Search Results (813)

Community pharmacists are in a perfect position to offer comprehensive wound management advice to patients with both chronic and acute wounds, which can result in major costs and emotional burdens. A wound that is managed well through correct assessment, suitable treatment and follow-up counselling will heal optimally and essentially save patients costs and stress. The study aimed to explore the role of South African community pharmacists in wound management. A list of community pharmacies was requested from the South African Pharmacy Council and an online questionnaire was conducted in August 2022 using QuestionPro^® Version 2. Stratified random sampling was used to select 350 community pharmacies out of a total of 3240 in South Africa. The response rate was 16.0% (n = 56). Half of the community pharmacists (n = 28) had adequate knowledge about acute wound care, with a third (30.4%, n = 17) indicating that they provide patients with chronic diabetic wound care advice at least once a week. Respondents indicated Continuous Professional Development (CPD) activities and reading journal articles, many relating to diabetic wound management, as ways in which they upskill themselves in wound care. Many of the respondent pharmacists were in favour of an increased focus on wound care services in their community pharmacies. Further training programmes and workshops could be offered to provide pharmacists with the knowledge necessary to manage both chronic and acute wounds in their pharmacies. Full article

Background: As Artificial Intelligence (AI) proliferates in society, community pharmacists must make decisions as to how to responsibly adopt this technology in their practice. Currently, there are few regulatory requirements or tools to support pharmacists in ensuring safe and ethical integration of AI in their work. Methods: An exploratory qualitative study of community pharmacists in Ontario, Canada was undertaken to examine their needs for guidance, regulation, and support in adopting AI in their practice. Results: Semi-structured interviews with 24 community pharmacists were undertaken to the point of thematic saturation. Constant-comparative analysis highlighted three key themes: (a) currently, AI is being used in unstandardized and unregulated ways; (b) pharmacists desire guidance or regulation focused on patient safety considerations; and (c) in the absence of regulation, ad hoc informal decision making is occurring. Conclusions: With or without formal regulation, AI is being adopted in pharmacy practice. Current reliance on informal network support without clear regulatory guidance raises concerns for pharmacists regarding patient safety and their work as professionals. Full article

National legislative frameworks governing prescribing, pricing, reimbursement, and dispensing play a decisive role in shaping access to medicines. This study examines the financial availability of medicines in Bulgaria and North Macedonia through a comparative review of national pharmaceutical legislation, pricing mechanisms, reimbursement models, and digitalisation policies, assessed in relation to European Union standards. The findings indicate that access to medicines in both countries is shaped by the combined effects of multiple regulatory and financial instruments rather than by individual policy measures. Both systems apply strict control of prescribing and dispensing, external reference pricing, and positive reimbursement lists, reflecting alignment with international recommendations. However, significant differences in policy design lead to divergent access outcomes. Bulgaria’s more advanced digitalisation of prescribing and reimbursement, including mandatory electronic prescribing for selected therapeutic groups, enhances regulatory oversight and expenditure control but is associated with higher patient out-of-pocket expenditure, partly due to the application of the standard value-added tax on medicines. In contrast, North Macedonia combines lower taxation with capped patient co-payments, higher regulated pharmacy margins, and fixed pharmacy remuneration per prescription, contributing to improved financial affordability for patients while supporting pharmacy sustainability. Additional instruments, such as the Generics without Co-Payment List, further strengthen patient financial protection. The study provides comparative evidence relevant to pharmaceutical policy reforms and highlights the importance of balanced regulatory approaches that promote affordability, system sustainability, and equitable access to medicines. Full article

Background: Medication use in paediatric populations is inherently complex and carries a heightened risk of prescribing errors, particularly within primary health-care settings. Despite this concern, evidence describing paediatric prescribing errors in Saudi Arabia remains scarce. Hence, the present study aimed to evaluate the prevalence and patterns of prescribing errors in paediatric primary care and to characterize the pharmacist-led interventions undertaken to resolve these errors. Methods: A prospective, mixed-methods cross-sectional study was conducted over three months at a primary health-care centre. Paediatric outpatient prescriptions were systematically reviewed during routine practice by trained clinical pharmacists. All suspected errors were independently validated and classified for severity by a multidisciplinary expert panel. Descriptive statistics were used to summarise prescribing errors, and associations with patient and prescription characteristics were assessed using chi-square tests. Qualitative data were analysed using a descriptive thematic approach to explore mechanisms of error identification and the nature of corrective pharmacist interventions. Results: A total of 545 paediatric outpatient prescriptions were reviewed, of which 142 prescriptions (26.1%) contained at least one prescribing error. Across these prescriptions, a total of 145 individual prescribing errors were identified. Dose-related errors were the most common (68.3%), followed by inaccuracies in dosing frequency (11.0%) and inappropriate drug selection (9.0%). The occurrence of prescribing errors was significantly associated with patient weight (p = 0.016), the number of medications per prescription (p < 0.001), and the recorded diagnosis (p = 0.018). The majority of errors were intercepted prior to medication dispensing (93.0%), and no cases of patient harm were identified. Qualitative analysis revealed that errors were predominantly detected through cross-checking with authoritative drug references, recalculation of weight-based doses, and application of clinical judgement, and were most often resolved through direct communication with the prescribing clinician. Conclusions: Prescribing errors occur frequently in paediatric outpatient settings; however, most are preventable with appropriate safeguards. Pharmacists play a critical role in identifying and resolving these errors before they result in patient harm. Enhancing paediatric prescribing support systems and strengthening interprofessional collaboration may further advance medication safety within primary health-care services. Full article

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

Introduction: This repeated cross-sectional study examined community pharmacies in Aotearoa New Zealand and the services they provide, including retail, dispensing, and expanded scope services (e.g., minor ailment management). Methods: Two cross-sectional surveys were conducted in 2021 (n = 504) and 2023 (n = 1000). Both assessed demographics, service use, and perceptions of pharmacists. The 2021 survey focused on trust, approachability, and role awareness, while the 2023 survey added willingness to pay, telehealth use, and comparisons with other health professionals. Best–Worst Scaling and logistic regression quantified and compared preferences. Results: Prescription filling remained the most preferred service, while beauty product sales were least preferred. Preference for vaccination declined, indicating post-pandemic shifts in preventive care. Trust in pharmacists remained high, with strong comfort discussing health needs. Awareness of pharmacist roles improved slightly, though cost barriers persisted. Conclusions: Consumer priorities for prescription services remained stable, while interest in vaccination declined. The low preference for non-clinical retail activities suggests pharmacies should focus on health services. The high trust in pharmacists supports expanded clinical roles, but targeted policies and funding are needed to reduce cost barriers and enhance equitable access to primary healthcare. Full article

Community and hospital pharmacists in Romania are valuable to healthcare, but their involvement in multidisciplinary teams is still not up to the mark when measured against international standards. A systematic literature review search was conducted using the PubMed, Embase, Web of Science, and Scopus databases, following the PRISMA 2020 guidelines, complemented by a bibliometric analysis with VOSviewer, to identify research trends and key contributors in the field. This review examines studies such as counseling effectiveness, clinical contribution, and professional obstacles faced by pharmacists in Romania published between 2014 and 2025 that mainly focus on community practice, integration into hospitals, and new areas such as pharmacogenetics and pharmacovigilance. The studies surveyed patients on how they evaluated counseling, tracked clinical pharmacists who adjusted drug doses through therapeutic monitoring, checked whether healthcare professionals followed safety warnings, and checked management systems within institutions. High costs and the removal of pharmacovigilance from compulsory university courses add to the obstacles. Romanian pharmacists already possess the knowledge or skills to raise treatment success and shield patients from unsafe self-medication through timely clinical advice. To use this capacity fully, the system must change, including health insurance covering pharmaceutical services, compulsory updating of course content, and official interdisciplinary protocols for this potential to be fully exploited. Full article

Background: Visual impairment (VI) describes decreased visual function that interferes with an individual’s ability to perform daily activities, such as reading, driving, and other executive tasks. Providing optimal pharmaceutical care for this population can be challenging for pharmacists, as individuals with VI face numerous obstacles in managing their medications. This study explores the challenges experienced by pharmacists and visually impaired patients and aims to compare their points of view to identify existing gaps and propose recommendations to optimize medication use among individuals with VI. Method: A cross-sectional study was conducted between September 2024 and January 2025 among pharmacists (n = 152) and visually impaired patients (n = 31) in the Qassim Region of Saudi Arabia. Pharmacists completed a self-administered questionnaire, while data from visually impaired patients were collected via structured face-to-face interviews. Data analysis was performed using IBM SPSS Version 21, with a significance level set at p < 0.05. Results: A total of 152 pharmacists and 31 visually impaired individuals participated in the study. Only 5.3% of pharmacists had received training related to VI care, and most counseling was directed to caregivers rather than patients (80.3%). pharmacists with additional training in VI were significantly more likely to employ unique or appropriate packaging methods (p < 0.001), and male pharmacists were more likely to rely on caregivers during OTC counseling (p = 0.014). Among the visually impaired participants, 77.5% reported difficulty reading medication packages and 67.7% faced challenges entering pharmacies. Braille literacy was significantly higher among males (p = 0.018) and those with higher education (p = 0.022). Overall, 90.3% expressed a need for improved accessibility tools and communication support in pharmacies. Conclusions: Pharmacists showed confidence in assisting visually impaired patients; however, most lacked formal training and relied heavily on caregivers for communication. Visually impaired individuals also reported difficulties accessing pharmacies, reading medication labels, and receiving complete information from pharmacists. Based on these findings, implementing specialized training programs, expanding Braille and tactile labeling, and integrating assistive technologies within pharmacies are recommended to improve safety and equitable medication use. Full article

Background/Objectives: Identification of tools to minimize opioid-related harms is critical in the U.S. The purpose of this study was to better understand community responder and healthcare provider perceptions and preferences regarding the design and function of a potential new opioid sensor device (OSD). Methods: Adults aged ≥ 18 years employed as community responders or healthcare providers in Alabama were recruited via email to participate in an anonymous online cross-sectional survey informed by the Unified Theory of Acceptance and Use of Technology (UTAUT). Primary outcomes were assessed via multiple-choice and 7-point Likert-type scales (1 = strongly disagree, 7 = strongly agree) and included the following topics: (1) past OSD utilization (4 items); (2) perceived importance of OSD design elements (15 items); (3) OSD function and cost preferences (3 items); and (4) UTAUT measures including perceived usefulness of OSDs (3 items), ease of use (4 items), social factors (4 items), resources (4 items), concerns (3 items), and intentions (3 items). Differences in UTAUT measures across professions were assessed via Mann–Whitney U tests, and predictors of OSD utilization intention were analyzed via multiple linear regression. Results: Respondents (N = 145) included pharmacists (40.0%), nurses (23.4%), physicians (14.5%), behavioral health (4.8%), social work (4.8%), and law enforcement (0.7%). Availability in hospital emergency departments was rated as the most important device element (mean [SD] score: 6.66 [0.80]), followed by sensitivity and specificity of the test (6.42 [0.98]), rapid detection time (6.42 [0.88]), ability to detect opioids in a broad range of substance (6.42 [0.93]), and availability in law enforcement offices (6.33 [1.08]). A 2–5 min detection time was rated as reasonable by 32.6% of respondents, with 53.0% preferring to pay <USD 15 per test. There were no statistically significant differences in UTAUT scale scores across professions. Perceived usefulness (β = 0.493; p < 0.001), social acceptance (β = 0.281; p = 0.023), and resource availability (β = 0.708; p = 0.002) were positive predictors and perceived ease of use was a negative predictor (β = −0.472; p = 0.007) of intention to use an OSD. Conclusions: Newly developed OSDs should consider prioritizing accessibility in hospital emergency departments and law enforcement offices, ability to detect a broad range of opioids, detection time between 2 and 5 min, and cost less than USD 15 per test. Future research may explore perspectives from a more diverse sample across multiple states and different professional roles. Full article

Although pharmacist-led vaccination is a global standard for expanding immunization coverage, its adoption in Romania remains at an early stage. While previous studies have focused on early adopters, this research evaluates barriers, perceptions, and readiness among community pharmacies that do not yet provide this service, thereby addressing a critical knowledge gap regarding the “non-vaccinating” majority. A cross-sectional mixed-methods study was conducted among 208 pharmacists representing national chains, regional networks, and independent pharmacies. Quantitative data were analyzed using Chi-square tests and Spearman correlations to identify structural disparities, while a thematic analysis was employed to explore qualitative insights related to professional identity and operational barriers. We identified a clear mismatch between pharmacies’ willingness to provide vaccination services and their practical ability to implement them. Independent pharmacies demonstrated a strong intention to adopt vaccination services (71.4%) but were limited by financial constraints, with high implementation costs identified as a significant barrier (p = 0.014). In contrast, national pharmacy chains had sufficient resources yet faced marked staff resistance, with 43.9% reporting extreme reluctance (p = 0.038). These chains were concentrated in the capital region (p = 0.002), thereby positioning other pharmacies as key providers in underserved areas. Furthermore, thematic analysis revealed a deep-seated “professional identity” crisis, in which pharmacists struggle with the transition from medication specialists to clinical practitioners. The expansion of vaccination services cannot rely on a “one-size-fits-all” strategy. Successful national implementation requires a segmented policy approach, including financial subsidies to support independent pharmacies, change management strategies to engage the corporate workforce, and targeted regulatory education for regional networks to prevent vaccination deserts. Full article

Background: Type 2 diabetes mellitus (T2DM) is a prevalent chronic disease requiring effective pharmacological treatment, sustained self-management, and patient education. Pharmacists are increasingly recognized as key contributors to diabetes care; however, their role remains underutilized in Bulgaria. This study aimed to assess self-management behaviors, medication adherence, patient awareness, and the perceived role of pharmacists among patients with T2DM in Bulgarian primary care. Methods: A cross-sectional observational study was conducted among 105 patients with T2DM using an anonymous questionnaire based on the Diabetes Self-Management Questionnaire and supplementary items adapted to the local healthcare context. Data were analyzed using descriptive statistics and non-parametric tests to explore associations between demographic characteristics, treatment patterns, self-management behaviors, and educational needs. Results: Most patients were treated with oral antidiabetic therapy (90.0%), predominantly metformin-based regimens (64.0%). Adherence to prescribed pharmacological treatment was high (93.0%), while adherence to dietary recommendations (70.0%), regular physical activity (60.0%), and blood glucose self-monitoring (63.0%) was less consistent. Although 92.0% of participants reported good or excellent disease awareness, 41.0% expressed a need for additional education, particularly regarding confidence in managing hypoglycemia and the use of digital monitoring tools. More than half of respondents (54.0%) had received diabetes-related information from a pharmacist; however, only 38.0% expressed willingness to participate in pharmacist-led education, while 34.0% were undecided. Female sex was associated with a higher prevalence of comorbidities (p = 0.010), while increasing age was associated with reduced metformin use (p = 0.004). Conclusions: Despite good pharmacological adherence and self-reported awareness, gaps remain in lifestyle-related self-management and patient education. The findings support an expanded role for pharmacists in diabetes care, particularly through structured educational and counseling interventions to enhance self-management and complement physician-led treatment. Full article

Background: Topical Corticosteroids (TCS) are potent therapeutic agents associated with severe local and systemic adverse effects if misused. In Jordan, the unauthorized supply of TCS for cosmetic purposes and the mismanagement of dermatological conditions remain significant public health concerns. This study utilized a repeated-measures simulated patient (SP) methodology to evaluate community pharmacists’ stewardship of TCS across a spectrum of clinical risks. Methods: A national cross-sectional study was conducted across 380 randomly selected community pharmacies in Jordan. Each pharmacy received four covert visits (N = 1520) corresponding to four distinct clinical scenarios representing different risk levels: cosmetic whitening, acne management, fungal infection, and pediatric diaper rash. The primary outcome was appropriate Practice, defined as the refusal to dispense unsafe medication or the provision of evidence-based alternatives. Results: Stewardship behavior varied significantly by clinical context (p < 0.001). Pharmacists demonstrated a hierarchy of safety, adhering to guidelines most strictly in the Pediatric scenario (82.1% appropriate refusal) but frequently abandoning safety standards in the Cosmetic scenario (30.0% appropriate refusal). Notably, 70.0% of pharmacists dispensed potent steroids for facial whitening, and 26.1% voluntarily offered to compound unauthorized steroid mixtures (Khaltat). In the acne scenario, 52.1% dispensed the contraindicated TCS, while only 37.9% appropriately switched the patient to an evidence-based alternative. In the fungal scenario, 60.0% failed to visually inspect the lesion, leading to a 40.0% rate of inappropriate TCS dispensing. Multivariable regression indicated that pharmacists working in chain pharmacies (aOR: 2.15, 95% CI: 1.68–2.75) and those holding advanced degrees (PharmD/MSc) (aOR > 1.38) were significantly more likely to practice appropriate TCS stewardship. High workload (>200 prescriptions/day) was a significant barrier to safety (aOR: 0.55). Conclusions: Community pharmacists in Jordan exhibited selective TCS stewardship, demonstrating high vigilance for pediatric safety, but widespread illegal practice regarding cosmetic misuse and differential diagnosis that may be unethical. The study results warrant the need for further urgent research to understand why these practices are occurring and how best to address them. Full article

Background: Antibiotic misuse and overuse remain a critical driver of antimicrobial resistance (AMR), a global health threat associated with increased morbidity, mortality, and healthcare costs. In Greece, where antibiotic consumption and resistance rates are among the highest in Europe, community pharmacists are well-positioned to contribute to antimicrobial stewardship efforts. Objective: This study aimed to assess the knowledge and attitudes of community pharmacists in Achaia, Western Greece, regarding antibiotic use and AMR, in order to identify knowledge gaps and inform future educational interventions. Methods: A cross-sectional survey was conducted between May and July 2023 among 207 pharmacists using a structured, self-administered questionnaire. The survey assessed demographics, knowledge of antibiotic indications, dispensing practices, and awareness of AMR. Statistical analysis included Chi-square tests and multivariate logistic regression. Results: Pharmacists demonstrated high levels of knowledge regarding appropriate antibiotic use in conditions such as sore throat (95%), bronchitis (76%), influenza (77.5%), and diarrhea (95%). However, knowledge was lower for rhinitis (60%) and sinusitis (56%). Almost all pharmacists (99%) were aware of AMR, and 86% perceived it as a significant public health issue in Greece. Logistic regression showed that pharmacists with 5–10 years of experience were significantly less likely to believe that antibiotics are always effective (OR = 0.08, p = 0.042). Conclusion: Pharmacists in Western Greece are generally well-informed about antibiotic use and AMR, yet misconceptions persist, especially for viral infections. Targeted educational interventions, interprofessional collaboration, and stricter enforcement of prescription regulations are needed to strengthen the role of pharmacists in combating AMR at the community level. Full article

Diabetes mellitus, particularly type 2 diabetes mellitus (T2DM), represents a rapidly expanding global health challenge with substantial public health and economic consequences. Recent advances in antidiabetic therapy—including dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), dual GIP/GLP-1 receptor agonists, and sodium–glucose cotransporter-2 (SGLT-2) inhibitors—have transformed diabetes management by providing benefits beyond glycemic control, such as cardiovascular and renal protection, weight reduction, and improved quality of life. As the therapeutic landscape becomes increasingly complex and patient-centered, ensuring the safe and effective use of these agents in real-world settings has emerged as a key concern for pharmacoepidemiology and pharmacovigilance. Community pharmacists, as highly accessible healthcare professionals, play an expanding role in diabetes care through medication optimization, patient education, adherence support, and monitoring of adverse drug reactions in primary care. Evidence from systematic reviews and meta-analyses indicates that pharmacist-led interventions improve glycemic outcomes, enhance self-care behaviors, and facilitate the appropriate adoption of contemporary antidiabetic therapies. This narrative review synthesizes current evidence on novel pharmacological treatments for T2DM and examines the evolving contribution of community pharmacists in translating therapeutic innovation into routine practice. Barriers to implementation and future perspectives for integrating pharmacist-led services into diabetes management and pharmacovigilance frameworks are also discussed. Full article

The human papillomavirus (HPV) is the leading cause of cervical and oropharyngeal cancers. Vaccination can prevent over 90% of HPV-attributed cancers. Rural populations are less likely to initiate and complete HPV vaccinations than urban. The primary objective of this paper is to systematically examine the multilevel (child/youth, parent/caregiver, physician/team, healthcare organization, community, and policy) influences on HPV vaccine uptake in the rural US population. As a secondary aim, we seek to identify gaps in the research that could contribute to the development of more precise intervention approaches in this population. The study adds to the limited number of recent reviews on rural HPV vaccine uptake in the US. Method: We conducted a systematic search of published empirical studies over 13 years (2010–2023), resulting in 1657 publications. The following databases were searched: Medline (OVID), Embase, CINAHL, PsychInfo, Cochrane, Sociological Abstracts, and Scopus using pre-specified inclusion criteria. Two reviewers independently coded 101 full texts; discrepancies were resolved by a third reviewer. The primary outcome was HPV vaccine uptake. Results: Adolescents themselves were the most common foci of change. Barriers to rural HPV uptake included limited; vaccine awareness, access to vaccines for children vaccination sites, and primary care recommendations. Conclusions: Tailored interventions to rural parents/caregivers could increase uptake of the vaccine. Provider training increases HPV vaccine recommendations; programs should also be targeted to rural school nurses, pharmacists, and dental care providers. Linking primary care practices and public health dissemination strategies are key. Full article