Research in Social & Administrative Pharmacy最新文献

{"title":"Racial and socioeconomic disparities in the utilization of diabetes medication: A comprehensive analysis of NHANES 2011–2023","authors":"Rawan O. Almadfaa","doi":"10.1016/j.sapharm.2025.10.013","DOIUrl":"10.1016/j.sapharm.2025.10.013","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the association between racial and socioeconomic health disparities and diabetes medications utilization using a nationally representative sample of the US population.</div></div><div><h3>Method</h3><div>This study included 4469 diabetic patients (weighted N = 23,678,032) aged ≥20 years from the National Health and Nutrition Examination Survey (NHANES) 2011–2023. Patients were classified into four groups based on medication use: insulin only, noninsulin glucose-lowering drugs (GLDs), both, or none. Univariate, bivariate, and multinomial logistic regression analyses were performed to assess associations between medication use and health disparities. All analyses were weighted for the survey's complex, multistage design of NHANES.</div></div><div><h3>Results</h3><div>Among the 4469 patients, 579 used insulin, 2411 used noninsulin GLDs, 754 used both, and 725 were untreated. Older patients had higher odds of using non-insulin GLDs (OR = 1.018, 95 % CI: 1.009–1.027) and both therapies (OR = 1.012, 95 % CI: 1.001–1.022) compared with younger adults. Males were more likely to use diabetes medications than females. Asians had higher odds of medication use, while other racial groups had lower odds than Whites. Participants with income higher income had lower odds of using both insulin and non-insulin GLDs (OR = 0.708, 95 % CI: 0.521–0.964) compared with those with lower income. Insured patients were more likely to use medications than the uninsured. Education level and marital status were not significantly associated with diabetes medication utilization.</div></div><div><h3>Conclusion</h3><div>This study identified demographic and socioeconomic differences in diabetes medication utilization among U.S. adults. Lower odds of medication use were observed among Mexican American, other Hispanic, other race group, females, and uninsured participants, as well as those with higher income, indicating potential gaps in equitable diabetes management. Targeted interventions to improve medication access and adherence among these groups are needed to promote more equitable diabetes care in the U.S.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 2","pages":"Pages 326-332"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From pill to purpose: Rethinking outcomes evaluation through patient-centered metrics in pharmacoepidemiology and chronic disease management","authors":"Mohamed AbdElrahman ,&nbsp;Mohammed D. Al-Rekabi ,&nbsp;Mohamed E.A. Abdelrahim","doi":"10.1016/j.sapharm.2025.11.001","DOIUrl":"10.1016/j.sapharm.2025.11.001","url":null,"abstract":"<div><div>Despite progress in medication and evidence-based protocols, a disparity persists between clinical outcomes and patients lived experiences. Conventional pharmacoepidemiologic metrics—such as biomarker targets or hospitalization rates—frequently do not capture what patients prioritize: functionality, autonomy, and quality of life. This article promotes a transition to patient-centered measures, such as patient-reported outcomes (PROs), goal attainment scaling (GAS), and behavioral adherence models. By incorporating these approaches into research and practice, healthcare systems can more effectively assess therapy efficacy in real-world settings. The opinion emphasizes data that supports Patient-Reported Outcomes (PROs) and Goal Attainment Scaling (GAS), addresses implementation problems, and advocates for the realignment of assessment systems towards purpose-driven care. Ultimately, aligning outcome evaluation with patients' objectives promotes relevance, equity, and participation in chronic disease management—prompting pharmacoepidemiology to evaluate not only the efficacy of pharmaceuticals but also their meaningful impact on the lives of users.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 2","pages":"Pages 354-356"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Aged Care On-site Pharmacist (ACOP) program in Australian residential aged care homes: Key considerations and next steps","authors":"Janet K. Sluggett ,&nbsp;Daria S. Gutteridge ,&nbsp;Annabel Calder ,&nbsp;Georgina A. Hughes ,&nbsp;Elizabeth Manias ,&nbsp;Shanthi A. Ramanathan ,&nbsp;Kurtis Budden ,&nbsp;Ingrid Sketris ,&nbsp;Sara Javanparast","doi":"10.1016/j.sapharm.2025.10.006","DOIUrl":"10.1016/j.sapharm.2025.10.006","url":null,"abstract":"<div><div>Older people who live in residential aged care homes (RACHs) often experience polypharmacy and use potentially inappropriate medications. In response to issues identified by a recent national inquiry that identified the need to improve medication management practices in Australian RACHs, a federal government-subsidized initiative to enable clinical pharmacists to practice on-site in Australian RACHs has recently been launched. This new optional program has been funded to enhance quality use of medicines and resident's health and wellbeing in Australian RACHs. This commentary discusses the need for a comprehensive evaluation of this population-based and publicly subsidized initiative to improve medication management in RACHs. It presents a program logic model that outlines the required activities, key outputs and anticipated impacts of Australia's RACH on-site pharmacist program to aid program implementers and beneficiaries to plan, communicate, and evaluate this new program. The program logic model presented can also inform the actions of policy makers and program implementers in other countries who are involved in planning, execution and evaluation of new pharmacist-led interventions or programs in RACHs.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 2","pages":"Pages 348-353"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145929328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causes and management of drug shortages: A scoping review","authors":"N. Cornelissen ,&nbsp;S.W. Zielhuis ,&nbsp;P.M.L.A. van den Bemt ,&nbsp;B.J.F. van den Bemt","doi":"10.1016/j.sapharm.2025.10.008","DOIUrl":"10.1016/j.sapharm.2025.10.008","url":null,"abstract":"<div><h3>Background</h3><div>Drug shortages form a significant global challenge and may lead to treatment delays, increased healthcare costs, and negative health outcomes. Gaining more insight into the causes is crucial to develop interventions to prevent shortages and manage their consequences. This scoping review aims to provide an overview of the causes and management of drug shortages in high-income countries.</div></div><div><h3>Methods</h3><div>This scoping review was conducted in accordance with the JBI methodology. A comprehensive search was performed in PubMed, EMBASE, Web of Science, and CENTRAL on December 21, 2023. Studies published in English or Dutch on the causes and management of drug shortages in high-income countries were included. Two reviewers independently screened titles/abstracts and full texts. Relevant data on study characteristics, causes, and interventions were extracted using a standardized form. Findings were analysed descriptively.</div></div><div><h3>Results</h3><div>Thirty-six studies were included out of 4531 citations. Causes of drug shortages included manufacturing issues, fluctuating demand and market forces, poor supply chain management, political and strategic decisions, and external influences. Several studies emphasized that causes were frequently unknown. Interventions to manage shortages focused on alternatives and substitutions, inventory management, communication and coordination, regulatory and policy measures, and forecasting. While causes are primarily linked to early stages of the product life cycle, most interventions occur at later stages and tend to be reactive.</div></div><div><h3>Conclusions</h3><div>Most current interventions focus on temporary solutions at the end of the supply chain, while shortages often originate earlier. A focus on early-stage causes is needed for more effective, preventive solutions.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 2","pages":"Pages 232-253"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the Processes of Pharmacist Therapeutic Reasoning: A Scoping Review and Development of the Pharmacist Therapeutic Reasoning Model","authors":"Daniel Rainkie ,&nbsp;Zachariah Nazar ,&nbsp;Pim Teunissen ,&nbsp;Karen Könings","doi":"10.1016/j.sapharm.2025.08.012","DOIUrl":"10.1016/j.sapharm.2025.08.012","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacists make complex therapeutic decisions. Yet the reasoning processes that result in these choices, therapeutic reasoning (TR), are poorly defined. Existing models of clinical reasoning often overlook how pharmacists weigh risks and benefits of treatment options.</div></div><div><h3>Aim</h3><div>To develop a conceptual model that characterizes the processes, subprocesses, and cognitive strategies used during pharmacist TR based on current literature.</div></div><div><h3>Methods</h3><div>A scoping review was conducted in February 2024 to identify studies describing pharmacist or pharmacy student reasoning during therapeutic decision-making. Data were extracted by two researchers using a standardized form and inductively analyzed. Codes were thematically organized based on shared properties: <em>discrete knowledge</em>, <em>reasoning connections</em>, or <em>modifying influences</em>. Theory use was assessed using the Continuum of Theory Talk framework.</div></div><div><h3>Results</h3><div>Ten studies met inclusion criteria representing diverse contexts, scope, and reasoning stimuli. A total of 109 unique codes were identified and synthesized into a conceptual pharmacist therapeutic reasoning model (Pharm-TRv1). It consists of three knowledge domains (<em>drug</em>, <em>disease</em>, and <em>patient information</em>), three core reasoning processes connecting these domains (<em>drug–patient</em>, <em>drug–disease</em>, <em>patient–disease</em>), and three to four related subprocesses. The model includes five influencing factors: two external (decision context and entry and exit from reasoning) and three internal cognitive modifiers (metacognition, closing a knowledge gap, and reflection).</div></div><div><h3>Conclusion</h3><div>Pharm-TRv1 provides a foundational model of pharmacist therapeutic reasoning grounded in current literature. It offers a structured way to describe, teach, and study how pharmacists evaluate treatment options. Future research should further explore specific processes and subprocesses, validate the model, and explore broader theoretical perspectives.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 1","pages":"Pages 116-127"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health first aid training for pharmacists: A scoping review","authors":"Clarisse Romera ,&nbsp;Md Abdul Aziz ,&nbsp;Eunice Valencia ,&nbsp;Mê-Linh Lê ,&nbsp;Lauren Kelly ,&nbsp;Dana Turcotte ,&nbsp;Christine Leong","doi":"10.1016/j.sapharm.2025.08.001","DOIUrl":"10.1016/j.sapharm.2025.08.001","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacists frequently encounter patients requiring assistance with mental health. However, training to prepare pharmacists in this area is limited and variable. Mental Health First Aid (MHFA) is gaining recognition among other mental health training programs. Its significance in pharmacy practice settings has not been widely studied.</div></div><div><h3>Objective</h3><div>To describe methods and outcomes that were measured in studies evaluating MHFA training in pharmacy practice, and to identify gaps in the current literature.</div></div><div><h3>Methods</h3><div>A scoping review was conducted to identify studies that examined methods and value of MHFA in pharmacy practice. MEDLINE, Embase, PsycINFO, International Pharmaceutical Abstracts and Scopus were searched for studies from inception to June 2, 2025. Search terms related to pharmacists (e.g., “Pharmacist”) AND “Mental Health First Aid” were included.</div></div><div><h3>Results</h3><div>Ten articles were included. Survey (n = 7, 70.0 %) was the most frequent method used in the identified studies. Social Distance Scale was the most common tool used (n = 3, 30.0 %). All studies have found improved confidence among MHFA-trained pharmacists. Mixed findings were observed for level of stigma and use of MHFA.</div></div><div><h3>Conclusion</h3><div>There is a limited number of studies conducted on MHFA training of pharmacists that found improved confidence associated MHFA training. Future research to study the impact MHFA-trained pharmacists on patient experiences is warranted.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 1","pages":"Pages 26-32"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote patient monitoring outpatient telepharmacy services: A systematic review","authors":"Meadow Gehrke ,&nbsp;Keshia R. De Guzman ,&nbsp;Marissa Ryan ,&nbsp;Centaine L. Snoswell","doi":"10.1016/j.sapharm.2025.07.007","DOIUrl":"10.1016/j.sapharm.2025.07.007","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this review was to describe the existing evidence internationally regarding remote patient monitoring (RPM) outpatient telepharmacy service models, with a secondary focus on patient and service outcomes, enablers, and barriers.</div></div><div><h3>Methods</h3><div>This systematic review was conducted using PubMed, CINAHL, and Embase. Key search terms included pharmacy, telepharmacy, and outpatient; data extraction and narrative analysis were then performed, along with quality assessment and characterisation of the level of evidence provided by each paper. Original research articles were included if they described the service model for an RPM telepharmacy intervention for adult outpatients. Pharmacy staff delivering the service had to be a pharmacist or pharmacy technician; pharmacy student telepharmacy models were not included. Models that did not have a clinical consult component, such as health professional to health professional interactions or medication delivery were excluded.</div></div><div><h3>Results</h3><div>There were 33 articles included in this review, and the service models included scheduled phone consultations for symptom monitoring, interactive voice response (IVR) systems, mobile applications, short message service (SMS) and web communications. The studies found positive patient outcomes, including improved blood pressure control, improved blood glucose and/or HbA1c levels, reduced number of individuals at high-risk of transplant rejection in the kidney transplant population and improved general patient outcomes, including compliance. Positive service outcomes were also reported, including service feasibility, satisfaction and acceptance, as well as a reduction in hospitalisations, healthcare costs, and utilisation.</div></div><div><h3>Conclusion</h3><div>RPM is being used across a range of outpatient service models in a variety of clinical specialties to deliver telepharmacy services. While more investigation is required, available evidence supports positive patient and service outcomes.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 1","pages":"Pages 1-25"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public, private, and out-of-pocket spending comparisons between respondents with and without opioids and the impact of the Comprehensive Addiction Recovery Act, 2008–2020: A serial cross-sectional study","authors":"Mark Bounthavong ,&nbsp;Meng Li ,&nbsp;Aryana Sepassi ,&nbsp;Britney Stottlemyer ,&nbsp;Patrick Spoutz ,&nbsp;Laura Hart ,&nbsp;Kangho Suh","doi":"10.1016/j.sapharm.2025.08.004","DOIUrl":"10.1016/j.sapharm.2025.08.004","url":null,"abstract":"<div><h3>Background</h3><div>Healthcare costs among opioid users in the United States (US) have increased adding to their economic burden. Moreover, the Comprehensive Addiction Recovery Act (CARA) may have impacted these trends. We sought to compare trends of Total, Public, Private, Out-of-pocket, and Other types of healthcare spending and the impact of CARA for respondents with and without an opioid prescription in the US.</div></div><div><h3>Methods</h3><div>A serial cross-sectional design was used to evaluate trends in healthcare spending (Total, Public, Private, Out-of-pocket, and Other) between respondents with (Opioid) and without an opioid (Non-opioid) prescription in the US using the Medical Expenditure Panel Survey data between 2008 and 2020. Linear regression models were constructed to compare healthcare spending trends between the Opioid and Non-opioid groups. An interrupted time series analysis (ITSA) was performed to evaluate healthcare spending trends before and after CARA implementation between the groups.</div></div><div><h3>Results</h3><div>The total weighted adult sample (N = 221,565,008) included 10 % (N = 22,143,556 in the Opioid group and 90 % (N = 199,421,453) in the Non-opioid group. Opioid respondents had significantly higher average Total (+$2491), Public (+$785), Private (+$1012), Out-of-pocket (+$315), and Other types (+$379) of healthcare costs compared to Non-opioid respondents. Between 2008 and 2020, Opioid respondents had greater increases in average annual Total (+358), Public (+$299), and Private (+$69) spending compared to Non-opioid respondents. In the ITSA analysis, immediately after CARA implementation, Opioid respondents had higher Total (+$1930) and Private (+1234) spending compared to Non-opioid respondents. No other meaningful changes in healthcare spending were reported due to CARA implementation.</div></div><div><h3>Conclusions</h3><div>Healthcare expenditures increased for both the Opioid and Non-opioid groups between 2008 and 2020; however, Opioid respondents were associated with higher rates of increased Total, Public, and Private healthcare spending. Immediately after CARA implementation, Opioid respondents had higher Total and Private healthcare spending but no other meaningful changes compared to Non-opioid respondents.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 1","pages":"Pages 54-65"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot of a pharmacist-delivered habit-based intervention to support medication adherence in primary care","authors":"Matthew Witry ,&nbsp;James Hoehns ,&nbsp;L. Alison Phillips","doi":"10.1016/j.sapharm.2025.09.003","DOIUrl":"10.1016/j.sapharm.2025.09.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Informed by the Extended Common Sense Model, this study aimed to pilot a pharmacist-led intervention to promote medication adherence through habit formation compared to standard education.</div></div><div><h3>Procedures</h3><div>Patients new to medication were recruited in two phases. During Phase 1, the pharmacist provided standard education (control). In Phase 2, the pharmacist added a habit-formation component by completing a habit worksheet with patients. Surveys measuring medication beliefs, habit strength, and adherence were completed at baseline and 100 days later. Cues from the habit worksheets were coded and analyzed.</div></div><div><h3>Findings</h3><div>The habit intervention group (N = 17) showed no significant difference from the control group (N = 16) in medication-taking habit strength (p = 0.37) or self-reported adherence (MARS-5) (p = 0.47) at follow-up. Habit strength was the only significant predictor of adherence (MARS-5)(p = 0.02), while necessity beliefs predicted missed doses (p = 0.03).</div></div><div><h3>Conclusion</h3><div>High levels of habit strength and adherence may result from high baseline adherence levels. Further research should target patients with known non-adherence or without established medication routines.</div></div><div><h3>Clinical trial</h3><div># NCT06230978.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 1","pages":"Pages 147-151"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contributing factors of pediatric medication errors involving high-alert medications: A qualitative content analysis of self-reported medication safety incidents","authors":"Sini Kuitunen ,&nbsp;Mari Saksa ,&nbsp;Anna-Riia Holmström","doi":"10.1016/j.sapharm.2025.09.002","DOIUrl":"10.1016/j.sapharm.2025.09.002","url":null,"abstract":"<div><h3>Background</h3><div>High-alert medications can cause severe medication errors (MEs) in pediatrics. A comprehensive understanding of the factors contributing to errors is needed to establish risk management actions.</div></div><div><h3>Objective</h3><div>To analyze incident reports involving high-alert medications and describe the contributing factors (CFs) of MEs in pediatrics.</div></div><div><h3>Methods</h3><div>A retrospective document analysis study utilizing an abductive qualitative content analysis of self-reported medication safety incidents concerning high-alert medications at a pediatric university hospital from 2018 to 2020. Incident reports (n = 426) were first subjected to an inductive qualitative content analysis to identify and categorize CFs, then quantified by frequencies and percentages, and ultimately deductively categorized based on the elements of the Systems Engineering Initiative for Patient Safety (SEIPS) model. The analysis was first conducted by one independent researcher, then reviewed by a second researcher, and later reviewed by the entire research group.</div></div><div><h3>Results</h3><div>A total of 933 CFs were identified, concerning 85.0 % (n = 362/426) of the incident reports. The most common main categories of CFs pertained to verifying the correct drug (11.1 %; n = 104/933), medications and pharmaceuticals (10.6 %; n = 99/933), and resourcing (10.5 %; n = 98/933). Over half of the CFs were linked to SEIPS elements involving tasks (39.6 %, n = 370) and tools and technologies (20.8 %, n = 194).</div></div><div><h3>Conclusions</h3><div>The CFs of pediatric MEs involving high-alert medications are multifaceted and have a wide impact on the entire system design, from organizational strategies to individual tasks. Risk management actions and further studies addressing pediatric-specific challenges are required to ensure the most optimal systemic defenses, enabling proactive monitoring error-provoking conditions in clinical practice.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 1","pages":"Pages 135-146"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}