Exploratory research in clinical and social pharmacy最新文献

{"title":"Evaluating the implementation of a deprescribing intervention in Swiss nursing homes: An observational study using qualitative and quantitative methods","authors":"Stephanie Mena ,&nbsp;Julie Dubois ,&nbsp;Florent Macé ,&nbsp;Joanna Moullin ,&nbsp;Damien Cateau ,&nbsp;Marie Schneider ,&nbsp;Anne Niquille","doi":"10.1016/j.rcsop.2026.100713","DOIUrl":"10.1016/j.rcsop.2026.100713","url":null,"abstract":"<div><div>Deprescribing, the withdrawal of inappropriate medications, is an appropriate approach to addressing polypharmacy in older adults. However, implementing deprescribing interventions in routine practice remains challenging. This study evaluated the implementation of medication reviews focused on deprescribing, called Individual Deprescribing Intervention (IDeI), in Swiss nursing homes.</div><div>Using a hybrid type 2 effectiveness-implementation design, we conducted a qualitative evaluation through semi-structured interviews with nurses, physicians and pharmacists, based on the Framework for the Implementation of Pharmacy Services (FISpH). Quantitative data were collected from administrative sources.</div><div>IDeI was successfully implemented in six of seven nursing homes and most healthcare professionals (HCPs) were satisfied. Fidelity was considered good, as only minor intervention adaptations were made. Five main determinants influenced implementation: interprofessional collaboration (facilitator), pharmacist access to medical records (facilitator), motivation fostered by the structured process (facilitator), resident/family resistance to deprescribing (barrier), and resident/staff turnover (barrier). Integration into routine practice was deemed feasible but sustained in only two nursing homes one year later.</div><div>IDeI achieved good reach, adoption and HCP satisfaction, providing insights for sustainability. Recommendations include financial incentives, pharmacist training, audit &amp; feedback and greater involvement of residents/families. Findings align with existing literature, emphasizing the need to reinforce interprofessional collaboration and long-term maintenance strategies.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"22 ","pages":"Article 100713"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192904","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}

{"title":"Automated dispensing cabinets and nurse-related medication errors in inpatient settings: A systematic review","authors":"Arab Elsadig Salih Osman ,&nbsp;Nour Isleem ,&nbsp;Dena Al-Thani ,&nbsp;Aya Elsakka","doi":"10.1016/j.rcsop.2026.100714","DOIUrl":"10.1016/j.rcsop.2026.100714","url":null,"abstract":"<div><h3>Background</h3><div>Automated Dispensing Cabinets (ADCs) are computerized medication storage and dispensing systems increasingly used in inpatient hospital settings to support safe medication administration. As nurses represent the final point of medication delivery to patients, understanding the impact of ADCs on nurse-related medication errors is critical. This systematic review aimed to assess the association between ADC implementation and medication errors involving nurses in inpatient hospital settings.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, MEDLINE, Scopus, and Google Scholar identified 16 eligible studies published between 2008 and 2025 from 184 retrieved records. Included studies employed quantitative, qualitative, and mixed-methods designs. Risk of bias was assessed using the Mixed Methods Appraisal Tool (MMAT), and findings were synthesized narratively due to heterogeneity in study designs and outcome measures.</div></div><div><h3>Results</h3><div>Across quantitative studies, ADC implementation was generally associated with reductions in reported medication errors, particularly omission errors and wrong drug or wrong dose events, although reported reductions varied widely. Some studies reported maintenance of previously low error rates. Qualitative findings described perceived improvements in workflow efficiency, medication access, and nurses' confidence in medication safety, alongside temporary workflow challenges during early implementation.</div></div><div><h3>Conclusions</h3><div>Overall, the evidence suggests that ADCs may support safer medication administration and nursing workflows when appropriately implemented. However, evidence quality is limited by largely observational designs, heterogeneous error definitions, and inconsistent outcome reporting, highlighting the need for more standardized and methodologically robust research.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"22 ","pages":"Article 100714"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192935","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}

{"title":"Discretion at the margins: An observational study of community pharmacists' adaptive practices in supporting migrant and ethnic minority health","authors":"Charlotte Sente ,&nbsp;Veerle Foulon ,&nbsp;Karina Kielmann","doi":"10.1016/j.rcsop.2026.100715","DOIUrl":"10.1016/j.rcsop.2026.100715","url":null,"abstract":"<div><h3>Background</h3><div>Migrants and ethnic minorities (MEM) often face health challenges and structural and social barriers in accessing primary care. Pharmacists, as accessible healthcare professionals with expertise in medication management can address some of these barriers, however, their roles in serving MEM remain underexplored.</div></div><div><h3>Objectives</h3><div>This study explored the adaptive communication and care practices of community pharmacists in responding to MEM clients in Flanders, Belgium.</div></div><div><h3>Methods</h3><div>We conducted 42 h of non-participant observation and short reflective consultations with pharmacy staff of seven community pharmacies in two cities during February and March 2025. Field notes were structured using a semi-structured topic guide covering duration and content of pharmacist-client interactions; modes of communication; and delivery of pharmaceutical care. Framework analysis was used to code and categorize field notes according to micro-, meso-, and macro-level factors identified as influencing interactions between pharmacy staff and MEM clients.</div></div><div><h3>Results</h3><div>Community pharmacy staff bridge healthcare gaps for MEM clients through multiple strategies, shaped by the dual logics of retail and healthcare. They were observed to accommodate diverse languages and proficiency levels; support medication and health (systems) literacy; address socio-economic challenges; and show sensitivity towards socio-cultural dynamics of care-seeking. Reflecting pharmacists' personal and professional motivations, these adaptive practices are shaped by meso-level factors such as staff composition, pharmacy layout, and social norms, as well as pharmacy-level discretionary actions within the Belgian health system and migration policy contexts.</div></div><div><h3>Conclusions</h3><div>While well positioned to guide MEM clients through a fragmented health system, community pharmacists require systemic policy support to serve diverse population needs effectively.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"22 ","pages":"Article 100715"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192936","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}

{"title":"Identifying patient data that should be available in community pharmacies for statutory dispensing and providing clinical pharmacy services: A Delphi study","authors":"Johanna Laakso ,&nbsp;Sonja Kallio ,&nbsp;Marja Airaksinen ,&nbsp;Maarit Dimitrow","doi":"10.1016/j.rcsop.2026.100716","DOIUrl":"10.1016/j.rcsop.2026.100716","url":null,"abstract":"<div><h3>Background</h3><div>Community pharmacy practice has evolved from dispensing and medication counseling towards clinical pharmacy services such as medication reviews to ensure rational pharmacotherapy. These functions require better access to patient data than are currently available in community pharmacies. This study aimed to identify and prioritize patient data that should be available in Finnish community pharmacies for 1) statutory dispensing, including medication counseling, and 2) clinical pharmacy services promoting rational pharmacotherapy.</div></div><div><h3>Materials and methods</h3><div>This study applied a three-round Delphi survey with an expert panel of 20 clinical pharmacists. A consensus was formed using a preliminary list of patient data (39 items) important for managing major long-term diseases and related pharmacotherapies in outpatient care. The list was based on literature and research group's expertise. A consensus ≥80% was required. The responses were analyzed quantitatively and qualitatively.</div></div><div><h3>Results</h3><div>Most panelists (<em>n</em> = 15/19) perceived the current patient data available in community pharmacies insufficient. More patient data should be available, especially for providing clinical pharmacy services, but also for dispensing and related medication counseling (34 vs. 11 items reached a consensus, respectively). For both purposes, patient data on diagnoses, kidney function, and blood pressure were rated most important to be available. Panelists expressed some concerns about community pharmacists' resources and competence to use the data.</div></div><div><h3>Conclusion</h3><div>Consensus was reached for a relatively large set of patient data items to be available in community pharmacies, especially for providing clinical pharmacy services.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"22 ","pages":"Article 100716"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192903","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}

{"title":"Class-level drug safety surveillance in hospital practice: A pharmacovigilance analysis of 84 therapeutic subclasses from a South Asian tertiary care center","authors":"Abdullah Umer ,&nbsp;Adam Khan Mohmand ,&nbsp;Naimal Mouzam Khan ,&nbsp;Ainan Arshad ,&nbsp;Sher M. Sethi","doi":"10.1016/j.rcsop.2026.100711","DOIUrl":"10.1016/j.rcsop.2026.100711","url":null,"abstract":"<div><h3>Objective</h3><div>Post-marketing drug surveillance is critical for strengthening pharmacovigilance in low- and middle-income settings. This study provides the first class-level pharmacovigilance analysis from a South Asian tertiary hospital, generating safety signals across 84 drug subclasses and evaluating concordance between Proportional Reporting Ratio (PRR) and Reporting Odds Ratio (ROR) methods.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cross-sectional analysis of electronic health records (2018–2022), comprising 718,088 drug administration events. Adverse drug reactions (ADRs) were identified using ICD-9-CM/ICD-10-CM codes. Disproportionality analyses using PRR and ROR were applied to each subclass.</div></div><div><h3>Results</h3><div>PRR identified positive signals in 5 subclasses, while ROR identified 7. The seven high-risk subclasses included antitubercular agents (PRR 3.24; ROR 4.14), anesthetic muscle relaxants (2.44; 2.84), aminoglycosides (2.24; 2.55), immunosuppressants (2.19; 2.47), neurologic sedatives (2.06; 2.29), antineoplastic cytotoxic agents (1.95; 2.15), and general anesthetic agents (1.88; 2.06). Concordance between PRR and ROR was high (96.4% agreement; κ ≈ 0.80; McNemar <em>p</em> = 0.48). Signal strength correlated inversely with overall drug exposure (ρ = −0.34).</div></div><div><h3>Conclusion</h3><div>This analysis establishes baseline class-level risk estimates in a developing pharmacovigilance environment, identifies disproportionately high-risk drug classes, and supports the robustness of PRR and ROR as complementary screening tools for regional drug safety monitoring.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"21 ","pages":"Article 100711"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215042","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}

{"title":"Corrigendum to Adherence to oral anticancer medications in metastatic versus nonmetastatic breast cancer patients: Insights from a low-middle-income country, Exploratory Research in Clinical and Social Pharmacy, Volume 20, December 2025, 100682","authors":"Abdel-Hameed I.M. Ebid ,&nbsp;Rana Elshewy ,&nbsp;Mahmoud I. Mostafa ,&nbsp;Reem Eid ,&nbsp;Emad Shash ,&nbsp;Mohamed A. Mobarez","doi":"10.1016/j.rcsop.2026.100708","DOIUrl":"10.1016/j.rcsop.2026.100708","url":null,"abstract":"","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"21 ","pages":"Article 100708"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367475","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}

{"title":"Sociodemographic differences in knowledge, perceptions, and intentions regarding stimulant misuse: A theory-informed national cross-sectional survey","authors":"Melissa Sanders ,&nbsp;Kathlyn Smith ,&nbsp;Madison Holland ,&nbsp;Erin Blythe ,&nbsp;Daisy Doan ,&nbsp;Hannah Higgins ,&nbsp;Josephine Ariella Lovings ,&nbsp;Anne Taylor ,&nbsp;Nicholas McCormick ,&nbsp;Brandy Davis ,&nbsp;Lindsey Hohmann","doi":"10.1016/j.rcsop.2025.100695","DOIUrl":"10.1016/j.rcsop.2025.100695","url":null,"abstract":"<div><h3>Background</h3><div>Stimulant misuse is a rising concern in the United States.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to better understand the U.S. general public's knowledge, perceptions, and intentions regarding stimulant misuse, and to assess sociodemographic differences.</div></div><div><h3>Methods</h3><div>Americans age ≥ 18 were recruited for a cross-sectional, anonymous online survey using Amazon Mechanical Turk. Outcomes, guided by the Health Belief Model, included: knowledge; perceived susceptibility, severity, and benefits surrounding prescription and non-prescription stimulant use/misuse; perceived barriers to medical stimulant use and seeking help for stimulant misuse; and non-medical stimulant use intentions. Mann-Whitney <em>U</em> tests assessed differences across age (young adults/adults [≤44] versus middle-aged/older adults [&gt;44]), sex, race, and urbanicity. Linear regression assessed predictors of intentions.</div></div><div><h3>Results</h3><div>Respondents (<em>N</em> = 303) were 48.2 % female, 80.2 % White, mean 43.65 years, and 84.2 % urban-residing. Stimulant knowledge was higher among females (<em>p</em> = 0.017) and White individuals (<em>p</em> = 0.043). Perceived severity of stimulant misuse was higher among &gt;44-year-olds (<em>p</em> = 0.006), females (<em>p</em> = 0.007), and rural residents (<em>p</em> = 0.009), with rural residents perceiving greater susceptibility overall (<em>p</em> = 0.022). Barriers to seeking help for stimulant misuse were higher among ≤44-year-olds (<em>p</em> = 0.025), while non-medical stimulant use intentions were higher among &gt;44-year-olds (<em>p</em> = 0.002), males (<em>p</em> &lt; 0.001), and urban residents (<em>p</em> = 0.031). Perceived severity of prescription (β = −0.268; p &lt; 0.001) and non-prescription misuse (β = −0.191; <em>p</em> = 0.001), non-prescription stimulant benefits (β = 0.239; p &lt; 0.001), barriers to seeking help (β = 0.078; <em>p</em> = 0.026), and age (β = −0.006; <em>p</em> = 0.028) predicted non-medical stimulant use intentions.</div></div><div><h3>Conclusions</h3><div>Knowledge, perceptions, and non-medical stimulant use intentions differed across age, sex, race, and urbanicity. Future studies should explore strategies to overcome these disparities.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"21 ","pages":"Article 100695"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790431","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}

{"title":"Exploring work engagement and its associated factors among supervising pharmacists in Japan","authors":"Yukari Ito ,&nbsp;Hiroko Suzuki ,&nbsp;Tetsuro Yumoto ,&nbsp;Sachiko Ohta ,&nbsp;Tomoo Hosoe","doi":"10.1016/j.rcsop.2025.100691","DOIUrl":"10.1016/j.rcsop.2025.100691","url":null,"abstract":"<div><h3>Background</h3><div>This study investigated the work engagement of supervising pharmacists and sought to identify factors associated with high work engagement.</div><div>Given the growing shortage of healthcare professionals in rapidly aging societies, enhancing work engagement among pharmacists is critical to improve productivity, prevent turnover, and ensure the quality of community healthcare. Supervising pharmacists weretargeted due to their pivotal role as gatekeepers between organizational leadership and frontline staff in community pharmacies.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among supervising pharmacists from major community pharmacy chainsbetween August 2023 and September 2024. Participants completed a web-based questionnaire assessing demographic data, occupational stress, and work engagement. The associations between work engagement and related factors were evaluated using bivariate and multivariate logistic regression analyses with high work engagement defined as the top quartile of UWES-17.</div></div><div><h3>Results</h3><div>Data from 973 participantswere analyzed. The median UWES-17 score was 2.82. Among the three dimensions, “dedication” scored the highest. The primary factors associated with high work engagement includedperceived “meaningfulness of work”, “job control”, “suitable jobs”, “age group (≥50 years)”, “coworker support”.</div></div><div><h3>Conclusion</h3><div>This study suggests that the distinct roles and workplace environments of supervising pharmacists are closely linked to their work engagement. Balancing job resources and demands is critical for sustaining engagement to maintain high-quality patient care. Interventions that strengthen self-awareness, peer collaboration, and career development within “Communities of Practice” could reinforce these gains.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"21 ","pages":"Article 100691"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736976","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}

{"title":"Pharmacists' recognition, support strategies, and perceived challenges in caring for patients with limited medication literacy in Saudi Arabia: A quasi-experimental study","authors":"Faten Alhomoud","doi":"10.1016/j.rcsop.2026.100710","DOIUrl":"10.1016/j.rcsop.2026.100710","url":null,"abstract":"<div><h3>Introduction</h3><div>Medication literacy is critical for safe and effective medication use; however, evidence indicates that many individuals in Saudi Arabia struggle to understand medication-related information. Pharmacists are well positioned to identify literacy needs and provide appropriate counselling, yet limited data exist on their current practices and the effect of targeted training. This study aimed to assess pharmacists' understanding of medication literacy, their approaches to supporting patients with limited literacy, and the impact of a brief educational intervention on self-reported practices.</div></div><div><h3>Methods</h3><div>A pre–post quasi-experimental design was employed. Pharmacists across Saudi Arabia were recruited using convenience and snowball sampling. Participants completed a baseline questionnaire assessing their understanding of medication literacy, assessment methods, counselling strategies, and perceived barriers. A 10-min educational video was then delivered, followed by a post-intervention questionnaire one month later. Descriptive statistics and chi-square tests were used for analysis.</div></div><div><h3>Results</h3><div>In total, 318 pharmacists completed the pre-intervention questionnaire, and 68 completed the follow-up. At baseline, 95.6% reported understanding medication literacy, but only 21.4% used standardized assessment tools. Common strategies included using simple language and prioritizing essential information (84.3%), teach-back methods (70.4%), and providing easy-to-read materials (58.8%). Post-intervention, 98.5% reported understanding medication literacy, and 82.4% reported assessing patients' literacy needs. Most participants indicated improved assessment (97.1%) and more tailored counselling practices (92.6%), and 92.6% found the module helpful. Major barriers included time constraints (82.1%), lack of incentives (24.8%), heavy workload (23%), and insufficient training. However, the substantial decline in participant numbers between the pre- and post-intervention samples may limit internal validity and the generalizability of post-intervention findings.</div></div><div><h3>Conclusion</h3><div>Brief targeted training may support improvements in pharmacists' literacy-sensitive practices. Broader implementation of standardized assessment tools, enhanced professional education, and system-level support are needed to strengthen medication safety and patient understanding.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"21 ","pages":"Article 100710"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204074","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}

{"title":"Dosage adjustments in renal impairment among medical ward patients: ChatGPT® and DeepSeek® models' effectiveness in assessing those adjustments","authors":"Rahi Bikram Thapa ,&nbsp;Ravindra Khadka ,&nbsp;Prasanna Dahal ,&nbsp;Subash Karki ,&nbsp;Sabin Shrestha","doi":"10.1016/j.rcsop.2025.100698","DOIUrl":"10.1016/j.rcsop.2025.100698","url":null,"abstract":"<div><h3>Background</h3><div>Due to altered drug clearance, renal impairment necessitates drug dose adjustments to prevent toxicity or therapeutic failure, yet inappropriate dosing persists. The utility of AI tools (e.g., ChatGPT®, DeepSeek®) in supporting renal dose adjustments remains understudied.</div></div><div><h3>Objective</h3><div>Evaluate renal dose adjustment practices in hospitalized patients and compare AI models (ChatGPT®, DeepSeek®) against UpToDate® guidelines.</div></div><div><h3>Method</h3><div>A prospective observational study (January–April 2024) included hospitalized patients with creatinine clearance &lt;60 mL/min in a general medicine ward. Medication regimens were assessed against UpToDate® guidelines. Five AI models (ChatGPT® 3.5, ChatGPT® 4.0, ChatGPT® 5.0, DeepSeek®, DeepThink®) were tested using 348 tailored prompts; sensitivity, specificity, and accuracy were calculated.</div></div><div><h3>Results</h3><div>Renal impairment prevalence was 30.9 %. Of 1461 drug orders, 23.8 % (348) required adjustment, with 63.5 % (221/348) inappropriately dosed in 76.4 % (113/148) of patients. Errors included 134 (38.5 %) unadjusted, 75 (21.6 %) inappropriately adjusted, and 12 (3.4 %) contraindicated regimens. Piperacillin/tazobactam (66.7 %), levofloxacin (83.33 %), and ranitidine (89.1 %) were most frequently inappropriately dosed. Severe renal impairment (CrCl ≤30 mL/min) increased improper dosing risk (AOR: 3.34; <em>p</em> = 0.004). DeepThink® showed the highest sensitivity (81.6 %) but low specificity (29 %) and 67.5 % accuracy. With advances in the ChatGPT® model, there was a modest improvement in prediction capacity, with the latest ChatGPT® 5.0 achieving balanced performance (64.3 % sensitivity, 54.8 % specificity, 61.7 % accuracy).</div></div><div><h3>Conclusion</h3><div>Inappropriate renal dosing is prevalent among hospitalized patients with renal impairment. While AI models show promise as clinical decision support tools, their accuracy limitations require further optimization via evidence-based database training, prompt refinement, and integration of clinical expertise for reliable implementation.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"21 ","pages":"Article 100698"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790497","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}