International Journal of Clinical Pharmacy最新文献

{"title":"Anticholinergic medicines - medication management, prescribing cascades, and deprescribing.","authors":"Ivana Tadic, Anita Elaine Weidmann","doi":"10.1007/s11096-025-01965-5","DOIUrl":"10.1007/s11096-025-01965-5","url":null,"abstract":"<p><p>This comment aims to raise awareness of the problems encountered when using anticholinergic burden (ACB) tools for the assessment of inappropriate medications (PIM), concerns related to prescribing cascades, and the process of deprescribing in patients older than 65 years. The first published tool, BEERS criteria from 1991, interpreted the ACB as the single biggest iatrogenic problem in treating older patients. Numerous subsequent publications repeated this interpretation rather than using real-world data. By comparing three internationally validated PIM tools (AGS BEERs criteria; EU(7)-PIM; PIM), this comment highlights how their anticholinergic (ACh) medicines lists differ, lack specific details on the strength of the ACh effect while also not providing suitable alternative pharmacological approaches. In addition, this comment considers the recognized contribution of ACh medicines in prescribing cascades and resultant inappropriate polypharmacy concerns while also considering barriers to deprescribing in the face of lacking detailed clinical guidance.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1532-1536"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835015","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":"A cross-sectional online survey: exploring the patient perspective of community pharmacies delivering care to ethnically diverse individuals with disabilities.","authors":"Cambrey B Nguyen, Brittany L Melton, Kristin R Villa","doi":"10.1007/s11096-025-01911-5","DOIUrl":"10.1007/s11096-025-01911-5","url":null,"abstract":"<p><strong>Background: </strong>Approximately 1.3 billion people or 16% of the global population have a disability and those from diverse backgrounds experience greater health disparities. To reduce inequities, healthcare professionals are encouraged to include the patient's cultures in their care.</p><p><strong>Aim: </strong>This study was a prospective, cross-sectional, questionnaire-based study that obtained patient perception of community pharmacies providing culturally responsive care to ethnically diverse patients with disabilities in the US.</p><p><strong>Method: </strong>Respondents (over 18 years and understand English) were recruited by Qualtrics to complete an anonymous, nationwide, online survey from August 7 to August 14, 2024. The survey asked for demographic information, frequency of encounters with the pharmacy, perception of quality of care based on their identities (ethnicity, disability), barriers in obtaining medications, and suggestions to improve services. Demographics were reported using descriptive statistics and the Kruskal-Wallis test was used to compare Likert scale responses.</p><p><strong>Results: </strong>A total of 1218 respondents completed the survey; 200 self-identified as white, non-Hispanic without disabilities which served as the control and 1018 patients were from an ethnically diverse background with a disability (n = 518) or without disabilities (n = 500). In all of the cohorts, over 50% of respondents were satisfied with the quality of care provided by pharmacists and pharmacy staff. Barriers identified by those with a disability were communication issues (specific to hearing) and the limited physical space for patients in wheelchairs.</p><p><strong>Conclusion: </strong>The barriers noted by the patients can be addressed through increasing cultural intelligence training or continuing education for pharmacists and staff to promote inclusion.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1270-1277"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985817","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":"A cross-sectional study of prescribing of antiseizure medication for the treatment of pain in Australia.","authors":"Ting Xia, Jenni Ilomaki, Louisa Picco, Suzanne Nielsen","doi":"10.1007/s11096-025-01915-1","DOIUrl":"10.1007/s11096-025-01915-1","url":null,"abstract":"<p><strong>Background: </strong>Antiseizure medications, particularly gabapentinoids like pregabalin, are increasingly prescribed for pain management. Despite their growing use, evidence of their effectiveness for pain is mixed. This highlights the need for a clearer understanding of the prevalence and prescribing patterns of antiseizure medications in pain management.</p><p><strong>Aim: </strong>To investigate the initiation of antiseizure medications in people with and without pain or epilepsy diagnoses and to explore the concurrent use of opioids.</p><p><strong>Method: </strong>This cross-sectional study used deidentified primary care data from 542 general practices in Victoria, Australia. Descriptive statistics were used to analyze antiseizure medication prevalence, concurrent opioid use, and prescribing patterns by age and gender.</p><p><strong>Results: </strong>We identified 171,619 primary care patients who initiated an antiseizure medication between January 1, 2018, and May 31, 2023, among whom 80.1% had pain without epilepsy. Pregabalin was the most commonly prescribed medicine (58.2%), followed by sodium valproate (7.0%), gabapentin (6.9%), and clonazepam (6.7%). Among younger patients (14-49 years old) with an epilepsy diagnosis, women were twice as likely as men to initiate topiramate (6.5% vs 4.4%) and lamotrigine (21.8% vs 11.4%), while men were more commonly initiated with sodium valproate (38.7% vs 18.9%).</p><p><strong>Conclusion: </strong>Given the widespread off-label use of gabapentinoids and the potential for serious harm, further research is warranted to better understand their clinical and safety outcomes.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1520-1525"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022177","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":"Exploring Australian pharmacists' experiences with the electronic National Residential Medication Chart: a qualitative descriptive study.","authors":"Jonathan Tan, Jasmine Tan, Leanna de Souza, Qianying Wang, Alexander Wong, Jarrod Mcmaugh, Kenneth Lee, Amy Page","doi":"10.1007/s11096-025-01894-3","DOIUrl":"10.1007/s11096-025-01894-3","url":null,"abstract":"<p><strong>Background: </strong>In Australia, the electronic National Residential Medication Chart (eNRMC) aims to enhance medication safety, reduce administrative burden, and communication in aged care facilities. However, research on its implementation is limited, with minimal pharmacist involvement, despite their critical role in medication management. It is essential to address the underrepresentation to optimise their experience with the eNRMC.</p><p><strong>Aim: </strong>This study aimed to explore the experiences of pharmacists who have used the (eNRMC) while providing care to residential aged care facilities.</p><p><strong>Method: </strong>A qualitative descriptive study design was employed, with thematic analysis conducted using The Framework Method. Pharmacists with experience using the eNRMC were recruited through purposive and snowball sampling and were invited to participate in semi-structured individual interviews in August 2024. Interviews were audio-visually recorded, transcribed using clean verbatim and analysed with NVivo software. An inductive coding approach was used to generate themes.</p><p><strong>Results: </strong>Twelve participants across Australia with varying levels of experience consented and completed semi-structured interviews. Three main themes were identified: (1) Improvements in Medication Management, (2) Limitations of the eNRMC Software, and (3) the Facility's Transition to eNRMC Software. Pharmacists reported enhanced medication safety, workflow, and communication. However, eNRMC incompatibilities, restricted editing and increased workloads were challenges during implementation. Additionally inadequate training and resistance from general practitioners contributed to charting errors and medication incidents.</p><p><strong>Conclusion: </strong>Pharmacists from various roles described the eNRMC as beneficial for enhancing medication management, but software limitations and lack of support remain barriers that increased frustrations amongst users and impede adoption.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1195-1203"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of sodium-glucose cotransporter-2 inhibitors on serum urate levels and gout in patients with and without type 2 diabetes: a systematic review and network meta-analysis.","authors":"Qiaozhi Hu, Shiwen Yang, Bofei Zhang, Na Su","doi":"10.1007/s11096-025-01950-y","DOIUrl":"10.1007/s11096-025-01950-y","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter-2 (SGLT-2) inhibitors can decrease serum uric acid (sUA) levels and have potential in the management of glucose levels and cardiorenal protection in patients.</p><p><strong>Aim: </strong>This systematic review and network meta-analysis aimed to investigate the effects of SGLT-2 inhibitors on sUA levels and incidence of gout in patients with or without type 2 diabetes.</p><p><strong>Method: </strong>A systematic search of PubMed, Embase, Cochrane Central Register of Controlled Trials, and Clinical Trials databases was performed to retrieve relevant articles published from inception to April 27, 2025, focusing on the impact of SGLT-2 inhibitors on sUA levels or the incidence of gout in the study participants. We performed a Bayesian random-effects network meta-analysis of the included studies using the Markov Chain Monte Carlo simulation techniques. The grading of recommendations, assessment, development, and evaluation approach was used to assess the certainty of the evidence.</p><p><strong>Results: </strong>A total of 57 trials were included. All SGLT-2 inhibitors reduced sUA levels. These inhibitors demonstrated a spectrum of sUA-lowering effects, with empagliflozin and dapagliflozin exhibiting particularly robust efficacy. Specifically, empagliflozin (10 mg: - 43 [95% CI - 52.45 to - 33.66]; 25 mg: - 41.99 [95% CI - 51.93 to - 31.9]; 50 mg: - 35.77 [95% CI - 68.04 to - 3.53]) and dapagliflozin (5 mg: - 36.91 [95% CI - 49.5 to - 24.46]; 10 mg: - 34.98 [95% CI - 43.75 to - 26.44]) displayed superior reductions in sUA levels compared to other agents within the class. Although there was a potential reduction in the incidence of gout associated with SGLT-2 inhibitors, the difference was not statistically significant.</p><p><strong>Conclusion: </strong>Future long-term studies should consider SGLT-2 inhibitors for individuals requiring sUA reduction and gout management. These results could serve as a reference for future guidelines addressing the treatment of individuals with diabetes, necessitating sUA lowering and gout management. Trial Registration PROSPERO registration number CRD42024521695.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1162-1176"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540128","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":"Optimizing chronic disease management through community-based pharmaceutical care for older adults in China: a systematic review and meta-analysis of randomized controlled trials.","authors":"Qingming Liu, Yushan Guo, Youshuang Zhang, Xiao Zhou, Wenfei Chen, Jiaqi Ni, Jinhan He, Jing Zhou","doi":"10.1007/s11096-025-01951-x","DOIUrl":"10.1007/s11096-025-01951-x","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic diseases present a critical healthcare concern amid global population aging. Community-based pharmaceutical care plays a vital role in the management of chronic diseases. Nevertheless, in China, the development of community-based pharmaceutical care remains in its early stages, and there is a lack of systematic evaluation of its effectiveness.</p><p><strong>Aim: </strong>This study aimed to investigate the effectiveness of community-based pharmaceutical care for older adults with chronic diseases, and characterize the service models in China.</p><p><strong>Method: </strong>A comprehensive literature search was conducted across PubMed, Embase, China National Knowledge Infrastructure, VIP China Science and Technology Journal, and, WanFang database from inception to February 7, 2025. Randomized controlled trials comparing community-based pharmaceutical care with regular follow-up were included. Reporting quality was evaluated using the Cochrane Risk of Bias Assessment Tool 2. Detailed information including study design, participants, and results was collected. Primary outcomes (medication effectiveness/safety, economic impact, quality of life, adherence, and medication knowledge) were analyzed through meta-analysis or reported descriptively. Mean differences or risk ratios with 95% confidence intervals were used for continuous and dichotomous outcomes, respectively. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework. Additionally, we analyzed the service models implemented across the studies.</p><p><strong>Results: </strong>Eighteen studies with 2842 patients were included. Twelve reported that community-based pharmaceutical care improved disease control (P < 0.05). Meta-analysis of 10 studies showed that it reduced adverse drug reactions [RR = 0.37 (0.27, 0.50), P < 0.00001] and potentially inappropriate medication [RR = 0.19 (0.08, 0.44), P = 0.0001]. Four studies revealed lower medication use rate [MD =  - 1.15 (- 1.67, - 0.63), P < 0.0001] and costs [MD =  - 74.12 (- 99.47, - 48.76), P < 0.00001]. Seventeen studies assessed adherence, with meta-analysis showing higher Morisky scores [MD = 1.35 (0.81, 1.89), P < 0.00001] and adherence rate [RR = 1.30 (1.13, 1.49), P = 0.0001]. However, its impact on patients' quality of life yielded conflicting results. Additionally, most studies implemented multiple services such as prescription review, treatment monitoring, and patient education, and the service models exhibited significant difference across studies.</p><p><strong>Conclusion: </strong>Our findings suggest that community-based pharmaceutical care in China effectively improved the clinical outcomes of older patients. However, there is a lack of a standardized service framework, and its impact on patients' quality of life needs further research.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1150-1161"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475113","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":"Overcoming challenges: implementing and scaling clinical pharmacy education and practice in the Republic of Srpska/Bosnia and Herzegovina.","authors":"Tijana Kovacevic, Josephine Falade","doi":"10.1007/s11096-025-01939-7","DOIUrl":"10.1007/s11096-025-01939-7","url":null,"abstract":"<p><p>Bosnia and Herzegovina, one of the six countries created from the breakup of Yugoslavia, is classified as a low resource setting despite its geographic position in Europe. It is one of the most severely affected by the Civil war and international sanctions resulting in damaged infrastructure and underdeveloped healthcare services. Clinical pharmacy, which aims to improve patient outcomes through optimized medication use, has been well established in high-income countries since the 1960s. However, in low-resource settings, its development is often delayed by inadequate education, lack of trained personnel, and limited institutional support. The main aims of this article are to present the development of clinical pharmacy services in a low-resource setting, using the example of the Republic of Srpska (an entity within Bosnia and Herzegovina), and to offer a replicable model for similar settings. This article highlights how clinical pharmacy can be gradually established through international training, structured mentorship, curriculum reform, political and institutional support. Starting in 2007 with the training of a pharmacist in the United Kingdom, the Republic of Srpska initiated a pilot clinical pharmacy service program that expanded to various hospital wards, introduced formal education programs, and integrated clinical pharmacy into daily clinical practice. Additionally, a fully reimbursed outpatient clinical pharmacy service was launched in 2023. This shows that with targeted investments and long-term strategy, countries with limited resources can establish clinical pharmacy practice. The Republic of Srpska's experience offers valuable lessons for accelerating clinical pharmacy development in other low-resource setting contexts.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1526-1531"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142489","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":"Perspective of older people on which medicines they need to report to healthcare professionals as part of a medicines history: a qualitative descriptive study.","authors":"Emily Griffin, Kenneth Lee, Christopher Etherton-Beer, Joon Soo Park, Amy Page","doi":"10.1007/s11096-025-01890-7","DOIUrl":"10.1007/s11096-025-01890-7","url":null,"abstract":"<p><strong>Background: </strong>The medicines that older people consider relevant as part of their medicine regime may be reflected in their reporting of medicines to healthcare professionals during a medicine history.</p><p><strong>Aim: </strong>This study aimed to understand the perspectives of people, aged 65 or older, on which medicine(s) they reported as part of their medicine regimen.</p><p><strong>Method: </strong>A qualitative descriptive study was conducted in Australia using semi-structured interviews to investigate the perspectives of which medicines were reported in a medicines history by people aged 65 years or older, taking at least one medicine. Participants were recruited until data saturation was reached. The interviews were audio recorded, transcribed, and thematically analysed using the Framework Method.</p><p><strong>Results: </strong>Six main themes emerged from sixteen participants: reporting medicines that solved a medical condition, medicines recommended by healthcare professionals, regular medicines, route of administration, combination products, and multiple tablets, doses, or part doses. Participants' beliefs and experiences impacted whether they included a medicine in their regimen. Participants inconsistently reported infrequent medicines, varying formulations, and multiple doses. Non-oral and over-the-counter medicines were commonly included if a healthcare professional recommended them. In contrast, supplements were seldom included.</p><p><strong>Conclusion: </strong>This study highlights the variation between participants' perspectives in reporting medicines, suggesting that older people's self-reporting of medicines is generally inconsistent. Our findings encourage clinicians to specifically enquire about medicines for acute health conditions, medicines commonly not prescribed by healthcare professionals, irregular medicines, and non-oral medicines to improve reporting by older people, to obtain the Best Possible Medication History.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1177-1185"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric evaluation of a Theoretical Domains Framework based questionnaire on community pharmacists' pharmaceutical care service for breastfeeding women.","authors":"Nazlican Ucar Yaman, Pinar Ay, Mesut Sancar, Derya Büyükkayhan, Betul Okuyan","doi":"10.1007/s11096-025-01902-6","DOIUrl":"10.1007/s11096-025-01902-6","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of validated Theoretical Domains Framework (TDF) based instruments to investigate barriers and facilitators for community pharmacists (CPs) to provide effective care for breastfeeding women.</p><p><strong>Aim: </strong>The aim of this study was to evaluate the psychometric properties of a TDF-14 (v2) based questionnaire to identify barriers and facilitators faced by Turkish CPs in provision of pharmaceutical care to breastfeeding women.</p><p><strong>Method: </strong>This observational study was carried out among CPs in Türkiye. After generating the English form of the questionnaire, translation and cultural adaptation of the questionnaire, an expert panel and pilot study were conducted. Data were collected through an online survey between October 2023 and January 2024. The psychometric properties of the questionnaire were tested by performing test-retest reliability, confirmatory factor analysis (CFA), and internal consistency analysis.</p><p><strong>Results: </strong>The test-retest reliability analysis (n = 30) indicated that the intraclass correlation coefficient values of each domain were between 0.75 and 0.96 (p < 0.001). Four hundred and sixteen CPs completed the questionnaire (response rate: 37.5%). Out of a total of 36 items, six items were excluded. The final questionnaire covered 13 out of the 14 TDF (v2) domains. Chi square/degree of freedom ( <math><mi>χ</mi></math> ²/df), comparative fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR) were 2.01, 0.96, 0.05, and 0.04; respectively. Cronbach's alpha values of each domain ranged from 0.63-0.90.</p><p><strong>Conclusion: </strong>This TDF-based questionnaire is a valid and reliable tool for evaluating CPs' enablers and barriers to providing pharmaceutical care to breastfeeding women.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1232-1238"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrative genetic analysis of shared genetic architecture of stroke and coronary artery disease: implications for pharmacist-led precision medicine.","authors":"Weizhong Shi, Luofei Zhang, Zhigang Zhao, Kefu Yu","doi":"10.1007/s11096-025-01952-w","DOIUrl":"10.1007/s11096-025-01952-w","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary artery disease (CAD) and stroke are leading causes of global morbidity and mortality. Their frequent comorbidities and overlapping risk profiles highlight the importance of understanding shared genetic mechanisms, particularly in identifying therapeutic targets relevant to personalized pharmacotherapy.</p><p><strong>Aim: </strong>This study aimed to explore the shared genetic architecture between stroke and CAD, identify common therapeutic targets, and provide implications for clinical pharmacy practice.</p><p><strong>Method: </strong>We integrated multi-ancestry genome-wide association study (GWAS) summary statistics (stroke: 110,182 cases; CAD: 210,842 cases) and employed linkage disequilibrium score regression to assess genetic correlations. Bidirectional two-sample Mendelian randomization (MR) was employed to infer causal inference. Shared genetic variants were identified through cross-trait meta-analyses (MTAG and CPASSOC) and validated using Bayesian colocalization. Pharmacogenomic pathways associated with shared genes were linked to approved drugs using a pathway-pairing score to assess the therapeutic alignment. A score of ≥ 0.5 indicated a strong alignment between a drug's pharmacological mechanism and the disease's genetic pathophysiology.</p><p><strong>Results: </strong>A significant genetic correlation was observed between stroke and CAD (rg = 0.48, P = 3.38 × 10^-34). Eight pleiotropic SNPs and five colocalized causal variants were identified, implicating ten disease-shared genes. Drug-target analyses prioritized the 19 approved cardiovascular agents. Beta-blockers (e.g., bisoprolol, esmolol) and antihypertensives (e.g., fenoldopam bromide/mesylate) demonstrated strong therapeutic potential (pathway score ≥ 0.5).</p><p><strong>Conclusion: </strong>This study provides genomic evidence to support integrated therapeutic strategies for stroke and CAD. Pharmacogenomic insights into shared genetic determinants can assist clinical pharmacists in optimizing treatment selection, mitigating polypharmacy risks, and guiding precision medicine in patients with dual cardiocerebrovascular risks.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1437-1446"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527844","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}