International Journal of Clinical Pharmacy最新文献

{"title":"Antimicrobial stewardship in acute exacerbations of COPD: a qualitative study of hospital pharmacists' perspectives.","authors":"Abdulaziz Alrashdi, Jan-Willem C Alffenaar, Jin-Gun Cho, Bandana Saini","doi":"10.1007/s11096-026-02217-w","DOIUrl":"https://doi.org/10.1007/s11096-026-02217-w","url":null,"abstract":"<p><strong>Introduction: </strong>Acute exacerbations of chronic obstructive pulmonary disease (COPD) are a common cause of antibiotic use and hospital admissions. Although antimicrobial stewardship (AMS) programs are well established, the specific contribution of pharmacists to COPD-related antimicrobial decision-making remains unclear.</p><p><strong>Aim: </strong>To explore hospital pharmacists' perspectives on their roles, responsibilities, and application of AMS principles in the management of hospitalised patients with COPD exacerbations.</p><p><strong>Method: </strong>We conducted a qualitative study using semi-structured interviews with hospital pharmacists involved in COPD care and/or AMS activities at two public tertiary hospitals in Sydney, Australia. Our research was informed by a constructivist epistemology and critical realist orientation. Interviews were conducted via Zoom, audio-recorded, transcribed verbatim, and analysed inductively using reflexive thematic analysis. Recruitment continued until data saturation was reached.</p><p><strong>Results: </strong>Seventeen pharmacists participated and three themes were identified. First, pharmacists described AMS as being a core component of their professional role, including reviewing antimicrobial indication, dose, duration, and spectrum, and promoting appropriate antimicrobial use. However, their involvement typically occurred after initial prescribing, with greater influence on treatment duration than agent selection. Second, organisational and structural factors shaped their scope of practice, including workload pressures, hierarchical prescribing cultures, limited prescribing authority, and electronic system challenges, particularly during transitions of care. Third, pharmacists described patient-centred roles alongside stewardship, including counselling on antibiotic use and discharge medicines, as well as support for inhaler technique, vaccination, and smoking cessation.</p><p><strong>Conclusion: </strong>Hospital pharmacists view AMS as a core part of managing COPD exacerbations. Their contributions include antimicrobial review, interdisciplinary communication, and patient education, but their involvement is often advisory and constrained by organisational structures, workload, and prescribing hierarchies.</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":"148976735","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":"Prevalence and factors influencing medication adherence after acute myocardial infarction: a systematic review and meta-analysis.","authors":"Ruolan Liao, Shihan Zhang, Qi Zhou, Jingyang Wang, Mengzhen Huang, Danxin Wang, Hua Zhang","doi":"10.1007/s11096-026-02224-x","DOIUrl":"https://doi.org/10.1007/s11096-026-02224-x","url":null,"abstract":"<p><strong>Introduction: </strong>Adherence to evidence-based secondary prevention medications is important for long-term management after acute myocardial infarction (AMI). Previous reviews have examined medication adherence and related factors but remain limited by heterogeneity in adherence measures and reliance primarily on narrative synthesis.</p><p><strong>Aim: </strong>We aimed to estimate the pooled prevalence of objectively measured medication adherence and identify associated factors after AMI.</p><p><strong>Method: </strong>Five databases (PubMed, Embase, Cochrane Library, Web of Science, and Ovid MEDLINE) were searched from January 1, 2000, to October 5, 2025. Observational studies using objective measures of medication adherence after AMI were included. Random-effects models were used to pool adherence prevalence estimates and adjusted odds ratios (ORs) for associated factors. Heterogeneity was explored through subgroup analyses by adherence measure, follow-up period, and geographical region. Robustness was assessed using leave-one-out sensitivity analyses.</p><p><strong>Results: </strong>We included 18 retrospective cohort studies involving 680,966 participants from eight countries. The pooled prevalence of adherence was 64.9% (95% CI 56.1-73.8%) for statins, 58.9% (95% CI 49.3-68.4%) for beta‑blockers, 56.7% (95% CI 45.3-68.0%) for P2Y12 inhibitors, 61.3% (95% CI 50.8-71.9%) for angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB), and 41.4% (95% CI 27.2-55.6%) for multiple-drug therapy (≥ 2 classes). Substantial heterogeneity remained within subgroups. Factors associated with higher adherence included hypertension (OR = 1.39, 95% CI 1.17-1.65), prior cardiovascular medication use (before the index admission for AMI; statins: OR = 1.33, 95% CI 1.15-1.54; beta-blockers: OR = 1.62, 95% CI 1.49-1.75; ACEI/ARB: OR = 1.77, 95% CI 1.65-1.89), ST-segment elevation myocardial infarction (OR = 1.23, 95% CI 1.02-1.48), percutaneous coronary intervention (OR = 2.16, 95% CI 1.34-3.46), and discharge from a cardiology ward (OR = 1.57, 95% CI 1.37-1.80). Factors associated with lower adherence included female sex (OR = 0.78, 95% CI 0.74-0.84), age ≥85 years (OR = 0.48, 95% CI 0.38-0.60), and chronic obstructive pulmonary disease (COPD; OR = 0.78, 95% CI 0.72-0.84).</p><p><strong>Conclusion: </strong>Medication adherence after AMI was suboptimal and associated with several factors. These findings may inform targeted monitoring and support but require further confirmation given substantial heterogeneity.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955855","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 study of the Care-at-Home Pharmacotherapy Service (CAHPS): pharmacy technician-led home visits for people receiving polypharmacy who are housebound living in socioeconomically deprived areas.","authors":"Tania Ramos, Louise Cochrane, Amit Verma, Ling Zhang, Andrew Beattie, Chris F Johnson, Richard Lowrie","doi":"10.1007/s11096-026-02211-2","DOIUrl":"https://doi.org/10.1007/s11096-026-02211-2","url":null,"abstract":"<p><strong>Introduction: </strong>People who are housebound frequently miss general practice-based long-term condition (LTC) reviews. Missingness from LTC reviews are associated with poorer health outcomes and higher costs. General practice pharmacy collaboration within primary care teams may help address the housebound missingness care gap.</p><p><strong>Aim: </strong>To evaluate the feasibility of implementing the Care-at-Home Pharmacotherapy Service, a general practice pharmacy technician-clinical pharmacist domiciliary review model for housebound patients living in areas of socioeconomic deprivation.</p><p><strong>Method: </strong>Pre-post intervention study, in two primary care general practices serving a socioeconomically deprived locality.</p><p><strong>Inclusion criteria: </strong>adults ≥ 60 years, coded as housebound with ≥ 2 LTCs and ≥ 5 regularly prescribed medications.</p><p><strong>Exclusions: </strong>adults lacking capacity or receiving palliative care.</p><p><strong>Baseline data: </strong>demographics, Scottish Index of Multiple deprivation (SIMD, a national measure of area-level deprivation), number of regular medications, falls frequency, health-related quality-of-life (EQ5D5L) score, and unscheduled care. Pharmacy technician domiciliary visits involved medication review, adherence support, education and physical assessment. A pharmacist provided clinical supervision and clinical review. Pre-post review outcomes were assessed at 3 months.</p><p><strong>Results: </strong>Twenty-five patients were included (median age 81, range 60-89; 56% female), with 56% living in the most deprived SIMD quintile. In total, twenty-three patients had missed 91 LTC reviews since becoming housebound and were prescribed a median of 14 regular medications (range 9-27). Across 83 encounters with a pharmacy technician, 21 medications were stopped, 19 initiated, and 15 adjusted. Fifteen clinical referrals were generated. Compared with the 3 months before pre-intervention, the total number of self-reported falls during the 3-month follow-up reduced from 8 (range 0-2) to zero (range 0-0). Mean EQ-5D-5L visual analogue score increased from 57 to 62%, and unscheduled care contacts reduced from a total of 56 (range 0-7) to 21 (0-4).</p><p><strong>Conclusion: </strong>Pharmacy technician-led domiciliary review with support from a clinical pharmacist is feasible and leads to identification of actionable unmet clinical and medication- needs in older adults who are housebound.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955808","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":"Therapeutic drug monitoring in leukemia: global research trends and implications for clinical pharmacy practice-a bibliometric analysis.","authors":"Jianchun Li, Lichaoyue Sun, Shuo Liang, Zhiheng Yu","doi":"10.1007/s11096-026-02187-z","DOIUrl":"https://doi.org/10.1007/s11096-026-02187-z","url":null,"abstract":"<p><strong>Introduction: </strong>Leukemia treatment has evolved rapidly over the past decade, with the introduction of targeted therapies, immunotherapies, and increasingly complex pharmacotherapeutic regimens. Many antileukemic agents and supportive medications exhibit substantial pharmacokinetic variability and have narrow therapeutic windows. Therefore, therapeutic drug monitoring (TDM) has emerged as an important strategy for optimizing individualized pharmacotherapy, improving treatment efficacy, and reducing drug-related toxicity. However, the overall research landscape, development trajectory, and emerging trends of TDM in leukemia have not been systematically evaluated.</p><p><strong>Aim: </strong>This study aimed to systematically analyze global research trends and hotspots in TDM for leukemia between 2001 and 2025 using bibliometric methods and to provide insights into future research directions and clinical pharmacotherapy applications.</p><p><strong>Method: </strong>Publications related to TDM in leukemia published between January 1, 2001, and December 31, 2025, were retrieved from the Web of Science Core Collection database. A topic-based search strategy was used to identify the relevant articles. Bibliometric analysis and visualization were conducted using VOSviewer and CiteSpace to evaluate publication output, collaboration networks among countries, institutions, and authors, journal distribution, highly cited publications, citation bursts, and keyword co-occurrence.</p><p><strong>Results: </strong>A total of 859 papers were retrieved, with the highest output (58 papers) observed between 2024 and 2025. The United States and China contributed the most publications. The University of Texas MD Anderson Cancer Center ranked first among the institutions. Highly cited papers primarily focused on pharmacotherapy for hematologic malignancies, pharmacodynamics and pharmacokinetic studies, and pre-transplant medication regimens. Burst analysis indicates that TDM in leukemia treatment has progressively evolved from early preliminary studies on exposure-response relationships to the implementation of precision dosing strategies and clinical guidelines, continuously expanding to cover an increasing number of therapeutic agents in leukemia treatment. Current research hotspots include tyrosine kinase inhibitors (particularly Bcr-Abl inhibitors), asparaginase, drug interactions, and safety management issues.</p><p><strong>Conclusion: </strong>From 2001 to 2025, research activities on TDM in leukemia treatment have shown continuous growth, with substantial expansion in both scope and depth. TDM is gradually becoming an increasingly important component of leukemia pharmacotherapy and may play a key role in supporting precision medicine and optimizing treatment outcomes in leukemia patients.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906292","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":"Near-miss dispensing errors in Japanese community pharmacies: error types and associated factors across dispensing stages.","authors":"Takashi Umino, Tsugumichi Sato, Yoshiaki Shikamura, Kazushige Ijuin, Asuka Fujisawa, Yuki Iwama, Mayu Usami, Tomoe Asai, Mai Shimoyama, Rumoi Takahashi, Takehisa Hanawa","doi":"10.1007/s11096-026-02208-x","DOIUrl":"https://doi.org/10.1007/s11096-026-02208-x","url":null,"abstract":"<p><strong>Introduction: </strong>The types and causes of dispensing errors vary across the stages of the complex dispensing process in community pharmacies. Notably, the analysis of near-miss reports may facilitate improvements in healthcare environments and operational practices.</p><p><strong>Aim: </strong>We aimed to identify the characteristics of the factors contributing to near-miss errors at each stage of the dispensing process and to determine which factors require priority action.</p><p><strong>Method: </strong>We conducted a secondary analysis of near-miss dispensing errors voluntarily reported by community pharmacies through the near-miss reporting system of the Japan Council for Quality Health Care. The associations between various types of near-miss errors and their contributing factors were estimated using multivariate logistic regression models.</p><p><strong>Results: </strong>Among the 45,483 near-miss incidents, most were reported during the dispensing and accuracy-checking stages (n = 35,384, 77.8%). At the prescription data entry stage, near-miss errors were primarily associated with the usability of computer systems and look-alike/sound-alike (LASA) drug names. At the dispensing and accuracy-checking stage, the characteristic contributing factors included LASA drug names and similar appearances, patient preferences for brand name/generic, user-friendliness of equipment, and human factors among pharmacists. During the medicine supply stage, factors associated with inadequate confirmation of the patient's understanding were identified. Finally, at the post-supply stage, patient-related factors and insufficient communication were identified as key contributors.</p><p><strong>Conclusion: </strong>Based on the reported near-miss events, priority actions are required to address LASA drug names and similar appearances, generic prescription systems, labour-intensive dispensing practices, the usability of computer systems and equipment, and inadequate communication with patients.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897294","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":"Knowledge, attitudes and practices among Australian community pharmacists towards naloxone and overdose prevention: a national cross-sectional study.","authors":"Louisa Picco, Monica Jung, Rose Laing, Jeffrey Bratberg, Beth Sproule, Suzanne Nielsen","doi":"10.1007/s11096-026-02219-8","DOIUrl":"https://doi.org/10.1007/s11096-026-02219-8","url":null,"abstract":"<p><strong>Introduction: </strong>Naloxone is an opioid overdose reversal drug that is available for free without a prescription via participating community pharmacies in Australia.</p><p><strong>Aim: </strong>To investigate Australian community pharmacists' knowledge, attitudes, practices, and provision of naloxone and overdose prevention, and identify barriers to and correlates of naloxone provision.</p><p><strong>Method: </strong>Data were collected between January and April 2025 via an anonymous, cross-sectional questionnaire among Australian community pharmacists who were recruited using a randomised representative sampling approach. Data pertaining to pharmacy and pharmacist-related characteristics, pharmacists' knowledge and attitudes towards naloxone, overdose prevention, and provision of naloxone, including barriers to provision, were captured. Multivariable logistic regression was conducted to determine the pharmacy (including jurisdiction, geographic location, pharmacy type, and provision of other harm reduction services) and pharmacist (including gender, years of experience, knowledge of, and attitudes towards naloxone and overdose prevention) characteristics associated with stocking naloxone.</p><p><strong>Results: </strong>Of the 730 pharmacists who completed the online questionnaire, approximately three-quarters (n = 534, 73.2%) stocked naloxone. Most pharmacists had positive attitudes towards naloxone (85%), and good or excellent self-reported knowledge (81%) of naloxone and overdose prevention. Logistic regression analyses revealed that pharmacies that had significantly greater odds of stocking naloxone were located in Australia's least populous states/territories (Australian Capital Territory, Northern Territory, Tasmania, South Australia) (aOR: 2.32; 95% CIs 1.17-4.61) and Queensland (aOR: 2.12; 95% CIs 1.17-3.83), provided Opioid Agonist Treatment (aOR: 2.77; 95% CIs 1.82-4.24), and had pharmacists with good or excellent knowledge of naloxone (aOR: 4.43, CIs 2.75-7.12; aOR: 6.19, CIs 3.53-10.84 respectively) and very positive attitudes towards naloxone supply (aOR: 2.29, 95% CIs 1.23-5.25). Lack of time to develop, implement and/or sustain the program (59.4%) and lack of training among pharmacy staff (44.6%) were identified as key barriers among the minority of pharmacists that did not stock naloxone.</p><p><strong>Conclusion: </strong>A large proportion of community pharmacies in Australia stocked naloxone, with variability across states/territories. While pharmacists' attitudes and knowledge were positive overall, there remains scope to increase provision of adequate education and targeted support to strengthen community pharmacies' harm reduction capacity and provide equitable access.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897289","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 qualitative analysis to identify implementation strategies for a deprescribing clinical practice guideline using the CFIR-ERIC Matching Tool: perspectives from consumers and professional stakeholders.","authors":"Hui Wen Quek, Xisco Reus, Kenneth Lee, Veronika Seda, Leon Adams, Osvaldo P Almeida, Gillian E Caughey, Jennifer Gowan, Kerryn Hart, Andrew Heredia, Anne-Marie Hill, Lisa Kalisch Ellett, Dina LoGiudice, Arduino A Mangoni, Anthony Marinucci, Treasure McGuire, Nilufeur McKay, Vasi Naganathan, Christopher Ng, Maz Osborne, Kevan R Polkinghorne, Constance D Pond, Sepehr Shakib, Angela Shiu, Andrew Stafford, Tim Whitmore, Christopher Etherton-Beer, Amy Page","doi":"10.1007/s11096-026-02218-9","DOIUrl":"https://doi.org/10.1007/s11096-026-02218-9","url":null,"abstract":"<p><strong>Introduction: </strong>Deprescribing is the planned withdrawal or dose reduction of medicines when harms outweigh benefits or when they are no longer required. Following publication of the Clinical Practice Guideline for Deprescribing in Older People in September 2025, supporting its uptake into routine practice is a critical next step.</p><p><strong>Aim: </strong>This study aimed to identify implementation strategies, informed by stakeholder-perceived barriers, to support the implementation of deprescribing guidelines.</p><p><strong>Method: </strong>A qualitative analysis was undertaken of open-text responses collected during the guideline public consultation (24 April-31 May 2025). Inductive thematic analysis identified implementation barriers, which were then deductively mapped to the Consolidated Framework for Implementation Research (CFIR). Relevant CFIR constructs were entered into the CFIR-Expert Recommendations for Implementing Change (ERIC) Matching Tool to generate implementation strategies. Strategies were ranked by cumulative percentage endorsement and grouped using ERIC concept-mapping clusters.</p><p><strong>Results: </strong>Of 313 survey respondents, 248 provided responses relevant to implementation. Three barrier themes were shared across consumer and professional/policy stakeholder groups. Theme 1: 'Knowledge gaps, beliefs, and limited readiness to deprescribe' describes gaps in consumers' and clinicians' knowledge, beliefs about medication use and deprescribing, and limited confidence or willingness to engage in deprescribing. Theme 2: 'Communication, hierarchy, or social influences limiting deprescribing' describes communication gaps, entrenched prescribing norms, power imbalances, and social influences that limited shared decision-making. Theme 3: 'System-level structures misaligned with deprescribing practice' describes broader healthcare system barriers, including financial, policy, workforce, organisational, and information-related constraints. Consumers additionally highlighted a lack of person-centred and adaptable approach for deprescribing, while professional/policy stakeholders identified barriers related to medicine formulations and guideline format and usability. Barriers mapped predominantly to the CFIR Inner Setting domain. The highest-ranked implementation strategy was 'Identify and prepare champions', within the 'Develop stakeholder interrelationships' cluster.</p><p><strong>Conclusion: </strong>Deprescribing barriers were largely situated within the Inner Setting domains. Recommended strategies emphasised stakeholder engagement and local champions, supporting locally led, relationship-based implementation approaches. Future work should evaluate the feasibility, acceptability, and effectiveness of these strategies in practice.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887366","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":"Evaluation of clinical interventions made by pharmacists, doctors and nurses in a hospital post-discharge telephone service: a retrospective cohort study.","authors":"Kum Chuan Leong, Darshana Meanger, Philip Wu, Alex Wong, Wee Tjun Tee, Michelle Simango, Bianca Levkovich","doi":"10.1007/s11096-026-02207-y","DOIUrl":"https://doi.org/10.1007/s11096-026-02207-y","url":null,"abstract":"<p><strong>Introduction: </strong>Clinician-led post-discharge telephone follow-up programs are effective in resolving medication-related problems (MRPs) in older adults. Our hospital offers a post-discharge telephone service, Talk-To-You-Tomorrow (TTYT), to general medicine patients to support medication management following hospital discharge. However, little is known about the the types of interventions used to address MRPs between clinicians within post-discharge telephone services.</p><p><strong>Aim: </strong>To compare the types of interventions utalised (pharmacists versus non-pharmacist clinicians) in addressing MRPs for general medicine patients identified through a post-discharge telephone follow-up (TFU) service.</p><p><strong>Method: </strong>A retrospective cohort study investigated interventions provided to general medicine patients between June 2022 to May 2023 who underwent TTYT in a large metropolitan health service. Contemporaneous records were used to identify patients with MRPs and there corresponding interventions. MRPs were categorised using the Drug Evaluation Tools (NESA: necessity, effectiveness, safety and adherence). Interventions were classified using The Swiss Society of Public Health Administration and Hospital Pharmacists tools (patient-level, prescriber-level, drug-level and other interventions). Primary outcome was the difference in interventions (pharmacists versus non-pharmacist clinicians). Secondary outcome was the types of MRPs identified by different clinicians. Outcomes were evaluated using the Pearson's χ² test. Odds of MRP identification by clinician group were estimated with an adjusted odds ratio (OR) and 95% confidence interval (CI).</p><p><strong>Results: </strong>From 3,815 TTYT consultation records, 526 patients had MRPs. All MRPs had at least one intervention (227 pharmacist's and 299 non-pharmacist clinicians'). Pharmacists liaised with other clinicians the most (7.9% (18/227) vs 4.7% (14/299)) versus non-pharmacist clinicians who utilised more drug-level interventions (18% (53/299) vs 13.2% (30/227)). There were no statistically significant differences in the intervention types across pharmacists versus non-pharmacists (X² (3, N = 526) = 4.271, p = 0.234) and MRP types identified by different clinicians (X² (6, N = 526) = 11.777, p = 0.067). The odds of a pharmacist identifying an MRP was 2.27 times greater than non-pharmacists (p < 0.001, CI: 1.82-2.82).</p><p><strong>Conclusion: </strong>Clinicians mostly provided patient-level interventions however, no difference in the types of MRP's identified in a post-discharge TTYT consult between various clinicians. Importantly, pharmacists were more likely identifying a MRP than other clinicians, which highlights the beneficial role of a pharmacist in medication management and their impact on medication safety.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880345","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":"Developing a core competency framework for psychiatric pharmacists: a Europe-wide e-Delphi consensus study conducted by the European Society of Clinical Pharmacy Mental Health Special Interest Group.","authors":"Ivana Tašková, Rosalind Gittins, Nikolaus Riesenhuber, Matej Stuhec, Martina Hahn, Nicole Šafářová, Daniela Fialová, Ita Fitzgerald","doi":"10.1007/s11096-026-02213-0","DOIUrl":"https://doi.org/10.1007/s11096-026-02213-0","url":null,"abstract":"<p><strong>Introduction: </strong>Consensus on essential clinical activities of psychiatric pharmacists is currently unavailable. Agreement on core non-clinical roles relating to research, education, leadership and management is also unavailable. Consensus on the core clinical and non-clinical functions of psychiatric pharmacists is urgently required to standardise the training of specialist pharmacists in psychiatric pharmacy and ensure the provision of high-quality patient care.</p><p><strong>Aim: </strong>The European Society of Clinical Pharmacy (ESCP) Mental Health Special Interest Group (SIG) aimed to develop a pan-European consensus-based core competency framework outlining clearly defined clinical and non-clinical competencies of psychiatric pharmacists.</p><p><strong>Method: </strong>A modified two-round e-Delphi method was used. Experts were purposively recruited and were eligible if they had at least three years of clinical experience in psychiatric pharmacy and were currently employed in a hospital-based clinical pharmacy service. Initial criteria were informed primarily by the International Pharmaceutical Federation Mental Health Care Handbook and elements of the College of Mental Health Pharmacy Advanced Pharmacist Mental Health Curriculum, and were adapted for the European context. Consensus was defined a priori as ≥ 80% agreement, a median score ≥ 3, and an interquartile range ≤ 1.</p><p><strong>Results: </strong>Of the 39 experts who agreed to participate, 32 (82.1%) completed Round 1 and 27 (69.2%) completed Round 2. Experts represented 13 European countries in Round 1 and 12 countries in Round 2. Thirty-three of the 45 initial criteria achieved consensus in Round 1. In Round 2, a further seven criteria achieved consensus, resulting in 40 final criteria for inclusion within the framework.</p><p><strong>Conclusion: </strong>The framework identifies 40 core criteria across seven domains of psychiatric pharmacy practice. This framework should be used to support the harmonised training of specialist psychiatric pharmacists, workforce development, and service planning across European healthcare systems. Future research should prioritise assessing factors affecting the effectiveness of implementation of criteria within each domain across clinical contexts and countries.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850721","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 and internal validation of an interpretable machine learning model for predicting vancomycin-induced nephrotoxicity in hospitalized children.","authors":"Xiuling Wang, Yao Fu, Jinxu Chen, Jie Wan, Wenqiang Kong","doi":"10.1007/s11096-026-02204-1","DOIUrl":"https://doi.org/10.1007/s11096-026-02204-1","url":null,"abstract":"<p><strong>Introduction: </strong>Vancomycin is widely used for severe Gram‑positive infections in children, but vancomycin‑induced nephrotoxicity (VIN) limits its safe application. Existing prediction models rely primarily on traditional logistic regression with limited discriminative performance in pediatric populations, and machine learning (ML) approaches have not been systematically evaluated.</p><p><strong>Aim: </strong>This study aimed to develop and internally validate an interpretable ML model for predicting VIN in pediatric patients using electronic health record (EHR) data.</p><p><strong>Method: </strong>We conducted a retrospective EHR-based study at a tertiary children's hospital. Children aged 1 month to 18 years who received vancomycin for ≥ 3 consecutive days between December 2017 and November 2024 were included. Patients with moderate-to-severe pre-existing renal dysfunction [estimated glomerular filtration rate (eGFR) ≤ 59 mL/min/1.73 m²], preterm birth, blood purification therapy, or major missing data were excluded. VIN was defined as an increase in serum creatinine of ≥ 0.5 mg/dL or > = 50% from baseline on at least two consecutive measurements. Eight ML models were constructed and compared. Model performance was evaluated using the area under the receiver-operating-characteristic curve (AUROC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy (ACC), F1 score, Brier score and the area under the precision recall curve (AUPR). The optimal model was interpreted using the Shapley Additive explanation (SHAP) method. Feature sets of 6, 8, 10, and full features were compared using DeLong's test. Clinical utility was assessed via decision curve analysis (DCA).</p><p><strong>Results: </strong>A total of 1,452 children were included, of whom 206 (14.2%) developed VIN. EXtreme gradient boosting (XGboost) achieved the best predictive performance (AUROC = 0.90, AUPR = 0.74, Brier score = 0.07). A simplified 6‑feature XGBoost model (eGFR, amphotericin B, early vancomycin trough concentration, albumin, immunosuppressant use, and acyclovir/ganciclovir co-administration) achieved comparable discrimination to the full model (AUROC = 0.87; P > 0.05 by DeLong's test) with acceptable calibration (ECE 3.8%). DCA suggested favorable net benefit across clinically relevant risk thresholds.</p><p><strong>Conclusion: </strong>Our interpretable 6-feature XGBoost model demonstrated promising internal discrimination for pediatric VIN prediction. Pending external validation and temporal evaluation, this model may serve as a hypothesis-generating decision-support framework for risk stratification.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818307","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}