Exploratory research in clinical and social pharmacy最新文献

{"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}

{"title":"Performance of antiretroviral drugs supply chain management and related challenges in Amhara National Regional State, Ethiopia. In the case of public health facilities found in the Central Gondar zone","authors":"Meseret Tilahun Zeleke ,&nbsp;Berhanemeskel Weldegerima Atsbeha ,&nbsp;Belachew Yebeyin Melaku ,&nbsp;Yesuneh Tefera Mekasha ,&nbsp;Abibo Wondie Mekonen ,&nbsp;Shimelis Dagnachew Nigatu","doi":"10.1016/j.rcsop.2025.100570","DOIUrl":"10.1016/j.rcsop.2025.100570","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Effective human immunodeficiency virus (HIV) treatment depends on uninterrupted delivery of prescribed antiretroviral (ARV) drug regimens at anti-retroviral therapy (ART) sites. However, interruptions in access and stock outs are the major challenges in the supply chain of antiretroviral drugs. The issues are very high, particularly in developing countries like Ethiopia. Therefore, this study aimed to assess the supply chain performance of ARV drugs and its challenges in public health facilities in the Central Gondar Zone.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A descriptive cross-sectional survey complemented by a qualitative research approach was conducted in 30 health facilities (7 hospitals and 23 health centers) that provide ART services. Structured self-administered questionnaires and observational checklists were used to collect quantitative data, while qualitative data were collected using semi-structured open-ended interview guides. Quantitative data was analyzed using SPSS version 26 and Microsoft Excel 2013. A thematic approach was used to examine the qualitative data, which required careful reading of the transcripts to find important themes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;This study revealed that, at the surveyed health facilities, the availability and utilization of bin cards were found to be 100 %. Bin card updating in the surveyed facilities was 90.4 % and 87.2 % on average at hospitals and health centers, respectively. The study found that stock outs of ARV drugs were high in hospitals (16.14 %) as compared to health centers (9.2 %). Lamivudine (3TC) + Dolutegravir (DTG) + Tenofovir (TDF) (300 mg + 50 mg + 300 mg) of 30 tablets was the most frequently stocked-out drug at hospitals and health centers in about 57 % and 39 %, respectively. About 42.8 % of hospitals and 26 % of health centers placed at least two emergency orders within the previous six months at the time of data collection. The storage condition of ARV drugs was not good (68.99 %) in health centers. However, it was better in hospitals and met the criteria for good storage conditions (89.52 %).The qualitative findings also revealed that inadequate infrastructure, a shortage of trained and qualified staff, and a lack of vehicles were the major challenges.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Overall, the study indicated that the surveyed health facilities were not satisfied with the timely updating of bin cards. Additionally, it identified issues such as stock outs of ARV drugs, poor storage conditions (particularly in health centers), inadequate infrastructure, a shortage of trained and qualified staff, and a lack of vehicles. Therefore, to improve the performance of ARV drug supply chain management, all the concerned bodies should work cooperatively in maintaining quality data and be dedicated to updating inventory recording tools, creating standard storage conditions, as well as recruiting pharmacy professionals, facilitating capa","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"17 ","pages":"Article 100570"},"PeriodicalIF":1.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149292","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":"Out-of-pocket prescription medicine expenditure amongst community-dwelling adults: Findings from the Irish longitudinal study on ageing (TILDA) in 2016","authors":"James Larkin ,&nbsp;Ciaran Prendergast ,&nbsp;Logan T. Murry ,&nbsp;Michelle Flood ,&nbsp;Barbara Clyne ,&nbsp;Sara Burke ,&nbsp;Conor Keegan ,&nbsp;Fiona Boland ,&nbsp;Tom Fahey ,&nbsp;Nav Persaud ,&nbsp;Rose Anne Kenny ,&nbsp;Frank Moriarty","doi":"10.1016/j.rcsop.2025.100565","DOIUrl":"10.1016/j.rcsop.2025.100565","url":null,"abstract":"<div><h3>Background</h3><div>The number of prescription medicines prescribed to older adults is increasing in Ireland and other countries. This is leading to higher out-of-pocket prescription medicine expenditure for older adults, which has several negative consequences including cost-related non-adherence. This study aimed to characterise out-of-pocket prescription medicine payments, and examine their relationship with entitlements, multimorbidity and adherence.</div></div><div><h3>Methods</h3><div>This cross-sectional study used 2016 data from a nationally-representative sample of adults in Ireland aged ≥50 years. Descriptive statistics and regression models were used to describe out-of-pocket prescription medicine payments and assess the association between out-of-pocket prescription medicine payments and the following variables: healthcare entitlements, multimorbidity, and cost-related non-adherence.</div></div><div><h3>Results</h3><div>There were 5,668 eligible participants. Median annual out-of-pocket prescription medicine expenditure was €144 (IQR: €0–€312). A generalised linear model showed that, amongst those with out-of-pocket prescription medicine expenditure, having fewer healthcare entitlements was associated with 4.74 (95%CI: 4.37–5.15) times higher out-of-pocket prescription medicine expenditure. Overall, 1.7% (<em>n</em> = 89) of participants reported cost-related non-adherence in the previous year. A multivariable model examining cost-related non-adherence found a significant association only for those prescribed 4–5 regular medications (compared to 3 medications) (OR: 1.87, 95%CI: 1.02–3.42).</div></div><div><h3>Conclusions</h3><div>Those with entitlements to subsidised prescription medicines had much lower out-of-pocket prescription medicine expenditure. This highlights the benefits of expanding healthcare entitlements and ensuring uptake of entitlements by those with eligibility.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"17 ","pages":"Article 100565"},"PeriodicalIF":1.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149835","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":"Hospital pharmacy implementation of a unit dose dispensing system: A qualitative interview study to determine experiences, views and attitudes of nursing staff","authors":"Theodora Steindl-Schönhuber ,&nbsp;Theresa Drechsel ,&nbsp;Gunda Gittler ,&nbsp;Anita Elaine Weidmann","doi":"10.1016/j.rcsop.2025.100566","DOIUrl":"10.1016/j.rcsop.2025.100566","url":null,"abstract":"<div><h3>Background</h3><div>Evolving automated technologies in the dispensing process promise effective solution to reduce medication error rates. The Unit-Dose-Dispensing-System (UDDS) is an essential element of the “Closed Loop Medication Management System” that enables the tracking of single medication items across the entire medication workflow thereby improving transparency, patient safety and healthcare efficiency”.</div></div><div><h3>Objective</h3><div>The aim of this study was to determine hospital nurses' attitudes towards the unit dose dispensing system implemented by the hospital pharmacy department, examine their perceptions of opportunities and barriers in everyday practice and explore their experiences with its implementation.</div></div><div><h3>Methods</h3><div>A qualitative interview study with 23 nurses from the Barmherzige Brüder Hospital Linz, Austria was conducted. The validated and piloted semi-structured interview guide was based on best practice guidelines for qualitative interview studies and the Consolidated Framework for Implementation Research (CFIR). Interviews were transcribed verbatim and mapped against the Framework of Implementation of Services in Pharmacy (FISpH) by two researchers independently.</div></div><div><h3>Results</h3><div>Twenty-three nurses were interviewed. Despite the overwhelmingly positive experiences with ease of use, resultant time saving, improved collaboration, patient safety, patient autonomy and a better facilitated discharge process considered as some of the positive attributes, several barriers were identified. Nurses commented on a lack in standardised workflow, erosion of knowledge and sustainability.</div></div><div><h3>Conclusion</h3><div>Nurses highlighted key factors for implementation success and advantages of the unit dose dispensing system, suggesting a need to adapt to local conditions and full electronic integration into patient care. Suggestions to further improve the reliability and efficiency were made.</div></div><div><h3>What does this paper contribute to the wider global clinical community?</h3><div><ul><li><span>•</span><span><div>There is no research qualitatively exploring the implementation facilitators and barriers of a unit dose dispensing system at hospital ward level from the nurses' perspectives.</div></span></li><li><span>•</span><span><div>Insights are provided into the significance of good collaboration between all ward staff to ensure the necessary workflow adaptations, the necessity of a seamlessly integrated IT system and the adaptability of the system depending on the patient population.</div></span></li><li><span>•</span><span><div>The findings highlight key factors for a successful implementation of a unit dose dispensing system at ward level while underlining its advantages for workload, staff shortages and patient safety.</div></span></li></ul></div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"17 ","pages":"Article 100566"},"PeriodicalIF":1.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149291","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}