Search Results (633)

Background/Objectives: Telemedicine-enabled medication dispensing and delivery was formally regulated in Jordan in 2025, but the Jordan Pharmacists Association publicly rejected the pharmacy-related provisions because of concerns about safety, liability, and the pharmacist’s professional role. This study evaluated community pharmacists’ acceptance of the regulated model and identified perceived patient safety risks, implementation barriers, and required safeguards. Methods: A convergent mixed-methods design was used. A cross-sectional online survey was completed by 350 licensed community pharmacists (response rate 83.3%). The questionnaire assessed willingness to participate, perceived patient safety risks, implementation barriers, and facilitators using 5-point Likert scales. Multivariable logistic regression examined predictors of willingness. Semi-structured interviews were conducted with 22 purposively sampled pharmacists until thematic saturation. Quantitative and qualitative findings were integrated using joint displays. Results: Only 28.3% of pharmacists were willing to participate under current conditions, 46.9% were unwilling, and 24.9% expressed conditional acceptance; 52.0% opposed national implementation. Patient safety concerns were great (mean 4.4 ± 0.6/5), especially regarding remote patient assessment (91.4%) and medication errors (88.9%). Implementation barriers were severe (mean 4.5 ± 0.5/5), mainly regulatory ambiguity (92.0%) and unclear liability (89.7%). Facilitators were strongly endorsed (mean 4.7 ± 0.4/5), particularly mandatory pharmacist verification (94.6%) and clear legal protections (93.4%). Qualitative findings reinforced pharmacists’ role as the “final safety checkpoint” and showed acceptance depended on strong safeguards. Conclusions: Jordanian pharmacists showed principled resistance to the current model. Acceptance depends on pharmacist oversight, legal clarity, and infrastructure readiness. Full article

Background/Objectives: Pharmacists play an essential role in healthcare delivery across Europe, yet growing professional demands, organisational constraints, and evolving practice models may negatively affect job satisfaction and professional fulfilment. This study aimed to evaluate job satisfaction and professional perception among pharmacists across multiple European countries and to identify sociodemographic and workplace-related factors associated with these outcomes. Methods: A cross-sectional, web-based survey was conducted between October 2023 and January 2024 among licensed pharmacists from 17 European countries. Eligible participants were pharmacists employed in community pharmacies, hospitals, clinical pharmacy services, or the pharmaceutical industry. The questionnaire, developed and administered in English, collected sociodemographic and professional data and included two composite measures: the Job Satisfaction Scale (12 items) and the Pharmacist Professional Perception Scale (6 items). Responses were recorded using 5-point Likert scales. Descriptive statistics and inferential analyses were performed using SPSS version 27.0. Results: A total of 789 pharmacists participated (median age 40 years; 80.1% female). The mean job satisfaction score was 3.26 (SD 0.88), with the lowest scores related to staffing adequacy and salary, and the highest to collegial relationships. The mean professional perception score was 3.08 (SD 0.81), indicating moderate perceived professional recognition. Significant associations were identified between both scales and workplace setting, income level, employment status, geographical region, education, and professional experience (p < 0.05). Conclusions: In this multi-country convenience sample, pharmacists reported moderate levels of job satisfaction and professional perception, with variation across workplace and sociodemographic factors. These findings should be interpreted cautiously, as the sample is not representative of all European pharmacists; however, they suggest that staffing conditions, remuneration, professional recognition, and career development opportunities may be relevant areas for further investigation and policy attention. Full article

Virtual patients (VPs) and artificial intelligence (AI) are being implemented in pharmacy education across various countries in order to learn different techniques to improve communication skills, identify drug-related problems, assess the pharmacist’s role in the self-medication process or assess students’ knowledge acquisition. The objective of this study was to assess the benefits of integrating VPs and AI in pharmacy education, particularly their impact on pharmacy students’ knowledge and skills in self-medication counselling. A literature search was conducted across PubMed, Scopus and Web of Science databases. Studies focused on the integration of VPs and AI tools in pharmacy education and their impact on students’ knowledge, counselling and communication skills related to self-medication, were evaluated. Eligible studies were full-text, peer-reviewed research articles published in English. No restrictions were applied regarding publication year. A total of 857 articles were identified through electronic databases and 9 met the inclusion criteria. Six studies were conducted in the USA and one each in Portugal, Sweden and Indonesia. Most studies employed a pre–post-study design. Six studies utilized VP simulations, while the remaining three implemented AI-based tools. Key outcomes covered in analyzed articles included improvements in knowledge score, communication, and consultation skills, along with positive perceptions, including increased student satisfaction and confidence levels. Using VP simulations and AI tools in pharmacy education could positively impact students by enhancing their knowledge as well as their confidence and counselling skills. Full article

Adverse Drug Reactions (ADRs) represent a major public health concern due to their impact on patient safety. In Spain, the Spanish Agency of Medicines and Medical Devices, through the FEDRA database, coordinates the reporting of suspected ADRs under real-world conditions of use, contributing to the continuous updating of safety information. In this context, community pharmacist, through Professional Pharmaceutical Care Services, plays a key role in the early detection of ADRs and Drug-Related Problems (DRPs). This article describes the case of a 70-year-old polymedicated woman included in a Personalized Dosage System (PDS). Following the substitution of diazepam with clonazepam and an increase in the dose of semaglutide, the patient developed urinary incontinence, nausea and abdominal pain. Coordinated intervention between the community pharmacy and primary care enabled adjustment of the clonazepam dose, optimization of semaglutide administration and discontinuation of unnecessary naproxen use. These measures resulted in improved treatment tolerance and safety, as well as optimization of pharmacotherapy. Full article

Pharmaceutical care provides the conceptual foundation for integrating pharmacogenetics into everyday pharmacy practice. Defined by Hepler and Strand as “the responsible provision of drug therapy for the purpose of achieving specific outcomes that improve a patient’s quality of life”, pharmaceutical care emphasizes a patient-centered approach in which the pharmacist collaborates with the patient, physician, and other healthcare professionals to design, implement, and monitor individualized therapeutic plans. In this context, pharmacogenetics can be regarded as an extension of pharmaceutical care: while the traditional model relies on monitoring patient outcomes and adherence, PGx adds a genetic dimension that allows treatment to be optimized from the very beginning. The pharmacist’s role therefore evolves from not only ensuring safe and effective use of medicines, but also interpreting genetic test results, supporting adherence to genetically guided therapy, and educating patients about the implications of their personal genetic profile. The introduction of pharmacogenetics testing as one of the potential services offered by community pharmacies is a promising proposition that may revolutionize the approach to drug therapy. Pharmacogenetics, a subset of pharmacogenomics, focuses on the study of DNA sequence variations that influence response to drugs. Thanks to advances in the field of genomics, it has become possible to study the genetic basis of variability in drug response. The identification of alleles responsible for the rapid or slow metabolism of xenobiotics has ushered in a new era in pharmacology. The aim of this interdisciplinary field, combining genetics and pharmacology, is to adapt treatment to a specific patient based on the analysis of their genome and gene polymorphism. Throughout the world, pharmacogenetics is gaining importance as a tool for personalizing medicine. In countries such as the United States, Canada, and the United Kingdom, programs integrating pharmacogenetics with healthcare are being developed. Clinical trials and the implementation of genetic tests into medical practice allow for better matching of medications and reducing the risk of side effects. Pharmacists will play a key role in integrating pharmacogenetics into healthcare. As specialists in the field of pharmacotherapy, they will support physicians in interpreting the results of genetic tests and adapting drug therapy to the individual needs of the patient. Additionally, pharmacists can educate patients and healthcare professionals about the benefits of pharmacogenetics and monitor the effects and safety of medications. Their involvement in the process of personalization of treatment may contribute to improving the effectiveness and safety of pharmacological therapies. Full article

Doping remains a major threat to athlete health and sport integrity. Although anti-doping efforts have traditionally focused on athletes, increasing attention has turned to Athlete Support Personnel (ASP) due to their influence on athletes’ decisions, behaviors and involvement in anti-doping rule violations. This narrative review aimed to synthesize the existing literature on the role of ASP (including coaches, physicians, pharmacists, sport psychologists, nutritionists, physiotherapists, parents and other family members) in anti-doping, with particular attention to their influence on athletes’ knowledge, attitudes, behaviors, education and decision-making related to doping. Coaches, physicians, and pharmacists are among the ASP groups most frequently examined in the literature, although substantial knowledge gaps remain across all groups. Coaches shape motivational climates and ethical norms but often lack adequate understanding of anti-doping regulations and supplement risks. Physicians and pharmacists play key roles in medication management and Therapeutic Use Exemptions procedures, though incomplete regulatory knowledge may contribute to inadvertent violations. Nutritionists are central in preventing supplement-related doping, while research on sport psychologists and physiotherapists remains limited despite their preventive potential. Parents significantly shape athletes’ moral development and susceptibility to doping, acting as protective or risk factors depending on family dynamics. Overall, anti-doping education for ASP remains inconsistent. In conclusion, ASP plays an essential yet heterogeneous role in influencing doping-related behaviors. Strengthening role-specific and interdisciplinary anti-doping education, particularly within university programs and professional development, appears critical for enhancing ASP competence and promoting a sustainable culture of clean sport. Full article

This narrative review examines topical anti-inflammatory therapies in veterinary medicine through the lens of the One Health framework, integrating pharmacology, dermatology, ecotoxicology, food safety, and regulatory science. It discusses the interconnected roles of veterinarians, pharmacists, environmental scientists, public health authorities, and regulatory bodies in addressing antimicrobial resistance, environmental contamination, zoonotic transmission, and drug residues in food-producing animals. By emphasising cross-sector collaboration, the review highlights how coordinated strategies can enhance animal welfare, safeguard human health, and reduce ecological burden. The article analyses inflammatory conditions in companion and farm animals and compares systemic versus topical anti-inflammatory approaches. Particular attention is given to corticosteroids, NSAIDs, immunomodulators, pro-resolving lipid mediators, and plant-derived bioactives, alongside advances in vehicles such as lipid nanocarriers and biodegradable film-forming systems designed to minimise systemic absorption and environmental dispersion. Regulatory considerations, residue control, pharmacovigilance gaps, and sustainability-oriented formulation strategies are critically addressed. Topical anti-inflammatory therapies, when rationally designed and monitored under One Health principles, represent a strategic opportunity to improve therapeutic precision while limiting systemic toxicity and ecological impact. Future directions should prioritise translational research, eco-compatible formulation design, and harmonised regulatory frameworks. Full article

Background/Objectives: Diabetes mellitus is a common chronic disease that may lead to multimorbidity and high drug use. Therefore, this study aims to examine the prevalence of polypharmacy and hyperpolypharmacy among adult patients diagnosed with type 2 diabetes mellitus (T2DM) with its associated factors. Methods: This is a retrospective cross-sectional study conducted from 1 May 2023 to 31 October 2024. The outcomes in our study were polypharmacy (from five to nine drugs) and hyperpolypharmacy (≥10 drugs). Baseline and demographic characteristics, along with multinomial logistic regression, were used to analyze the data. Results: The total number of patients with T2DM was 2435. The prevalence rate of polypharmacy was 46.98%, while hyperpolypharmacy was 24.27%. Older age was significantly associated with a higher risk of polypharmacy [OR = 1.031, 95% (1.022–1.040)] and hyperpolypharmacy [OR = 1.037, 95% (1.026–1.049)]. In addition, patients with higher levels of hemoglobin A1c showed a significantly higher risk of polypharmacy and hyperpolypharmacy ([OR = 1.162, 95% (1.105–1.221)] and [OR = 1.284, 95% (1.209–1.364)], respectively). The comorbidities that increased the odds of hyperpolypharmacy were hypertension [OR = 2.136, 95% (1.449–3.148)], pulmonary disease [OR = 2.375, 95% (1.292–4.367)], mental disorders [OR = 6.269; 95% (3.284–11.964], and congestive heart failure [OR = 8.014, 95% (2.768–23.200)]. Conclusions: The prevalence of polypharmacy and hyperpolypharmacy is high in patients with T2DM. The predictors that may play a significant role in increasing the risk of hyperpolypharmacy are the poor control of HbA1c and the coexistence of comorbidities. Providing proper prescribing of patients’ therapy plans can improve individuals’ health outcomes. Therefore, this study highlights the important role of primary care physicians in coordinating care, along with clinical pharmacists, in the identification of polypharmacy. Full article

Background: Access to reliable medicines information is essential to support safe medicine use during pregnancy and breastfeeding, where concerns regarding fetal and neonatal safety complicate clinical decision-making. Analgesics are widely used during these periods, yet uncertainty regarding safety persists due to evolving evidence, regulatory changes, and inconsistent information sources. Obstetric medicines information services play a critical role in addressing these information needs. This study aimed to evaluate patterns of analgesic-related enquiries to a pharmacist-led specialist obstetric medicines information service over a 20-year period. Methods: A retrospective observational study was conducted using enquiry data from the King Edward Memorial Hospital Obstetric Medicines Information Service (KEMH OMIS), Western Australia. All enquiries recorded between 1 January 2001 and 31 December 2020 were extracted from the Microsoft Access^® database. Records with incomplete data were excluded. Data were standardised, coded, and analysed using Microsoft Excel^® and SPSS^® Version 25. Descriptive statistics were used to summarise enquiry characteristics, caller type, the timing of exposure, and analgesic medicines involved. Trends over time were analysed. Results: A total of 48,458 enquiries were analysed, of which 4,978 (10.3%) related to analgesics, making this the third most common medicine class. Most enquiries related to breastfeeding (62.1%), followed by pregnancy (32.7%). The public accounted for 60.9% of calls, while health professionals contributed 39.1%. The highest frequency of breastfeeding enquiries occurred within the first four weeks postpartum, and pregnancy enquiries were most common in the second trimester. Paracetamol was the most frequently enquired analgesic (24.5%), followed by codeine (19.8%), ibuprofen (14.4%), diclofenac (7.2%), and tramadol (9.3%). Analgesic-related enquiries declined significantly over time (p < 0.001), particularly codeine-related enquiries following regulatory safety warnings. Conclusions: Analgesics represent a substantial proportion of medicines information enquiries in pregnancy and breastfeeding, reflecting widespread use and ongoing safety concerns. Pharmacist-led medicines information services play a critical role in supporting safe analgesic use. Full article

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: This scoping review aimed to identify gaps in the literature regarding medication therapy problems (MTPs) among hospitalized adults with decreased kidney function. Specifically, it aimed to answer the following questions: (1) What types of MTPs have been reported? (2) What is the reported prevalence of MTPs? (3) Do MTPs differ by type of kidney disease? (4) What gaps exist regarding MTPs and pharmacists’ involvement? Methods: Studies involving adult patients with decreased kidney function that investigated MTPs were included. Studies focused exclusively on post-transplant care, chemotherapy, or a single MTP type were excluded. Literature searches were conducted in PubMed, EMBASE, Cochrane Library, Web of Science, and International Pharmaceutical Abstracts. Two independent reviewers screened and extracted data, with a third reviewer resolving discrepancies. All identified MTPs were re-categorized using the Pharmacy Quality Alliance (PQA) framework and the Pharmaceutical Care Network Europe (PCNE) classification. Results: A total of 23 studies met the inclusion criteria, including two conference proceedings, encompassing 7151 patients. The most common MTP framework was the PCNE classification (13 studies, 57%). Reclassification using the PQA yielded 10,596 MTPs, most frequently “Safety—dosage too high” (n = 2464) and “Effectiveness—dosage too low” (n = 2262). Reclassification using the PCNE yielded 11,574 MTPs, most frequently “Drug selection” (n = 6974) and “Dose selection” (n = 2636). All studies involved patients with chronic kidney disease (CKD), and two also included acute kidney injury (AKI). Conclusions: Dosage-related MTPs were most prevalent among hospitalized patients with decreased kidney function. Variability in MTP definitions, limited representation of patients with AKI and AKD, and minimal reporting on pharmacists’ roles reveal important gaps. Addressing these gaps through standardized MTP classification and further research in understudied kidney disease populations may enhance patient safety and support clinical pharmacists’ contributions to optimizing medication safety across the kidney disease continuum. Full article

Purpose: Opioids are widely used for pain management but are associated with adverse events that may differ between women and men. However, post-marketing safety data are rarely examined at the individual level to characterize these sex differences. This study aimed to identify sex disparities in opioid-associated adverse events using the FDA Adverse Event Reporting System (FAERS) to inform safer opioid selection for women. Methods: Opioid drugs were identified using the FDA’s Opioid Analgesic Risk Evaluation and Mitigation Strategy (REMS) list and official drug labeling. Relevant FAERS reports were extracted, and adverse events were classified into 27 System Organ Classes (SOCs) based on the Medical Dictionary for Regulatory Activities (MedDRA). Sex-specific signals of disproportionate reporting were evaluated using proportional reporting ratios and reporting odds ratios for drug–SOC pairs. Results: Across most opioid drugs and SOCs, adverse events were reported more frequently in women than in men. The largest sex disparities were observed for codeine, fentanyl, tapentadol, hydrocodone, and sufentanil, with significantly higher disproportionate reporting rates among women. These findings indicate pronounced sex-specific differences in the post-marketing safety profiles of several commonly used opioids. Conclusions: Women demonstrate higher disproportionate reporting of adverse events for certain opioid medications, particularly codeine and fentanyl. These results suggest the need for increased awareness of sex-specific safety differences and support sex-informed prescribing and monitoring strategies to improve opioid safety in women. Since pharmacists are medication experts and play a key role in promoting rational and safe use, our findings may further support pharmacists counseling patients and monitoring for opioid-related adverse events. 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

Colorectal cancer is the third most commonly diagnosed cancer and the second leading cause of cancer deaths worldwide, despite existing effective prevention strategies. Pharmacists are increasingly involved in various colorectal cancer prevention programs and are well-positioned to support these prevention efforts. In this systematic review, we investigate evidence regarding pharmacist-led interventions for colorectal cancer prevention by conducting a comprehensive search across the following electronic databases: MEDLINE, Embase, Web of Science, CINAHL, PubMed, and ClinicalTrials.gov. Studies were included only if they examined the role of pharmacists in early colorectal cancer detection and screening, lifestyle counseling to support prevention, and risk awareness and education. Risk of bias was assessed using the Pre–Post Quality Assessment developed by the National Institutes of Health. A total of 1405 studies were identified, of which four were included in the review. The included studies were quasi-experimental studies that mainly addressed screening awareness with fecal immunochemical test distribution, referrals, and counseling. The results of these studies showed an increase in screening participation, an improvement in knowledge of colorectal cancer risk factors and screening, and enhanced colorectal cancer referral rates. This systematic review highlights the potential of pharmacist-led interventions in enhancing colorectal cancer prevention efforts, but further well-designed studies are needed. Full article

Background: Medicine shortages present a critical challenge for health systems worldwide, impacting patient care and health outcomes. This study investigated healthcare professionals’ perceptions of the impact of medicine shortages in public health facilities of the Eastern Cape, South Africa. Methods: A quantitative, cross-sectional design was employed, using a self-administered questionnaire distributed to 394 healthcare professionals (professional nurses, pharmacists, and medical officers). Results: The findings revealed a strong consensus that shortages negatively affect all stakeholders, with 96.7% of respondents agreeing that they increase provider stress and reduce patient trust. A significant majority also reported that shortages lead to delayed treatment (70.6%) and compromised health outcomes (67%). However, perceptions varied significantly by profession. Pharmacists were significantly more likely than nurses and medical officers to perceive that shortages result in increased out-of-pocket costs for patients, treatment errors, and compromised health outcomes. Conclusions: The study concludes that medicine shortages severely impact patient safety, clinical outcomes, and healthcare providers’ well-being in this setting. The pronounced concerns among pharmacists highlight their strained role in managing the crisis and underscore the urgent need for strengthened pharmaceutical supply chain governance, interprofessional collaboration, and targeted policies to mitigate the effects of shortages and protect patients from financial hardship. Full article