International Journal of Clinical Pharmacy最新文献

{"title":"Learning, adopting, and sustaining the pharmacist-clinician role in clinical practice: a qualitative study among early adopters in the Netherlands.","authors":"Kim-Lara Klerk-Bos, Marije P Hennus, Marco Ehlert, Manon Kluijtmans, Toine C G Egberts, Ingeborg Wilting","doi":"10.1007/s11096-026-02150-y","DOIUrl":"https://doi.org/10.1007/s11096-026-02150-y","url":null,"abstract":"<p><strong>Introduction: </strong>Hospital pharmacists are increasingly involved in direct patient care; however, little is known about how to learn, adopt, and sustain this pharmacist-clinician role in practice.</p><p><strong>Aim: </strong>This study aimed to examine the implementation of the pharmacist-clinician role by exploring the key factors that shape its learning, adoption, and sustainment in clinical practice.</p><p><strong>Method: </strong>Early adopters of the pharmacist-clinician role in Dutch hospitals were recruited through purposive sampling via professional networks and national outreach. A semi-structured interview was conducted with the respondents. Data were analysed inductively using thematic analysis and were subsequently interpreted using the Normalisation Process Theory (NPT) to investigate key factors in learning, adopting, and sustaining the pharmacist-clinician role.</p><p><strong>Results: </strong>A total of 21 Dutch pharmacists working in a hospital were included. Factors, grouped into four themes (Scope and role enactment of the pharmacist-clinician role, interprofessional collaboration as the driver for adoption, experiential workplace learning is more important than formal learning, and organisational conditions shape sustainment and scalability) described how the pharmacist-clinician role develops from local sense-making and interprofessional adoption to enactment through workplace learning. Although individual initiative enabled early uptake, the role remained highly context-dependent. An NPT-informed synthesis showed that long-term sustainment relied mainly on organisational support and structural embedding, and less on individual factors.</p><p><strong>Conclusion: </strong>Our findings imply that embedding the pharmacist-clinician role should be approached as an organisational effort rather than merely as an expansion of professional competencies. Its sustainable development requires deliberate implementation, clear role definition, and organisational support for embedding the role in everyday practice.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147836961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ESCP Workshop on Clinical Pharmacy. 5 steps of medication safety: medication without harm, where are we now? : 19-20 February 2026, Innsbruck, Austria.","authors":"","doi":"10.1007/s11096-026-02136-w","DOIUrl":"https://doi.org/10.1007/s11096-026-02136-w","url":null,"abstract":"","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Economic cost-benefit analysis of person-centred medicines reviews by general practice pharmacists.","authors":"Cian O'Mahony, Kieran Dalton, Leon O'Hagan, Kevin D Murphy, Clare Kinahan, Emma Coyle, Laura J Sahm, Stephen Byrne, Ciara Kirke","doi":"10.1007/s11096-026-02116-0","DOIUrl":"https://doi.org/10.1007/s11096-026-02116-0","url":null,"abstract":"","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: 52nd ESCP Symposium on Clinical Pharmacy. Implementing and scaling sustainable clinical pharmacy practice.","authors":"","doi":"10.1007/s11096-026-02115-1","DOIUrl":"https://doi.org/10.1007/s11096-026-02115-1","url":null,"abstract":"","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ketoproof? A systematic classification of pharmaceutical excipients for ketogenic diet therapy.","authors":"Samir El Abdouni, Manon G den Uil, Zikrullah Kafa, Tatiana Soares Ribeiro, Elles J T M van der Louw, Elisabeth J Ruijgrok, A Laura Nijstad","doi":"10.1007/s11096-026-02156-6","DOIUrl":"https://doi.org/10.1007/s11096-026-02156-6","url":null,"abstract":"<p><strong>Introduction: </strong>Ketogenic diet therapy (KDT) is an evidence-based treatment for refractory epilepsy, particularly in children. Strict adherence to carbohydrate restriction is essential to maintain ketosis, yet many medications contain excipients that can disrupt this balance. Pharmacists play a crucial role in evaluating and adjusting medication regimens for patients on KDT, but limited transparency regarding excipient content often makes this process inefficient and inconsistent. Although some regional databases exist, no systematic and comprehensive resources have been developed for broader use.</p><p><strong>Aim: </strong>This study aimed to systematically classify pharmaceutical excipients and label all medications marketed in the Netherlands according to their compatibility with KDT (\"Ketoproof\" status) using a transparent, reproducible framework that can serve as the foundation for safer prescribing and international standardization.</p><p><strong>Method: </strong>A retrospective cross-sectional database analysis was conducted using data from the Dutch G-Standaard (June 2023-March 2024), a national pharmaceutical reference database used in the Netherlands. All excipients authorized in medications marketed in the Netherlands were extracted and classified based on chemical composition, metabolic fate, and administration route. Excipients were assigned a Ketoproof status through a structured decision flowchart, expert consensus, and quality control review. Finally, pharmaceutical products were labeled by cross-referencing their excipient profiles against the classified dataset.</p><p><strong>Results: </strong>A total of 1047 excipients were identified. Of these, 778 (74%) were successfully classified: 590 (56%) as Ketoproof and 188 (18%) as non-Ketoproof. The remaining 269 (26%) were unclassified. Excipients requiring expert consensus included polyols and sugar alcohols, organic acids, and coloring and flavoring agents, which were carefully assessed for clinical relevance. Among 28,721 pharmaceutical products analyzed, 41% (n = 11,781) were labeled as Ketoproof. The full dataset was integrated into KetoMed, a web-based tool designed to support healthcare professionals in reviewing medications for patients on KDT.</p><p><strong>Conclusion: </strong>This study presents the first systematic classification of pharmaceutical excipients for KDT compatibility. The transparent, evidence-informed framework enables structured labeling of medications and supports safer prescribing for patients undergoing KDT. Broader adoption and international collaboration are recommended to establish consensus on excipient classification, enhance regulatory transparency, and integrate Ketoproof labeling into clinical decision-support systems to optimize ketogenic therapy management.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators for the implementation of medication safety recommendations: focus groups with stakeholders.","authors":"Mirthe A M Oude Lansink, Marcia Vervloet, Lise van Tholen, Marloes Dankers, Mette Heringa, Bart J F van den Bemt, Liset van Dijk, Victor J B Huiskes","doi":"10.1007/s11096-026-02141-z","DOIUrl":"https://doi.org/10.1007/s11096-026-02141-z","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple medication safety recommendations to reduce preventable medication-related hospitalisations have been introduced in the Netherlands. Still, these hospitalisations remain prevalent. This might be due to suboptimal implementation in clinical practice. Therefore, more insight is needed into barriers and facilitators for the implementation of these medication safety recommendations across healthcare sectors.</p><p><strong>Aim: </strong>This study aimed to identify barriers and facilitators for implementing medication safety recommendations across healthcare sectors from the perspective of various stakeholders.</p><p><strong>Method: </strong>A selection of 17 Dutch medication safety recommendations targeting medications responsible for a large proportion of medication-related hospitalisations was evaluated in focus groups to identify barriers and facilitators to their implementation. These included recommendations for: reducing fall risk in elderly; initiating prophylactic medication; monitoring patients at risk of electrolyte disorders; clarifying responsibilities for patient care; informing patients about alarm symptoms; and prescribing antithrombotics on strict indication. Stakeholders were selected through purposive sampling based on their profession and healthcare sector. Transcripts of audio-recordings were analysed inductively, after which implementation factors were categorised using the Consolidated Framework for Implementation Research.</p><p><strong>Results: </strong>Thirty stakeholders were divided into five focus groups. These included community pharmacists (n = 9), general practitioners (n = 4), hospital pharmacists (n = 3), representatives from healthcare knowledge organisations (n = 3), patient representatives (n = 2), medical specialists (n = 2), nurses (n = 2), and other stakeholders (n = 5). Forty-nine barriers and facilitators were identified. Key themes were lack of specified responsibilities, limited information exchange, local collaboration and protocol adherence. Recommendations with a lower level of implementation often required collaboration with multiple healthcare providers, whereas recommendations with a higher level of implementation were frequently supported by clinical decision support systems.</p><p><strong>Conclusion: </strong>A broad range of barriers and facilitators to the implementation of medication safety recommendations was identified. Overall, the findings highlight the need for recommendations with specified responsibilities, improved information exchange, strengthened local collaboration, and increased protocol adherence.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and duration of hospital-initiated opioids, benzodiazepines and antipsychotics: a retrospective cohort study.","authors":"Judith de Ruijter-van Dalem, Marjo J A Janssen, Johanna H M Driessen, Carl E H Siegert, Alex Marmorale, Daniala L Weir, Fatma Karapinar-Çarkit","doi":"10.1007/s11096-026-02152-w","DOIUrl":"https://doi.org/10.1007/s11096-026-02152-w","url":null,"abstract":"<p><strong>Introduction: </strong>Many patients receive temporarily indicated medications, such as opioids, benzodiazepines, and antipsychotics (potentially inappropriate medications (PIMs) of interest) in hospitals. This could result in PIM use thereafter, when medication is continued.</p><p><strong>Aim: </strong>This study aimed to investigate the incidence and duration of hospital-initiated PIM use.</p><p><strong>Method: </strong>This retrospective cohort study included patients aged ≥ 18 years who visited a Dutch teaching hospital between January 2019-May 2023 and received a new prescription for an opioid, benzodiazepine, or antipsychotic initiated at discharge or outpatient visit and continued thereafter. Patients were followed for one year using data from the hospital's information system and community pharmacy dispensing records. The primary outcomes were the incidence of PIMs of interest and duration of use. Secondary outcomes included duration of PIM use across age categories and the proportion of prescriptions classified as actually inappropriate medication based on the documented indications in a subset of patients. Descriptive data analysis was used. Chi-square tests were used to assess differences between age categories and duration of continued use.</p><p><strong>Results: </strong>Among 6,835 patients with a new prescription of one of the medications, 82.7% were prescribed and dispensed an opioid (n = 5,652, mean age 61.1 years, 57.3% female), 14.7% a benzodiazepine (n = 1,005, mean age 60.7 years, 53.3% female) and 2.6% an antipsychotic (n = 178, mean age 69.2 years, 48.9% female). A significant proportion used the medication > 182 days following the hospital visit (13.4% opioids, 20.9% benzodiazepine, 36.0% of antipsychotics). PIMs were not more frequently discontinued in older adults. Among 156 randomly evaluated prescriptions, a clear justification for continued use was often lacking, mainly for benzodiazepines (83.1%) and opioids (76.0%).</p><p><strong>Conclusion: </strong>Potentially temporarily indicated medications were often continued following a hospital visit without justification for continued use. These results highlight the importance of carefully assessing the timely discontinuation or specifying a discontinuation date for PIMs.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient perspectives on atrial fibrillation management and pharmacist roles in outpatient clinics: a qualitative study.","authors":"Margaret Dennehy, Anna Seoighe, Cathal Cadogan, Kate Burke, Emma Murtagh, Ronan Collins, Derek Hayden, Christine McAuliffe","doi":"10.1007/s11096-026-02155-7","DOIUrl":"https://doi.org/10.1007/s11096-026-02155-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with increased risk of stroke and mortality. Effective management requires both patient engagement and clear understanding of treatment goals yet evidence suggests persistent gaps in knowledge and involvement in care. Pharmacists are increasingly involved in AF clinics, yet little is known about how patients perceive their role, particularly in the context of potential pharmacist prescribing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To explore patients' perspectives on the management of AF and the role of pharmacists in an Irish outpatient AF clinic, including attitudes toward potential pharmacist prescribing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;A qualitative study was conducted using 15 one-to-one semi-structured interviews with adults aged ≥ 65 years attending a specialist AF clinic at Tallaght University Hospital, Dublin, Ireland. Interviews took place between March and May 2025. Participants were purposively sampled to capture a range of clinical and demographic characteristics. Interviews were audio-recorded, transcribed verbatim, and analysed using Braun and Clarke's six-step reflexive thematic analysis. An inductive approach was adopted. Coding and theme development were conducted iteratively, with a subset of transcripts independently reviewed by supervisors to enhance analytical rigour and consistency.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Five overarching themes were identified relating to understanding of AF, pharmacotherapy, satisfaction with care, perceptions of the pharmacist's role, and views on pharmacist prescribing. Participants demonstrated variable understanding of AF, with limited awareness of stroke risk despite consistent recognition of anticoagulant therapy. Knowledge of anticoagulant safety, particularly bleeding risk, was strong and well retained, whereas understanding of rate-control medicines was limited. Satisfaction with care was high; however, most participants adopted a passive role in decision-making, expressing trust in healthcare professionals. Pharmacists were frequently misidentified as doctors or nurses, reflecting limited role visibility. Once recognised, pharmacist input, particularly in anticoagulant counselling and medication advice, was highly valued. Views on pharmacist prescribing were mixed: while participants acknowledged pharmacists' expertise in medicines, many preferred doctors to retain prescribing responsibility due to established trust.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;While patients spoke positively about pharmacists' input, many struggled to identify the pharmacist within the clinic and were unclear about the scope of their role. Gaps in understanding of stroke risk and broader treatment goals highlight the need for structured patient education. As Ireland considers expanding pharmacist prescribing beyond the current common conditions scheme in community pharmacy, strengthening patient education and f","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-marketing safety surveillance of EGFR-targeted agents and disseminated intravascular coagulation risk: a disproportionality analysis based on the FDA Adverse Event Reporting System.","authors":"Hai-Yu Liu, Mei-Yu Qu, Shu-Yun Wang, Jun-Jin Liu, Si-Yang Wang, Rui-Gang Hou","doi":"10.1007/s11096-026-02153-9","DOIUrl":"https://doi.org/10.1007/s11096-026-02153-9","url":null,"abstract":"<p><strong>Introduction: </strong>The epidermal growth factor receptor (EGFR) serves as a principal therapeutic target in oncology, with EGFR inhibitors representing essential agents in cancer treatment. Although thrombotic complications related to EGFR inhibitors have been reported in the literature, the evidence remains insufficient. Notably, EGFR inhibitor-associated disseminated intravascular coagulation (DIC) constitutes a potentially fatal condition that currently lacks comprehensive systematic investigation.</p><p><strong>Aim: </strong>To systematically assess the signal and clinical characteristics of DIC potentially associated with EGFR inhibitors using pharmacovigilance data.</p><p><strong>Method: </strong>Individual case safety reports (ICSRs) from the FDA Adverse Event Reporting System (FAERS) were extracted, with the 11 currently approved EGFR inhibitors designated as the primary suspect agents. Each drug's data was extracted from the initial approval date (or January 1, 2004, if approved prior to 2004) to December 31, 2024. After deduplication, disproportionality analyses were performed using four algorithms: Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-item Gamma Poisson Shrinker (MGPS). Positive and negative controls were used to evaluate potential reporting bias.</p><p><strong>Results: </strong>In FAERS, 104 ICSRs of DIC potentially associated with EGFR inhibitors were identified, of which 64 (61.54%) were fatal. Healthcare professionals accounted for the predominant proportion (82.69%) of ICSR submissions. All seven drugs with reports-cetuximab, panitumumab, gefitinib, erlotinib, afatinib, osimertinib and lapatinib-generated significant disproportionality signals. Cetuximab and gefitinib displayed the strongest disproportionality signals. ICSRs were predominantly reported from Asia, with Japan accounting for 43 ICSRs (41.35%). The median patient age was 68 years, with a balanced gender distribution. Non-small cell lung cancer (NSCLC) was the primary indication (24.04%).</p><p><strong>Conclusion: </strong> DIC may represent a pharmacovigilance signal associated with EGFR inhibitors, and may exhibit a potential class effect. Further clinical validation is required to establish causality. Proactive monitoring for DIC in patients receiving EGFR inhibitors is recommended.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and acceptability of pharmacist-led remote patient monitoring for carvedilol dose titration in clinically significant portal hypertension.","authors":"Sheridan Rodda, Chloe McAinch, Jo Hunter, Edward Saxby, Sue Kirsa, Stephen Pianko, Sally Bell, Suong Le","doi":"10.1007/s11096-026-02151-x","DOIUrl":"https://doi.org/10.1007/s11096-026-02151-x","url":null,"abstract":"<p><strong>Introduction: </strong>Carvedilol reduces the risk of hepatic decompensation and improves survival in patients with compensated cirrhosis and clinically significant portal hypertension (CSPH). Remote patient monitoring (RPM) has demonstrated benefits in other chronic conditions but has yet to be investigated for carvedilol titration in CSPH.</p><p><strong>Aim: </strong>We aimed to evaluate the feasibility and acceptability of a novel pharmacist-led, technology enabled model of care called Optimising One Medication for Patients with Cirrhosis (OOMPa-C).</p><p><strong>Method: </strong>In this prospective mixed-methods feasibility study, participants were provided with a Bluetooth-enabled blood pressure (BP) and heart rate (HR) monitor linked to a smartphone app during a home visit from a nurse. Initial education on how to take daily BP and HR readings was provided by a pharmacist via telehealth. Two pharmacists then conducted RPM of BP and HR and regular telehealth visits with patients to titrate carvedilol, following a protocol, to a maximum of 12.5 mg daily as tolerated. Semi-structured interviews with participants and stakeholders were undertaken to explore acceptability of the program.</p><p><strong>Results: </strong>Twenty-two participants were recruited, 20 of whom achieved successful dose optimisation. Readings were transmitted on at least 90% of study days by 20 (91%) participants and 18 (82%) were taking the target dose of 12.5 mg daily at study completion. Despite issues with internet connectivity and the telehealth application, the program was broadly perceived as easy to use. Participants reported benefits including convenience and greater self-efficacy, while stakeholders noted advantages in efficiency and quality of care. Participants described apprehension in using new technologies, but family and carers were seen to facilitate participation. Nurses involved with the program described time constraints due to unfamiliarity with digital navigation processes.</p><p><strong>Conclusion: </strong>Our study established the feasibility, acceptability and implementation outcomes of a new pharmacist-led model of care for carvedilol dose optimisation. We provide practical insights to inform the implementation of similar technology enabled multidisciplinary models of care at scale for patients with cirrhosis.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}