Exploratory research in clinical and social pharmacy最新文献

{"title":"Knowledge, attitude, and practice among community pharmacists toward adverse drug reaction reporting and pharmacovigilance: A nationwide survey","authors":"Tahani Alwidyan ,&nbsp;Mohannad Odeh ,&nbsp;Ameerah Hasan Ibrahim ,&nbsp;Eman Harahsheh ,&nbsp;Aya Banat","doi":"10.1016/j.rcsop.2025.100578","DOIUrl":"10.1016/j.rcsop.2025.100578","url":null,"abstract":"<div><h3>Background</h3><div>To enhance the impact of pharmacovigilance on drug safety, it must be integrated into the healthcare system. This study aimed to examine community pharmacists' knowledge, attitudes, and practices regarding adverse drug reaction reporting and pharmacovigilance.</div></div><div><h3>Methods</h3><div>A self-administered, cross-sectional questionnaire study was conducted among eligible community pharmacists between July and September 2023. Participants completed online and paper-based questionnaires after providing prior consent. Descriptive and inferential analyses were performed using the Statistical Package for Social Sciences (SPSS, version 28). One-way ANOVA was used to assess the significance of the association between knowledge, attitude, practice scores, and demographic characteristics.</div></div><div><h3>Results</h3><div>A total of 239 pharmacists completed the questionnaire (response rate of 67.5 %). Of them, 65.3 % were females. Poor knowledge regarding pharmacovigilance was evident in 66.1 % of participants, while only 11 % demonstrated good knowledge. Attitudes were primarily neutral (72.8 %), and practices were categorized as fair for 41.0 % and poor for 31.0 % of pharmacists. Significant factors influencing adverse drug reaction reporting included years of experience (<em>P</em> = 0.012) and awareness of the pharmacovigilance center (<em>P</em> = 0.000). The serious nature of adverse drug reactions was identified as the key facilitator for reporting (40.5 %), while well-documented adverse drug reactions in the literature (21.2 %) and lack of time (19.5 %) were the primary barriers among pharmacists.</div></div><div><h3>Conclusion</h3><div>This study emphasizes the potential enhancement of adverse drug reaction reporting among community pharmacists by addressing poor knowledge, neutral attitudes, and barriers like time constraints. Targeted educational interventions and structured reporting frameworks are essential to enhance pharmacovigilance and ensure medication safety.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"18 ","pages":"Article 100578"},"PeriodicalIF":1.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511900","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":"Improving medication safety with proactive reconciliation in acute coronary syndrome patients: A randomized trial","authors":"Mahdieh Fatemi-Nejad ,&nbsp;Maryam Mehrpooya ,&nbsp;Davoud Ahmadimoghaddam ,&nbsp;Kimia Shirmohammadi ,&nbsp;Maryam Zamanirafe ,&nbsp;Mahdis Sharifikia ,&nbsp;Azadeh Eshraghi","doi":"10.1016/j.rcsop.2025.100577","DOIUrl":"10.1016/j.rcsop.2025.100577","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Patients with acute coronary syndrome (ACS) are at an increased risk of medication errors due to the complexity of medication regimens, frequent transitions of care, the use of high-risk medications, and their vulnerability to adverse events.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This randomized controlled trial aimed to compare the effectiveness and time efficiency of proactive versus retroactive medication reconciliation models in preventing unintentional medication discrepancies in patients hospitalized with ACS.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Conducted from January to June 2024 at a specialty cardiovascular teaching hospital in West Iran, the study included 162 eligible patients admitted to the coronary care unit (CCU) with a diagnosis of ACS and taking at least five regular medications. Patients were randomly assigned to either the proactive or retroactive reconciliation group (81 each). A clinical pharmacist led both reconciliation models, supported by trained pharmacy interns who conducted patient interviews to obtain detailed medication histories. Primary outcome measures included the number and types of unintentional medication discrepancies identified, as well as their potential harm.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 654 medications were reconciled using the proactive approach, compared to 627 with the retroactive method. Among the discrepancies identified, 13 % were unintentional in the proactive group, whereas 44 % were unintentional in the retroactive group (&lt;em&gt;p&lt;/em&gt; &lt; 0.001). Additionally, 66.7 % of patients in the retroactive group had at least one discrepancy, compared to 38.3 % in the proactive group (&lt;em&gt;p&lt;/em&gt; &lt; 0.001). The average number of unintentional discrepancies per patient was significantly lower in the proactive approach (0.6) than in the retroactive model (1.7; p &lt; 0.001). Over 51 % of errors in the retroactive group had the potential for moderate or severe harm, while most errors in the proactive model were assessed as having only mild harm (86.5 %; &lt;em&gt;p&lt;/em&gt; &lt; 0.001). The acceptance rate of pharmacist recommendations regarding unintentional medication discrepancies was higher in the retroactive reconciliation group compared to the retroactive group (68 % vs. 21 %; p &lt; 0.001), and physicians reported greater satisfaction with the proactive method. Furthermore, the proactive model demonstrated superior time efficiency in completing the medication reconciliation process and resolving discrepancies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Our findings demonstrate that the proactive model of medication reconciliation is more time-efficient and effective in preventing unintentional medication discrepancies in patients hospitalized with ACS compared to the retroactive approach.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Trial registration&lt;/h3&gt;&lt;div&gt;The trial was registered at Iranian Registry of Clinical Trials (&lt;span&gt;&lt;span&gt;https://irct.behdasht.gov.ir/trial/74760&lt;/span&gt;&lt;svg&gt;&lt;p","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"18 ","pages":"Article 100577"},"PeriodicalIF":1.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465119","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":"Probing the in-depth analysis of Serious Adverse Drug Reactions in a tertiary care hospital of Central India","authors":"Preeti Singh ,&nbsp;Shekhar Verma ,&nbsp;Yogesh Vaishnav ,&nbsp;Usha Joshi ,&nbsp;Manju Agrawal","doi":"10.1016/j.rcsop.2025.100579","DOIUrl":"10.1016/j.rcsop.2025.100579","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Serious Adverse Drug Reactions (ADRs) represent a critical challenge in contemporary healthcare, necessitating comprehensive investigation and analysis. Within Central India, where healthcare systems grapple with unique demographic, epidemiological, and infrastructural dynamics, understanding the landscape of serious ADRs is paramount.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study aimed to evaluate serious ADRs related to age, gender, most implicated class of drugs &amp; single drug, hospital admission, most affected system organ classes, causality and outcome of reactions and fatalities.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This retrospective study analysed serious individual case safety reports (ICSRs) recorded from January 2016 to December 2019 at the Department of Pharmacology, Pt. JNM Medical College, Raipur (ADR monitoring centre), and submitted to the Pharmacovigilance Programme of India database using VigiFlow® for further process. ADRs were collected from Dr. BRAM Hospital and DKS Hospital and recorded using the standard suspected ADR reporting form (version 1.4). Cases were classified as serious if they met at least one criterion from the WHO-UMC scale, with some cases meeting multiple criteria. Causality was assessed using the WHO-UMC scale, ensuring patient and reporter confidentiality. Descriptive statistics such as number and frequency were used to analyse serious ADRs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 762 ICSRs were entered into VigiFlow® during the study period, of which 239 (31.36 %) were classified as serious ADRs. The demographic distribution revealed a slight preponderance of females 125 (52.30 %) over males 113 (47.28 %). The hospital admissions due to ADRs were 57 (23.84 %). Antibiotics were the most commonly associated drug class (52.30 %), followed by Non-Steroidal Anti-Inflammatory Drugs (11.29 %). Among individual drugs, ceftriaxone and phenytoin were the most common drugs involved in serious ADRs. Adults were the most affected, 185 (77.40 %) compared to other age groups. The skin and subcutaneous tissue disorders, system organ class (SOC)155 (46.55 %) was highly affected, while erythematous and maculopapular rashes were the most common. Eleven Stevens-Johnson syndrome cases and three toxic epidermal necrolysis cases, like specific ADRs, were also obtained. The most ADRs were probable 121 (50.60 %) and possible 100 (41.84 %) category.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This study highlights the significant burden of serious ADRs within Central India, emphasising the need for heightened pharmacovigilance and targeted interventions, especially among adults. The prevalence of serious ADRs in females and adults and the impact on hospitalisations emphasise the need for cautious drug use, especially in inpatient settings. Limited understanding and reporting exist regarding the profile of serious ADRs in resource-limited countries. The findings will contribute to developing s","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"17 ","pages":"Article 100579"},"PeriodicalIF":1.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The extent and type of use, opportunities and concerns of ChatGPT in community pharmacy: A survey of community pharmacy staff","authors":"Emma Janske de Ruiter ,&nbsp;Vesna Maria Eimermann ,&nbsp;Claudia Rijcken ,&nbsp;Katja Taxis ,&nbsp;Sander Diederik Borgsteede","doi":"10.1016/j.rcsop.2025.100575","DOIUrl":"10.1016/j.rcsop.2025.100575","url":null,"abstract":"<div><h3>Background</h3><div>Since the widespread availability of Chat Generative Pre-Trained Transformer (ChatGPT), the public is confronted with accessible artificial intelligence tools. There is limited knowledge on the use, concerns and opportunities of ChatGPT in pharmacy practice in the Netherlands.</div></div><div><h3>Objectives</h3><div>The aims of this study were to explore the extent and type of use of ChatGPT in community pharmacy and to identify concerns and opportunities for pharmacy practice.</div></div><div><h3>Methods</h3><div>A questionnaire was developed, tested and distributed to professionals that work in community pharmacy. The answers were analysed descriptively using frequency tables.</div></div><div><h3>Results</h3><div>Of all participants (<em>n</em> = 106), 50.9 % had used ChatGPT, and 38.7 % (<em>n</em> = 24) of these users has used it in pharmacy. Participants saw opportunities for using ChatGPT as writing assistant or in quickly answering clinical questions. Concerns included not knowing what ChatGPT could be used for in pharmacy and not knowing what ChatGPT's answer is based on.</div></div><div><h3>Conclusions</h3><div>This research shows that using ChatGPT as a writing assistant is valuable and can free up time. Although clinical questions seem promising, ChatGPT's answers are currently too unreliable and do not meet the required quality standards for good pharmaceutical care. If ChatGPT is used to answer clinical questions, crossreferencing with reliable sources is recommended.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"17 ","pages":"Article 100575"},"PeriodicalIF":1.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422256","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":"Towards eco-friendly pharmaceuticals: Regulatory and policy approaches for sustainable medicines use","authors":"Ammar Abdulrahman Jairoun ,&nbsp;Sabaa Saleh Al-Hemyari ,&nbsp;Moyad Shahwan ,&nbsp;Sahab Alkhoujah ,&nbsp;Faris El-Dahiyat ,&nbsp;Ammar Ali Saleh Jaber ,&nbsp;Sa'ed H. Zyoud","doi":"10.1016/j.rcsop.2025.100576","DOIUrl":"10.1016/j.rcsop.2025.100576","url":null,"abstract":"<div><h3>Objectives</h3><div>The current study aimed to investigate how regulatory frameworks and policies are used to support the use of sustainable medicines within the pharmaceutical sector.</div></div><div><h3>Methods</h3><div>The Scopus database was searched to retrieve papers. Advanced search tool of the Scopus online database was used focused on the papers that have the search query included in their titles. Data analysis incorporated bibliometric indicators like publication counts and trends, visualized through VOSviewer software version 1.6.20.</div></div><div><h3>Key findings</h3><div>A total of 43 publications on Sustainable Medicines Use were found between 2000 and 2024. Leading countries in publication output on sustainable medicines use were United Kingdom, United States, India, Italy, Portugal, and Switzerland, indicating their collaborative relationships and publication volumes. A total of 92 institutions have been involved in research on Sustainable Medicines Use. Key institutions such as the Faculty of Engineering and the Laboratory for Process and Environmental Engineering, Lowell Center for Sustainable Production, Greiner Environmental Inc., and the University of Florence are prominently featured, indicating their significant contributions to research in this area. Key journals such as the “Journal of Cleaner Production,” “Business Strategy and the Environment,” “Chemical Engineering Transactions,” “Benchmarking,” and “Lecture Notes in Mechanical Engineering” are prominently featured. The retrieved articles have been cited an average count of 22.26. The overlay visualization created using VOSviewer suggest a shift towards exploring new drug categories, innovative approaches, and the commercial aspects of sustainability. Future research directions are likely to delve deeper into innovative methods and sustainable chemical practices (green chemistry), reflecting an emphasis on developing greener processes and products.</div></div><div><h3>Conclusion</h3><div>This study offers a thorough analysis of the legislative and governmental strategies promoting the use of sustainable medicine. It offers important insights for promoting sustainability in the pharmaceutical industry by pointing out gaps, defining useful frameworks, and suggesting doable solutions. Achieving sustainable pharmaceutical practices that support worldwide environmental and public health objectives requires sustained research, policy development, and international cooperation. The area needs to keep developing and implementing sustainable methods like green chemistry to decrease environmental harm and improve sustainability. Furthermore, collaborations among academia, industry, and international organizations are essential to progress and interchange effective strategies.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"17 ","pages":"Article 100576"},"PeriodicalIF":1.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422258","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":"Understanding and mapping the antibiotic prescribing and administration process in assisted living facilities","authors":"Deepthi Jacob,&nbsp;Betty Chewning,&nbsp;James H. Ford II","doi":"10.1016/j.rcsop.2025.100572","DOIUrl":"10.1016/j.rcsop.2025.100572","url":null,"abstract":"<div><h3>Objective</h3><div>Inappropriate prescribing practices significantly contribute to antibiotic resistance which poses a significant public health challenge. While antibiotic prescribing and administration process has been widely studied in various settings including nursing homes, little is known about Assisted Living Facilities (ALFs). This study aims to map the antibiotic prescribing and administration processes in ALFs.</div></div><div><h3>Design</h3><div>A qualitative descriptive study using the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 model.</div></div><div><h3>Methods</h3><div>Seven semi-structured interviews were conducted with staff from five ALFs located in a mid-western state. Participating staff were either involved in or knowledgeable about the process. The interviews were analyzed in NVivo using SEIPS 2.0 model as a theoretical framework.</div></div><div><h3>Results</h3><div>The analysis informed the mapping of a 33-step antibiotic prescribing and administration process for residents in ALFs. They were grouped into five sections: admission, resident having a change in condition, antibiotic prescribing, obtaining the prescription from the pharmacy, and antibiotic administration and follow-up. Pharmacies played critical role in delivery of prescriptions to ALFs and are uniquely positioned to support antibiotic stewardship efforts.</div></div><div><h3>Conclusions and implications</h3><div>This study is among the first to systematically map the antibiotic prescribing and administration process in ALFs. Insights gathered regarding the use of preferred pharmacies highlight opportunities for pharmacists in stewardship practices. Comparison of the process to that of nursing homes, suggests that several pharmacist-led stewardship interventions used there could be adapted effectively in ALFs. Further research is essential to assess the impact of antibiotic prescribing and pharmacist-driven stewardship interventions tailored specifically for ALFs.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"17 ","pages":"Article 100572"},"PeriodicalIF":1.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the need for a clinical decision support system for deprescribing - A qualitative interview study","authors":"Aryoutha Asmar Talani ,&nbsp;Tora Hammar ,&nbsp;Ylva Böttiger","doi":"10.1016/j.rcsop.2025.100574","DOIUrl":"10.1016/j.rcsop.2025.100574","url":null,"abstract":"<div><h3>Background</h3><div>Deprescribing (i.e., the process of discontinuing an inappropriate medication) requires time, knowledge, and care, but there is a lack of education, support, and guidelines for this important clinical task. A clinical decision support system (CDSS) aims to influence the quality of care by combining structured medical knowledge with patient-specific information to generate recommendations.</div></div><div><h3>Objective</h3><div>The objective was to examine the need to develop a CDSS for drug deprescribing. Furthermore, this study aimed to examine the obstacles to deprescribing and potential users' requirements for a CDSS for deprescribing.</div></div><div><h3>Methods</h3><div>The qualitative design consisted of semistructured interviews with physicians (<em>n</em> = 10) in Sweden from different disciplines, including geriatrics, primary care and internal medicine. The interviews were conducted using a predefined guide containing multiple questions about any challenges related to deprescribing and the perceived need for a CDSS. A qualitative content analysis was performed to analyse the empirical data.</div></div><div><h3>Results</h3><div>The interviews provided several aspects of the difficulty of deprescribing medicines. The structure and usability of the CDSS knowledge database in clinical practice needs to be ensured from the outset. Physicians needs fast, simple and up-to-date information filtered, summarized and synthesized from reliable sources. The information should preferably be integrated into pre-existing electronic health record.</div></div><div><h3>Conclusion</h3><div>There is a need to develop a CDSS for deprescribing<em>.</em> There is little, if any, guidelines or support for deprescribing, which is regarded as a large obstacle. The current findings contribute to further knowledge regarding the perspective of physicians when deprescribing medication.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"17 ","pages":"Article 100574"},"PeriodicalIF":1.8,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143316217","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":"Lived experience of affordability as a barrier to prescription medicines: A longitudinal qualitative study","authors":"Pauline Norris ,&nbsp;Shirley Keown ,&nbsp;Molly George ,&nbsp;Vanda Symon ,&nbsp;Rosalina Richards ,&nbsp;Sandhaya Bhawan ,&nbsp;Lauralie Richard","doi":"10.1016/j.rcsop.2025.100571","DOIUrl":"10.1016/j.rcsop.2025.100571","url":null,"abstract":"<div><h3>Background</h3><div>Lack of affordability is a major barrier to medicines access in many countries. It can result in ethnic and other inequities in medicines use and these have been documented in New Zealand. We aimed to understand the lived experience of barriers to accessing medicines faced by groups that are likely to encounter them, and to explore how they played out over time. This paper presents results related to affordability.</div></div><div><h3>Methods</h3><div>We carried out a longitudinal qualitative study, repeatedly interviewing 21 households about their lives and access to medicines, over a year. Participants were Māori, Pacific, former refugee, or Pākehā (New Zealand Europeans) with limited incomes.</div></div><div><h3>Results</h3><div>Many participants faced social disadvantage and many had physical and mental health problems. Often, they had busy and stressful lives, and this formed the backdrop to issues with medicines. Charges for GPs and medicines could directly prevent access, but also eroded relationships with healthcare providers, reducing acceptability of services. There could be confusion about charges, and when they were perceived as unreasonable participants felt aggrieved. At the time of the study, most (but not all) pharmacies had prescription charges, and limited financial resources drove some participants' choice of pharmacy. Some felt forced to choose between cost and physical accessibility or quality of care. Lack of affordability also interacted with other barriers to access, such as lack of transport, to prevent access to needed medications. Lack of affordability also made participants more vulnerable to the impact of small mistakes in prescribing and dispensing.</div></div><div><h3>Discussion</h3><div>Exploring lived experience provides insights into the multiple ways that lack of affordability prevents access to medicines: directly, through interaction with other barriers to access including transport, by damaging trust and reducing acceptability of services, and by making participants less able to deal with mistakes made by health professionals.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"17 ","pages":"Article 100571"},"PeriodicalIF":1.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149836","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":"e-Health applications for outpatient professional pharmaceutical care services: A scoping review","authors":"Raquel Agudelo ,&nbsp;Jaime Andrés Pereañez ,&nbsp;Sandra Milena Correa Muñoz ,&nbsp;Johan Granados ,&nbsp;Mauricio Ceballos","doi":"10.1016/j.rcsop.2025.100567","DOIUrl":"10.1016/j.rcsop.2025.100567","url":null,"abstract":"<div><h3>Background</h3><div>eHealth, or electronic or digital health, integrates information and communication technologies (ICT) into healthcare, including professional pharmaceutical care services. Nevertheless, to date, there is a lack of guidance in establishing the technologies' requirements, design, and implementation. Therefore, it urges the need to conduct a study regarding this topic is needed.</div></div><div><h3>Objectives</h3><div>To identify and map information regarding the functionalities, contents, and structures of e-health applications designed for professional pharmaceutical care services in outpatient settings and to explore their effectiveness, usability, and user-friendliness.</div></div><div><h3>Methods</h3><div>A scoping systematic review was conducted on the PubMed/Medline and Scielo databases, following the PRISMAScR guidelines. The study covered articles published between May 2018 and December 2023. The main search terms were “pharmaceutical care, dispensation, adverse drug reaction, mobile phone, app.” Other related terms were also included.</div></div><div><h3>Results</h3><div>1469 articles were identified, of which different exclusion criteria excluded 1409. Sixty full-text articles were reviewed, of which six contained relevant information about the characteristics and functionalities of software designed to support pharmaceutical care activities, such as dispensation, pharmacovigilance, health education, and pharmacotherapeutic follow-up. In addition, one reference was identified in the selected articles, which was deemed relevant to the study. The characteristics and structures in mobile applications include medication information, identification of adverse drug reactions, pharmacist follow-up, indicators of safety and effectiveness, and interaction of patients with health care personnel, among others. In addition, two applications reported the effectiveness evaluation, whereas four showed results about usability tests.</div></div><div><h3>Conclusions</h3><div>This review retrieved six applications for outpatient professional pharmaceutical care services. Most of them are directed to the patients, and the most relevant functionalities were general information about medication and reminders, identification of interactions and adverse drug reactions, and adherence, among others. Two of six apps tested the effectivity, four tested usability, and three of six performed UCD, mainly using surveys. This review highlights the scarce information about implementing ICT in outpatient pharmaceutical care services.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"17 ","pages":"Article 100567"},"PeriodicalIF":1.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149824","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":"Community pharmacists' decision-making patterns in clinical prescription checking: A simulation-based study","authors":"Ali Elgebli,&nbsp;Jason Hall,&nbsp;Denham L. Phipps","doi":"10.1016/j.rcsop.2025.100569","DOIUrl":"10.1016/j.rcsop.2025.100569","url":null,"abstract":"<div><h3>Background</h3><div>Community pharmacists (CPs) make a significant number of decisions on the clinical appropriateness of prescriptions daily to ensure safe and effective use of medications, in a process known as “clinical checking”. The process is complex and is affected by multiple factors in practice. This study aimed to investigate the cognitive processes involved in clinical prescription checking by CPs.</div></div><div><h3>Method</h3><div>This qualitative study employed a purposive sampling technique to recruit a diverse sample from the population of CPs in England. Engaging in Zoom interviews, participants clinically checked three simulated prescriptions, providing concurrent verbal accounts of their thoughts. The participants' commentaries during the task were audio-recorded, transcribed verbatim, and underwent deductive thematic analysis based on Klein's recognition-primed decision-making (RPD) model.</div></div><div><h3>Results</h3><div>Twelve CPs from diverse backgrounds and varied working conditions were recruited and completed the online checking task. Making decisions on the clinical appropriateness of prescriptions appeared to be a multi-staged procedure whereby several levels of concerns exist, and pharmacists vary in their ability to recognise and resolve those concerns. CPs behaved in a manner similar to that described by the RPD model; they mostly engaged in pattern-recognition during clinical checking, but adopted a more analytical approach when they recognised an atypical situation. Participants showed more consistency when processing cues and expectancies; however, their subsequent actions exhibited substantial variability, coupled with a degree of hesitancy.</div></div><div><h3>Conclusion</h3><div>Clinical checking of prescriptions is a multifaceted process in which pharmacists employ a blend of pattern recognition and analytical thinking when making decisions. The process differs notably among pharmacists, underscoring the need to understand the factors driving these variations and any hesitancy in decision- making, as well as their potential impact on patient safety.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"17 ","pages":"Article 100569"},"PeriodicalIF":1.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149326","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}