Karl R. Kodweis, Theodore J. Cory, Elizabeth A. Hall, Christa M. George, Katherine L. March
{"title":"Let's chat(GPT): Implementation of a ChatGPT-generated social determinants of health activity","authors":"Karl R. Kodweis, Theodore J. Cory, Elizabeth A. Hall, Christa M. George, Katherine L. March","doi":"10.1016/j.rcsop.2024.100553","DOIUrl":"10.1016/j.rcsop.2024.100553","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI)- powered chatbots have provided some notable benefits for learners. Educators are beginning to explore their possible utility and find ways to leverage AI in their classrooms.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the implementation of ChatGPT-generated social determinants of health (SDOH) activity in a team-based pharmacy education course.</div></div><div><h3>Methods</h3><div>Instructors asked the software to generate a set of learning objectives, an in-class activity, assessment strategies, and summative assessments for a student's conceptual understanding of SDOH. During a required first-year, team-based pharmacy course at the University of Tennessee Health Science Center, participants (<em>n</em> = 95) completed a ChatGPT-generated, in-class activity on SDOH within groups. The students' views on the quality of the activity were evaluated using five Likert-scale questions. Four of the questions assessed the applicability and usefulness of the assignment, with rankings on a scale of 1–4 (1 = strongly disagree; 4 = strongly agree). The fifth question evaluated the quality of the activity compared to activities generated by the instructor, using a scale of 1–5 (1 = far worse; 5 = far better).</div></div><div><h3>Results</h3><div>For applicability and usefulness,”94.7 % (<em>n</em> = 90) of students agreed that “This in-class exercise was valuable to my professional development as a pharmacist;” 96.8 % (<em>n</em> = 92) agreed with “It is necessary for pharmacists to understand SDOH;” 94.7 % (n = 90) agreement with the statement, “<em>The quality of this in-class activity was on-par with other in-class activities in the course</em>;” and 90.5 % (<em>n</em> = 86) agreed with “<em>This in-class exercise was just as impactful to my professional development as other in-class activities.</em>” The majority of students (63.2 %; <em>n</em> = 60) selected either “somewhat better” (40 %; <em>n</em> = 38) or far better (23.2 %; <em>n</em> = 22) for, “Regarding quality, I feel the in-class activity was ____ than other in-class activities.”</div></div><div><h3>Conclusions</h3><div>Most students reported that the ChatGPT-generated activity on social determinants of health was useful, applicable, and somewhat or far better than instructor activities. However, AI can generate incorrect information and potentially hinder student learning of conceptual frameworks; thus, instructors should review all output carefully.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"18 ","pages":"Article 100553"},"PeriodicalIF":1.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shanice Thomas , Jane Griffiths , Gabrielle Saunders , Denham Phipps , Chris Todd , Penny Lewis
{"title":"Exploring the barriers and facilitators to effective communication with people with age-related hearing loss in community pharmacy settings","authors":"Shanice Thomas , Jane Griffiths , Gabrielle Saunders , Denham Phipps , Chris Todd , Penny Lewis","doi":"10.1016/j.rcsop.2025.100573","DOIUrl":"10.1016/j.rcsop.2025.100573","url":null,"abstract":"<div><h3>Background</h3><div>As populations age, there is a growing number of people who are affected by age-related hearing loss, who are living with chronic health conditions, treated using multiple medicines. Community pharmacy plays an important role in ensuring safe and effective medicine use.</div></div><div><h3>Objective</h3><div>This study explored the barriers and facilitators to effective communication with people with age-related hearing loss in the community pharmacy setting.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with sixteen pharmacy users with self-reported age-related hearing loss in the United Kingdom (UK). Eight community pharmacists took part across two focus groups and one interview<em>.</em> Using a deductive-inductive approach to framework analysis, three overarching themes were generated.</div></div><div><h3>Results</h3><div>‘Navigating the environment’ highlights barriers related to pharmacists reportedly high workloads and time pressures, also reflected in pharmacy user's accounts. Background noise reduced the confidentiality and effectiveness of communication. Participants had differing views on the extent to which hearing aids could overcome these challenges. ‘Debating the need to communicate and to disclose hearing loss’ reflects barriers relating to pharmacy users' tendency to not disclose their needs, in relation to their personal feelings (embarrassment), perceptions of, and limited contact with, community pharmacy services. Yet, pharmacists emphasised a need to know about hearing loss to adapt communication effectively. Participants reported similar and distinct perspectives regarding ‘coping strategies and solutions to communicate effectively’.</div></div><div><h3>Conclusion</h3><div>Participants identified a need to improve pharmacists' capacity to implement communication adaptations for people with hearing loss, for which pharmacists suggested digital interventions, and to visibly recognise sensory needs, to promote disclosure.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100573"},"PeriodicalIF":1.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Helene Marie Haldorsen Gombos , Tonje Krogstad , Marthe Rambøl Bjørknes , Hege Sletvold , Milada Cvancarova Hagen , Karin Svensberg
{"title":"A qualitative non-participant observational study of non-prescription counseling in community pharmacies","authors":"Helene Marie Haldorsen Gombos , Tonje Krogstad , Marthe Rambøl Bjørknes , Hege Sletvold , Milada Cvancarova Hagen , Karin Svensberg","doi":"10.1016/j.rcsop.2025.100611","DOIUrl":"10.1016/j.rcsop.2025.100611","url":null,"abstract":"<div><h3>Background</h3><div>The global rise in self-care and non-prescription product sales allows more people to self-treat minor ailments, and pharmacies have a key role in guiding this use. However, discrepancies between counseling standards and practice suggest a gap in ensuring safe and informed self-medication, necessitating exploration and understanding.</div></div><div><h3>Objectives</h3><div>This study investigates counseling on all non-prescription products in pharmacies, with the following objectives: 1) assess compliance with The Norwegian OTC Counseling Standard (the Standard), 2) identify factors predicting standard compliance, and 3) describe the content of non-prescription counseling.</div></div><div><h3>Methods</h3><div>A non-participant observation study (<em>n</em> = 275) was conducted in the self-care section of Norwegian pharmacies (<em>n</em> = 7) from September 2022 to March 2023. During the encounters, 494 products were purchased. Notes from the observations were transformed into transcripts. The transcripts were analyzed using Content Analysis, where codes were quantified and compiled into a spreadsheet. Statistical analysis was performed using Chi-square tests and Logistic regression to evaluate standard compliance and predictive factors.</div></div><div><h3>Results</h3><div>Full compliance with the standard was 14.6 %; however, ∼40 % of product inquiries did not meet the requirements. Busier pharmacies showed higher standard compliance compared to quieter, and counseling starting at the shelves was more comprehensive. Moreover, pharmacists were likelier than pharmacy technicians to provide information about OTC products (<em>p</em>-value = 0.01). Standard compliance was higher for other non-prescription products than for OTC products. Assessment of the customer's product needs typically revolved around previous use, the intended user, and symptoms, with less emphasis on patient-specific factors (e.g., contraindications, interactions). Information was usually practical, for example, instructions on use and dosage, while discussions on effects and adverse drug reactions depended on customer prompts.</div></div><div><h3>Conclusion</h3><div>The study found infrequent compliance with the standard, with information often being generic and not tailored to customer needs. OTCs have lower standard compliance than other products sold in pharmacies. Further efforts need to be made to improve counseling, including revising the standard focusing on communication skill promotion and expanding to consider all health-related products in the self-care section. This could improve self-treatment and reduce the burden on other healthcare providers.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"18 ","pages":"Article 100611"},"PeriodicalIF":1.8,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hiba Abdelmunim Suliman Elsheikh , Safaa Badi , Ahmed Hafiz Kamal , Mazen Karar , Mohamed Fouad , Omar Khalid , Omnia Abdullah , Setana Mamoun
{"title":"Impact of switching from neutral protamine hagedorn insulin (NPH) to glargine insulin on glycemic control and clinical outcomes in pediatric patients with type 1 diabetes","authors":"Hiba Abdelmunim Suliman Elsheikh , Safaa Badi , Ahmed Hafiz Kamal , Mazen Karar , Mohamed Fouad , Omar Khalid , Omnia Abdullah , Setana Mamoun","doi":"10.1016/j.rcsop.2025.100612","DOIUrl":"10.1016/j.rcsop.2025.100612","url":null,"abstract":"<div><h3>Background</h3><div>Treatment of type 1 diabetes requires insulin therapy, and various types of insulin can be used. Insulin glargine has been shown to provide effective glycemic control with reduced hypoglycemia. However, there are no prior studies investigating the effects of switching from neutral protamine hagedorn (NPH) insulin to glargine insulin in Sudan, due to limited use of glargine insulin and funding constraints.</div></div><div><h3>Objective</h3><div>This study aimed to assess the impact of switching from NPH insulin to glargine insulin on glycemic control in children with type 1 diabetes, and to identify factors precipitating the switch.</div></div><div><h3>Methods</h3><div>This observational cross-sectional study included 221 children (aged 1–19 years) with type 1 diabetes who switched from NPH insulin to glargine insulin at Mohamed Alamin Hamid Pediatric Hospital. Simple random sampling was used to select participants.</div></div><div><h3>Results</h3><div>Of the 221 participants, 83 (37.5 %) switched to glargine insulin, 60 (27.1 %) continued on NPH insulin, and 78 (32.5 %) started on glargine from the beginning. Switching to glargine insulin was associated with a statistically significant reduction in HbA1c (<em>P</em> < 0.001) and a significant decrease in fasting blood glucose (FBG) levels (P < 0.001). Additionally, 69.9 % of participants experienced an increase in their insulin dose (P < 0.001). The primary reason for switching, as reported by 57.8 % of caregivers, was that mixed insulin had not effectively controlled blood glucose, with 60.4 % of these participants experiencing hypoglycemia. Of those who switched, 94 % were satisfied, with 33.3 % reporting better blood sugar control and 89.7 % indicating improvements in general health. A significant increase in weight was observed after switching to insulin glargine (<em>P</em> = 0.0001).</div></div><div><h3>Conclusion</h3><div>Switching from NPH to glargine insulin among Sudanese pediatric patients with type 1 diabetes offer significant benefits in glycemic control, as reflected by improved HbA1c and FBG levels. Additionally, insulin dose and weight increased, contributing to enhanced overall health and blood glucose management. Hypoglycemia was a major reason for switching.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"18 ","pages":"Article 100612"},"PeriodicalIF":1.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L.S. Wong, S.L. Scahill, E. Barton, X.Y. Lim, J. Hikaka, J. Boey, D.J. Exeter, M. Hudson, A. Nu'u, Sanyogita (Sanya) Ram
{"title":"Conscientious objection in pharmacist codes of ethics: An international comparison through document analysis","authors":"L.S. Wong, S.L. Scahill, E. Barton, X.Y. Lim, J. Hikaka, J. Boey, D.J. Exeter, M. Hudson, A. Nu'u, Sanyogita (Sanya) Ram","doi":"10.1016/j.rcsop.2025.100609","DOIUrl":"10.1016/j.rcsop.2025.100609","url":null,"abstract":"<div><h3>Background</h3><div>Conscientious objection (CO) in pharmacy refers to the refusal to provide certain services based on moral or religious beliefs. Person-centred care helps to carve a way forward in balancing the duality of private conscience and public role expectations of the pharmacist. While individual conscience is a factor, pharmacists must also adhere to professional, legal, and regulatory standards. This interplay highlights the need for clear, context-sensitive guidance for both pharmacists and patients to ensure equitable access to services.</div></div><div><h3>Objective</h3><div>This review aimed to explore and understand the similarities, differences, and limits across international pharmacist codes of ethics in relation to CO clauses.</div></div><div><h3>Methods</h3><div>The document search focused on a list of OECD member countries. The International Federation of Pharmacists (FIP) website assisted with the identification of relevant regulatory pharmacist organisations (POs) within OECD countries. Information on Codes of Ethics and CO clauses published in English were gathered from POs' websites using specific keywords. Document analysis was employed to qualitatively examine individual Codes of Ethics.</div></div><div><h3>Results</h3><div>A survey of OECD countries (<em>n</em> = 38) identified 96 relevant documents pertaining to pharmacist Codes of Ethics or legislation on CO. Of these, 24 Codes of Ethics in English were identified, 12 of which explicitly mentioned CO. Among these, nine explicitly permitted CO, while six inferred it through moral, religious, or personal grounds. Most (<em>n</em> = 11) emphasized the importance of maintaining continuity of care to ensure patient access to services.</div></div><div><h3>Conclusion</h3><div>There are similarities and differences in Codes of Ethics governing pharmacists' CO worldwide, suggesting variability in practice norms. Consistent guidance across jurisdictions is needed to safeguard patients' rights to access treatment. Future studies on how pharmacists apply ethical codes in CO scenarios could provide valuable insights for updating professional regulatory standards.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"18 ","pages":"Article 100609"},"PeriodicalIF":1.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khalid S. Alghamdi , Max Petzold , Mahdi H. Alsugoor , Hafiz A. Makeen , Christina Ljungberg Persson , Laith Hussain-Alkhateeb
{"title":"Multi-stakeholder perspective on community pharmacy services in Saudi Arabia: A systematic review and meta-analyses for 2010–2020","authors":"Khalid S. Alghamdi , Max Petzold , Mahdi H. Alsugoor , Hafiz A. Makeen , Christina Ljungberg Persson , Laith Hussain-Alkhateeb","doi":"10.1016/j.rcsop.2025.100608","DOIUrl":"10.1016/j.rcsop.2025.100608","url":null,"abstract":"<div><h3>Background</h3><div>Community pharmacists are the third-largest group of healthcare professionals globally; their capacity often extends far beyond dispensing medication, and they are increasingly involved in a diverse range of advanced health service delivery, which can potentially improve public health outcomes. Among the many initiatives of the Saudi national transformation program towards Saudi Vision 2030 are plans to transform the current model of community pharmacy services by expanding their role to include patient-centered healthcare provision.</div></div><div><h3>Objectives</h3><div>This systematic literature review (2010−2020) of the multi-stakeholder perspective aimed to evaluate services provided by Saudi community pharmacies and satisfaction levels, investigate perceived factors associated with the practice, and identify barriers affecting services.</div></div><div><h3>Materials and methods</h3><div>Seven scientific electronic databases were searched. The review was conducted in accordance with PRISMA guidelines. This review was subjected to descriptive analyses, meta-analyses of proportion, and narrative synthesis. The Mixed Methods Appraisal Tool version 2018 was used to assess the quality of studies.</div></div><div><h3>Results</h3><div>Minimal physician participation, community pharmacies' owners and managers, and gender imbalance among pharmacists all arose as gaps in Saudi Arabia. The findings showed that community pharmacies enable self-medication, with one-third of antibiotics being dispensed without prescriptions despite the threat of law enforcement. The deficiency of patient counseling by community pharmacists threatens patient safety, and the lack of knowledge about clinical services diminishes opportunities for adequate practice.</div></div><div><h3>Conclusion</h3><div>Several factors contributing to this inadequate performance and low satisfaction levels were reported. The findings were alarming and highlighted the need to intensify efforts towards Saudi Vision 2030, which aims to improve the overall population health and healthcare system in Saudi Arabia. Our review suggests that more efforts are needed to integrate key commercial, administrative, and technical sectors associated with the processes of community pharmacy dispensing and counseling.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"18 ","pages":"Article 100608"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Irene Boateng , Carlos Rodriguez Pascual , Paul Grassby , Zahid Asghar
{"title":"The impact of potentially inappropriate medicines on adverse clinical outcomes in the aged: A retrospective cohort study","authors":"Irene Boateng , Carlos Rodriguez Pascual , Paul Grassby , Zahid Asghar","doi":"10.1016/j.rcsop.2025.100610","DOIUrl":"10.1016/j.rcsop.2025.100610","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine the association between potentially inappropriate medicines (PIMs) and mortality, hospitalization, adverse drug reactions and falls and specific inappropriate medicines which are associated with the outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was carried out using 1000 patients aged 75 years and above from the Clinical Practice Research Datalink. PIMs were estimated using the Screening Tool of Older People's Prescriptions. The association between PIMs and mortality, falls, adverse drug reactions, or hospitalization was determined using logistic regression analysis. Subgroup analyses were carried out by including an interaction term between different categories of PIMs and age, gender, and morbidity.</div></div><div><h3>Key findings</h3><div>Data of 1000 people were analysed. 36 % were male and the mean age was 83 years. Adjusted odds ratios with their 95 % confidence intervals for association between PIMs and outcomes were: mortality 1.03(0.92 to 1.14), hospitalization 1.21(1.04 to 1.40), falls 1.30(1.12 to 1.51) and adverse drug reactions 1.20(1.02 to 1.40). The effect of PIMs on the outcomes was high in men and ≥ 86 years old and increased with an increasing number of PIMs. Tricyclic antidepressants, elemental iron in doses ≥200 mg daily, benzodiazepines, neuroleptics and long-acting opioids were associated with at least one of the outcomes.</div></div><div><h3>Conclusion</h3><div>Potentially inappropriate medicines are associated with hospitalization, falls and adverse drug reactions but not mortality.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"18 ","pages":"Article 100610"},"PeriodicalIF":1.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marc Fleming , Saharnaz Nedjat , Jon C. Schommer , Crystal K. Hodge
{"title":"Enhancing holistic patient care of black individuals diagnosed with HIV and comorbid chronic conditions","authors":"Marc Fleming , Saharnaz Nedjat , Jon C. Schommer , Crystal K. Hodge","doi":"10.1016/j.rcsop.2025.100607","DOIUrl":"10.1016/j.rcsop.2025.100607","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacists can play a crucial role in delivering the holistic care model. Research suggests that HIV-positive African American patients particularly benefit from this approach compared to other communities. Typically, pharmacists in community pharmacy settings are limited in their access to a patient's medical record, preventing holistic care delivery.</div></div><div><h3>Objectives</h3><div>This study addressed the impact of access to medical records on a holistic patient care approach among pharmacists engaged in medication therapy management.</div></div><div><h3>Methods</h3><div>This was a sub-analysis of a randomized controlled trial of the impact of community pharmacist access to medical records during MTM for African Americans diagnosed with HIV and multimorbidity with hypertension (HTN) and/or type 2 diabetes mellitus (DM). A random sample was selected of 30 participants (15 in the intervention arm with access to medical records and 15 in the control arm) who completed at least seven study visits between 2019 and 2021. A quantitative content analysis of the study pharmacist visit notes was conducted to identify themes of pharmacist interventions. The percentages of the theme's repetitions were compared across study groups using the Fisher exact test.</div></div><div><h3>Results</h3><div>Thirteen themes were extracted from the pharmacists' visit notes. The intervention group demonstrated a higher repetition of themes concerning any disease, medicine, exercise/weight/diet, sexual, sleeping, smoking, alcohol/marijuana, vaccination, will/power of attorney, food/ housing, and depression/stress. Themes related to career goals and recommending consultation with a provider were repeated more in the control group. The two study groups had statistically significant differences in the percentages of repetition of seven themes.</div></div><div><h3>Conclusion</h3><div>Access to medical records enables pharmacists to focus more on mental health, lifestyle, and social determinants of health.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"18 ","pages":"Article 100607"},"PeriodicalIF":1.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdullah Al Masud , Ramesh Lahiru Walpola , Malabika Sarker , Muhammad Asaduzzaman , Md. Saiful Islam , Ayesha Tasnim Mostafa , Zubair Akhtar , Alamgir Kabir , Holly Seale
{"title":"Antibiotic dispensing practices in community pharmacies: Implications for antimicrobial stewardship in resource-constrained settings","authors":"Abdullah Al Masud , Ramesh Lahiru Walpola , Malabika Sarker , Muhammad Asaduzzaman , Md. Saiful Islam , Ayesha Tasnim Mostafa , Zubair Akhtar , Alamgir Kabir , Holly Seale","doi":"10.1016/j.rcsop.2025.100606","DOIUrl":"10.1016/j.rcsop.2025.100606","url":null,"abstract":"<div><h3>Background</h3><div>Over-the-counter antibiotic sales in community-pharmacies significantly drive antimicrobial resistance (AMR) in low- and middle-income countries (LMICs) due to inappropriate use and early treatment discontinuation. In Bangladesh, community pharmacies, which dispense 56.6 % of antibiotics without prescriptions, serve as the first health-seeking touchpoint, yet conventional stewardship strategies often overlook these informal providers, heightening AMR risks. This study examines drug-sellers' understanding and practices towards antibiotic dispensing and compares their symptomatic-treatment practices with Bangladesh's Standard Treatment Guidelines (STGs) to understand the extent of antibiotic misuse.</div></div><div><h3>Methods</h3><div>A cross-sectional survey in two urban and two rural areas of Bangladesh involved 120 drug-sellers from 30 randomly selected pharmacies per site. Knowledge was compared between drug-sellers with pharmacy-dispensing training and those without training, and their suggested treatments for two simulated health-symptoms—upper respiratory-tract and gastrointestinal infections—were evaluated against STGs to determine the extent of misuse.</div></div><div><h3>Results</h3><div>Most drug-sellers were aged 41–50 years (35.0 %), with 39.2 % holding a bachelor's degree or higher, and 65.8 % having pharmacy-dispensing training. The overall knowledge score on antibiotic use and AMR was moderate at 60.2 % (5–7 out of 10), with 32.5 % scoring ≤4, indicating poor knowledge; trained drug-sellers scored significantly better (<em>p</em> = 0.008). Over half (57.5 %) were unaware of antibiotic dispensing policies, though most (75.8 %) acknowledged the link between AMR and antibiotic use. For simulated upper respiratory-tract infections, 54.2 % recommended single antibiotic-90.8 % Watch, 9.2 % Access (per WHO-AWaRe classification)-with 66.2 % of these prescriptions deviating from guidelines due to inappropriate selection or dosage. For gastrointestinal infections, 55.8 % recommended single antibiotic (40.3 % Watch, 59.7 % Access), with 82.1 % deviated from the guidelines. Additionally, 26.7 % recommended two antibiotics (51.6 % Watch, 48.4 % Access), all of which were inconsistent with guideline recommendations. For both simulated symptoms, no significant difference was observed in drug sellers' treatment practices based on their knowledge level.</div></div><div><h3>Conclusion</h3><div>This study highlights the need for context-specific policies and regulatory measures in informal healthcare settings. While improving drug-sellers' knowledge is vital for antimicrobial stewardship in LMICs like Bangladesh, it alone is insufficient due to market competition, weak regulation, and patient-driven demand. Thus, curbing inappropriate antibiotic use at the community level requires stronger enforcement and multifaceted, context-tailored interventions—including public awareness, targeted training, and market-responsive stra","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100606"},"PeriodicalIF":1.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shane Desselle , Joy Moverley , Jamila Beckford , Anh Vo , Karen Sarpong , Irene Bugriyev
{"title":"Pharmacy and physician assistant students experience benefits from an interprofessional education experience incorporating motivational interviewing training","authors":"Shane Desselle , Joy Moverley , Jamila Beckford , Anh Vo , Karen Sarpong , Irene Bugriyev","doi":"10.1016/j.rcsop.2025.100605","DOIUrl":"10.1016/j.rcsop.2025.100605","url":null,"abstract":"<div><h3>Background</h3><div>While interprofessional education (IPE) has become commonplace, incorporation of motivational interviewing (MI) using standardized patients (SPs) has been rare, particularly use of a multi-pronged strategy of engagement among pharmacy and physician assistant students.</div></div><div><h3>Objective</h3><div>The aim of this study was to determine the impact of an IPE MI training intervention that employed students in teams interacting with standardized patients (SPs); specifically, the intervention impact on MI self-efficacy, professional identity formation (PIF) and attitudes toward interprofessional care.</div></div><div><h3>Methods</h3><div>First-year PharmD students (PGY1) and second-year physician assistant students (PA-S2) underwent a three-hour didactic class session featuring lecture and video simulations followed by an activity where teams of 6–8 students interacted with 5 different standardized patients (SPs). The educational intervention also featured a group debriefing session and written reflection prompted by answering several questions about how they fared with the SPs. Students' completed pre- and post- intervention surveys featuring standardized instrumentation measuring self-efficacy to engage in MI, professional identity formation, and attitudes toward interprofessional education.</div></div><div><h3>Results</h3><div>Students did not achieve substantive gains in MI self-efficacy, yet reported significant improvements in professional identity formation and attitudes toward interprofessional education. Qualitative comments from the post-intervention survey were positive for interprofessional integration and team dynamics (<em>n</em> = 14), though both PGY1 and PA-S2 students commented that academic year concordance, i.e., matching a PGY1 with a PA-S1, in future simulations could improve self-efficacy and confidence.</div></div><div><h3>Conclusions</h3><div>An IPE event featuring lecture, interaction with SPs, and an opportunity for mutual self-reflection on one another's roles in patient care might be beneficial to include in pharmacy and PA curriculum, even while such endeavors might be further enhanced using a longitudinal approach.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"18 ","pages":"Article 100605"},"PeriodicalIF":1.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}