Pharmacy最新文献

{"title":"Performance, Determinants, and Acceptability of a Clinical Pharmacy Assessment in Hospital Pharmacy Education.","authors":"Sébastien Chanoine, Quentin Perrier, Elisa Vitale, Arnaud Tanty, Benoît Allenet, Pierrick Bedouch","doi":"10.3390/pharmacy14040090","DOIUrl":"10.3390/pharmacy14040090","url":null,"abstract":"<p><p><i>Background:</i> Pharmacy students in France complete an equivalent six-month full-time hospital placement during the fifth year of their university curriculum. At our school, it includes a clinical pharmacy within a medical ward, with daily supervision by a clinical pharmacist and a pharmacy resident. This training has been strengthened by the introduction of a workplace-based formative assessment conducted at the end of the clinical pharmacy rotation, alongside weekly clinical case discussions at the school, culminating in an end-of-year oral assessment. <i>Objective</i>: To assess the performance, determinants, and acceptability of this assessment model. <i>Methods:</i> We conducted a retrospective, single-center study over ten academic years (2013-2023). The evaluation combined three complementary components: the workplace-based clinical assessment based on real patient interactions, the case-based oral assessment, and students' satisfaction. <i>Results:</i> Nearly one thousand students were included. Students' performances remained stable over time. Higher scores were observed among students with prior clinical experience and those enrolled in hospital-focused training pathways. Student satisfaction was high, particularly in settings with direct pharmaceutical supervision, which was strongly associated with improved perceived learning, engagement, and supervision quality. <i>Conclusions:</i> Beyond performance measurement, this model appears to foster clinical reasoning, professional development, and student engagement, suggesting its relevance for competency-based pharmacy education.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593679","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":"Cumulative Anticholinergic Burden and Risk of Delirium Among Older Adults with Alzheimer's Disease.","authors":"Ashna Talwar, Jeffrey Sherer, Susan Abughosh, Satabdi Chatterjee, Rajender R Aparasu","doi":"10.3390/pharmacy14040089","DOIUrl":"10.3390/pharmacy14040089","url":null,"abstract":"<p><p>Delirium is a transient neuropsychiatric condition that is a severe and prevalent condition affecting 2.6 million older adults each year. Alzheimer's disease (AD) and anticholinergic medication use are risk factors for delirium. This study evaluated the association between cumulative anticholinergic burden (CAB) and risk of delirium among older adults with AD initiating cholinesterase inhibitors (ChEIs). This retrospective cohort study used 2013-2017 Medicare claims data, and included adults 65 years and older with AD who initiated any of the ChEIs (donepezil, rivastigmine, and galantamine) after a 12-month washout period. CAB, as the primary exposure, was measured on the index date and calculated as the monthly total standardized daily dose of anticholinergic medications. A multivariable Cox proportional hazards regression model with inverse probability of treatment weighting (IPTW) generated using generalized boosted models was used to evaluate the risk of delirium associated with the CAB. This study identified 143,320 older adults with AD who initiated ChEIs. Most patients were in the low/no burden (62.73%) group, followed by high burden (21.12%) and moderate burden (16.14%). Overall, delirium diagnosis was observed in 19.11% of the cohort. The Cox regression model with IPTW found that moderate (aHR, 1.56; 95% CI, 1.52-1.61; <i>p</i> < 0.0001) and high CAB (aHR, 1.45; 95% CI, 1.42-1.49; <i>p</i> < 0.0001) were associated with an increased risk of delirium compared to low/no burden. Among older adults with AD initiating ChEIs, moderate and high CAB were associated with an increased risk of delirium compared with low/no CAB. These findings highlight the need to carefully reduce the CAB, especially dose and duration, along with utilizing anticholinergic alternatives in older adults with AD.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13414801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593591","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":"Tailoring the CFIR to Medication Adherence Interventions: A Delphi and Living Lab Study.","authors":"Mirthe A M Oude Lansink, Bart J F van den Bemt, Caroline H P A van de Steeg-van Gompel, Marcia Vervloet, Liset van Dijk, Charlotte L Bekker","doi":"10.3390/pharmacy14030088","DOIUrl":"10.3390/pharmacy14030088","url":null,"abstract":"<p><p>The implementation of medication adherence interventions is suboptimal. To guide implementation, this study aimed to tailor an existing implementation determinant framework to support the assessment of the implementability of such interventions in a specific context prior to implementation, and to investigate whether experts can assess in advance which determinants are important for implementing medication adherence interventions. In a Delphi study, experts rated determinants based on constructs of the Consolidated Framework for Implementation Research (CFIR) in terms of their importance for implementing medication adherence interventions. Determinants were then prospectively evaluated in four Dutch living labs implementing medication adherence interventions. The results were compared to assess agreement between expert opinion and real-world practice. Of 40 evaluated CFIR determinants, 16 were important in the majority of the living labs. These determinants concerned the inner setting, characteristics and roles of involved individuals, and implementation process domains of the CFIR. After comparing the prospective evaluation with Delphi results, expert opinions matched living lab observations for 18 out of 40 determinants (45%) regarding (un)importance. The CFIR was tailored to primary care medication adherence interventions based on practice observations, offering a potentially helpful framework to assess implementability of these interventions in specific contexts in advance. Determinant frameworks could benefit from incorporating real-world practice data.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13306722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319641","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":"Seasonal Influenza Vaccination Uptake, Illness and Economic Burden, and Vaccine Information Exposure Among Young Adults in the San Francisco Bay Area.","authors":"Taiwo Opeyemi Aremu, Carinne Brody, Shadi Doroudgar, Ikenna Chidozie Ezejiaku, Shahin Teimourtash","doi":"10.3390/pharmacy14030087","DOIUrl":"10.3390/pharmacy14030087","url":null,"abstract":"<p><strong>Background: </strong>Seasonal influenza prevention in young adults is influenced by access, trust, and vaccine information exposure, but local evidence linking vaccination uptake with illness and economic burden is limited.</p><p><strong>Methods: </strong>We conducted a non-probability, cross-sectional electronic survey of adults aged 18-49 years who lived, worked, or studied in the San Francisco Bay Area during the 2025 to 2026 influenza season. Measures included vaccination uptake, influenza-like illness, recovery, functional and economic burden, vaccination sites, and vaccine information exposure. Multivariable logistic regression examined factors associated with vaccination uptake; Kaplan-Meier and Cox models examined time to recovery.</p><p><strong>Results: </strong>Of 554 responses, 463 were included. Vaccination uptake was 86.2% (<i>n</i> = 399; 95% confidence interval [CI], 82.7-89.2%), likely reflecting a health-engaged convenience sample. Influenza-like illness was reported by 38.4%; median recovery time was 5 days, median missed work or school was 2 days, and median direct out-of-pocket cost was US$20. Prior season vaccination (adjusted odds ratio [aOR], 2.24; 95% CI, 1.15-4.34) and greater trust in Centers for Disease Control and Prevention (CDC) or public health agencies (aOR, 1.46; 95% CI, 1.05-2.02) were associated with vaccination. Pharmacies were the second most common vaccination site and preferred future site.</p><p><strong>Conclusions: </strong>Influenza prevention for young adults may benefit from pharmacy-inclusive, multichannel access paired with trusted communication. Findings should be interpreted in light of non-probability recruitment and likely overrepresentation of health-engaged respondents.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13306451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319569","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":"Impact of an Interdisciplinary Educational Intervention on Healthcare Provider Knowledge and Beliefs Regarding Opioid Harm Reduction in Older Adults: A Pre-Post Survey Study.","authors":"Ariel Dulaney, Anne Taylor, Haley Phillippe, Renee Delaney, Lindsey Hohmann","doi":"10.3390/pharmacy14030086","DOIUrl":"10.3390/pharmacy14030086","url":null,"abstract":"<p><p>Opioid misuse continues to be a major public health issue in the United States. Older adults (≥65) are at particular risk of harm from opioids due to changes in opioid pharmacokinetics with age; however, healthcare professionals lack training and confidence in addressing opioid harm reduction strategies in this population. Therefore, the purpose of this study was to improve healthcare professional knowledge and beliefs regarding opioid harm reduction strategies amongst older adults. An 8 h interprofessional conference was conducted 1 May 2025 to educate healthcare providers about opioid misuse prevention strategies for older adults. This study utilized a quasi-experimental one-group pretest-posttest design to assess changes in healthcare professional knowledge and beliefs before and after the conference. Healthcare professionals in the U.S. were recruited to participate in the conference via email listservs with national reach, predominantly concentrated in Alabama. Data were collected at pre- and post-conference via an anonymous online survey informed by the Theory of Planned Behavior and Health Belief Model. Primary outcome measures included: (1) knowledge of opioid use and misuse in older adults (5 items); (2) prescribing and dispensing attitudes surrounding opioids and medications for opioid use disorder (MOUD) (5 items); (3) perceived susceptibility to harm from opioids (4 items); and (4) perceived barriers to opioid harm reduction in older adults (17-items). Constructs were measured using multiple-choice questions (knowledge) and Likert-type scales (1 = strongly disagree, 5 = strongly agree). Secondarily, intention to join a Microsoft Teams working group for ongoing collaboration was assessed through a single categorical (Yes/No/Unsure) multiple-choice question at post-conference. Data were analyzed using descriptive statistics, and differences in mean knowledge, attitudes, susceptibility, and barriers scale scores from pre- to post-conference were analyzed using Wilcoxon signed-rank tests (alpha = 0.05). Of N = 75 survey respondents, the majority were White (86.7%), female (74.7%), 50 years of age on average, and employed as pharmacists (68%). Overall, mean (SD) knowledge (83.73% [19.92] versus 90.67% [12.45]; <i>p</i> = 0.011) and perceived susceptibility (3.82 [0.63] versus 4.03 [0.63]; <i>p</i> = 0.002) increased from pre- to post-conference, while perceived barriers decreased (2.71 [0.54] versus 2.54 [0.58]; <i>p</i> = 0.001). Despite an upward trend, there was no statistically significant change in the mean prescribing and dispensing attitudes from baseline to post-conference. Additionally, 34.7% intended to join the Microsoft Teams working group at post-conference. Findings support the utility of interprofessional educational interventions to increase healthcare provider knowledge and beliefs regarding opioid harm reduction strategies amongst older adults.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13306577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319510","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":"From Laboratory to Patient Access: A Scoping Review of the Multi-Dimensional Challenges in Drug Repurposing.","authors":"Antonio Ivanov, Veselina Ruseva, Ines Hababa-Ivanova, Violeta Getova-Kolarova, Hristina Lebanova, Ilko Getov","doi":"10.3390/pharmacy14030085","DOIUrl":"10.3390/pharmacy14030085","url":null,"abstract":"<p><p>Drug repurposing is often promoted as a faster, lower-risk alternative to de novo discovery, yet substantial barriers continue to limit successful implementation. We performed a scoping review of articles included in PubMed and ScienceDirect with the aim to identify and categorize challenges and analyze the intersections between them. Our review included 73 articles which revealed scientific, clinical, regulatory, economic, and implementation barriers, with the principal being the clinical translation of generated candidates. Scientific challenges include the necessity for new Phase II/III trials to validate efficacy, safety, and optimal dosing in new therapeutic contexts. Across disease areas, domain-specific barriers include subgroup-dependent responses in oncology, resistance and penetration challenges in anti-infectives, and data scarcity in rare diseases. Computational and AI-assisted approaches face fragmented data, model robustness, and insufficient validation. In addition, off-patent drugs face evidence requirements as rigorous as those for de novo entities, yet lack the market exclusivity incentives required to attract private investment. Additionally, an \"institutional bottleneck\" hinders academic researchers from bringing findings \"on-label\" due to a lack of regulatory infrastructure and collaborative frameworks. We conclude that drug repurposing requires a distinct translational paradigm involving multi-stakeholder collaboration and early regulatory engagement to bridge the gap between laboratory discovery and patient access.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13306824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319472","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":"Enhancing Discretion and Consistency in Emergency Contraception Counselling: Implementation of a Digital Support Tool in Community Pharmacies.","authors":"Esther Spinatsch, Sabrina Zelger, Samuel S Allemann","doi":"10.3390/pharmacy14030083","DOIUrl":"10.3390/pharmacy14030083","url":null,"abstract":"<p><p>Emergency contraception (EC) is a time-sensitive pharmacy service in which consistent, patient-centred counselling is important but can be challenging to deliver in routine practice. This prospective implementation study evaluated the feasibility and real-world use of a digital counselling support tool for pharmacist-led EC consultations in Swiss community pharmacies. The tool combines patient self-reporting with structured, evidence-based support for pharmacist counselling. All EC consultations between 1 November 2023 and 14 February 2026 using the tool in 10 Swiss community pharmacies were analysed descriptively (<i>n</i> = 3428), alongside a voluntary anonymous post-consultation survey (<i>n</i> = 148) assessing patient-reported experience and acceptance. Median total consultation duration was 11:32 min, including 4:27 min of direct pharmacist counselling, indicating partial transfer of assessment to the digital pre-consultation phase. Ulipristal acetate was dispensed in 71% and levonorgestrel in 26% of consultations. Prior to counselling, 80% of patients reported uncertainty regarding the optimal active ingredient, underscoring the relevance of pharmacist involvement. Survey respondents rated the tool as easy to use (97%), discreet (99%), and trustworthy (98%); 85% preferred it over standard paper-based procedures. These findings demonstrate the feasibility and patient acceptance of integrating a digital tool into routine EC services and suggest that such tools may support structured, evidence-based counselling within community pharmacy practice.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13307340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319491","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":"Kisspeptin as a Precision Biomarker in Personalized Pharmacy: Implications for Individualized Monitoring of Early Pregnancy Viability.","authors":"Ani Paunova, Angelina Mollova-Kyosebekirova, Maria Koleva, Ekaterina Uchikova, Nikoleta Parahuleva","doi":"10.3390/pharmacy14030084","DOIUrl":"10.3390/pharmacy14030084","url":null,"abstract":"<p><strong>Background: </strong>Precision medicine aims to improve early, individualized risk stratification using biologically relevant biomarkers. In early pregnancy, markers reflecting placental function remain limited. Kisspeptin, a placentally derived peptide that rises during normal gestation, has emerged as a potential indicator of pregnancy viability.</p><p><strong>Objectives: </strong>We aimed to evaluate evidence on maternal serum kisspeptin levels and placental KISS1/KISS1R expression in early pregnancy loss, and to assess its potential relevance as a precision biomarker within personalized pharmacy and individualized monitoring frameworks.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, Web of Science, and Google Scholar (up to 2025) was conducted according to the PRISMA 2020 guidelines. Studies assessing circulating kisspeptin and/or placental expression in early pregnancy loss versus viable pregnancies were included. A formal meta-analysis was not performed due to substantial heterogeneity in study design, biological material, assay methods, gestational age, and outcome reporting formats. Under these conditions, quantitative pooling was considered methodologically inappropriate; therefore, qualitative synthesis was performed.</p><p><strong>Results: </strong>Six studies met the inclusion criteria. Most reported significantly lower maternal serum kisspeptin levels in early pregnancy loss, with good discriminatory accuracy. Immunohistochemical analyses showed reduced placental and choriodecidual KISS1/KISS1R expression in miscarriage and recurrent pregnancy loss, indicating disrupted local signaling. Concordant systemic and tissue findings suggest that circulating kisspeptin reflects placental dysfunction.</p><p><strong>Conclusions: </strong>Kisspeptin appears to be a promising precision biomarker for monitoring early pregnancy viability and supporting individualized pharmaceutical care. Standardized assays and large prospective studies are needed before routine clinical implementation.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13306833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319602","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":"Through the Lens of Expanded Scope of Practice: Training Requirements for Pharmacist-Prescribed Contraception Across the United States.","authors":"Taylor Clark, Ioana Sandru, Samantha Kunkel, Sarah Lynch","doi":"10.3390/pharmacy14030082","DOIUrl":"10.3390/pharmacy14030082","url":null,"abstract":"<p><p>Thirty-one U.S. states and the District of Columbia currently authorize pharmacists to prescribe hormonal contraception. Expansion of pharmacist scope of practice into areas such as contraceptive prescribing represents an extension beyond traditional baseline licensure authority. As a result, jurisdictions frequently require additional training to address competency, patient safety, and liability considerations. Because regulation of pharmacy practice occurs at the state level, training requirements vary across jurisdictions. State boards of pharmacy websites and publicly available regulatory materials were reviewed to identify training requirements for pharmacists authorized to prescribe hormonal contraception. Relevant statutes, regulations, and prescribing protocols were examined. Identified requirements were extracted and categorized into thematic groupings based on the level and type of training specified. Most jurisdictions require pharmacists to complete training beyond standard pharmacy education prior to prescribing hormonal contraception. Such requirements are characteristic of newly expanded scope-of-practice authorities, where regulators seek to verify competency and mitigate liability risk. As prescribing activities become more fully incorporated into pharmacy practice acts and professional education, separate training requirements may diminish over time.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13306993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319625","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":"Bridging the Rural-Urban Divide: Independent Pharmacies and Women's Contraceptive Access.","authors":"Amie M Ashcraft, Anthony Peluso, Taylor Thompson, Amy Brenwalt, Sidney Sisson, Melody Phillips, Courtney S Pilkerton, Charles D Ponte","doi":"10.3390/pharmacy14030081","DOIUrl":"10.3390/pharmacy14030081","url":null,"abstract":"<p><p>Independent community pharmacies serve as critical healthcare access points in rural areas, yet they consistently underperform chain pharmacies on contraceptive access measures. This narrative commentary draws on mystery caller studies, implementation research, and policy analyses to examine pharmacy-based contraceptive access in the United States (US). Using emergency contraception (EC) as a case study, we show that independent pharmacies stock EC at dramatically lower rates than chains (e.g., 14.6% vs. 76.3% in West Virginia), provide less accurate information about purchase requirements and timing, and impose more barriers to access. Because independent pharmacies account for 76.5% of pharmacies in rural areas, this disparity concentrates contraceptive inaccessibility in communities already facing the highest rates of unintended pregnancy, maternal mortality, and maternity care deserts. This pattern extends beyond EC to pharmacist-prescribed contraception and over-the-counter daily oral contraceptives. These disparities reflect systemic barriers, such as inadequate reimbursement, limited training infrastructure, and absence of corporate support, rather than failures of individual pharmacies. Drawing on implementation research and the success of West Virginia's COVID-19 vaccination model, this paper proposes coordinated, sector-specific strategies to transform independent pharmacies from barriers into bridges for rural women's contraceptive access.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"14 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13306805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319488","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}