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Pharmacy

Pharmacy is an international, scientific, peer-reviewed, open access journal dealing with pharmacy education and practice and is published bimonthly online by MDPI.

Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
High Visibility: indexed within ESCI (Web of Science), PubMed, PMC, Embase, and other databases.
Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 24.6 days after submission; acceptance to publication is undertaken in 3.3 days (median values for papers published in this journal in the second half of 2024).
Recognition of Reviewers: Reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.

Impact Factor: 2.0 (2023); 5-Year Impact Factor: 2.2 (2023)

Imprint Information Journal Flyer Open Access ISSN: 2226-4787

Latest Articles

14 pages, 252 KiB

Open AccessArticle

A Clinical Pharmacy Service to Prevent Drug–Drug Interactions and Potentially Inappropriate Medication: A Consecutive Intervention Study in Older Intermediate Care Patients of a Regional Hospital

by Alexander Kilian Ullmann, Oliver Bach, Kathrin Mosch and Thilo Bertsche

Pharmacy 2025, 13(3), 60; https://doi.org/10.3390/pharmacy13030060 - 24 Apr 2025

Background: In intermediate care, older patients with polypharmacy are vulnerable to drug–drug interactions (DDI) and potentially inappropriate medication (PIM). Aims: To perform a consecutive intervention study to evaluate DDI/PIM. Methods: Clinically-relevant DDI/PIM were identified using AMeLI (electronic medication list) and PRISCUS 2.0 (PIM [...] Read more.

Background: In intermediate care, older patients with polypharmacy are vulnerable to drug–drug interactions (DDI) and potentially inappropriate medication (PIM). Aims: To perform a consecutive intervention study to evaluate DDI/PIM. Methods: Clinically-relevant DDI/PIM were identified using AMeLI (electronic medication list) and PRISCUS 2.0 (PIM list). Consecutive patients (standard care group) were screened for DDI/PIM after admission (t0) and again before discharge (t1). In an interim period, physicians received general education about DDI/PIM. Then, consecutive patients (independent clinical pharmacy group) were screened for DDI/PIM after admission (t2). Physicians were then provided with patient-individualized recommendations by a clinical pharmacist to prevent DDI/PIM. The patients were then screened again for DDI/PIM before discharge (t3). Results: In each group, 100 patients were included with data available for evaluation from 97 (standard care group, median age: 78 years [Q25/Q75: 69/84]) and 89 (clinical pharmacy group, 76 years [67/84]). In the standard care group, DDI were identified in 55 (57%) patients after admission (t0) and 54 (56%) before discharge (t1, ARR[t0/t1] = 0.01, NNT[t0/t1] = 100, n.s.). In the clinical pharmacy group, DDI were identified in 32 (36%) after admission (t2; ARR[t0/t2] = 0.21/NNT[t0/t2] = 5, p < 0.01) and 26 (29%) before discharge (t3; ARR[t2/t3] = 0.07/NNT[t2/t3] = 15, n.s.; ARR[t1/t3] = 0.27/NNT[t1/t3] = 4, p < 0.001). PIM were identified in patients at t0: 34 (35%), t1: 35 (36%, ARR[t0/t1] = −0.01/NNH[t0/t1] = 100, n.s.), t2: 25 (26%, ARR[t0/t2] = 0.09/NNT[t0/t2] = 12, n.s.), t3: 23 (24%, ARR[t2/t3] = 0.11/NNT[t2/t3] = 10, n.s.; ARR[t1/t3] = 0.12/NNT[t1/t3] = 9, n.s.). Conclusions: In the standard care group, after admission, many DDI/PIM were identified in older intermediate care patients. Before discharge, their number was hardly influenced at all. General education for physicians led to DDI prevention after admission. In addition, the DDI frequency decreased by providing physicians with patient-individualized recommendations. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

16 pages, 2707 KiB

Open AccessArticle

Exploring Doping Awareness: Medical Experts’ Perspectives and Their Commitment to Doping Prevention

by Vanya Rangelov Kozhuharov, Radiana Staynova, Kalin Ivanov, Hristo Manev and Stanislava Ivanova

Pharmacy 2025, 13(3), 59; https://doi.org/10.3390/pharmacy13030059 - 24 Apr 2025

Humanity has used and explored various performance-enhancing remedies since ancient times. To protect clean sport, athletes’ health, and to provide fair and transparent competitions, different anti-doping policies were implemented. Nowadays, the anti-doping policies are evolving every year and are governed by the World [...] Read more.

Humanity has used and explored various performance-enhancing remedies since ancient times. To protect clean sport, athletes’ health, and to provide fair and transparent competitions, different anti-doping policies were implemented. Nowadays, the anti-doping policies are evolving every year and are governed by the World Anti-Doping Agency. The use of doping in sports is regarded as a persistent problem across various athletic disciplines; at the same time, the topic of whether doping is preventable is highly discussed. The aim of this study was to assess the knowledge of medical specialists about doping compounds and to analyze their willingness and preparedness to participate in doping prevention programs. A cross-sectional questionnaire-based study was conducted between March 2024 and May 2024. Study participants included medical and pharmacy students, pharmacists, and medical doctors. Statistical analysis was performed using IBM SPSS Statistics version 24.0. Descriptive statistics, one-way analysis of variance (ANOVA), and independent-samples t-test were applied to analyze different variables. The results from the study suggested that healthcare professionals, particularly pharmacists, could be successfully engaged in doping prevention. Additionally, community pharmacies could also be involved in doping-prevention strategies since they are recognized as easily accessible healthcare locations. The relationship between medical specialists and professional athletes is essential for raising awareness, receiving trustworthy information, and developing decision-making capability to prevent not only the intentional but also the unintentional anti-doping rule violations. Full article

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11 pages, 448 KiB

Open AccessArticle

Training the Next Generation of Pharmacist Educators (NextGenRxEd): Outcomes from a Longitudinal 4-Year Teaching and Research Program

by Candis M. Morello, Mark Bounthavong and Jan D. Hirsch

Pharmacy 2025, 13(3), 58; https://doi.org/10.3390/pharmacy13030058 - 22 Apr 2025

To combine didactic education with clinical and research experiences that would empower student pharmacists to consider postgraduate training and a career in pharmacy education or academics, in 2009, the Next Generation of Pharmacist Educators (NextGenRxEd) program, a four-year longitudinal education program, was implemented [...] Read more.

To combine didactic education with clinical and research experiences that would empower student pharmacists to consider postgraduate training and a career in pharmacy education or academics, in 2009, the Next Generation of Pharmacist Educators (NextGenRxEd) program, a four-year longitudinal education program, was implemented at the University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences. Directed by two pharmacist faculty, a clinician and researcher, student pharmacists were exposed to hands-on experience with clinical management, patient care, and research processes. A post-graduation survey was created and administered in Fall 2024 to evaluate outcomes for all student pharmacists who completed the program. Key performance indicators included the number of pharmacy students proceeding to postgraduate training, research practices, and pharmacist positions involving education and academics. During 2009–2024, 34 student pharmacists completed the NextGenRxEd program; 71% achieved postgraduate education (22 PGY1 residencies and two fellowships). Following quality improvement implementation, this percentage increased from 50% to 89%, for Classes 2009–2015 and 2016–2024, respectively. Overall, the PGY1 match rate was 92%, and 19 abstracts/posters and 10 manuscripts were published, respectively. The post-graduation survey response rate was 85%, with 93% of respondents reporting that they precepted PharmD students; 14% became faculty members, and 66% participated in research. The NextGenRxEd program provides a model whereby student pharmacists are equipped to obtain post-graduate education and pursue a career with a significant role in pharmacy education or academic pharmacy. This program has the potential to be implemented at other pharmacy schools/colleges to benefit faculty and student participants. Full article

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12 pages, 1410 KiB

Open AccessArticle

SMART Pharmacist—The Impact of Education on Improving Pharmacists’ Participation in Monitoring the Safety of Medicine Use in Montenegro

by Snežana Mugoša, Arijana Meštrović, Veselinka Vukićević, Milanka Žugić and Michael J. Rouse

Pharmacy 2025, 13(2), 57; https://doi.org/10.3390/pharmacy13020057 - 17 Apr 2025

Pharmaceutical care as a concept was introduced in Montenegro during the last 10 years. The Pharmaceutical Chamber of Montenegro (PCM) and the Institute for Medicines and Medical Devices (CInMED) conducted SMART Pharmacist Program educational activities for pharmacists as a project to improve their [...] Read more.

Pharmaceutical care as a concept was introduced in Montenegro during the last 10 years. The Pharmaceutical Chamber of Montenegro (PCM) and the Institute for Medicines and Medical Devices (CInMED) conducted SMART Pharmacist Program educational activities for pharmacists as a project to improve their impact on monitoring drug safety. In the period from September 2023 to May 2024, a total of 78 pharmacists participated in the project, of which 53 (68%) submitted valid reports of suspected adverse drug reactions (ADRs). During the project, a total of 302 valid reports were submitted, and the pharmacists’ share in total reporting increased to 74% in 2023 compared to less than 10% in the previous 5 years. The results of this research will be used to make recommendations for further improvement of the pharmacovigilance system, as well as to create plans for continuing education (CE) of other health workers in the area of rational and safe use of medicines. Full article

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11 pages, 191 KiB

Open AccessArticle

Factors Influencing Community Pharmacists’ Participation in Antimicrobial Stewardship: A Qualitative Inquiry

by Tasneem Rizvi, Syed Tabish R. Zaidi, Mackenzie Williams, Angus Thompson and Gregory M. Peterson

Pharmacy 2025, 13(2), 56; https://doi.org/10.3390/pharmacy13020056 - 14 Apr 2025

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 [...] Read more.

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

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

14 pages, 591 KiB

Open AccessReview

Heparin-Induced Hyperkalemia Assessment Utilizing the Naranjo Adverse Drug Reaction Probability Scale: A 40-Year Systematic Review

by Divita Singh, Omnia A. E. A. Mesalhy and Michael J. Cawley

Pharmacy 2025, 13(2), 55; https://doi.org/10.3390/pharmacy13020055 - 11 Apr 2025

Background: Adverse drug reactions have been reported as leading causes of morbidity and mortality. Unfractionated heparin- and low-molecular-weight heparin-induced hyperkalemia are side effects that have been reported in approximately 7 to 8% of heparin-treated patients. Algorithms, assessment tools, and decision aids are needed [...] Read more.

Background: Adverse drug reactions have been reported as leading causes of morbidity and mortality. Unfractionated heparin- and low-molecular-weight heparin-induced hyperkalemia are side effects that have been reported in approximately 7 to 8% of heparin-treated patients. Algorithms, assessment tools, and decision aids are needed to assist in determining the causality of these adverse drug reactions. Aim: The aim of this study was to determine the number of case reports of hyperkalemia resulting from unfractionated heparin or low-molecular-weight heparin use by utilizing the Naranjo Adverse Drug Reaction Probability Scale. Methods: PubMed, International Pharmaceutical Abstracts, and the Cochrane Library were searched for relevant publications. Search terms and Boolean operators, including “hyperkalemia AND heparin”, “hyperkalemia AND low molecular weight heparin”, “heparin AND hypoaldosteronism”, and “low molecular weight heparin AND hypoaldosteronism”, were used. Searches were limited to case reports and human specimens. Results: A total of 29 case reports were identified, incorporating 38 patient cases. Of the 38 patient cases, 5 [4 involving unfractionated heparin and 1 involving low-molecular-weight heparin] (13.2%) utilized the Naranjo Adverse Drug Reaction Probability Scale to identify the possibility of an adverse drug reaction occurring due to exposure to unfractionated or low-molecular-weight heparin as probable. Conclusions: The available evidence suggests that clinicians’ use of the Naranjo Adverse Drug Reaction Probability Scale to determine the potential of hyperkalemia occurring due to exposure to unfractionated heparin and low-molecular-weight heparin is limited. Clinicians should be encouraged to utilize an objective monitoring tool to help standardize assessment of causality for all adverse drug reactions. Full article

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6 pages, 722 KiB

Open AccessArticle

Evaluating Pharmacy Student Perspectives and Attitudes Towards Compliance Aids and Devices Through Health Disparity Simulation

by Bradley Phillips and Jason Powell

Pharmacy 2025, 13(2), 54; https://doi.org/10.3390/pharmacy13020054 - 10 Apr 2025

Objective: This study intends to evaluate simulated experiences provided to pharmacy students that directly compare the perspective of patients managing chronic disease states through traditional means without compliance aids to those using compliance aids, such as continuous glucose monitors (CGMs) and other devices. [...] Read more.

Objective: This study intends to evaluate simulated experiences provided to pharmacy students that directly compare the perspective of patients managing chronic disease states through traditional means without compliance aids to those using compliance aids, such as continuous glucose monitors (CGMs) and other devices. Methods: This simulation was conducted with third-year pharmacy students enrolled in the ambulatory care elective course at the University of Florida College of Pharmacy. It was designed to simulate a patient responsible for self-administering an array of medications for multiple chronic diseases that the students are likely to encounter during clinical practice. For the first week, students were tasked with adhering to a complex medication schedule from their associated pill bottles without the use of compliance aids (pill organizers, alarms, etc.) and checking their blood glucose twice daily using a traditional glucometer. In the second week, students continued the role of the patient; however, they were provided with compliance aids and encouraged to set alarms and use CGMs. Using a questionnaire developed based on the traditional Likert scale model, the students were able to quantify their experiences in a way that allowed the investigators to observe any changes. Results: Regarding the overall implications of this experience, most participants (>80%) agreed that this project increased their understanding of the value of compliance aids and devices and encouraged them to not only incorporate them into their future patient care plans but also advocate for accessibility to improve health outcomes. Conclusion: Students who completed this experience reported better adherence to chronic disease state control using compliance aids and, in turn, the applicability of the use of compliance aids in managing those with complex medication regimens. This simulation may encourage future pharmacists to incorporate compliance aids with their patients to improve health outcomes. Full article

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30 pages, 6346 KiB

Open AccessArticle

Investigating the Time-Varying Nature of Medication Adherence Predictors: An Experimental Approach Using Andersen’s Behavioral Model of Health Services Use

by Vasco M. Pontinha, Julie A. Patterson, Dave L. Dixon, Norman V. Carroll, D’Arcy Mays, Karen B. Farris and David A. Holdford

Pharmacy 2025, 13(2), 53; https://doi.org/10.3390/pharmacy13020053 - 9 Apr 2025

Medication adherence is a crucial factor for managing chronic conditions, especially in aging adults. Previous studies have identified predictors of medication adherence. However, current methods fail to capture the time-varying nature of how risk factors can influence adherence behavior. This objective of this [...] Read more.

Medication adherence is a crucial factor for managing chronic conditions, especially in aging adults. Previous studies have identified predictors of medication adherence. However, current methods fail to capture the time-varying nature of how risk factors can influence adherence behavior. This objective of this study was to implement multitrajectory group-based models to compare a time-varying to a time-fixed approach to identifying non-adherence risk factors. The study population comprised 11,068 Medicare beneficiaries aged 65 and older taking select medications for hypertension, high blood cholesterol, and oral diabetes medications, between 2008 and 2016. Time-fixed predictors (e.g., sex, education) were examined using generalized multinomial logistic regression, while time-varying predictors were explored through multitrajectory group-based modeling. Several predisposing, enabling, and need characteristics were identified as risk factors for following at least one non-adherence trajectory. Time-varying predictors displayed an alternative representation of those risk factors, especially depression symptoms. This study highlights the dynamic nature of medication adherence predictors and the utility of multitrajectory modeling. Findings suggest that targeted interventions can be developed by addressing the key time-varying factors affecting adherence. Full article

(This article belongs to the Topic Optimization of Drug Utilization and Medication Adherence)

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11 pages, 1003 KiB

Open AccessArticle

Impact of Removing Race Coefficient from Glomerular Filtration Rate Estimation Equations on Antidiabetics Among Black Patients

by Dhakrit Rungkitwattanakul, Ebony Evans, Ewanna Brown, Kent Patterson Jr., Weerachai Chaijamorn, Taniya Charoensareerat, Sanaa Belrhiti, Uzoamaka Nwaogwugwu and Constance Mere

Pharmacy 2025, 13(2), 52; https://doi.org/10.3390/pharmacy13020052 - 2 Apr 2025

Background: In 2021, the National Kidney Foundation–American Society of Nephrology (NKF-ASN) recommended the use of the 2021 refit equation without race; however, the effect of the removal is unclear. Our research aimed to examine the implications of antidiabetic dosing and eligibility on the [...] Read more.

Background: In 2021, the National Kidney Foundation–American Society of Nephrology (NKF-ASN) recommended the use of the 2021 refit equation without race; however, the effect of the removal is unclear. Our research aimed to examine the implications of antidiabetic dosing and eligibility on the new 2021 equation among Black patients. Methods: This is a retrospective analysis of patients receiving care at the diabetes treatment center (DTC) of an academic medical center. Estimated glomerular filtration rates (eGFRs) based on serum creatinine were calculated using the 2009 and 2021 CKD-EPI equations. A Monte Carlo simulation was performed to create 10,000 virtual patients. Dosing simulations based on each estimate of kidney function were performed for antidiabetics based on product labeling. The proportion and percentage of patients who were eligible based on the estimates were calculated. Results: The percentages of patients ineligible for metformin based on the estimates from the 2009 and 2021 CKD-EPI equations at the DTC were comparable (8.02% and 8.36%, respectively). In our 10,000 simulated virtual patients, the percentage of ineligibility increased only by 1%. For the GFR cut points of 20 mL/min and 25 mL/min, the rates of ineligibility were similar in our cohort and simulated patients. Conclusions: The exclusion of race from the 2021 CKD-EPI equation may slightly reduce medication eligibility among Black patients. Full article

(This article belongs to the Special Issue Medication Use and Patient Safety in Clinical Pharmacy)

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11 pages, 183 KiB

Open AccessArticle

Challenges of Key Performance Indicators and Metrics for Measuring Medical Science Liaison Performance: Insights from a Global Survey

by Samuel Dyer, Cherie Hyder and Jeff Kraemer

Pharmacy 2025, 13(2), 51; https://doi.org/10.3390/pharmacy13020051 - 2 Apr 2025

Background: Medical Science Liaisons (MSLs) serve a vital role in facilitating the exchange of scientific knowledge between pharmaceutical companies and health care professionals (HCPs), including pharmacists, ensuring the dissemination of accurate, evidence-based information to support clinical decision-making. Evaluating MSL performance is critical for [...] Read more.

Background: Medical Science Liaisons (MSLs) serve a vital role in facilitating the exchange of scientific knowledge between pharmaceutical companies and health care professionals (HCPs), including pharmacists, ensuring the dissemination of accurate, evidence-based information to support clinical decision-making. Evaluating MSL performance is critical for demonstrating their value, yet defining appropriate key performance indicators (KPIs) remains challenging due to the combination of scientific engagement, relationship-building, and other activities that are difficult to measure. Objective: This study examines the current and perceived ideal use of quantitative and qualitative metrics for MSL performance evaluation, the difficulties in measuring MSL impact, and the perceived effectiveness of existing KPIs. Methods: A global survey of 1023 medical affairs professionals across 63 countries was conducted, gathering data on which KPIs are currently used versus which should be used, the preferred weighting of qualitative vs. quantitative metrics, and opinions on measurement difficulty and KPI effectiveness. Results: The results reveal a strong preference for qualitative metrics (52%) over quantitative metrics (7%), though most organizations primarily use activity-based metrics such as the number of key opinion leader (KOL) engagements (92%). Despite these practices, many respondents believe that MSL KPIs should focus more on impact-based qualitative metrics, such as the quality of KOL/HCP relationships and/or engagements (70%) and the quality of actionable insights gathered (67%). Furthermore, 67% of participants reported it is “difficult” or “very difficult” to measure MSL performance accurately, and only 3% revealed current KPIs and metrics used to measure MSL performance are “very effective”. These findings highlight a disconnect between the way MSLs are evaluated and the value they provide. Conclusions: This study demonstrates the need for a balanced KPI framework that integrates both qualitative and quantitative measures. A more refined performance evaluation system (incorporating stakeholder feedback, insight quality, and strategic impact) can ensure fair assessments and drive MSL effectiveness. Full article

23 pages, 2304 KiB

Open AccessReview

Medication Safety in Saudi Arabia: Evaluating the Current Situation and Identifying the Areas for Improvement

by Anwar A. Alghamdi

Pharmacy 2025, 13(2), 50; https://doi.org/10.3390/pharmacy13020050 - 1 Apr 2025

Drug safety is crucial in healthcare, ensuring the secure and effective administration of medications to protect patient welfare. Drug and medication safety is a major concern among Saudi healthcare providers, with numerous studies outlining the incidence of medication errors and the need for [...] Read more.

Drug safety is crucial in healthcare, ensuring the secure and effective administration of medications to protect patient welfare. Drug and medication safety is a major concern among Saudi healthcare providers, with numerous studies outlining the incidence of medication errors and the need for enhanced safety standards. This review will examine the existing level of drug-related safety in Saudi Arabia, categorizing the areas for improvement and highlighting concepts to improve safety practices. The overview discusses the history and evolution of pharmaceutical safety procedures, the present regulatory framework, major stakeholders, and the types and origins of prescription errors. It also examines the role of healthcare personnel and the use of technology and patient education in promoting pharmaceutical safety. The data reveal that the rate of pharmaceutical errors in Saudi hospitals is shockingly high, ranging from 13 to 56 per 100 medication orders, highlighting the urgent need for effective medication safety standards. Despite the formation of the Saudi Food and Drug Authority (SFDA) and the National Pharmacovigilance and Drug Safety Centre, issues such as poor understanding among healthcare providers and the need for more effective reporting methods remain a challenge. The evaluation highlights the deficiencies in ongoing education, such as real-world case scenarios and related trainings, inadequate incorporation of skills in assessment methods, and deficiency in standardized protocols for error reporting. To address these gaps, it is proposed to implement structured competency-based training, simulation exercises must be preferred for periodic skill assessments, and a safe reporting culture should be encouraged for the sake of transparency and learning from errors. We recognize the use of technology, such as electronic health records and computerized physician order input systems, as an important technique for improving medication safety. Future directions include creating national guidelines, establishing a centralized pharmaceutical error reporting system, and fostering a safety culture inside healthcare organizations. By addressing these obstacles and capitalizing on the opportunities indicated, we may improve pharmaceutical safety and, ultimately, patient care and outcomes in Saudi Arabia. Full article

(This article belongs to the Special Issue Medication Use and Patient Safety in Clinical Pharmacy)

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12 pages, 203 KiB

Open AccessArticle

Is Pharmacy a Friendly Profession for Everyone in the U.S.? A Probe into Gender and Other Income Disparities

by Ioana Popovici and Manuel J. Carvajal

Pharmacy 2025, 13(2), 49; https://doi.org/10.3390/pharmacy13020049 - 26 Mar 2025

The literature shows that women persistently earn less than men for similar roles and qualifications; yet, pharmacy has been portrayed as an egalitarian profession, with a small gender earnings gap relative to other occupations. There is a lack of recent studies, and some [...] Read more.

The literature shows that women persistently earn less than men for similar roles and qualifications; yet, pharmacy has been portrayed as an egalitarian profession, with a small gender earnings gap relative to other occupations. There is a lack of recent studies, and some evidence suggests a significant gender gap when earnings are estimated separately for male and female pharmacists. This study compared the nature and magnitude of gender income disparities using two alternative methodological procedures and evaluated the evidence for policy implications. The study was based on 2019–2022 American Community Survey (ACS) data collected by the U.S. Census Bureau. The sample consisted of 12,450 pharmacists (61.5% women) ages 25–64 years practicing in the U.S. Ordinary least-squares models calculated pharmacist annual incomes as functions of work input, human-capital, and job-related covariates. Results estimated a gender earnings gap of up to 18.6%. Differences across sociodemographic groups suggested that pharmacy is only friendly to selected segments of the profession. The empirical evidence reported here is expected to be used by healthcare managers and policymakers to inform ongoing discussion regarding the need for policy changes and cultural shifts to promote gender equity. Full article

(This article belongs to the Special Issue Women's Special Issue Series: Pharmacy and Pharmacists)

12 pages, 1258 KiB

Open AccessArticle

Prescription Audit in Outpatient Pharmacy of a Tertiary Care Referral Hospital in Haryana Using World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) Core Prescribing Indicators: A Step Towards Refining Drug Use and Patient Care

by Nikhil Verma, Shanmugapriya Vinayagam, Niti Mittal, Rakesh Mittal and Neeraj Bansal

Pharmacy 2025, 13(2), 48; https://doi.org/10.3390/pharmacy13020048 - 25 Mar 2025

Background: The evaluation of internationally comparable indicators of medicine use is important to devise strategies to promote the rational use of medicines (RUM). Methods: A cross-sectional study was conducted in a tertiary care hospital from January to June 2024. Prescriptions were collected from [...] Read more.

Background: The evaluation of internationally comparable indicators of medicine use is important to devise strategies to promote the rational use of medicines (RUM). Methods: A cross-sectional study was conducted in a tertiary care hospital from January to June 2024. Prescriptions were collected from the outpatient pharmacy using systematic random sampling and analyzed for WHO/INRUD core prescribing indicators, index of rational drug prescribing (IRDP) and completeness (general, treatment and prescribers’ details). Results: Out of 844 prescriptions collected, 607 were analyzed. A total of 1837 drugs were prescribed, with a mean (SD) of 3.03 (1.51) drugs per prescription; 1378 (75%) drugs were prescribed as generic names; 125 prescriptions (20.59%) had an antibiotic prescribed; and injectables were given in 7 (1.15%) prescriptions. Of the total 1837 drugs, 1018 (55.4%) were mentioned in the National List of Essential Medicines (NLEM) 2022, while 934 (50.8%) were included in the Haryana state essential medicines list (2013–2014). The IRDP was calculated as 3.86. The mean (SD) completeness score of the prescriptions was 10.33 (0.8) (range 5 to 11). Conclusions: There was a high incidence of polypharmacy, brand name and non-essential drug prescribing, while antibiotic and injection use were in accordance with WHO standards. Full article

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9 pages, 414 KiB

Open AccessBrief Report

Timing of Naldemedine Initiation and Occurrence of Diarrhea in Patients Receiving Strong Opioid Analgesics: A Retrospective Study

by Takuma Matsumoto, Takuya Mura, Tsubasa Wada, Yuki Tsugo, Naoko Mukai, Terutaka Hamaoka, Shuji Horita, Yasushi Semba and Shinichi Watanabe

Pharmacy 2025, 13(2), 47; https://doi.org/10.3390/pharmacy13020047 - 21 Mar 2025

Naldemedine, a peripherally acting μ-opioid receptor antagonist, is used to treat opioid-induced constipation (OIC). However, it causes diarrhea as an adverse effect. This retrospective study aimed to investigate whether the occurrence of diarrhea was dependent on the timing of naldemedine treatment initiation. Inpatients [...] Read more.

Naldemedine, a peripherally acting μ-opioid receptor antagonist, is used to treat opioid-induced constipation (OIC). However, it causes diarrhea as an adverse effect. This retrospective study aimed to investigate whether the occurrence of diarrhea was dependent on the timing of naldemedine treatment initiation. Inpatients who were initially treated with naldemedine at the Department of Respiratory Medicine, NHO Iwakuni Medical Center, Japan, between 1 December 2017 and 31 March 2021 were included in this study and divided into the simultaneous combination group, in which naldemedine was introduced at the same time as strong opioid analgesics, and the non-simultaneous combination group, in which naldemedine was introduced after the initiation of treatment with strong opioid analgesics. This study included 45 patients, 15 (33.3%) of whom developed diarrhea. Among the patients in the simultaneous combination group and non-simultaneous combination group, diarrhea occurred in 2 (11.1%) and 13 (48.1%) patients, respectively. Multivariate logistic regression analysis revealed that the delayed introduction of naldemedine was significantly associated with the development of diarrhea (odds ratio: 6.68, 95% confidence interval: 1.220–36.700, p = 0.028). Our analysis reveals that the simultaneous administration of naldemedine and oxycodone may prevent the development of diarrhea associated with naldemedine use for OIC. Full article

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18 pages, 745 KiB

Open AccessSystematic Review

Factors and Disparities Influencing Sodium-Glucose Cotransporter 2 Inhibitors and Glucagon-like Peptide 1 Receptor Agonists Initiation in the United States: A Scoping Review of Evidence

by Josiah Moore, Ndidi Iheme, Nicholas S. Rebold, Harriet Kusi, Constance Mere, Uzoamaka Nwaogwugwu, Earl Ettienne, Weerachai Chaijamorn and Dhakrit Rungkitwattanakul

Pharmacy 2025, 13(2), 46; https://doi.org/10.3390/pharmacy13020046 - 19 Mar 2025

Introduction: Health disparities affecting minority populations and resulting in poorer outcomes for disadvantaged groups have been documented in the literature. Sodium/glucose-cotransporter 2 (SGLT2i) inhibitors and GLP-1 receptor agonists (GLP-1RA) markedly decrease mortality from kidney and cardiovascular events. However, little is known about the [...] Read more.

Introduction: Health disparities affecting minority populations and resulting in poorer outcomes for disadvantaged groups have been documented in the literature. Sodium/glucose-cotransporter 2 (SGLT2i) inhibitors and GLP-1 receptor agonists (GLP-1RA) markedly decrease mortality from kidney and cardiovascular events. However, little is known about the factors and disparities that lead to differences in SGLT2i and GLP-1RA initiation across different ethnic groups. Methods: This scoping review queried databases using key terms related to disparities in the initiation of SGLT2i and GLP-1RA among high-risk populations. Relevant data from eligible studies were extracted, organized, and analyzed thematically to identify key trends and patterns in the literature. Result: Nineteen studies were included in this review. Key risk factors influencing uptake included age, provider type, race, sex, education, comorbidities, insurance, and income, with minority patients consistently showing lower rates of initiation due to systemic barriers and socioeconomic disparities. Patients who were younger, male, had higher education or income levels, and received care from specialists were more likely to use these therapies. Conclusion: The adoption of SGLT2i and GLP-1RA remains suboptimal despite their proven kidney and cardiovascular benefits. Targeted efforts to reduce socioeconomic and racial inequities based on the factors identified should be encouraged. Full article

(This article belongs to the Topic Optimization of Drug Utilization and Medication Adherence)

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11 pages, 191 KiB

Open AccessArticle

A Qualitative Study on Ethics Education at Pharmacy Colleges in Japan Based on a Survey of Ethics Educators

by Etsuko Arita, Yuko Masamura and Rieko Takehira

Pharmacy 2025, 13(2), 45; https://doi.org/10.3390/pharmacy13020045 - 18 Mar 2025

Background: In pharmacy education in Japan, efforts continue to develop a model for ethics education that fosters high ethical standards and the problem-solving skills essential for medical professionals. This study qualitatively analyzed the attitudes of ethics educators—those who teach ethics classes—to establish [...] Read more.

Background: In pharmacy education in Japan, efforts continue to develop a model for ethics education that fosters high ethical standards and the problem-solving skills essential for medical professionals. This study qualitatively analyzed the attitudes of ethics educators—those who teach ethics classes—to establish a model of ethics education for pharmacy colleges in Japan. Methods: This study analyzed open-ended responses from 32 universities to the question, “What do you think about ethics education provided by faculties of pharmaceutical sciences?” Result: The qualitative analysis revealed that ethics educators at pharmacy colleges in Japan believe in the potential of ethics education to nurture problem-solving skills and logical thinking. However, the educator’s question whether or not the students would be able to apply ethics content in clinical settings as medical professionals. Another issue is that faculties of pharmaceutical sciences lack the staff and expertise to teach ethics. In other words, the educators lack the wherewithal to break the logjam in ethics education through their efforts; hence, they are desperate for an ethics education model. Conclusions: Based on our findings, further research is needed to design strategies that can enhance the quality of pharmacy education in Japan. Full article

(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)

12 pages, 205 KiB

Open AccessArticle

Patterns and Appropriateness of Psychotropic Medications Prescribing in Primary Healthcare in Jordan

by Derar H. Abdel-Qader, Alia Saleh, Abdullah Albassam, Esra’ Taybeh, Nadia Al Mazrouei, Khalid Awad Al-Kubaisi, Rana Ibrahim, Reham Aljalamdeh, Salim Hamadi, Sahar Jaradat and Shorouq Al-Omoush

Pharmacy 2025, 13(2), 44; https://doi.org/10.3390/pharmacy13020044 - 18 Mar 2025

Background: Although psychotropic medications (PMs) have enormous adverse events and may cause serious harm if administered inappropriately, there is a scarcity of research concerning the patterns and appropriateness of prescribing these medications in primary care in Jordan. This study aimed to investigate the [...] Read more.

Background: Although psychotropic medications (PMs) have enormous adverse events and may cause serious harm if administered inappropriately, there is a scarcity of research concerning the patterns and appropriateness of prescribing these medications in primary care in Jordan. This study aimed to investigate the patterns and appropriateness of PM prescription in primary care, as well as the types and frequency of pharmacist interventions in community pharmacies. Methods: A prospective observational study was conducted in 16 community pharmacies across Jordan. A data reporting sheet was developed, validated, piloted to ensure its applicability, and filled out over 12 weeks (April to June 2023), covering three regions in Jordan. Results: Overall, 426 patients with 469 prescriptions containing 919 PM orders were observed. Among the PMs prescribed, 19.4% were prescribed inappropriately. Among the PMs, 78.7% were dispensed by pharmacists. The inappropriate prescription categories (n = 178) were overprescribing (45, 25.3%), underprescribing (19, 10.7%), inappropriate medication choice (39, 21.9%), inappropriate duration of medication therapy (64, 36.0%), and inappropriate medication dosage (11, 6.2%). The top therapeutic category requested was anti-epileptics (23.9%). Conclusions: This study evaluated the prescribing patterns and appropriateness of PMs in Jordan, revealing notable instances of inappropriate PM prescriptions alongside varied and extensive pharmacist interventions. Full article

9 pages, 584 KiB

Open AccessCase Report

Ekbom Syndrome Management in Elderly Patients: Challenges in Risperidone Titration and Treatment Adherence

by Florina Madalina Mindru, Adrian Gheorghe Bumbu and Darian Faur

Pharmacy 2025, 13(2), 43; https://doi.org/10.3390/pharmacy13020043 - 16 Mar 2025

Ekbom Syndrome, also known as Delusional Parasitosis (DP), is considered a rare psychiatric condition. Based on diagnostic criteria, it is characterized by the strong belief of being infested with various parasites, as well as the presence of perceptual disturbances, usually tactile and/or visual [...] Read more.

Ekbom Syndrome, also known as Delusional Parasitosis (DP), is considered a rare psychiatric condition. Based on diagnostic criteria, it is characterized by the strong belief of being infested with various parasites, as well as the presence of perceptual disturbances, usually tactile and/or visual hallucinations. The syndrome can manifest idiopathically or in connection with other medical conditions and substance use. Diagnosis is challenging, as patients tend to pursue dermatological care initially. This case report describes an 81-year-old female diagnosed with Ekbom Syndrome, presenting with severe anxiety, insomnia, and persistent delusions of infestation. Initial treatment with low-dose Risperidone (2 mg/day) was ineffective, requiring a dose escalation to 4 mg/day. However, the patient’s nonadherence to follow-up limited the assessment of long-term outcomes. This case highlights key clinical challenges in elderly patients, particularly dose titration, treatment response, and adherence issues. Comparative analysis with prior case reports suggests that higher doses of Risperidone (3–6 mg/day) may be required for symptom remission, but long-term outcomes remain uncertain. Additionally, nonadherence remains a major barrier, underscoring the need for structured monitoring and caregiver involvement. These findings offer insights into antipsychotic strategies for Ekbom Syndrome, highlighting individualized pharmacotherapy, long-term follow-up, and adherence support in elderly patients. Full article

(This article belongs to the Topic Optimization of Drug Utilization and Medication Adherence)

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14 pages, 514 KiB

Open AccessArticle

Long-Term Impact of Sustained Knowledge, Confidence, and Clinical Application Following a First-Year Student Pharmacist Diabetes Self-Care Education Program

by Candis M. Morello and Eduardo S. Fricovsky

Pharmacy 2025, 13(2), 42; https://doi.org/10.3390/pharmacy13020042 - 11 Mar 2025

With diabetes reaching epidemic proportions globally, it is imperative to increase the number of providers equipped to screen, educate, and help patients achieve glycemic control. This study evaluated the long-term results of student pharmacists attending a first-year Diabetes Self-Care Education Program (DSEP) by [...] Read more.

With diabetes reaching epidemic proportions globally, it is imperative to increase the number of providers equipped to screen, educate, and help patients achieve glycemic control. This study evaluated the long-term results of student pharmacists attending a first-year Diabetes Self-Care Education Program (DSEP) by measuring knowledge retention, confidence, and clinical applicability of skills learned over time. The DSEP, integrated into the early pharmacy curriculum, is a 9-h training program made up of interactive lectures, glucose monitoring assignments, and active-learning workshops. Following DSEP training, two cohorts of first-year student pharmacists were surveyed annually for 3 and 5 years to assess knowledge retention, confidence, and clinical use of the DSEP content in their practice sites. By the year 1 follow-up survey, the response rate from the pre-survey period for cohort 1 was 88% and 78% for cohort 2; over time, the response rate decreased. For the long-term follow-up surveys, cohort 1 (5 years) and cohort 2 (3 years) demonstrated overall significantly improved sustained knowledge of diabetes (48% higher average test score, p < 0.001), perceived confidence, and clinical ability (over 60% and 76% increases from baseline, p < 0.001). Within 12 months of completing the DSEP, about two-thirds of students applied their training to assist patients with diabetes and their caregivers. Long-term, participants in both cohorts reported educating and screening over 22,000 patients with diabetes and caregivers in multiple clinical settings over 3 years and 5 years, respectively, following DSEP training. The positive impact of improved knowledge, confidence, and clinical applicability of the DSEP training obtained by student pharmacists was sustained for 3 or more years, impacting thousands of patients with diabetes and caregivers. Considering the growing global diabetes epidemic, pharmacy schools around the world should consider implementing an early DSEP program. Full article

(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)

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22 pages, 817 KiB

Open AccessArticle

Clinical and Operational Applications of Artificial Intelligence and Machine Learning in Pharmacy: A Narrative Review of Real-World Applications

by Maree Donna Simpson and Haider Saddam Qasim

Pharmacy 2025, 13(2), 41; https://doi.org/10.3390/pharmacy13020041 - 7 Mar 2025

Over the past five years, the application of artificial intelligence (AI) including its significant subset, machine learning (ML), has significantly advanced pharmaceutical procedures in community pharmacies, hospital pharmacies, and pharmaceutical industry settings. Numerous notable healthcare institutions, such as Johns Hopkins University, Cleveland Clinic, [...] Read more.

Over the past five years, the application of artificial intelligence (AI) including its significant subset, machine learning (ML), has significantly advanced pharmaceutical procedures in community pharmacies, hospital pharmacies, and pharmaceutical industry settings. Numerous notable healthcare institutions, such as Johns Hopkins University, Cleveland Clinic, and Mayo Clinic, have demonstrated measurable advancements in the use of artificial intelligence in healthcare delivery. Community pharmacies have seen a 40% increase in drug adherence and a 55% reduction in missed prescription refills since implementing artificial intelligence (AI) technologies. According to reports, hospital implementations have reduced prescription distribution errors by up to 75% and enhanced the detection of adverse medication reactions by up to 65%. Numerous businesses, such as Atomwise and Insilico Medicine, assert that they have made noteworthy progress in the creation of AI-based medical therapies. Emerging technologies like federated learning and quantum computing have the potential to boost the prediction of protein–drug interactions by up to 300%, despite challenges including high implementation costs and regulatory compliance. The significance of upholding patient-centred care while encouraging technology innovation is emphasised in this review. Full article

(This article belongs to the Special Issue The AI Revolution in Pharmacy Practice and Education)

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