rural and remote locations is needed to ensure the successful implementation of sustainable funding models to deliver better access and health outcomes for consumers in these communities. Full article

Background: Medication-related problems (MRPs) are common among home-care patients urgently needing improvement. Due to limited resources, patients with the greatest risk of MRPs should be prioritised for interventions. Objectives: We sought to develop a collaborative assessment tool for nurses and pharmacists to identify home-care patients at high risk of developing MRPs. Methods: Using Pubmed^® for a first scoping literature review, we sought existing tools identifying patients at risk of MRPs or prioritising patients for clinical pharmacy services. Extracted items were prioritised in a first interprofessional Delphi round. Results from the first Delphi round were complemented by individual risk factors identified in a second scoping literature review and again submitted to the expert panel in a second Delphi round. Each item was rated for its relevance to identify home-care patients at risk of MRPs. The highest scoring factors were combined into an interprofessional assessment tool. Results: Literature review one yielded 19 risk tools and six lists containing potentially inappropriate medications. The 78 resulting risk factors were submitted to experts (five pharmacists, five physicians, five nurses) in Delphi round one. Since the identified tools did not fit the scope (interprofessional assessment in home care) entirely, the results of Delphi round one were complemented with individual risk factors identified in a second literature review, leading to 82 potential risk factors for Delphi round two. Experts decided on a 15-item tool for future pilot testing—the doMESTIC RISK tool. It incorporated diverse factors potentially influencing medication safety: demographic information, social context, diagnosis, specific medication and health care resources use. Conclusions: With expert feedback from a Delphi process, we developed a 15-item tool to help nurses and pharmacists jointly identify home-care patients at a high risk of MRPs. Validation of the doMESTIC RISK tool will be imperative to verify its value in clinical practice. Full article

Background: Saudi Arabia is undertaking a comprehensive reform of its healthcare system to improve the efficiency and accessibility of public healthcare services. A key aspect of this initiative is outsourcing outpatient pharmacy services within the public health sector to retail pharmacies through an electronic prescribing platform known as Wasfaty. The National Unified Procurement Company (NUPCO) manages this platform to ensure spending efficiency and patient accessibility to essential medications. However, there has been a lack of research evaluating the adherence of the Wasfaty e-prescribing platform to established best practices for Computerized Provider Order Entry (CPOE), which are commonly used to assess the performance of various ambulatory e-prescribing systems globally. Objective: This study aimed to assess the level of adherence of Wasfaty to best practices for CPOE. Methods: This descriptive cross-sectional single-center study reviewed filled prescriptions through Wasfaty from May 2022 to December 2023. A list of 60 functional features, including but not limited to patient identification and data access, medication selection, alerts, patient education, data transmission and storage, monitoring and renewals, transparency and accountability, and feedback, was utilized to evaluate adherence. The adherence level was categorized into four groups: fully implemented, partially implemented, not implemented, and not applicable. Two pharmacy interns, a clinical pharmacist, and a researcher, reviewed the prescriptions to determine the platform’s adherence to these 60 CPOE features. Results: From May 2022 to December 2023, a total of 1965 prescriptions were filled in retail pharmacies for out-of-stock medications for 1367 patients. These prescriptions included medications for various areas, with the following distribution: gastroenterology (44.10%), cardiology (18.14%), anti-infectives (2.42%), urology (8.85%), dermatology (3.6%), hematology (0.29%), muscle relaxants (0.8%), neurology (19.17%), pulmonology (1.46%), and other categories (1.23%). Of the 60 functional characteristics a CPOE platform should include, only 19 (31.66%) were fully implemented, while 10 (16.66%) were partially implemented. Conclusions: The Wasfaty platform is deficient in several key functional features necessary for e-prescribing, which are essential for ensuring patient safety and enhancing the satisfaction of both prescribers and patients. This study underscores the importance of improving the Wasfaty platform to reduce the risk of adverse drug events. Full article

Very few studies, all employing surveys, have investigated the perceptions of community pharmacists regarding antimicrobial stewardship (AMS). A qualitative inquiry exploring factors affecting community pharmacists’ participation in AMS may assist in the implementation of AMS in the primary care setting. This study aimed to explore the perceived barriers and enablers of community pharmacists’ participation in AMS. One-on-one semi-structured telephone interviews were conducted with a sample of community pharmacists from across Australia. Interviews were transcribed verbatim and analysed using the Framework Analysis method. Twenty community pharmacists (70% female), representing urban, regional, and remote areas of Australia participated in the study. Pharmacists identified a discord between clinical needs of patients and practice policies as the primary source of excessive prescribing and dispensing of antibiotics. The fragmented nature of the primary healthcare system in Australia was seen as limiting information exchange between community pharmacists and general practitioners about antibiotic use, that was encouraging inappropriate and, at times, unsupervised use of antibiotics. The existing community pharmacy funding model in Australia, where individual pharmacists do not benefit from any financial incentives associated with clinical interventions, was also discouraging their participation in AMS. Pharmacists suggested restricting default antibiotic repeat supplies, reducing legal validity of antibiotic prescriptions to less than the current 12 months, and adopting a treatment duration-based approach to antibiotic prescribing instead of the ‘quantity-based’ approach, where the quantity prescribed is linked to the available pack size of the antibiotic. Structural changes in the way antibiotics are prescribed, dispensed, and funded in the Australian primary care setting are urgently needed to discourage their misuse by the public. Modifications to the current funding model for pharmacist-led cognitive services are needed to motivate pharmacists to participate in AMS initiatives. Full article

Background: Pharmacogenomics (PGx) is the future of healthcare and implementation is being driven by increasing evidence. Understanding the workflow in a PGx clinic provides insight into the development and implementation of PGx services. It considers the patient’s perspective, the role of the interprofessional team and the pivotal input of the pharmacist. Objectives: The purpose of this study was to describe the clinical workflow followed in selected PGx clinics. Methods: Four different sites that offer PGx clinical services (United States of America) were included. Qualitative data were collected through semi-structured interviews and observations providing valuable insights into the workflow followed in both community-based and hospital-based PGx clinics. Results: Although each setting differed, the processes were similar with setting-specific workflows and barriers. This study highlights the role of the pharmacist and the interprofessional team, the resources used for interpretation of PGx test results and the importance of patient and healthcare education. Conclusions: Understanding the workflow and the role of the interprofessional team in PGx is essential to ensure successful implementation and sustainable precision medicine practices in resource-limited settings. Full article