International Journal of Clinical Pharmacy最新文献

{"title":"Impact of preoperative dual antiplatelet therapy vs. aspirin monotherapy on perioperative outcomes in carotid endarterectomy patients: a retrospective cohort study.","authors":"Wenjun Yang, Wei Hu, Yifeng Pan, Xiangkun Meng, Leilei Tang, Jie Chen, Huimin Xu","doi":"10.1007/s11096-026-02160-w","DOIUrl":"10.1007/s11096-026-02160-w","url":null,"abstract":"<p><strong>Introduction: </strong>The preoperative use of dual antiplatelet therapy (DAPT) in patients undergoing carotid endarterectomy (CEA) is controversial.</p><p><strong>Aim: </strong>This study aimed to compare perioperative major bleeding and major adverse cardiovascular events (MACEs) between patients receiving aspirin alone and those receiving DAPT (clopidogrel plus aspirin).</p><p><strong>Method: </strong>This retrospective cohort study included patients with carotid artery stenosis who underwent CEA between January 2020 and December 2024. Patients were grouped according to preoperative antiplatelet therapy (DAPT vs. aspirin), and inverse probability of treatment weighting (IPTW) was applied to adjust for baseline imbalances. The primary outcome was 30-day post-CEA major bleeding (neck hemorrhage requiring reoperation or intracranial hemorrhage). The secondary outcome was 30-day post-CEA MACEs (ischemic stroke, myocardial infarction, or death). Multivariate logistic regression was performed to identify the predictors of major bleeding.</p><p><strong>Results: </strong>A total of 741 patients were included (aspirin, n = 504; DAPT, n = 237). Patients in the DAPT group had a higher prevalence of symptom, prior stroke, coronary artery disease, hyperlipidemia, and prior revascularization. After IPTW adjustment, DAPT was associated with a higher risk of major bleeding than Aspirin (OR 4.21, 95% CI 1.81-9.78), with no significant difference in MACEs (OR 1.49, 95% CI 0.57-3.85). Multivariate analysis confirmed DAPT as an independent predictor of major bleeding (OR 3.40, 95% CI 1.42-8.19, p = 0.006), whereas preoperative statin use was independently associated with a reduced risk (OR 0.13, 95% CI 0.03-0.51, p = 0.003).</p><p><strong>Conclusion: </strong>Compared with aspirin monotherapy, preoperative DAPT was associated with an increased risk of perioperative major bleeding without a reduction in perioperative MACEs in patients undergoing CEA. Larger multicenter prospective studies are needed to confirm these findings.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1884-1892"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987460","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":"Comparison of existing polypharmacy measures to a measure incorporating all modes of administration: an observational study using routinely collected data.","authors":"David Lim, David Youens, Rachael Moorin, Andrew Stafford","doi":"10.1007/s11096-026-02194-0","DOIUrl":"10.1007/s11096-026-02194-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Polypharmacy is often associated with adverse clinical outcomes and increased medication management complexity. However conventional analyses of medicine burden and polypharmacy using administrative data are limited to oral medicines (i.e. tablets and capsules), potentially underestimating overall medicine exposure. These products may significantly increase the burden of medication management and therefore risk to patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study compared traditional measures of polypharmacy with a measure incorporating all modes of medicine administration and examined how these differences impacted estimates of polypharmacy prevalence among adults aged &gt; 65 years in Western Australia (WA) from 2012/13 to 2018/19, between two independent cohorts: community-dwelling and residential aged care home populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;Linked medication dispensing data were used to classify and compare medicines between community-dwelling and residential aged care populations in Western Australia. Conventional medicine capture was extended to include medicines via various modes of administration, including creams, ointments, patches, and eye and ear drops. Medicines were classified into five categories: 0, 1, 2-4, 5-8, 9 + medicines, and counts were compared across care settings to assess changes in observed medicine burden and measures of polypharmacy. Comparative analysis was performed between two methods: Method 1 (conventional medicine capture) and Method 2 (all medicines including non-oral preparations).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Inclusion of medicines via mode of administration increased observed medicine burden in both subpopulations, with a greater relative increase in residential aged care. This approach notably contributed to total medicine counts, revealing previously unrecognised medicine exposure. This resulted in absolute increases in the 5 + medicine category of 4.0% in 2012/13 and 3.4% in 2018/19. Among aged care residents, opioid analgesics previously ranked as the most common medicine class using Method 1, was reclassified as separate oral and patch formulations using Method 2, ranking 4th and 5th. Drugs for dry eyes also emerged as the 7th most common medicine class, with only minor ranking changes observed for the other top medicine classes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Incorporating all modes of medicine administration into a polypharmacy measure substantially altered estimates of medicine burden and identified previously unrecognised exposure, particularly among residential aged care populations. The impact was greatest in higher polypharmacy categories, indicating that conventional approaches may underestimate medicine use in individuals with more complex therapeutic regimens. These findings highlight the importance of accounting for formulation diversity and support the inclusion of mode-of-administration-based measures to provide a more comprehensive assessm","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"2158-2168"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630232","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":"Helicobacter pylori eradication treatment dispensing in the Irish General Medical Services population from 2012 to 2022: a repeated cross-sectional analysis.","authors":"Marta Dobrić, Carlos Medina, Kathleen Bennett, Joseph Gallagher, Deirdre McNamara, Sinéad M Smith, Cristín Ryan","doi":"10.1007/s11096-026-02229-6","DOIUrl":"https://doi.org/10.1007/s11096-026-02229-6","url":null,"abstract":"<p><strong>Background: </strong>Helicobacter pylori (H. pylori) infection contributes substantially to peptic ulcer disease and gastric cancer. Increasing clarithromycin resistance has shifted guidelines towards 14-day treatment, bismuth quadruple therapy, and second-generation proton pump inhibitors (PPIs). Most studies evaluating H. pylori treatment trends reflect gastroenterologist prescribing rather than primary care.</p><p><strong>Aim: </strong>This study aimed to examine demographic differences in H. pylori eradication treatment dispensing according to sex and age group, and describe trends in eradication regimens, PPI selection, and treatment duration from 2012 to 2022 in relation to clinical guidelines. A secondary aim was to explore concomitant dispensing of multiple PPIs.</p><p><strong>Method: </strong>Our repeated cross-sectional study used a pharmacy claims database including General Medical Services (GMS) patients (~ 30% of the Irish population) from 2012 to 2022. Demographic differences (male/female; aged <45/≥45 years) in treatment dispensing were assessed using annual GMS population proportions. Annual dispensing rates were calculated for eradication regimens and PPIs. Temporal trends in PPI use and treatment duration (7 vs. 14 days) were analysed using negative binomial regression.</p><p><strong>Results: </strong>In total, 112,816 eradication treatments were dispensed. Annually, a higher proportion of women than men (0.46-0.65% vs. 0.40-0.60%) and individuals aged ≥ 45 than <45 years (0.64-0.81% vs. 0.26-0.46%) received treatment. Clarithromycin-amoxicillin triple therapy accounted for 72.4% of treatments, and bismuth quadruple therapy 0.1%. Esomeprazole was the most dispensed PPI (47.5%). Same-day multiple-PPI dispensing occurred on 2.7% of treatment-dispensing dates. First-generation PPI dispensing decreased 5.3% annually (incidence rate ratio [IRR] 0.95, 95% confidence interval [CI] 0.93-0.97); the second-generation annual rate change was 7.6% higher (interaction IRR 1.08, 95% CI 1.05-1.11), corresponding to a 1.9% annual increase (IRR 1.02, 95% CI 1.00-1.04). Seven-day dispensing decreased 16.2% annually (IRR 0.84, 95% CI 0.81-0.87); the annual rate change for 14-day regimens was 53.3% higher (interaction IRR 1.53, 95% CI 1.46-1.62), corresponding to a 28.5% annual increase (IRR 1.28, 95% CI 1.24-1.33).</p><p><strong>Conclusion: </strong>Increasing use of 14-day eradication treatments and esomeprazole suggests improving alignment with clinical guidelines. Continued reliance on clarithromycin-based triple therapy, minimal bismuth quadruple therapy use, and potential PPI duplication highlight opportunities for medicines optimisation.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069547","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":"Microarray patches as a potential alternative to injectable fertility medications: a qualitative study of patients' and healthcare professionals' perceptions.","authors":"Laura Koenitz, Megan Quigley, Abina Crean, Sonja Vucen, Michelle O'Driscoll","doi":"10.1007/s11096-026-02220-1","DOIUrl":"https://doi.org/10.1007/s11096-026-02220-1","url":null,"abstract":"<p><strong>Introduction: </strong>Many fertility treatments require regular injections that can impact patients' everyday lives. Transdermal delivery may reduce the treatment burden, but physical and biochemical barriers of the skin limit the drugs' bioavailability. Microarray patches (MAPs) present a novel formulation option that helps delivering medicines through the skin. Their administration is perceived to be straightforward and patient-friendly; however, existing acceptability studies have largely focused on MAP-based vaccination.</p><p><strong>Aim: </strong>This study aimed to investigate patients', partners' and healthcare professionals' experiences of fertility injections, and to explore their perspectives on potential MAP use and key factors for optimal user acceptance in fertility care.</p><p><strong>Method: </strong>A qualitative interview study was conducted in Ireland between September 2025 and January 2026. Patients, partners and healthcare professionals (including nurses, pharmacists, midwives and consultants) were eligible to participate. Interviewees were recruited by convenience sampling through researchers' networks, advertisement on social media and targeted outreach to fertility clinics. Semi-structured interviews followed a topic guide. Audio recordings were transcribed verbatim and transcripts analysed using Braun and Clarke's reflexive thematic analysis.</p><p><strong>Results: </strong>Twenty-two participants (n=10 patients/n=1 partner, n=11 healthcare professionals) of varying age, professional/educational background, residential/practise location, and experience with fertility care were interviewed. Five key themes emerged: (1) The complexity of administration-drug and formulation considerations; (2) The importance of support systems-partners, peers, and healthcare professionals; (3) Managing expectations-medicine information and treatment outcome; (4) Making it work-logistical and lifestyle adjustments; and (5) Education and training-healthcare professionals and patients. Participants highlighted patients' hopes for treatment success and their resilience to endure practical and emotional challenges like reconstituting injectables, sharps disposal, and fear of mistakes. While MAPs could enhance treatment experiences, they should meet important acceptability criteria including straightforward use, flexible dosing, room temperature storage, minimal pain and skin reactions, comparable efficiency and cost to injectables, and comprehensive counselling.</p><p><strong>Conclusion: </strong>This study highlighted the potential positive impact of MAPs on the unique practical and emotional challenges of fertility patients. The findings will help to inform next steps in exploring MAP-based fertility treatments but also have implications for the development of future fertility injectables.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030367","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":"Pathway to Access UTI Management (PATH-UTI): evaluating pharmacist prescribing and management practices for uncomplicated urinary tract infections in community pharmacy in New South Wales and the Australian Capital Territory, Australia.","authors":"Mitchell Budden, Francisco Martinez-Mardones, Shalom I Benrimoj, Anna Campain, David Peiris, Sarah Dineen-Griffin","doi":"10.1007/s11096-026-02226-9","DOIUrl":"https://doi.org/10.1007/s11096-026-02226-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Pharmacist prescribing has been introduced internationally to improve timely access to treatment in primary care. For uncomplicated urinary tract infections, pharmacist-led services report favourable outcomes, however, the evidence base remains limited by small sample sizes and heterogenous study designs. Large-scale evaluations are needed to better understand pharmacist management practices and prescribing outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To explore pharmacist management practices for uncomplicated urinary tract infections in community pharmacy settings, including the effectiveness and safety of pharmacist prescribing and variation in clinical outcomes by antibiotic type.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;Data from the PATH-UTI cohort study were analysed across community pharmacies in New South Wales and the Australian Capital Territory. The trial included an initial two-month feasibility pilot followed by a 10-month main study period (July 2023-May 2024). Women aged 18-65 years presenting with symptoms consistent with an uncomplicated urinary tract infection were assessed and managed by trained pharmacists using a structured clinical management protocol aligned with national guidelines. Consultation data were routinely recorded during the pharmacy visit, and patient-reported outcomes were collected by follow-up survey 7 days later. The primary outcome was self-reported complete symptom resolution at 7-day follow-up. Secondary outcomes included antibiotic prescribing rates, patient reported adherence, referrals, and patient reported adverse events. Differences in symptom resolution by antibiotic type were assessed using a chi-square test of independence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 18,143 consultations were recorded, with 14,680 follow-up surveys (81.0%) completed. Antibiotics were supplied in 92.6% of consultations, most commonly trimethoprim (95.5%). Complete symptom resolution at 7 days was reported by 79.4% of patients. A further 17.9% reported partial symptom improvement. There was no statistically significant difference in effectiveness across the three antibiotics (χ&lt;sup&gt;2&lt;/sup&gt;(2) = 3.88, p = 0.14). Referrals to a general practitioner or emergency department occurred in 6.9% of cases. Self-reported adverse events were documented in 5.0% of patients, predominantly mild gastrointestinal side effects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Pharmacist prescribing for uncomplicated urinary tract infections achieved symptom resolution rates comparable to previous pharmacy- and physician-led studies. Low rates of adverse events and complications, and strong adherence to the clinical management protocol were also observed. These results suggest that structured, protocol-based pharmacist prescribing for uncomplicated urinary tract infections can support safe and effective management in primary care, with the potential to improve access to treatment and help manage demand on general practice.&lt;/p&gt;&lt;p&gt;&lt;s","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030537","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 the factors influencing pharmacists' therapeutic reasoning in decision-making: a concurrent think aloud and semi-structured interview study.","authors":"Daniel Rainkie, Zachariah Nazar, Pim Teunissen, Karen Könings","doi":"10.1007/s11096-026-02216-x","DOIUrl":"https://doi.org/10.1007/s11096-026-02216-x","url":null,"abstract":"<p><strong>Introduction: </strong>Models of therapeutic reasoning conceptualize how pharmacists apply knowledge to weigh the benefits and risks of treatment options for patients but provide limited detail on the specific factors considered during the process.</p><p><strong>Aim: </strong>To explore the factors that prescribing pharmacists consider during therapeutic reasoning when making treatment decisions and how those factors are structured hierarchically.</p><p><strong>Method: </strong>This qualitative study explored the therapeutic reasoning of eight prescribing pharmacists as they worked through three primary care cases selected from hypertension, diabetes, heart failure and pediatric fever. Participants completed a think-aloud protocol to verbalize their thoughts in real time, a post-encounter form to promote reflection, and a semi-structured interview to clarify and elicit additional reasoning considerations. Data were audio-recorded, transcribed, and analyzed using template analysis. Each template iteration was critically reviewed by the research team with a detailed audit trail. Information power was reached at 18 cases (six pharmacists), with the remainder used for confirmation.</p><p><strong>Results: </strong>We identified 35 factors across five themes: treatment planning, evidence and experience, drug-related factors, patient-centered factors, and setting influences. Therapeutic reasoning typically started with treatment planning to list broad options available in context and rule out options based on contraindications, cost and coverage. The remaining tailored list of options were evaluated using a non-linear process informed by evidence and experience, drug-related factors, and patient-centered factors. Setting influences, such as external pressures, access to clinical decision support systems, or the preferences of other clinicians influenced how the pharmacist considered treatment options. In total, 11 factors were associated with ruling out options, while the remaining factors informed the relative ranking of viable alternatives. Two levels of reasoning were observed: generic reasoning (case-independent) which relied on knowledge alone and patient-specific reasoning where relevant knowledge was applied to the patient case. Dynamic prioritization was observed as factor importance varied by case.</p><p><strong>Conclusion: </strong>This study advances the conceptualization of therapeutic reasoning by specifying the factors and their functional roles within decision-making. These findings provide a practical foundation for teaching, assessing, and supporting structured clinical decision-making in pharmacy practice.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001844","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 of a pilot preceptorship programme for pharmacists working towards the advanced career stage in Scotland: a mixed-methods study.","authors":"Mairi-Anne McLean, Paul Forsyth, Chris F Johnson, Anne C Boyter","doi":"10.1007/s11096-026-02222-z","DOIUrl":"https://doi.org/10.1007/s11096-026-02222-z","url":null,"abstract":"<p><strong>Introduction: </strong>Structured preceptorship programmes may support pharmacists working towards the advanced career stage, yet evidence on feasibility remains limited.</p><p><strong>Aim: </strong>The aim of this study was to evaluate the feasibility of a pilot preceptorship programme for pharmacists working towards the advanced career stage.</p><p><strong>Method: </strong>An embedded mixed-methods pilot study was conducted in primary care practices within one territorial health board in NHS Scotland, recruiting four preceptor-preceptee pairs for a 16-week preceptorship programme. Quantitative data assessed programme delivery, including joint clinical sessions, shadowing sessions and changes in preceptee-reported self-efficacy and competence from baseline to 16 weeks. Qualitative data from semi-structured interviews with preceptors, preceptees, and senior pharmacy management explored perceptions of implementation barriers and enablers. Data were analysed using the COM-B framework, which considers Capability, Opportunity, and Motivation as key influences on behaviour.</p><p><strong>Results: </strong>Feasibility assessment demonstrated incomplete implementation, with preceptee-reported delivery of 14 of 60 anticipated joint clinical sessions (including both preceptee led clinics and shadowing sessions) and 3 of 12 anticipated structured review meetings over the 16-week programme. Self-reported self-efficacy and competence data were collected over the study period; however, due to incomplete implementation, these data are not interpreted as evidence of programme effect. Qualitative analysis identified participants' perceptions of barriers to implementation, including competing workload priorities, lack of protected time, logistical challenges, limited stakeholder engagement, and insufficient holistic feedback (as feedback primarily focused on clinical rather than practical aspects), alongside enablers such as access to resources and the perceived value of preceptorship.</p><p><strong>Conclusion: </strong>The pilot preceptorship programme was not fully feasible in this professional context, highlighting important considerations for future implementation. Despite incomplete delivery, participants reported perceived changes in self-reported self-efficacy and competence; however, these findings do not provide evidence of programme effect, highlighting the need for further refinement and evaluation of preceptorship models in advanced pharmacist practice.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001810","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":"Development of a Core Outcome Measurement Set for studies of community pharmacist-led medication reviews in older patients with multimorbidity and polypharmacy.","authors":"Cathrin J Vogt, Christiane Eickhoff, Veerle Foulon, Carmel Hughes, Jens Kessler, Cinara Paul, Cristín Ryan, Martin Schulz, Martina Teichert, Ronja Woltersdorf, Viktoria S Wurmbach, Hanna M Seidling","doi":"10.1007/s11096-026-02223-y","DOIUrl":"https://doi.org/10.1007/s11096-026-02223-y","url":null,"abstract":"<p><strong>Introduction: </strong>A Core Outcome Set (COS) can harmonize outcome reporting. For medication review (MR) studies targeting older, multi-morbid patients with polypharmacy, a COS with seven outcomes is available: Health-related Quality of Life (HRQoL), pain relief, overuse, underuse, potentially inappropriate medications (PIMs), clinically significant drug-drug-interactions (DDIs), drug-related hospitalization. However, the lack of standardized outcome measurement is a barrier to its application. Thus, the next step is to operationalize each outcome by standardizing their measurement, resulting in a Core Outcome Measurement Set (COMS). As operationalization is setting-specific, a COMS was developed for MR studies in community pharmacies. Depending on the outcome type, the aims were to (1) identify outcome measurement instruments (OMIs), (2) define quality criteria for OMI selection, (3) refine outcome definitions, and/or (4) seek agreement on the appropriate measurement methods.</p><p><strong>Method: </strong>Literature searches were conducted to identify OMIs. A group of 10 experts was assembled, with at least one expert contributing to each outcome. Throughout the study, they completed two online surveys and took part in two online workshops. Based on the type of outcome, different approaches were undertaken: (1) The experts selected the most appropriate OMIs for HRQoL and pain relief. (2) Recognizing national differences in OMIs for overuse, underuse and PIMs, experts established universal quality criteria for OMIs' selection to be applied for studies. (3) To operationalize DDIs and drug-related hospitalization, experts refined the definitions of what to measure. (4) For drug-related hospitalization experts sought to identify the best measurement method.</p><p><strong>Results: </strong>(1) The experts selected the EQ-5D-5L as most appropriate OMI for HRQoL and upon numerical and visual analogue scales for pain relief. (2) Seven quality criteria were defined for the content of OMIs on overuse, underuse, and PIMs. No thresholds were established for validity and feasibility criteria. (3) DDIs to be measured were refined as those with a 'major' severity rating. Drug-related hospitalization was refined as unplanned overnight stays; (4) measured by patients' reporting.</p><p><strong>Conclusion: </strong>By translating the existing COS into a practical measurement framework, this COMS supports more standardized and comparable MR research.</p><p><strong>Trial registration: </strong>Registered on 16 August 2023 at Open Science Framework ( https://osf.io/57jfc ).</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982514","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":"Pharmacists' role in recognising medication-related oral health risks in aged care: a qualitative study of pharmacists' and dentists' perspectives.","authors":"Joon Soo Park, Amy T Page, Estie Kruger, Woosung Sohn, Bradley Christian, Arash Rudman","doi":"10.1007/s11096-026-02225-w","DOIUrl":"https://doi.org/10.1007/s11096-026-02225-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Medication-related oral health complications, including salivary gland hypofunction, xerostomia, dental caries, candidiasis, mucosal injury, and swallowing difficulties, are common among older adults exposed to polypharmacy across aged-care and broader clinical practice contexts. Pharmacists are increasingly involved in medication management in residential aged care and may be well positioned to support the earlier recognition of medication-related oral health risks. Despite this, previous literature suggests that oral health is often insufficiently integrated into medication management, interdisciplinary care pathways, and pharmacist education frameworks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study aimed to explore pharmacists' and dentists' perspectives on pharmacists' role in recognising medication-related oral health risks in aged-care practice, including pharmacists' educational needs, interdisciplinary care considerations, and preferred implementation strategies for practical oral health resources.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;A qualitative descriptive study was conducted in Australia using semi-structured interviews with pharmacists and dentists who had experience caring for older adults, managing polypharmacy, or working in aged-care-related practice. Participants were recruited using purposive sampling to capture a range of clinical perspectives across pharmacy and dental settings. Interviews were audio-recorded, transcribed verbatim, and analysed using reflexive thematic analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Three major themes were identified from thirteen participants (six dentists and seven pharmacists): limited formal preparation for medication-related oral health risks; reactive recognition of oral complications within fragmented care systems; and the need for practical, workflow-integrated resources to support pharmacists' involvement in oral health care. Participants described limited oral health education, delayed recognition of oral complications, unclear referral pathways, and poor interdisciplinary communication. Xerostomia was the most commonly recognised symptom, although participants demonstrated less consistent recognition of objective salivary gland hypofunction and its consequences, including dental caries, candidiasis, swallowing difficulties, and nutritional decline. Concise educational resources, decision-support tools, and electronic prompts were strongly preferred to support earlier recognition and referral within medication management workflows.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Pharmacists and dentists described educational, interdisciplinary, and systems-level challenges affecting pharmacists' involvement in recognising and managing medication-related oral health risks in aged-care practice. Findings suggest that practical educational resources, clearer referral pathways, and stronger interdisciplinary collaboration may support pharmacists' involvement in recognising medication","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982522","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":"Trends and patterns of pharmacist-administered vaccination in a predominantly Western Australian pharmacy group: retrospective analysis of routinely collected data.","authors":"Ashenafi Kibret Sendekie, Petra Czarniak, Tin Fei Sim, Anneika Tonkin, Kristian Ray, Leanne Chalmers","doi":"10.1007/s11096-026-02221-0","DOIUrl":"10.1007/s11096-026-02221-0","url":null,"abstract":"<p><strong>Introduction: </strong>Pharmacists are integral to vaccination strategies globally and within Australia's National Immunisation Program. However, limited evidence exists regarding how uptake of pharmacist-administered vaccination varies across demographic groups and geographic locations.</p><p><strong>Aim: </strong>This study aimed to analyse trends and patterns in pharmacist-administered vaccinations delivered within a predominantly Western Australian community pharmacy network.</p><p><strong>Method: </strong>A retrospective descriptive analysis was undertaken using de-identified routine vaccination records from January 2021 to April 2025. Data were sourced from a booking system (January 2021-March 2024) and a clinical record system (April 2024-April 2025) of a selected pharmacy group. Temporal trends and vaccination patterns, stratified by demographic (age and sex) and geographical distributions, including Modified Monash Model (MMM) category and proximity to medical centres, were assessed. Vaccination rates per 100, 000 population were calculated across age, sex, and MMM groups using Western Australian vaccination records as the numerator and corresponding population estimates as the denominator.</p><p><strong>Results: </strong>Over 1.1 million vaccination records spanning 19 vaccine types were analysed. COVID-19 vaccines accounted for 59.4% of all vaccinations, peaking between late 2021 and early 2022. Influenza vaccination showed consistent seasonal peaks (March-June), with a decline in 2024 compared with previous years. Administration of other routine vaccines was variable but gradually increased, particularly in 2024. Vaccination rate per 100,000 population was highly variable among age groups, with an overall lower vaccination rate among younger individuals (aged 5-19 years) and older people (aged ≥85 years). Vaccination services were concentrated in metropolitan areas and pharmacies near medical centres, with a similar pattern between males and females.</p><p><strong>Conclusion: </strong>Community pharmacists played a vital role in vaccination delivery, particularly during the COVID-19 pandemic and seasonal influenza periods. Routine vaccine administration has the potential to expand further with targeted health campaigns to improve public awareness and uptake across all populations and regions. Further research should develop strategies to enhance equitable access across geographic areas.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976689","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}