International Journal of Clinical Pharmacy最新文献

{"title":"Socioeconomic deprivation and its association with polypharmacy in England: results from a national cross-sectional survey.","authors":"Yusuff Adebayo Adebisi, Najim Z Alshahrani, Duaa Abdullah Bafail","doi":"10.1007/s11096-025-01990-4","DOIUrl":"https://doi.org/10.1007/s11096-025-01990-4","url":null,"abstract":"<p><strong>Introduction: </strong>Polypharmacy is a growing public health concern, yet its association with area-level socioeconomic deprivation in England has been under-explored.</p><p><strong>Aim: </strong>To investigate whether socioeconomic deprivation, measured by the Index of Multiple Deprivation (IMD), is associated with polypharmacy among adults.</p><p><strong>Method: </strong>We analysed cross-sectional data from the 2021 Health Survey for England, including 1705 adults aged 16+ who completed nurse visits and reported prescribed medication use in the past week. Polypharmacy was defined as the use of five or more prescribed medications. IMD scores were categorised into quintiles (least to most deprived). Multivariable logistic regression estimated adjusted odds ratios (ORs) with 95% confidence intervals (CIs), controlling for age, sex, ethnicity, multimorbidity, obesity, smoking, alcohol use, and GP visit frequency. A polynomial contrast test assessed linear trends, and adjusted predicted probabilities were calculated to illustrate the deprivation-polypharmacy gradient.</p><p><strong>Results: </strong>In the fully adjusted model, adults residing in the most deprived IMD quintile had significantly higher odds of polypharmacy (OR 1.82; 95% CI 1.09-3.04; p = 0.022) compared to those living in the least deprived areas. No statistically significant associations were observed for intermediate quintiles. A polynomial contrast test confirmed a significant linear trend across IMD levels (p = 0.010), indicating that the odds of polypharmacy increased progressively with greater area-level deprivation. This gradient was further illustrated by adjusted predicted probabilities, which rose from 18.3% (95% CI 15.3-21.3%) in the least deprived quintile to 24.6% (95% CI 20.1-29.2%) in the most deprived (p < 0.001).</p><p><strong>Conclusion: </strong>Socioeconomic deprivation is independently associated with polypharmacy, even after adjusting for multimorbidity and other confounders, highlighting persistent health inequalities within England's healthcare system. Targeted strategies, including regular medication reviews and enhanced access to care in deprived communities, may help mitigate risks and promote equity in prescribing practices.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953197","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":"Clinical risk assessment of serum creatinine abnormalities during vancomycin therapy: a retrospective study using machine learning models.","authors":"Yilei Yang, Haiying Yan, Xiangyue Wang, Jiahui Lao, Ruiqiu Zhang, Zhaoyang Chen, Shiyu Ma, Yan Li, Xiao Li","doi":"10.1007/s11096-025-01981-5","DOIUrl":"10.1007/s11096-025-01981-5","url":null,"abstract":"<p><strong>Introduction: </strong>Vancomycin is a widely used antibiotic for the treatment of serious Gram-positive bacterial infections. However, its clinical utility is often limited by the risk of nephrotoxicity, typically reflected by abnormalities in serum creatinine levels, which may indicate the occurrence of acute kidney injury (AKI). Timely identification of patients at increased risk is essential for early intervention and improved clinical outcomes.</p><p><strong>Aim: </strong>This study aimed to identify clinical risk factors associated with vancomycin-induced abnormalities in serum creatinine levels and to develop predictive models capable of identifying high-risk hospitalized patients during vancomycin therapy.</p><p><strong>Method: </strong>We conducted a retrospective cohort study including 1,008 hospitalized patients who received vancomycin treatment between January 2018 and June 2022 at the First Affiliated Hospital of Shandong First Medical University. Patients were grouped based on the presence or absence of serum creatinine abnormalities, defined as an increase of ≥ 26.5 μmol/L or ≥ 50% from baseline. Multivariate logistic regression was applied to identify independent risk factors. Five machine learning algorithms-logistic regression, random forest, support vector machine, extreme gradient boosting, and gradient boosting machine (GBM)-were trained and compared. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity.</p><p><strong>Results: </strong>The incidence of serum creatinine abnormalities was 9.22%. Chronic kidney disease, respiratory failure, pancreatitis, pneumonia, and mechanical ventilation were identified as significant risk factors (all p < 0.05). Among the models tested, the GBM algorithm showed the highest predictive performance with an AUC of 0.783, along with good balance between sensitivity and specificity. The final model was deployed as a freely accessible web-based prediction tool using the R Shiny framework.</p><p><strong>Conclusion: </strong>Abnormalities in serum creatinine levels during vancomycin therapy remain a clinically significant concern, especially in patients with comorbidities or critical illness. The machine learning-based predictive model developed in this study offers a practical tool for individualized risk assessment, enabling early risk stratification and proactive management. Incorporating such tools into clinical workflows may enhance patient safety and optimize antibiotic use.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873077","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":"Clinical prediction of sodium valproate-induced movement disorders in hospitalized patients: a nomogram-based model using real-world data.","authors":"Liqiang Cui, Man Zhu, Tianlin Wang, Ao Gao, Pengzhi Zhao, Jing Xiao, Daihong Guo","doi":"10.1007/s11096-025-01984-2","DOIUrl":"10.1007/s11096-025-01984-2","url":null,"abstract":"<p><strong>Introduction: </strong>Drug-induced movement disorders (DIMDs) are often underrecognized and challenging to diagnose and manage in clinical practice. Sodium valproate (VPA), a widely prescribed antiepileptic drug, causes DIMDs. Predictive modeling based on electronic medical records and machine learning algorithms offers a promising approach to improve early identification of adverse drug reactions (ADRs) and enhance clinical safety.</p><p><strong>Aim: </strong>This study aimed to conduct real-world active surveillance of VPA-associated DIMDs using hospital information system data, to identify independent risk factors, and to develop a clinically applicable prediction model for early warning and intervention.</p><p><strong>Method: </strong>In this retrospective case-control study, data were collected from hospitalized patients prescribed sodium valproate between 2018 and 2022. DIMD cases were identified through automated alerts generated by the ADE Active Surveillance and Assessment System II, and subsequently confirmed using the Naranjo scale for manual causality assessment. A clinical prediction model was developed using LASSO logistic regression and was presented as a nomogram. Model performance was evaluated using area under the receiver operating characteristic (ROC) curve, calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC).</p><p><strong>Results: </strong>Of the 6692 patients screened, 98 were confirmed to have DIMDs, yielding an incidence rate of 1.46%. Four independent protective factors were identified: higher lymphocyte count, red blood cell count, serum sodium concentration, and co-administration of levetiracetam. The nomogram demonstrated good discrimination (AUC = 0.774), acceptable calibration (Brier score = 0.194), and strong clinical utility across a threshold probability range of 10-70%.The results of the external validation suggest that the efficiency of the model remained stable and showed no significant decline. It had better predictive ability in high- and medium-risk groups and had significant potential for clinical application. The incidence of DIMDs was significantly higher among patients receiving VPA for therapeutic purposes than among those receiving VPA prophylactically.</p><p><strong>Conclusion: </strong>VPA-associated DIMDs are common in hospitalized patients. The prediction model based on routine clinical indicators enabled the identification of high- and middle-risk individuals, thereby facilitating timely monitoring and targeted interventions to reduce the burden of movement-related ADRs.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873076","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":"Perceived importance of tailored education to prevent second victim phenomenon in clinical pharmacy practice: a focus group study with community pharmacists.","authors":"Ivana Zimonjić, Valentina Marinković, Dragana Jocić, Lazar Dražeta, Marina Odalović","doi":"10.1007/s11096-025-01987-z","DOIUrl":"https://doi.org/10.1007/s11096-025-01987-z","url":null,"abstract":"<p><strong>Background: </strong>The second victim phenomenon, referring to the impact of patient safety incidents on healthcare professionals, also affects pharmacists. Dispensing errors or inadequate counselling cause anxiety, reduced motivation, and staff turnover. Support programmes exist for healthcare professionals, but not specifically for pharmacists.</p><p><strong>Aim: </strong>To explore pharmacists' perceptions of tailored education to enhance competencies in overcoming second victim experiences, including (i) potential impacts, (ii) recommended content for professional development and undergraduate curricula, (iii) preferred design and delivery methods, and (iv) experience with existing programmes.</p><p><strong>Method: </strong>A qualitative focus group study using the experiences, opinions, and recommendations approach was conducted in Serbia. Data were collected through a semi-structured guide and a self-reported questionnaire on participation in existing programmes. Discussions continued until saturation. Recordings were transcribed verbatim and analysed using the inductive thematic approach with MAXQDA software. Descriptive statistics summarised programme participation.</p><p><strong>Results: </strong>Participants perceived tailored education as necessary for improving error response, empowering individuals and the profession, and enhancing pharmaceutical care. Thematic analysis identified four themes: (i) impacts of tailored programmes, (ii) topics for professional development, (iii) topics for undergraduate curricula, and (iv) programme design and delivery. Key areas included soft skills, risk and stress management. Undergraduate education should strengthen communication, motivation, and career development. Preferred methods were workshops and blended learning. Of 25 participants, 20 (80%) attended support programmes; 20 (80%) reported improved competence, and 20 (80%) would recommend them to colleagues.</p><p><strong>Conclusion: </strong>Community pharmacists perceived tailored education addressing second victim experiences as important for professional resilience and improving pharmaceutical care.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855202","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":"Safety evaluation of deucravacitinib: a real-world analysis based on the FDA adverse event reporting system database.","authors":"Haowen Tan, Xiubi Chen, Xuan Ou, Ying Chen","doi":"10.1007/s11096-025-01980-6","DOIUrl":"https://doi.org/10.1007/s11096-025-01980-6","url":null,"abstract":"<p><strong>Introduction: </strong>Deucravacitinib is a novel, highly selective tyrosine kinase 2 allosteric inhibitor recently approved for the treatment of moderate-to-severe psoriasis in adults, though post-marketing safety data remain limited.</p><p><strong>Aim: </strong>The purpose of this study was to perform a post-marketing safety evaluation of deucravacitinib based on the Food and Drug Administration Adverse Event Reporting System (FAERS) database.</p><p><strong>Method: </strong>This study collected adverse event (AE) reports of deucravacitinib as primary suspected drug in the FAERS database from the third quarter of 2022 to the fourth quarter of 2024. Four main methods of the disproportionality analysis, including reporting odds ratio, proportional reporting ratio, Bayesian confidence propagation neural network, and multi-item gamma Poisson shrinker, were employed for signal detection. Potential risk signals were deemed significant only when all four algorithms simultaneously met their thresholds. The important medical event (IME) terms list was used to identify IMEs of deucravacitinib. Additionally, the Weibull distribution was used to evaluate the time-to-onset (TTO) characteristics.</p><p><strong>Results: </strong>Thirty-nine preferred terms were identified as potential risk signals. The most commonly reported AE were acne, mouth ulceration and folliculitis. Sixteen AEs with potential risk signals not mentioned on the label were also identified, including urticaria, oral pain, oropharyngeal pain, swelling face, lip swelling, eye swelling, cellulitis, ear pain, pharyngeal swelling, Bell's palsy, mouth swelling, cheilitis, mycobacterium tuberculosis complex test positive, facial paralysis, hepatitis A, and central nervous system (CNS) infection. Rhabdomyolysis, Bell's palsy, facial paralysis, and CNS infection were identified as the IMEs associated with deucravacitinib in this study. The Weibull distribution indicated that the TTO characteristics of deucravacitinib-associated AEs followed an early failure type.</p><p><strong>Conclusion: </strong>This study provides new safety data for deucravacitinib in real-world settings, uncovering previously unrecognized risks and identifying several IMEs. These findings have somewhat supplemented the safety data for deucravacitinib. Given the limitations of the FAERS database, further post-marketing safety surveillance studies on deucravacitinib remain necessary in the future.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804049","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":"The effect of pharmacist intervention on medication adherence measured with proportion of days covered: a systematic review and meta-analysis.","authors":"Lei Wang, Yuyanzi Zhang, Qiran Wei, Xiao Liang, Jiting Zhou, Aixia Ma, Luying Wang","doi":"10.1007/s11096-025-01974-4","DOIUrl":"https://doi.org/10.1007/s11096-025-01974-4","url":null,"abstract":"<p><strong>Introduction: </strong>Pharmacist-led interventions improve medication outcomes, but existing evidence on adherence remains limited by heterogeneous tools and qualitative outcomes. The proportion of days covered (PDC) offers a quantifiable measure of adherence, with recommended threshold (PDC ≥ 80%) supporting evidence-based optimization of pharmacy services in chronic care management. However, studies using PDC to evaluate pharmacist interventions versus usual care show heterogeneity.</p><p><strong>Aim: </strong>This study aimed to systematically review and meta-analyze the effect of pharmacist-led interventions versus usual care using standardized PDC-based outcomes, and synthesize quantifiable evidence for pharmacy practice.</p><p><strong>Method: </strong>Five databases were searched from inception to March 2024. Eligible studies included randomized controlled trials (RCTs) or non-randomized studies evaluating pharmacist-led interventions versus usual care with adherence measured by PDC. Two reviewers independently screened studies and extracted data. RCTs were assessed using Cochrane risk of bias 2.0 and non-randomized studies with the Newcastle-Ottawa Scale. Meta-analyses were conducted using random-effects models (I² ≥ 40%) to pool mean differences (MD) for continuous outcomes (mean PDC) and risk ratios (RR) for binary outcomes (PDC ≥ 80%). Subgroup analyses explored variability by region, sample size, baseline adherence, publication year, PDC calculation method, intervention duration, and delivery modality. Sensitivity analyses were conducted restricting to RCTs or excluding low-quality studies.</p><p><strong>Results: </strong>Twenty-nine studies were included in the analysis. Quality appraisal identified 54.5% of non-randomized studies as high quality, and the majority of RCTs were rated as low risk or some concerns. Pharmacist-led interventions significantly enhanced adherence versus usual care, with a pooled MD of 0.08 (95% CI 0.04-0.12) for mean PDC and an RR of 1.09 (95% CI 1.06-1.13) for adherence rate. Greater effects were observed for lipid-lowering (MD = 0.08, 0.04-0.11) and hypotensive medications (MD = 0.06, 0.03-0.10) than for antidiabetics (MD = 0.02, 0.01-0.03), for 6-month (MD = 0.12, 0.07-0.17) versus 12-month interventions (MD = 0.03, 0.01-0.06), and for telephone-based delivery (RR = 1.16, 1.06-1.28) versus multifaceted counterparts (RR = 1.12, 1.01-1.25). High heterogeneity was observed across pooled analyses. Sensitivity analyses confirmed the robustness of results.</p><p><strong>Conclusion: </strong>Pharmacist-led interventions enhance medication adherence in mean PDC and adherence rate. These consistent effects across different durations and delivery methods show their adaptability and scalability in clinical settings, highlighting their value in real-world pharmacy practice.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799006","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":"Updating the potentially inappropriate medication (PIM)-China criteria for 2024: a Delphi consensus study for improved medication safety in older adults.","authors":"Xiaoxuan Xing, Ke Wang, Zhizhou Wang, Xiaoxi Li, Jiaming Liu, Chen Liu, Yujie Qiu, Suying Yan, Xianzhe Dong, Lan Zhang","doi":"10.1007/s11096-025-01977-1","DOIUrl":"https://doi.org/10.1007/s11096-025-01977-1","url":null,"abstract":"<p><strong>Background: </strong>The potentially inappropriate medications (PIM)-China criteria, published in 2017, require updates to reflect new therapeutic evidence and address limitations such as outdated medications and condition-specific considerations.</p><p><strong>Aim: </strong>This study aimed to develop an updated version of the PIM-China criteria through a modified Delphi consensus methodology, ensuring evidence-based and clinically relevant recommendations for older adults in China.</p><p><strong>Method: </strong>A literature review of six PIM criteria (Beers, STOPP, FORTA, EU(7)-PIM, Japan and Korea criteria) and relevant literature (2018-2023) informed a preliminary list of PIMs. A multidisciplinary panel of 33 experts, comprising 12 physicians and 21 pharmacists, evaluated 210 candidate criteria over three Delphi rounds. Statistical measures were used to validate consensus, including Kendall's W, coefficient of variation (CV), and expert authority coefficient (Cr). Cr values ≥ 0.80 indicated high reliability, while Kendall's W > 0.20 signified moderate to strong agreement.</p><p><strong>Results: </strong>The updated criteria consist of 154 items, a 57% increase from 2017, including 100 individual medications or drug classes and 54 condition-specific PIMs. Notable additions include recommendations addressing drug-drug interactions, renal function adjustments, and alternative treatments. Consensus improved significantly across rounds, with Kendall's W increasing from 0.145 to 0.271 for individual PIMs and 0.118 to 0.360 for condition-specific PIMs (P < 0.05). Cr reached 0.85, reflecting the panel's high authority.</p><p><strong>Conclusion: </strong>The updated 2024 PIM-China criteria enhance prescribing safety and clinical relevance by incorporating new evidence and expert consensus. These criteria are vital for reducing adverse drug events, optimizing prescribing practices, and improving healthcare for older adults in China.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799007","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 mixed methods evaluation of a shared electronic health record between general practice and community pharmacy.","authors":"J Fynn, M Lamptey, G Coote, M J Twigg, J Newman, S Lingard, M Cooper, H Nazar","doi":"10.1007/s11096-025-01972-6","DOIUrl":"https://doi.org/10.1007/s11096-025-01972-6","url":null,"abstract":"<p><strong>Introduction: </strong>Integrating community pharmacies into primary care via digital infrastructure is crucial to enhancing continuity, coordination, and safety of care. Historically, community pharmacies have not had full access to general practice electronic health records (EHRs), limiting their ability to provide informed interventions. The introduction of shared, interoperable EHRs has the potential to address this limitation and redefine the clinical role of community pharmacists.</p><p><strong>Aim: </strong>This study aimed to evaluate the feasibility, acceptability, and impact of granting community pharmacies read-and-write access to a shared EHR system (SystmOne) across selected sites in the East of England.</p><p><strong>Method: </strong>A 12-month mixed-methods pilot (Jan-Dec 2023) was conducted using an explanatory sequential and convergent approach. Data were collected from 35 community pharmacies and 31 general practices via activity logs, surveys, and semi-structured interviews. Descriptive statistics was used to analyse quantitative data and thematic coding used for analysing qualitative data. Data was then integrated to evaluate service delivery, communication, and user experience.</p><p><strong>Results: </strong>Thirteen community pharmacies actively used the EHR, documenting over 19,000 appointments and 16,000 clinical entries. Usage varied, with barriers including workload, technical complexity, and duplicated documentation requirements. However, users reported improvements in patient safety, interprofessional communication, and service efficiency. Appointment booking and task-sharing functions fostered collaborative working, while access to real-time clinical information supported clinical decision-making. Training support, trust between sectors, and policy alignment were identified as critical enablers for system uptake.</p><p><strong>Conclusion: </strong>Providing community pharmacies with read-and-write access to a shared EHR is feasible and contributes to safer, more integrated patient care. Improved communication, clinical documentation, and task delegation between pharmacists and general practice staff represent a major shift in digital collaboration. However, successful scale-up requires investment in interoperability, national IT infrastructure alignment, and streamlined reimbursement processes to prevent duplication of effort. These findings support the evolving clinical role of community pharmacists and suggest that integrated digital systems are essential to realising the full potential of community pharmacy in the modern NHS to improve patient care.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799004","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 interventions addressing excessive polypharmacy: a scoping review.","authors":"Rania Ouraou, Benoît Cossette, Marie-Eve Perron, Catherine Hudon","doi":"10.1007/s11096-025-01971-7","DOIUrl":"https://doi.org/10.1007/s11096-025-01971-7","url":null,"abstract":"<p><strong>Introduction: </strong>Excessive polypharmacy, which is defined as the use of ten medications or more, poses considerable challenges regarding patient health and healthcare resources. Individuals who exhibit excessive polypharmacy are predisposed to adverse drug effects, drug interactions, and non-adherence, which can result in increased hospitalization, emergency room visits, and mortality. Given their expertise in medication management, pharmacists are uniquely positioned to address the risks associated with excessive medication use. Therefore, exploring their role in this phenomenon across their various fields of practice is essential.</p><p><strong>Aim: </strong>The aim of this review was to summarize the existing literature on the role of pharmacists in addressing excessive polypharmacy in different care settings and to highlight areas where more research is needed.</p><p><strong>Method: </strong>A scoping review was conducted by adopting Arksey and O'Malley's methodological framework, along with subsequent enhancements implemented by Levac et al. It was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) guidelines. A comprehensive search was conducted across five databases: MEDLINE, EMBASE, PubMed, CINAHL and Cochrane CENTRAL from their inception until June 2024. Covidence was used for data selection and extraction. The results were analyzed using narrative synthesis.</p><p><strong>Results: </strong>We identified 5236 articles, of which 19 were included. All studies were available in English and were conducted in high-income countries with the majority (84%) being published after 2019. The interventions were carried out in primary care clinics, hospitals, home care, and long-term care facilities, but none of the studies were conducted in community pharmacies. The analysis identified four predominant roles: performing medication reconciliation during care transitions, assessing medication appropriateness, raising awareness among prescribing healthcare professionals, and ensuring patient follow-up and monitoring. These roles emphasized collaboration between patients and interprofessional teams and were supported by various polypharmacy management tools.</p><p><strong>Conclusion: </strong>This review's results highlight pharmacists' various roles in managing excessive polypharmacy across care settings. The scope of practice, physical proximity to other health professionals, expertise, higher qualifications and/or additional training all influenced these roles.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768630","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":"The role of large language models in self-care: a study and benchmark on medicines and supplement guidance accuracy.","authors":"Branco De Busser, Lynn Roth, Hans De Loof","doi":"10.1007/s11096-024-01839-2","DOIUrl":"10.1007/s11096-024-01839-2","url":null,"abstract":"<p><strong>Background: </strong>The recent surge in the capabilities of artificial intelligence systems, particularly large language models, is also impacting the medical and pharmaceutical field in a major way. Beyond specialized uses in diagnostics and data discovery, these tools have now become accessible to the general public.</p><p><strong>Aim: </strong>The study aimed to critically analyse the current performance of large language models in answering patient's self-care questions regarding medications and supplements.</p><p><strong>Method: </strong>Answers from six major language models were analysed for correctness, language-independence, context-sensitivity, and reproducibility using a newly developed reference set of questions and a scoring matrix.</p><p><strong>Results: </strong>The investigated large language models are capable of answering a clear majority of self-care questions accurately, providing relevant health information. However, substantial variability in the responses, including potentially unsafe advice, was observed, influenced by language, question structure, user context and time. GPT 4.0 scored highest on average, while GPT 3.5, Gemini, and Gemini Advanced had varied scores. Responses were context and language sensitive. In terms of consistency over time, Perplexity had the worst performance.</p><p><strong>Conclusion: </strong>Given the high-quality output of large language models, their potential in self-care applications is undeniable. The newly created benchmark can facilitate further validation and guide the establishment of strict safeguards to combat the sizable risk of misinformation in order to reach a more favourable risk/benefit ratio when this cutting-edge technology is used by patients.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1001-1010"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791815","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}