Journal of Pharmaceutical Policy and Practice最新文献

{"title":"Comment on 'A point prevalence survey on antibiotic dispensing practices identifies targets for quality improvement of antimicrobial stewardship in community pharmacies in Dar es Salaam, Tanzania'.","authors":"Ayman M Mustafa, Shkar Mariwan Ahmed, Ari Jamal Hassan","doi":"10.1080/20523211.2026.2715838","DOIUrl":"10.1080/20523211.2026.2715838","url":null,"abstract":"","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2715838"},"PeriodicalIF":2.6,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety without the counter: transparency of online safety information for women's over-the-counter medicines across markets.","authors":"Samar J Melhem, Hamzeh Al Momani, Rimal Mousa, Eman Massad, Yazan Al Rashdan, Sameh Alzubiedi, Violet Kasabri, Rula Darwish, Nailya Bulatova","doi":"10.1080/20523211.2026.2707406","DOIUrl":"10.1080/20523211.2026.2707406","url":null,"abstract":"<p><strong>Background: </strong>The rapid expansion of e-pharmacy platforms has shifted over-the-counter (OTC) medicine selection from physical pharmacies to digital environments, where consumers increasingly rely on online product pages for safety-critical information. For women's health OTC products, this shift raises particular concerns due to pregnancy- and lactation-related risks, frequent self-care use, and reduced access to professional counseling at the point of purchase. Despite growing reliance on e-pharmacies, evidence on the completeness of online safety information across regulatory contexts remains limited.</p><p><strong>Methods: </strong>A cross-sectional observational study assessed the transparency of safety information for women's health OTC medicines and supplements sold on licensed e-pharmacy platforms across seven markets (United States, United Kingdom, Canada, Australia; United Arab Emirates, Saudi Arabia, Qatar). Product pages were evaluated using a standardized 12-item transparency framework capturing essential safety elements. Comparative analyses employed nonparametric tests and multivariable regression to identify regional, platform-level, and product-related predictors of transparency.</p><p><strong>Results: </strong>A total of 119 products were analyzed. The mean Transparency Score was 6.25 (SD 1.81) out of 12, indicating moderate completeness. Critical elements, including expiry date, batch or lot number, and drug interaction information, were rarely disclosed. While overall transparency differed modestly by region, warnings and precautions were significantly less likely to appear on Middle Eastern platforms. Independent or regional pharmacies demonstrated lower transparency than chain platforms. Pregnancy and lactation guidance was inconsistently provided outside pregnancy-specific categories.</p><p><strong>Conclusion: </strong>Licensed e-pharmacy platforms frequently provide incomplete safety information for women's health OTC products, with meaningful variation by market region, platform type, and availability of supplementary digital resources. Transparency deficits are embedded within regulated digital pharmacy systems rather than limited to illicit sellers. These findings underscore the need for harmonized regulatory standards, mandatory digital safety disclosures, and strengthened platform accountability to support safe, informed self-care in online pharmacy environments.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2707406"},"PeriodicalIF":2.6,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding OTC medicine access in non-pharmacy settings for self-medication: a scoping review.","authors":"Adin Hakim Kurniawan, Rani Sauriasari, Agusdini Banun Saptaningsih, Rudi Safarudin, Syed Azhar Syed Sulaiman, Atika Wahyu Puspitasari","doi":"10.1080/20523211.2026.2701915","DOIUrl":"10.1080/20523211.2026.2701915","url":null,"abstract":"<p><strong>Introduction: </strong>In recent years, OTC distribution has expanded into non-pharmacy retail settings, with 19 of 30 European countries permitting non-pharmacy OTC sales. This may increase accessibility and promote self-medication, but it also creates risks of misuse, overdose, and greater retail market concentration. Therefore, countries have adopted various regulatory mechanisms to balance accessibility with patient safety. This scoping review aimed to examine the global regulatory models governing OTC dispensing and distribution at non-pharmacy retail settings, with particular emphasis on regulatory mechanisms influencing availability and accessibility.</p><p><strong>Methods: </strong>A scoping review was conducted following the PCC framework and reported in accordance with PRISMA-ScR and JBI guidance. Literature published between January 2015 and August 2025 was identified through PubMed/MEDLINE, Scopus, ScienceDirect, and citation searching. Eligible studies were selected through systematic screening and synthesised using thematic analysis.</p><p><strong>Results: </strong>The search identified 295 studies, followed by the removal of 15 duplicates. After screening 280 unique studies, 8 met the inclusion criteria. Data from empirical studies and regulatory documents were synthesised. Three major themes were identified; the first was regulation and supervision, including medication classification, dispensing, pack-size limits, age restrictions, and oversight mechanisms. The second was self-medication and consumer behaviour, showing convenience-driven purchasing and limited risk awareness. The third was deregulation and service system changes, indicating expanded access through supermarkets, convenience stores, and online platforms, alongside concerns about safety and shifting market dynamics.</p><p><strong>Conclusion: </strong>This scoping review indicates that deregulation, particularly in regions with limited healthcare access, enhances availability of medications and facilitates self-medication. Risk-based governance relies on safety-based classification, which establishes dispensing restrictions and determines where and how products may be accessed. These safeguards are further supported by controls such as pack-size limitations, mandated personnel qualifications, regulatory oversight, and consumer education to promote safe usage.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2701915"},"PeriodicalIF":2.6,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolution of pharmacovigilance system in Bangladesh: present landscape and strategic priorities.","authors":"Bulbul Ahamed, Rabia Hussain","doi":"10.1080/20523211.2026.2711325","DOIUrl":"10.1080/20523211.2026.2711325","url":null,"abstract":"<p><p>Adverse drug reactions (ADRs) represent a significant public health issue, substantially contributing to preventable morbidity, mortality, and healthcare expenditures globally. Pharmacovigilance is important for protecting public health and ensuring safe and effective medicine use, especially in low- and middle-income countries where regulatory systems are still developing. Bangladesh has achieved significant advancements in developing a national pharmacovigilance framework under the Directorate General of Drug Administration (DGDA), which includes the establishment of an Adverse Drug Reaction Monitoring (ADRM) cells, involvement in the World Health Organization Programme for International Drug Monitoring, and the introduction of national pharmacovigilance guidelines. Despite these efforts, Bangladesh's pharmacovigilance system is still in its infancy and faces a number of challenges, such as significant underreporting of ADRs, a lack of awareness and training among healthcare professionals (HCPs), insufficient enforcement of regulations, inadequate technology infrastructure, and weak stakeholder coordination. The commentary will narrate the current status of pharmacovigilance in Bangladesh, identify the key challenges and potential areas for strengthening the system.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2711325"},"PeriodicalIF":2.6,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic evaluation and optimisation strategies for the synergy of high-value medical consumables policies in China.","authors":"Huitong Yang, Shuzhen Chu","doi":"10.1080/20523211.2026.2673696","DOIUrl":"10.1080/20523211.2026.2673696","url":null,"abstract":"<p><strong>Background: </strong>The excessively high prices of High-Value Medical Consumables (HVMCs) and the substantial financial burden on patients are core issues in China's healthcare reform. Although the Volume-Based Procurement (VBP) policies have significantly reduced prices, insufficient policy coordination has led to frequent implementation deviations, constraining the effectiveness of reforms.</p><p><strong>Methods: </strong>Guided by a three-dimensional framework encompassing policy intensity, measures, and objectives, this study employed an integrated analytical process. Text mining facilitated initial thematic identification, which was then iteratively refined and validated through the Delphi method to establish quantifiable indicators within the framework. These indicators were analysed using a synergy degree model to evaluate policy alignment. 21 national-level policies from 2004 to 2024 are analysed.</p><p><strong>Results: </strong>Based on the constructed synergy indices, policy development underwent three stages: 'initial exploration, gradual development, and stable optimization'. As indicated by the model, the synergy degree showed an evolutionary trend, moving from early dispersion, to mid-term leap, and later differentiation. According to the indices, planning guidance and administrative measures showed relatively high synergy over the long term but appeared to squeeze the synergy space for other measures. The results also indicated that imbalances existed among policy objectives, with contradictions between cost control and innovation goals, and insufficient adaptation between medical insurance payment and industry development. Based on these model-based findings, optimisation strategies such as classified coordination mechanisms, dynamic weight adjustment, and closed-loop feedback for quality and supply are proposed.</p><p><strong>Conclusion: </strong>Theoretically, this study is the first to systematically quantify the degree of synergy of high-value medical consumables policies by developing a framework-based coordination analysis model using constructed indices. Practically, it provides a scientific basis for optimising policy combinations, balancing short-term cost control with long-term industrial innovation, and improving medical insurance support mechanisms.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2673696"},"PeriodicalIF":2.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of pricing, availability, and affordability of essential medicines in a resource-limited setting.","authors":"Faiza Inayat, Nasir Mahmood, Bashir Ahmad, Muhammad Sheeraz Ahmad","doi":"10.1080/20523211.2026.2701916","DOIUrl":"10.1080/20523211.2026.2701916","url":null,"abstract":"<p><strong>Background: </strong>Access to essential medicine is a worldwide issue, driven by high prices, low affordability and limited availability. Under funded health systems, weak local production, poor supply chain governance, and discriminatory policies are the main hurdles. Low and middle-income countries are continuously making efforts to improve healthcare services. To evaluate the extent to which the intended objectives have been met, the present study undertakes an investigation into the pricing, availability, and affordability of selected essential medicines in Pakistan.</p><p><strong>Methods: </strong>A survey of 50 essential medicines, including 14 from the global core list and 36 selected from the national essential medicine list, was carried out from November 2025 to February 2026, using an adaptation of WHO/HAI methodology in five geographical areas of Pakistan. Data were acquired from 9 pharmacies of government hospitals and 18 retail pharmacies of the private sector. Prices were evaluated on the basis of the Median Price Ratio (MPR); affordability was determined by estimating how many days a minimum salaried employee of the government must spend to buy the prescribed regimen.</p><p><strong>Results: </strong>In the public sector mean availability was 12.65% (IB), 36.2% (LPG) and in private sector it was 45.7% (IB) and 55.2% (LPG). In private retail pharmacies, 13.61% were stocked with oncology medicines. Median price ratios in the private sector varied between 0.11-6.85 for LPG and 0.17-23.37 for IB. Median price ratio of 12 medicines (out of 36 calculated for MPR) was approximately similar between LPG and IB. However, prices for cardiovascular and antidiabetic medicines increased.</p><p><strong>Conclusion: </strong>Availability of LPGs has improved in the private sector. Median price ratios have decreased over time, but medicines are still unaffordable, especially for diabetes, viral, fungal and bacterial infectious diseases.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2701916"},"PeriodicalIF":2.6,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring pharmaceutical waste management in Southern Africa: a scoping review.","authors":"Tessa Moleman, Aukje K Mantel-Teeuwisse, Raffaella Ravinetto, Fatima Suleman, Jennie Lates, Saleh Aljadeeah","doi":"10.1080/20523211.2026.2700215","DOIUrl":"10.1080/20523211.2026.2700215","url":null,"abstract":"<p><p>Pharmaceutical waste management is an emerging health and environmental concern, particularly in low- and middle-income countries with limited waste infrastructure. This scoping review examined pharmaceutical waste practices and policies in Botswana, Eswatini, Lesotho, Namibia and South Africa at the healthcare facility and household levels. We systematically searched databases and grey literature sources from 2004 to 2024. Out of 729 research studies and 129 reports identified, we included 28 publications. The results were synthesised to show segregation, treatment and disposal practices. Regulatory frameworks existed in most countries, but often lacked detailed guidance and effective enforcement. Definitions of pharmaceutical waste varied, and documentation practices were inconsistent. Inappropriate practices of pharmaceutical waste management, such as inadequate incineration and landfilling conditions, were frequently reported. These findings are concerning and indicate a need for clearer, context-appropriate policies, stronger implementation mechanisms, improved segregation systems and further research, particularly at the household level.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2700215"},"PeriodicalIF":2.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacy inventory management practices and constraints in Asia-Pacific hospitals: a systematic review and qualitative synthesis.","authors":"Wuan Shuen Yap, Wing Loong Cheong, Li Ling Yeap","doi":"10.1080/20523211.2026.2701922","DOIUrl":"10.1080/20523211.2026.2701922","url":null,"abstract":"<p><strong>Background: </strong>Persistent medicine shortages across the Asia-Pacific region suggest variability in hospital inventory management capacity. Despite available guidelines, variations exist across hospitals in adopting recommended inventory management practices. Thus, this study aimed to identify existing inventory management methods, evaluate related challenges, and highlight recommendations for improvement.</p><p><strong>Methods: </strong>Searches were performed to identify relevant sources from 39 countries on CINAHL, Cochrane, Embase, PubMed, Scopus, Business Source Complete, and Emerald Insight. Non-indexed literature was retrieved through Google Scholar and general Google searches. Backward and forward citation searching was conducted. Data were extracted based on an initial framework comprising three components: planning and procurement, storage and stock management, and staff management. The framework was later expanded through inductive coding to include 12 subcomponents. Findings were narratively synthesised to describe inventory management methods and their impact on medicine supply. Methodological quality of the included empirical publications was assessed using the Mixed Methods Appraisal Tool (MMAT).</p><p><strong>Results: </strong>Seventy-two publications from 20 countries were included. Practices varied between hospitals even within the same country. Hospitals shared common inventory management challenges that weakened medicine supply systems. A conceptual framework was developed to outline three key themes: systemic constraints, infrastructural limitations, and staff skill gaps. Overcoming systemic constraints requires streamlining expenditure and enhancing central distribution systems. Implementing multi-supplier contracts may be effective at stabilising supply. Infrastructural improvements in storage space and inventory tracking systems may bolster medicine availability. Addressing staff skill gaps requires significant investment in training programmes to strengthen adherence to effective inventory management methods.</p><p><strong>Conclusion: </strong>This study mapped key determinants of medicine availability in hospitals, providing guidance on priority areas for intervention to policymakers, hospital leadership, and inventory personnel. Securing medicine supplies in hospitals requires practical inventory management guidelines that account for systemic constraints and infrastructural limitations while empowering staff to optimise pharmacy inventory management practices.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2701922"},"PeriodicalIF":2.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13417656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-utility and budget impact analysis of herpes zoster vaccines in Thai patients with end-stage renal disease.","authors":"Nattanichcha Kulthanachairojana, Pattheera Phothong, Pitch Promkladphanao, Chollakarn Singharerg, Jatapat Hemapanpairoa","doi":"10.1080/20523211.2026.2701918","DOIUrl":"10.1080/20523211.2026.2701918","url":null,"abstract":"<p><strong>Background: </strong>Patients with end-stage renal disease (ESRD) are increased risk of herpes zoster (HZ). The economic value of HZ vaccines in Thai patients with ESRD has not been assessed. This study evaluated the cost-utility and budget impact of two HZ vaccination strategies - zoster vaccine live (ZVL) and recombinant zoster vaccine (RZV) - compared with no vaccination in Thailand.</p><p><strong>Methods: </strong>A Markov model was developed to estimate lifetime health and economic outcomes in patients with ESRD. Cost-utility analysis was conducted from a societal perspective, while budget impact analysis was performed from a payer perspective over a 5-year time horizon. Model inputs were derived from published literature and Thai data sources. Uncertainty was assessed using deterministic, probabilistic, and scenario sensitivity analyses.</p><p><strong>Results: </strong>In the base-case analysis, both ZVL and RZV were cost-effective compared with no vaccination, with incremental cost-effectiveness ratios (ICER) of USD 1,599.14 (THB 51,912.56) and USD 2,920.09 (THB 94,794.30) per quality-adjusted life year (QALY) gained, respectively - both below Thailand's willingness-to-pay threshold. RZV generated greater health benefits but was associated with higher costs. Sensitivity analyses confirmed the robustness of cost-effectiveness results across key assumptions. Over a 5-year period, the estimated budget impact ranged from USD 4.99-9.55 million (THB 161.86-310.02 million) for ZVL and USD 28.92-55.42 million (THB 938.95-1,799.09 million) for RZV, depending on vaccine uptake assumptions, with expenditures largely concentrated in the first year due to vaccination of prevalent patients.</p><p><strong>Conclusion: </strong>Both HZ vaccines are cost-effective options for preventing HZ in Thai patients with ESRD. While RZV provides greater health gains, it requires substantially higher budgetary investment. These findings support prioritising HZ vaccination for patients with ESRD and initiating pilot implementation within dialysis care settings to assess system-level impact and feasibility.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2701918"},"PeriodicalIF":2.6,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practices and attitudes of Thai community pharmacists in managing diabetic peripheral neuropathy using neurotropic B vitamins.","authors":"Kitiyot Yotsombut, Thanompong Sathienluckana, Sirinoot Palapinyo, Naeti Suksomboon","doi":"10.1080/20523211.2026.2701910","DOIUrl":"10.1080/20523211.2026.2701910","url":null,"abstract":"<p><strong>Background: </strong>Diabetic peripheral neuropathy (DPN) affects approximately half of individuals with diabetes. Community pharmacists play a pivotal role in the early management of DPN. This exploratory study examined community pharmacist practices in DPN assessment and management, with particular focus on attitudes toward and factors influencing neurotropic B vitamin recommendations.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among a convenience sample of community pharmacists in Bangkok, Thailand. The questionnaire focused on pharmacists' attitudes and practices in managing patients presenting with negative symptoms, positive symptoms, or diagnosed DPN.</p><p><strong>Results: </strong>Ninety community pharmacists participated in this study. Most patients presented with mild symptoms. Symptom severity was primarily assessed based on patient history and pain scales. Among patients presenting with negative symptoms and overt DPN, the most frequently recommended medication was a combined neurotropic B vitamin (48.11% and 44.73%, respectively). The factor associated with likelihood of recommending combined neurotropic B vitamins was reasonable product price, while guideline recommendation, package labelling, and brand reputation showed inverse association with recommendation behaviour.</p><p><strong>Conclusion: </strong>Community pharmacists frequently recommend neurotropic B vitamins for early-stage and painless DPN - presentations not addressed in current clinical guidelines. The inverse associations between guideline endorsement and recommendation behaviour likely reflect these guideline gaps rather than inappropriate practice. Pharmacy-specific clinical guidelines and clearer product labelling addressing both painful and painless DPN are needed. Given the exploratory design and convenience sampling from Bangkok, findings should be interpreted as hypothesis-generating.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"19 1","pages":"2701910"},"PeriodicalIF":2.6,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}