International Journal of Clinical Pharmacy最新文献

{"title":"Development and evaluation of an e-learning program on drug-related problems for community pharmacists.","authors":"Cathrin J Vogt, Alesia Reuther, Viktoria S Wurmbach, Marina Weißenborn, Janina A Bittmann, Katharina Wien, Anette Lampert, Emilia Maria Boček Eknes, Patrick Schäfer, Hanna M Seidling","doi":"10.1007/s11096-026-02111-5","DOIUrl":"10.1007/s11096-026-02111-5","url":null,"abstract":"<p><strong>Introduction: </strong>Community pharmacists (CPs) are pivotal in the management of drug-related problems (DRPs), yet a need for additional training has been recognized.</p><p><strong>Aim: </strong>The aim was to develop and evaluate an e-learning program to enhance pharmacists' ability to detect and manage DRPs.</p><p><strong>Method: </strong>The e-learning program provided a self-paced learning experience with 10 modules, each focusing on a DRP. The DRPs were chosen as part of a previous Delphi consensus study. The development team, consisting of researchers, clinical pharmacists, and CPs, considered DRPs applicable if they occurred frequently and could be solved in a pharmacy. Moreover, a predefined checklist was established to guide the development of new modules and specify quality standards. Each module was structured into an educational phase (tutorials, pre- and post-knowledge quizzes, in-depth exercises), and a practical phase (documentation of anonymized patient encounters). After completing all modules, participants took a final comprehensive quiz with 2 questions per module (in total 20 questions). The program was evaluated on multiple levels: pharmacists' knowledge change, how they implemented this knowledge in practice, and their feedback. Data were analyzed descriptively. Comparison between the quizzes were calculated using the Wilcoxon test.</p><p><strong>Results: </strong>A total of 203 pharmacists registered to participate in the study, with participation declining across modules (184 participants completed Module 1 pre-knowledge quiz vs. 119 in Module 10). Across all modules, a significant knowledge increase was observed when comparing pre- and post-knowledge-quizzes (p < 0.001). Knowledge levels remained high in the final quiz (on average 1.63 ± 0.61 correct answers). Participants documented 13,778 patient encounters, thereof 5073 encounters with at least one DRP. According to the participants, most of the DRPs (90.1%, n = 4550) could be resolved. A total of 1137 feedbacks were received. Overall, feedback was positive, with participants highlighting improved abilities to engage with patients (85.2%, n = 969) and to identify DRPs (82.0%, n = 629).</p><p><strong>Conclusion: </strong>By bridging the gap between theoretical learning and practical application, this e-learning program improves pharmacists' skills in DRP management.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1349-1358"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511806","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":"Cost-effectiveness of toripalimab plus bevacizumab versus sorafenib as first-line treatment for advanced hepatocellular carcinoma in China and the United States healthcare systems.","authors":"Junhao Yang, Haixia Ding","doi":"10.1007/s11096-026-02133-z","DOIUrl":"10.1007/s11096-026-02133-z","url":null,"abstract":"<p><strong>Introduction: </strong>Toripalimab combined with bevacizumab has demonstrated significant clinical efficacy and survival benefits in patients with advanced hepatocellular carcinoma (HCC). However, the high cost of this combination therapy raises concerns regarding its cost-effectiveness in healthcare systems in China and the U.S.</p><p><strong>Aim: </strong>This study evaluated the cost-effectiveness of toripalimab plus bevacizumab compared with sorafenib from the perspectives of the Chinese and U.S. healthcare systems. The findings are intended to inform value-based pricing strategies, reimbursement decisions, and clinical resource allocation.</p><p><strong>Method: </strong>A partitioned survival model (PSM) was developed to estimate incremental cost-effectiveness ratios (ICERs) from the healthcare system perspective. Willingness-to-pay (WTP) thresholds were set at $40,011 per quality-adjusted life year (QALY) in China and $100,000-$150,000 per QALY in the U.S. Deterministic and probabilistic sensitivity analyses were conducted to evaluate the robustness of the model outcomes.</p><p><strong>Results: </strong>In China, toripalimab plus bevacizumab produced an ICER of $55,764.00/QALY compared with sorafenib, exceeding the local WTP threshold of $40,011/QALY. In the U.S., the ICER was $460,054.17/QALY, which also exceeded the commonly accepted WTP thresholds. Sensitivity analyses indicated that the discount rate and the proportion of patients receiving subsequent anti-cancer therapies were the primary cost drivers in China and the United States, respectively. Probabilistic sensitivity analysis showed a 0.7% and 1.5% probability of cost-effectiveness at WTP thresholds of $100,000/QALY and $150,000/QALY in the U.S., respectively. In China, the probability of cost-effectiveness was 3.2% at a WTP threshold of $40,011/QALY.</p><p><strong>Conclusion: </strong>At current pricing levels, toripalimab plus bevacizumab is unlikely to be cost-effective compared with sorafenib in either China or the U.S. These findings highlight the need for value-based pricing strategies and more efficient allocation of healthcare resources.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1533-1547"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689898","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":"The association between age and medication-related hospital admission in adults: a systematic review and meta-analysis.","authors":"Reema Mohammad Munshi, Eimear Ni Sheachnasaigh, Monica Strugaru, Folasade Olawoye, Catherine Comiskey, Tamasine Grimes","doi":"10.1007/s11096-026-02167-3","DOIUrl":"10.1007/s11096-026-02167-3","url":null,"abstract":"<p><strong>Introduction: </strong>Medication-related hospital admission is a major contributor to preventable patient harm and healthcare burden worldwide. The relationship between age and medication-related hospital admission has not been comprehensively synthesised.</p><p><strong>Aim: </strong>To evaluate the association between age and medication-related admission in adults and to provide research recommendations.</p><p><strong>Method: </strong>MEDLINE (Ovid), EMBASE, Scopus, Web of Science, PsycINFO, CINAHL, Cochrane Library, and Global Health databases were searched from January 2000 to March 2025. Studies of adults reporting medication-related admission, providing data on participant age for an exposed and comparator group, published in English were included. Studies restricted to children were excluded. Selection through dual, independent title/abstract screening and full-text assessment using predefined eligibility criteria. Disagreements resolved by third reviewer or consensus. Study quality assessed using Joanna Briggs Institute tool for systematic reviews addressing questions of prevalence. Findings were reported descriptively and two meta-analyses were performed. Risk ratios of experiencing medication-related admission by age group (16-64 years-old, 65+years-old) were pooled. Mean ages of those experiencing medication-related admission compared to another cause of admission were pooled. Prediction intervals and sub-group analyses were used to explain heterogeneity.</p><p><strong>Results: </strong>Fifty studies, recruiting 210,514 participants, were included, with the majority judged as good quality. Thirteen studies exclusively recruited an older cohort, 30 studies were undertaken in Europe. Age data were variably described. The pooled risk ratio 1.64, (95% CI 1.15-2.35, K = 12, I² = 96%, n = 56,101) suggested adults ≥ 65 years had a higher risk of experiencing medication-related admission than younger adults (16-64 years). Studies undertaken in Africa had a higher effect size. The pooled mean difference (2.86 years, 95% CI - 1.63-7.36; p = 0.21, K = 10, I² = 93%, n = 12,440) indicated no statistically significant difference in age between groups. Risk of bias judgement was a statistically significant contributor to heterogeneity. Prediction intervals for both meta-analyses were wide, suggesting that findings of future studies could differ significantly. The certainty of evidence, GRADE approach, was very low.</p><p><strong>Conclusion: </strong>Age is an unreliable predictor for medication-related admission without accounting for confounding and context. Future research should consistently define age categories and better explore other risk factors for medication-related admission.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1267-1283"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156457","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":"Evaluating time-based outcomes of a pharmacist-doctor collaborative discharge medication reconciliation model: an observational study.","authors":"Suzanne Soudah, Matt Percival, Aaron Noble, John Dalziel, Catherine Edmunds, Kate Hill, H Laetitia Hattingh","doi":"10.1007/s11096-026-02118-y","DOIUrl":"10.1007/s11096-026-02118-y","url":null,"abstract":"<p><strong>Introduction: </strong>Medication reconciliation at hospital discharge is essential to prevent medication discrepancies and ensure continuity of care. Competing clinical priorities often delay reconciliation, reducing discharge efficiency and increasing the risk of medication-related harm. Collaborative pharmacist-doctor models have potential to improve the quality and timeliness of discharge medication processes.</p><p><strong>Aim: </strong>To evaluate the impact of a pharmacist-doctor collaborative discharge medication reconciliation model on discharge timeliness, reconciliation quality, and pharmacist resource utilisation.</p><p><strong>Method: </strong>This observational study was conducted in a large tertiary hospital across two inpatient units over 12 weeks: six weeks usual care (1 September-12 October 2025) followed by 6 weeks intervention (13 October-28 November 2025). In the intervention phase, clinical pharmacists performed reconciliation planning, which involved preparing the draft discharge medication reconciliation plan for subsequent medical officer review and authorisation. Time-and-motion methodology captured discrete intervals across the discharge workflow. Quantile regression analysed time-based outcomes, and Poisson regression evaluated count-based outcomes including prescription adjustments. The primary outcome was time from discharge confirmation to patient departure; secondary outcomes included reconciliation completion rates, prescribing adjustments, and pharmacist workload.</p><p><strong>Results: </strong>A total of 116 patients were included (control n = 65; intervention n = 51). The collaborative model improved discharge efficiency, reducing the median time from discharge confirmation to leaving the ward by 78 min (p = 0.022). Time from decision to discharge to reconciliation completion was more than halved (30 vs 76 min, p < 0.001). Reconciliation completeness was significantly higher in the intervention group (90.2% vs 67.7%, p = 0.007), with fewer partial completions and no missing reconciliations. Analysis demonstrated earlier availability of discharge prescriptions (40 vs 80 min, p = 0.011) and shorter intervals between reconciliation completion and medication list preparation (14 vs 32 min, p = 0.008). Importantly, reconciliation planning by the pharmacist required a median of only 3 min per patient, confirming that improved timeliness required minimal additional pharmacist resourcing.</p><p><strong>Conclusion: </strong>A pharmacist-doctor collaborative discharge medication reconciliation model improved discharge efficiency and reconciliation accuracy without increasing pharmacist workload. These findings support broader implementation of collaborative models to enhance patient safety and hospital workflow performance. Further research should explore cost-effectiveness and patient-centred outcomes.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1401-1411"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473656","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":"Evolution of community pharmacy services in the European Union and beyond: a cross-country survey of 33 national pharmacy organisations.","authors":"Jorge P B Batista, Anita Elaine Weidmann, Erika Mallarini, Martin C Henman, Ilaria Passarani","doi":"10.1007/s11096-026-02137-9","DOIUrl":"10.1007/s11096-026-02137-9","url":null,"abstract":"<p><strong>Introduction: </strong>Community pharmacy practice in Europe has evolved, expanding beyond dispensing roles to include preventive, counselling, and clinical services. However, evidence on the implementation, reimbursement, and regulation of these services across the European Union (EU) remains limited, especially after the COVID-19 pandemic. Understanding these developments is crucial to inform workforce planning, funding frameworks, and the integration of pharmacists into primary care. With limited healthcare resources, investing in pharmacy-based public health interventions leverages pharmacies' accessibility, geographic distribution, trusted patient relationships, and skilled workforce.</p><p><strong>Aim: </strong>This study aimed to update the mapping of community pharmacy services (CPS) across Europe, comparing 2025 data with pre-pandemic (2020) findings, and to examine trends in service provision, reimbursement, and regulatory barriers from a health policy perspective.</p><p><strong>Method: </strong>A cross-sectional survey was conducted among national pharmacy associations in all 27 EU Member States and six neighbouring countries (n = 33), to contextualise EU findings within the wider European pharmacy practice landscape. A previously validated instrument was used to collect data on 47 CPS, including implementation level and reimbursement status. Responses were validated through national review, and data were analysed descriptively and compared with 2020 results.</p><p><strong>Results: </strong>Across the 33 countries, a median of 26 services per country was reported (range: 9-43). Using a consistent data collection instrument and methodology, 77% (n = 36) of mapped CPS were available in a greater number of countries in 2025 than in 2020. Notable growth was observed in vaccination (10-19 countries), medication reconciliation (7-15), and first-time dispensing interventions (11-16). Public reimbursement increased for 49% (n = 23) of services between 2020 and 2025, with the largest increases in vaccination (+ 5 countries), screening (+ 4 countries), and dose administration aids (+ 3 countries). Despite this progress, variation between countries persists, alongside regulatory and operational barriers (remuneration, workforce capacity and interprofessional integration).</p><p><strong>Conclusion: </strong>Since 2020, CPS have expanded across Europe, with wider availability and, in some cases, progression from pilots or individual provision to national implementation. Wider and more sustainable implementation appears to depend on supportive regulatory frameworks and public remuneration.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1559-1572"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689854","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":"Healthcare professionals' perspectives of pharmacist roles in residential aged care: a qualitative systematic review and meta-synthesis.","authors":"Tiernan McDonough, Emily Griffin, Amy Page, Lisa Kalisch Ellett, Christopher Etherton-Beer, Jacinta Johnson","doi":"10.1007/s11096-026-02166-4","DOIUrl":"10.1007/s11096-026-02166-4","url":null,"abstract":"<p><strong>Introduction: </strong>Aged care systems are under increasing pressures, demanding optimised interdisciplinary teams. Pharmacist roles are expanding into these teams, and successful integration requires an understanding of team member perspectives.</p><p><strong>Aim: </strong>This systematic review and meta-synthesis aimed to identify, analyse and present the published literature pertaining to healthcare professional perspectives of the roles of pharmacists working in residential aged care settings.</p><p><strong>Method: </strong>A systematic search of literature published between 2000 and 2025, in English language only, was undertaken across Embase, Medline, CINAHL and Web of Science. Primary studies addressing the research aim were eligible for inclusion. The Mixed Methods Appraisal Tool was used to assess methodological quality of each paper; no papers were excluded based on quality. Two researchers independently reviewed and reached consensus agreement for all studies to include. Both researchers undertook a thematic synthesis of qualitative data to identify analytic themes.</p><p><strong>Results: </strong>After removing duplicates, 1874 unique papers were identified through database searching and an additional two papers identified through citation searching. After screening, we included 39 papers for data extraction and analysis. Three overarching themes were identified. Theme 1: 'Supporting the role' describes how pharmacist roles in aged care are supported through building trust with the team, education and experience, access to information, specific attributes, organisational buy-in, favourable models of care, and role clarity. Theme 2: 'Medicines expertise activities' describes how pharmacists perform three key roles valued by healthcare staff: knowledge and communication brokers, filling existing gaps in care, and optimising quality use of medicines. Theme 3: 'Helping the team' illustrates health professionals' perception of three distinct outcomes of pharmacist input (ie enhanced confidence, improved workforce capacity and capability, and improved person-centred care).</p><p><strong>Conclusion: </strong>This meta-synthesis of the evidence regarding the perceptions of healthcare professionals on the role of pharmacists in aged care provides contextual information for individuals, organisations and policy-makers for future implementation. Pharmacists are perceived to improve stakeholder confidence, staff capacity and capability, and overall person-centred care. Embedded roles that foster interdisciplinary collaboration are preferred to irregular visiting roles. These embedded roles are enabled through a range of mechanisms that policymakers, organisations and individuals may leverage for successful implementation in future iterations.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1246-1266"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148042036","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":"Barriers and facilitators for the implementation of medication safety recommendations: focus groups with stakeholders.","authors":"Mirthe A M Oude Lansink, Marcia Vervloet, Lise van Tholen, Marloes Dankers, Mette Heringa, Bart J F van den Bemt, Liset van Dijk, Victor J B Huiskes","doi":"10.1007/s11096-026-02141-z","DOIUrl":"10.1007/s11096-026-02141-z","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple medication safety recommendations to reduce preventable medication-related hospitalisations have been introduced in the Netherlands. Still, these hospitalisations remain prevalent. This might be due to suboptimal implementation in clinical practice. Therefore, more insight is needed into barriers and facilitators for the implementation of these medication safety recommendations across healthcare sectors.</p><p><strong>Aim: </strong>This study aimed to identify barriers and facilitators for implementing medication safety recommendations across healthcare sectors from the perspective of various stakeholders.</p><p><strong>Method: </strong>A selection of 17 Dutch medication safety recommendations targeting medications responsible for a large proportion of medication-related hospitalisations was evaluated in focus groups to identify barriers and facilitators to their implementation. These included recommendations for: reducing fall risk in elderly; initiating prophylactic medication; monitoring patients at risk of electrolyte disorders; clarifying responsibilities for patient care; informing patients about alarm symptoms; and prescribing antithrombotics on strict indication. Stakeholders were selected through purposive sampling based on their profession and healthcare sector. Transcripts of audio-recordings were analysed inductively, after which implementation factors were categorised using the Consolidated Framework for Implementation Research.</p><p><strong>Results: </strong>Thirty stakeholders were divided into five focus groups. These included community pharmacists (n = 9), general practitioners (n = 4), hospital pharmacists (n = 3), representatives from healthcare knowledge organisations (n = 3), patient representatives (n = 2), medical specialists (n = 2), nurses (n = 2), and other stakeholders (n = 5). Forty-nine barriers and facilitators were identified. Key themes were lack of specified responsibilities, limited information exchange, local collaboration and protocol adherence. Recommendations with a lower level of implementation often required collaboration with multiple healthcare providers, whereas recommendations with a higher level of implementation were frequently supported by clinical decision support systems.</p><p><strong>Conclusion: </strong>A broad range of barriers and facilitators to the implementation of medication safety recommendations was identified. Overall, the findings highlight the need for recommendations with specified responsibilities, improved information exchange, strengthened local collaboration, and increased protocol adherence.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1607-1621"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the impact of pharmacists in outpatient mental health settings: a systematic review.","authors":"Muireann Vaughan, Maria Donovan, Stephen Byrne, Fulvio Bedani, Sinéad O'Brien, Ciaran Halleran, Laura J Sahm","doi":"10.1007/s11096-026-02135-x","DOIUrl":"10.1007/s11096-026-02135-x","url":null,"abstract":"<p><strong>Introduction: </strong>Mental disorders are estimated to affect one in seven people globally and are often linked to premature mortality. Psychotropic medicines play an important role in the management of many mental health conditions particularly where symptoms are moderate to severe, persistent, or complex. Pharmacists are increasingly recognised as key members of multidisciplinary mental health teams, with their role focusing on safe and effective use of psychotropic medicines. Mental healthcare is increasingly delivered in outpatient settings, however, the impact of pharmacists on these services remains underexplored.</p><p><strong>Aim: </strong>To systematically review and evaluate the impact of pharmacist-led or pharmacist-involved interventions specifically within outpatient mental health settings globally, across the full spectrum of mental disorders.</p><p><strong>Method: </strong>A systematic search of five electronic databases (MEDLINE, Embase, CINAHL, CENTRAL, and PsycINFO) was conducted from inception to October 2025. Grey literature sources including ClinicalTrials.gov and Google Scholar were also searched. Inclusion criteria were: (i) evaluation of a pharmacist-led or pharmacist-involved intervention with a measurable outcome; (ii) conducted in an outpatient mental health setting involving adults with a diagnosed mental disorder classified according to ICD (up to and including ICD-11) or DSM criteria (up to and including DSM-5), excluding dementia; and (iii) inclusion of a comparator or control group. Study screening, data extraction, and quality appraisal, were performed independently by two reviewers. Due to heterogeneity in study design and outcomes, a narrative synthesis was conducted.</p><p><strong>Results: </strong>Twenty-three studies met the inclusion criteria: 11 randomised controlled trials and 12 non-randomised studies. Pharmacist interventions varied, but most commonly included medication reviews, psychoeducation, adherence support and monitoring for side effects or drug interactions. Outcomes were grouped into seven domains: patient-reported, symptom-related, treatment-related, medication adherence, cost, monitoring and hospitalisations. Pharmacist impact was associated with improvements across multiple domains, particularly in medication adherence, treatment-related and symptom-related outcomes. While outcome measures varied between studies, a majority (82.6%) reported positive trends in at least one domain, favouring pharmacist-led or pharmacist-involved care over usual care.</p><p><strong>Conclusion: </strong>Pharmacist-led interventions in outpatient mental health settings are associated with positive clinical and healthcare-related outcomes across a range of mental disorders globally. These findings support the integration of pharmacists into multidisciplinary outpatient mental health teams and highlight the need for more high-quality, standardised research to inform service development and policy.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1197-1213"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689922","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":"Feasibility and acceptability of pharmacist-led remote patient monitoring for carvedilol dose titration in clinically significant portal hypertension.","authors":"Sheridan Rodda, Chloe McAinch, Jo Hunter, Edward Saxby, Sue Kirsa, Stephen Pianko, Sally Bell, Suong Le","doi":"10.1007/s11096-026-02151-x","DOIUrl":"10.1007/s11096-026-02151-x","url":null,"abstract":"<p><strong>Introduction: </strong>Carvedilol reduces the risk of hepatic decompensation and improves survival in patients with compensated cirrhosis and clinically significant portal hypertension (CSPH). Remote patient monitoring (RPM) has demonstrated benefits in other chronic conditions but has yet to be investigated for carvedilol titration in CSPH.</p><p><strong>Aim: </strong>We aimed to evaluate the feasibility and acceptability of a novel pharmacist-led, technology enabled model of care called Optimising One Medication for Patients with Cirrhosis (OOMPa-C).</p><p><strong>Method: </strong>In this prospective mixed-methods feasibility study, participants were provided with a Bluetooth-enabled blood pressure (BP) and heart rate (HR) monitor linked to a smartphone app during a home visit from a nurse. Initial education on how to take daily BP and HR readings was provided by a pharmacist via telehealth. Two pharmacists then conducted RPM of BP and HR and regular telehealth visits with patients to titrate carvedilol, following a protocol, to a maximum of 12.5 mg daily as tolerated. Semi-structured interviews with participants and stakeholders were undertaken to explore acceptability of the program.</p><p><strong>Results: </strong>Twenty-two participants were recruited, 20 of whom achieved successful dose optimisation. Readings were transmitted on at least 90% of study days by 20 (91%) participants and 18 (82%) were taking the target dose of 12.5 mg daily at study completion. Despite issues with internet connectivity and the telehealth application, the program was broadly perceived as easy to use. Participants reported benefits including convenience and greater self-efficacy, while stakeholders noted advantages in efficiency and quality of care. Participants described apprehension in using new technologies, but family and carers were seen to facilitate participation. Nurses involved with the program described time constraints due to unfamiliarity with digital navigation processes.</p><p><strong>Conclusion: </strong>Our study established the feasibility, acceptability and implementation outcomes of a new pharmacist-led model of care for carvedilol dose optimisation. We provide practical insights to inform the implementation of similar technology enabled multidisciplinary models of care at scale for patients with cirrhosis.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1682-1693"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitators and barriers in using barcode technology to ensure safe medication dispensing, preparation, and administration in a children's hospital: a focus group study for clinical pharmacists.","authors":"Laura Laakkonen, Kirsi Kvarnström, Katja Janhunen, Carita Linden-Lahti, Sini Kuitunen","doi":"10.1007/s11096-026-02132-0","DOIUrl":"10.1007/s11096-026-02132-0","url":null,"abstract":"<p><strong>Introduction: </strong>Barcode technology is widely used in hospitals to improve medication safety. Although this technology is considered effective for making system-wide improvements, its implementation faces several challenges. Hospital pharmacists play a key role in supporting this process.</p><p><strong>Aim: </strong>To explore clinical pharmacists' perceptions of the facilitators and barriers to using barcode technology in a pediatric hospital setting.</p><p><strong>Method: </strong>A qualitative focus group study. Fourteen clinical pharmacists working in the pediatric department of a university hospital were chosen for the focus groups (n = 3) using purposive sampling to identify the individuals who regularly use barcode technology in clinical practice. The focus group discussions, guided by a semi-structured interview guide with six questions, were recorded and transcribed verbatim. Two researchers independently conducted inductive content analysis, which was later thoroughly reviewed by the entire research group.</p><p><strong>Results: </strong>The data revealed four main themes: factors encouraging the adoption of barcode technology, factors complicating barcode workflow, ideas to improve workflow efficiency, and at-risk behaviors. Factors encouraging the adoption of barcode technology were associated with the benefits and usability of barcode technology, increased expertise and teamwork, positive user experience, and supportive functions of the electronic health record (EHR) system. Factors complicating barcode workflow included deficiencies related to barcodes in labels and drug packages, negative attitudes of users, organizational factors, the use of the EHR system, and deficiencies in workstations and equipment. These factors were found to contribute to at-risk behaviors, while ideas to improve workflow efficiency focused on removing factors complicating barcode workflow and reducing at-risk behaviors.</p><p><strong>Conclusion: </strong>Various factors can influence the implementation of barcode technology in clinical practice, underscoring the importance of an organizational process to identify system deficiencies and continuously improve usability. Building on previous studies, our research emphasized the issues related to dispensing and preparation workflows, as well as the need for pediatric-specific EHR system customization as key development areas. Our findings can guide risk management efforts in implementing and maintaining barcode technology in hospitals.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1519-1532"},"PeriodicalIF":3.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591866","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}