Mapping the activities and outcomes of pharmacist and physician collaboration in chronic obstructive pulmonary disease care: A scoping review.

The implementation of new services in healthcare is complex, and an effective strategy is required to produce the desired patient outcomes. This paper aims to describe the implementation of a pharmacist-led post-discharge medication review clinic and outline the clinical pharmacist activities provided during the clinic review. The Knowledge to Action (KTA) framework was used to map the actions involved for the planning, implementation and review of outcomes of the clinic. The Consolidated Framework for Implementation Research (CFIR) was used to describe dependent and independent barriers and facilitators encountered throughout the implementation process. The clinical pharmacist activities provided during the clinic review were defined according to local guidelines. The KTA framework provided the key steps to implement the clinic service, monitor patient outcomes, that included 30-day hospital readmissions, and review clinic processes. Follow-up and troubleshooting of patient non-attendance and referral pathways were a key component of utilising the circular nature of the KTA framework. Facilitators included hospital funding models, growing evidence for pharmacist-led medication review and support from key stakeholders. Barriers included running costs, patient understanding of the service, attendance, and technology constraints. The clinic review included five key clinical pharmacist activities: confirmation of a best possible medication history, medication reconciliation, medication review, patient education, and communication of medication related problems identified with the patient's healthcare team. The KTA framework was a useful tool for implementing the pharmacist-led post-discharge medication review clinic, adapting and monitoring processes and improving knowledge of key stakeholders. Identified barriers and facilitators are relevant to implementing future clinic models.

New approaches are needed to respond to increasing numbers of patients with type 2 diabetes and high HbA1c (glycated haemoglobin). This pilot supported additional care from five primary care nurses and community pharmacists for people with type 2 diabetes with high HbA1c. To describe uptake, outcomes and experiences of a collaborative pharmacy and general practice diabetes programme. Quantitative data from patients enrolled before 31 August 2022 included change in HbA1c and medication, and pharmacist activity. Interviews with seven patients, five pharmacists and four practice nurses were analysed thematically. The evaluation included 26 people with an average baseline HbA1c of 97.6mmol/mol (range 69-136mmol/mol), of whom 84.6% were Māori or Pacific peoples. HbA1c reduced by an average 25.2mmol/mol; 20.7mmol/mol for Māori and Pacific peoples. HbA1c reduced by ≥5mmol/mol in 84.6% of service users, and 81.8% of Māori and Pacific peoples. HbA1c reductions were sustained an average 7.5months after programme completion. Pharmacists tailored their actions to the individual. The programme was highly acceptable to patients, pharmacists and nurses, with generally good communication and trust between them. Understanding about diabetes and medication, and medication adherence improved. New, effective medicines and insulin were often introduced. Some participants described increased blood glucose testing and lifestyle changes. Diabetes distress and denial, goal setting, client understanding of HbA1c and dropouts need further attention. COVID-19, staffing changes and staff shortages impacted enrolments. Pharmacist mentoring may help enrolments. A collaborative pharmacy-general practice model has potential to improve HbA1c in patients with type 2 diabetes through relatively simple interventions.

Enhancing the role of pharmacists may help reduce medication errors in nursing homes (NHs). To launch the embedding of onsite pharmacists in Flemish NHs, KU Leuven developed a postgraduate course. This pilot study aimed to (1) evaluate the course and (2) to explore pharmacists' tasks and activities in NHs. The course consisted of three main components: (1) an e-learning, (2) a NH internship, and (3) round table discussions with fellow pharmacists completing the course. Pharmacists also maintained a portfolio, documenting their tasks and activities. Data were collected during two consecutive course cycles, i.e. in 2022 and 2023. Round table discussions were considered as focus groups and included in the evaluation, as were pharmacists' portfolios. Additionally, focus groups were held with NH staff. All round table discussions and focus groups were audio-taped and transcribed verbatim. All data were analysed using an inductive thematic framework. Nineteen pharmacists and 36 NH staff members participated. Six themes emerged: (1) a promising e-learning with opportunities for improvement, (2) the crucial but challenging NH internship, (3) a variety of tasks performed by onsite pharmacists, 4) round table discussions as sources of inspiration and reassurance, (5) call for structural embedding of pharmacists in NHs, (6) consensus on the need for onsite pharmaceutical expertise. The pilot study highlighted the potential role of onsite pharmacists in NHs, emphasizing resident-level and system-level contributions. It also identified opportunities to optimize the postgraduate course and calls for the structural embedding of pharmacists in NH practice.

Critical care pharmacists (CCPs) are recognized as essential members of the intensive care unit (ICU) multidisciplinary patient care team, yet still find it necessary to justify their presence. Therefore, it is important to understand which CCP activities provide the most value to patient outcomes to inform discussions about CCP practice and guide development of quality measures (QM) and key performance indicators (KPI). We aimed to conduct a scoping review of studies that assessed the effect of CCP patient care activities on clinically relevant outcomes in an intensive care unit (ICU) to guide development of QM/KPI. The Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Healthcare Administration Databases (via ProQuest), PubMed, and Web of Science from 1980 through October 1, 2025 were searched using the following search terms: "pharmacist," "critical care," "critically ill," "intensive care units," and "ICU." The search strategy retrieved 5971 articles of which 71 studies were included. Most studies were single-center evaluations, and the most common areas of CCP activity were antimicrobial stewardship (17 studies, 24%), sedation optimization (11 studies, 15%), pharmacotherapy management (10 studies, 14%), and medication safety (8 studies, 11%). The most common outcomes assessed were ICU length of stay (LOS) (55 studies, 77%), mortality (44 studies, 62%), hospital LOS (29 studies, 41%), duration of mechanical ventilation (20 studies, 28%), and medication errors (11 studies, 15%). Forty-two studies (59%) showed a statistically significant difference in the outcomes assessed favoring the CCP activity. Multiple QM/KPI were derived from specific CCP activities performed in these studies. Many studies documented improvements in clinically relevant outcomes because of the care provided by a CCP. QM/KPI derived from CCP activities performed in these studies may be useful in standardizing CCP practice and workflow and further establish CCP value.

The relevance of the study lies in expanding our understanding of the functional-pragmatic and linguistic characteristics of medical instructions for the use of medications and the need to classify them as a specific discursive practice. The subject of the study is the pragmastylistic essence of the genre under consideration. Based on the methodology of speech genre modeling by T.V. Shmelyova, the main communicatively significant parameters of medical instructions texts are characterized, taking into account their linguopragmatic specificity, which defines the purpose of this study. It has been established that when the patient is indicated as the primary recipient in the package insert, the patient's level of awareness and ability to adequately receive information is low, and professional training is necessary to interpret information about the composition and pharmacological properties of the medication, its effects, methods of use, potential side effects, etc. Therefore, based on the results of the study, the author concludes that the text of the medication package insert is primarily intended for specialized recipients. This vector of addressability allows us to point out the pragmatic passivity of the addressee-consumer (patient) in the context of the indispensable professional communicative activity of doctors and pharmacists. The linguistic features (modalities of possibility/obligation, the presence of impulsive/prohibitive constructions) confirm the high degree of normativity and impersonality of the communicative organization of these texts. The study concludes with the author's definition of drug instructions as a specific speech genre. The proposed interpretation of a specific genre contributes to the study of the theory of speech genres and can contribute to the further development of genres in medical and pharmaceutical discourse.

The exploding food supplement trade makes ensuring and monitoring their proper use and risk minimization by individuals increasingly difficult. Even though there is a common legal framework for those activities in the European Union (EU), too little importance has been given to respecting ethics in making them available to patients. Pharmacists involved in activities related to food supplements could play a decisive role in protecting the rights of patients who use them. The purpose of this study was to determine the position of European pharmacists in this field and to propose ethical standards for their activities related to food supplements. We used textual analysis to investigate the pharmacists' codes of ethics in force in the EU Member States. Our findings led us to develop proposals to optimize the ethical standards for pharmacist activities related to food supplements. To position our proposals internationally, we performed a comparative analysis with ethical standards adopted in Australia and the United States (US). Most of the codes of ethics we analysed address some of those activities through explicit and/or implicit provisions. From those provisions, we derived common ethical standards regarding the responsibility of pharmacists for the quality, safety and effectiveness of food supplements dispensed from pharmacies and for honesty and loyalty in promoting and advertising food supplements. As policy recommendations, we proposed optimized ethical standards, including standards for research and development, marketing notification, manufacturing, wholesale distribution, market surveillance, and risk management of food supplements. In the Australian Code of Ethics and US guidelines, we observed similar standards for most of these activities. Establishing ethical standards for all pharmacists' activities related to food supplements would stimulate discussion, reflection, the evolution of their codes of ethics and practices, and professional development. The standards we proposed could serve as a starting point for developing national and international policies, using the motivational power of ethics. The commitment of professional associations of pharmacists, food companies, and competent health authorities to adopt ethical policies in all activities related to food supplements would make an important contribution to respecting patients' rights in using them.

Abstract Chronic diseases represent a substantial healthcare burden in Saudi Arabia, with diabetes affecting approximately 24% and hypertension affecting approximately 26% of the adult population. Clinical pharmacy services have emerged as essential components of comprehensive chronic disease management within Saudi healthcare settings. This narrative review examines the evolving role of clinical pharmacists in managing chronic diseases in Saudi Arabia, synthesizing evidence from peer-reviewed studies published between 2020 and 2025. The review identifies significant contributions of pharmacist-led interventions across diabetes, cardiovascular diseases, and other chronic conditions. Evidence demonstrates that clinical pharmacist interventions achieve meaningful clinical outcomes, including hemoglobin A1c reductions of 1.2 to 1.78 percentage points in diabetes management, time in therapeutic range improvements from 52% to 87% in anticoagulation clinics, and physician acceptance rates of pharmacist recommendations exceeding 90% in most settings. Drug-related problem identification and resolution remain core pharmacist activities, with dosing errors comprising 25%–77% of interventions across healthcare facilities. Despite the substantial progress, challenges persist, including workforce shortages, limited interprofessional collaboration frameworks, and variable professional recognition. Saudi Vision 2030’s Health Sector Transformation Program provides a strategic impetus for expanding clinical pharmacy services, with a projected demand for approximately 12,000 clinical pharmacists by 2030. This review highlights the evidence base supporting clinical pharmacy integration into chronic disease care pathways and identifies priorities for future practice development and research in Saudi Arabia.

Abstract. The article presents a comprehensive study of the formation of terminological competence in future pharmacy specialists in the process of learning the Latin language, which serves as a fundamental basis for mastering the international pharmaceutical terminology system. The key principles, pedagogical approaches, and methodological tools aimed at developing students’ terminological awareness are analyzed, including the integration of practical Latin classes with professionally oriented courses. It is emphasized that the acquisition of pharmaceutical terminology is grounded in a thorough understanding of the phonetic, orthographic, morphological, and syntactic norms of Latin grammar, which ensures the formation of skills necessary to correctly interpret the structure of terms, their word-formation models, and semantic content. The main objectives of the Latin language course in medical higher education institutions are identified, including the development of skills in analyzing and reproducing international pharmaceutical vocabulary, as well as the ability to work with regulatory documentation, international pharmacopoeial standards, and medicinal product instructions. The article highlights that pharmaceutical terminology is an essential component of both the educational process and the professional activity of pharmacists, as the accuracy of terminology directly affects the quality of medical communication, pharmacotherapeutic decision-making, and patient safety. The necessity of unifying specialized pharmaceutical terminology in accordance with the requirements of the European Pharmacopoeia is substantiated, as such harmonization is a prerequisite for aligning national standards with international ones. It is noted that the main challenges in standardizing pharmaceutical terminology are related to polysemy, synonymy, and the influence of the English language on chemical nomenclature, which lacks a case system and is characterized by an analytical mode of word formation. Particular attention is drawn to discrepancies in the spelling of term elements and medicinal product names caused by the absence of unified transliteration rules and standardized approaches to foreign borrowings. To enhance and harmonize the pharmaceutical terminology system, the article proposes developing a universally accepted national standard for the formation, spelling, and practical use of conventional names of medicinal products, which will ensure consistency of the terminological space and improve the effectiveness of professional training for future pharmacists.

Background: Optimal collaboration between pharmacists and other healthcare professionals such as physicians is integral in implementing pharmaceutical care. However, there are concerns regarding the role of pharmacists, especially among low- and middle-income countries. This study explored the perceptions, expectations, and experience of physicians working in various hospital settings of Punjab, Pakistan, about pharmacists and their roles.Methods: A self-administered questionnaire consisting of four sections was administered from April to July 2025. Descriptive and inferential statistics such as Kruskal- Wallis and Mann-Whitney tests were used for data analysis using SPSS.Results: Six hundred and seventy-eight physicians participated in this study with a response rate of 77.9%. Most of the physicians reported minimal to no interaction with pharmacists (n = 521, 76.8%). However, more than three-quarters of physicians (n = 660, 97.3%) accepted pharmacists as evidence-based sources of drug information. In addition, many physicians (n = 574, 84.7%) strongly agreed that pharmacists should attend patient care rounds to respond promptly to questions related to patient medication. A limited number of physicians (n = 124, 18.3%) assumed that pharmacists were advising their patients regarding the judicial use of their drugs. Median expectation and experience score had a significant association with age, experience, and education of physicians (P < 0.05). Conclusions: The perception of physicians was positive toward certain roles of pharmacists, coupled with high expectations. However, their experience was low, with most of the activities of pharmacists due to inadequate interprofessional coordination.

As the healthcare model in the United States transitions to encompass value-based care, it is increasingly important to capture pharmacist impact on medication-related patient outcomes to justify clinical pharmacists' presence within interdisciplinary teams. Therefore, the aims of this project were (1) to apply a previously developed standardized process for identifying and prioritizing outcome measures related to acute care pharmacy practice and (2) to identify pharmacist activities and interventions associated with select outcome measures. Pharmacists, physicians, and advanced practice providers completed a 3-round survey. The survey aimed to create a complete list of outcome measures impacted by acute care pharmacy practice; obtain consensus on whether each listed outcome is impacted by acute care pharmacy practice; and assess measures based on criteria including feasibility, importance, validity, and pharmacist impact using a 5-point Likert scale and free-response items. Survey respondents also provided pharmacist activities and interventions related to each outcome measure. The primary outcome of this study was the ranked list of outcome measures related to acute care pharmacy practice. The secondary outcome included pharmacist activities and interventions related to each outcome measure. The results of this study include a list of 15 prioritized outcome measures and a list of 28 related pharmacist activities and interventions. The outcome measure identification and prioritization process was successfully adapted and applied to acute care pharmacy practice to produce a prioritized list of clinical outcome measures related to acute care pharmacy practice. These results will be used to direct efforts towards capturing and tracking related pharmacist activities.

Evaluation of work activities for pharmacists in community pharmacy settings.

To develop evidence-based ambulatory oncology clinical pharmacy key performance indicators (AOcpKPIs). A systematic, modified Delphi process was used to reach consensus on AOcpKPIs. Following an environmental scan of current oncology pharmacy practices across Canada, a literature review identified critical activities linked to patient-centered outcomes. A panel of oncology pharmacists engaged in three Delphi rounds and a virtual live meeting, assessing and refining candidate AOcpKPIs on the basis of predefined criteria. A total of 17 candidate AOcpKPIs were evaluated. Consensus was achieved on 14 AOcpKPIs. These AOcpKPIs reflect critical pharmacist activities including clinical order review, patient education, medication adherence assessment, and management of drug therapy problems. This suite of AOcpKPIs provides a standardized approach for evaluating oncology pharmacist activities in ambulatory care, facilitating benchmarking and supporting evidence-based improvements in patient outcomes. This study represents a significant advancement in defining quality metrics for ambulatory oncology pharmacy practice. The consensus-based AOcpKPIs provide a foundation for enhanced patient care, professional accountability, and continuous quality improvement within oncology pharmacy. Implementing these AOcpKPIs has the potential to elevate oncology pharmacy practice, supporting pharmacists in meeting evolving health care demands and fostering evidence-based patient outcomes.

Process standardization of encounter labeling to characterize ambulatory care pharmacist activity.

In some emergency departments (EDs), pharmacists review and follow-up on microbiological test results for recently discharged patients, intervening when empiric therapy is missing or inadequate to ensure appropriate antimicrobial use. Currently, this practice is not well described in Canada. Characterizing these ED pharmacist activities can help identify antimicrobial stewardship opportunities and allow for more tailored education and training. The primary objective of this study was to describe culture review and follow-up pharmacy practice in terms of antimicrobial stewardship interventions. Secondary objectives included describing the types of cultures being managed and the antimicrobials prescribed empirically and post-culture review. A retrospective chart review was conducted using pharmacist workload tracking documentation to identify patients with eligible cultures from six EDs in Alberta. Three hundred cultures were included in this study, and one hundred twenty-nine interventions (40.7% of all cultures reviewed) were performed by ED pharmacists. Initiation of therapy was the most common (33.3%), followed by tailoring therapy (21.7%). Urine cultures were predominant (55.7%), and the antibiotics most prescribed, empirically, and post-culture for urine, were cefixime (44%) and trimethoprim-sulfamethoxazole (34%), respectively. Five patients with asymptomatic bacteriuria were treated with antibiotics. Five patients with skin and soft tissue infections were treated with dual oral antibiotics when culture and sensitivity results indicated monotherapy would have been sufficient. Eight extra days of cefixime therapy were prescribed due to unaccounted doses administered in the ED. This study highlights the critical role of ED pharmacists in culture review and follow-up activities and their contributions to antimicrobial stewardship. By characterizing culture review and follow-up practices, several opportunities for minimizing unnecessary antimicrobial use were identified. These findings will help inform the development of targeted education and training programs to help strengthen the stewardship capabilities of ED pharmacists and prescribers.

Abstract BackgroundPeople with end‐stage kidney disease receiving dialysis in any form commonly experience symptoms associated with their reduced renal function and dialysis treatment, often requiring complex medication therapy to manage. Pharmacists are ideally placed as medicines experts to contribute alongside the multidisciplinary team in optimising patient care. However, specialty dialysis clinical pharmacist roles are beginning to emerge, and few studies have been conducted evaluating the impact of clinical pharmacists in dialysis services.AimThis scoping review aimed to identify and evaluate clinical pharmacy services implemented, and outcomes measured, for patients receiving haemodialysis or peritoneal dialysis in the hospital or home setting.DesignThis scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR) guidelines. Studies published in English, with participants aged over 18 years receiving any chronic dialysis and involving clinical pharmacist services were included. Studies were excluded if they included only medication supply services or only included patients receiving continuous renal replacement therapy.ResultsThirty‐five studies, published 1997–2024, detailing 17 unique pharmacist interventions for patients receiving dialysis were identified and measured using 17 different outcomes. In the 25 studies, the most common pharmacist interventions included specialist pharmacist medication review (n = 29), pharmacist inclusion in the multidisciplinary team (n = 22), extended pharmacist consultation (n = 20), and targeted adherence counselling (n = 18). The outcomes measured were categorised into three broad themes: therapy‐effectiveness, patient‐centred, and health‐system measures.ConclusionThe interventions detailed in the included studies highlight an opportunity to extend the scope of pharmacist activities in providing dialysis services in Australia. This expansion would be in line with the ongoing reviews of scope of practice for health professionals and the broader trend of expanding the clinical pharmacist's role. The variability of detail provided in the studies limits transparency and transferability to different dialysis contexts and may impact the achievement of the outcomes described, but further inquiry is warranted.

Translated article] Activities of clinical pharmacists in intensive care units.

The concept of pharmaceutical care transforms the role of pharmacists in the healthcare system, expanding their functions from dispensing medications to counseling and managing pharmacotherapy, especially for chronic diseases. Research shows that integrating pharmacists into multidisciplinary teams improves treatment outcomes for chronic diseases. However, in Ukraine, the practical activities of pharmacists often do not meet the requirements for full implementation of the pharmaceutical care concept. It is necessary to implement not only basic but also specialized pharmaceutical services focused on prevention and medication therapy management. The aim of the work is to analyze the regulatory framework for the provision of pharmaceutical care and pharmaceutical services and approaches to their standardization for further optimization of such services in Ukraine. The research materials included regulatory acts of Ukraine and the EU, documents of pharmaceutical associations, and scientific publications. A systematic approach, content analysis, comparative analysis, and structural-logical method were applied. Definitions of pharmaceutical care and services in various documents were analyzed. The analysis showed that the key EU document is Resolution CM/Res(2020)3, which contains recommendations for implementing pharmaceutical care. In Ukraine, the concepts of pharmaceutical care and services were introduced into the legal field by the new edition of the Law «On Medicines». The main components of care provision were identified: professional interaction, assessment and planning, implementation and optimization, monitoring and evaluation, prevention and education, quality assurance. A hierarchical structure of types of regulatory acts governing standardization was developed. It was established that Ukrainian legislation, having introduced the concepts of pharmaceutical care and services for the first time, corresponds in content to European definitions. The research results emphasize the importance of a comprehensive approach to standardizing pharmaceutical care and services, which considers international experience and national features of the healthcare system. For effective implementation of the pharmaceutical care concept, it is necessary to develop regulatory acts at all levels, including national guidelines, standards, protocols, and standard operating procedures. Particular attention should be paid to developing documents on medication therapy management as a key element of pharmaceutical care, ensuring an individualized approach to treating patients with chronic diseases. Implementation of the proposed hierarchical structure of regulatory documents will allow systematizing the process of providing pharmaceutical care and services, improving their quality and effectiveness. This, in turn, will contribute to optimizing pharmacotherapy, reducing risks associated with medication use, and improving overall public health.

Patient centred clinical pharmacy activities have demonstrated improvements in patient outcomes. There are limited published data on workflow practices of pharmacists to assist with clinical pharmacy service delivery improvement. To determine the amount of time clinical pharmacists spend each day performing their work tasks, interventions and interruptions. To determine the proportion of time performing clinical tasks and tasks face-to-face with patients. Trained pharmacy students observed clinical pharmacists and recorded clinical activities using the timer app Clockify™ on a smart device (phone or tablet) at four hospitals over 9days between 29th July and 8th August 2024. Pharmacy students recorded the number and types of patients seen, interventions and interruption patterns. A total of 678.3h of pharmacist activity were recorded. The mean time spent per day per patient type was 25.9min (discharge patient), 23.5min (new patient) and 10.3min (review patient). Pharmacists spent the largest proportion of time (21.9%) on discharge patients followed by review patients (21.6%). Over 80% of pharmacist time was spent performing clinical activities, of which almost 12% was spent face-to-face with patients. Pharmacists were interrupted 34 times per day and performed 67 interventions per 100 patients. Pharmacists spend over 80% of their work time performing clinical activities for patients, of which almost 12% is spent face-to-face with patients. The largest proportion of time is spent with discharge patients followed by review patients.

Pharmaceutical care as a concept was introduced in Montenegro during the last 10 years. The Pharmaceutical Chamber of Montenegro (PCM) and the Institute for Medicines and Medical Devices (CInMED) conducted SMART Pharmacist Program educational activities for pharmacists as a project to improve their impact on monitoring drug safety. In the period from September 2023 to May 2024, a total of 78 pharmacists participated in the project, of which 53 (68%) submitted valid reports of suspected adverse drug reactions (ADRs). During the project, a total of 302 valid reports were submitted, and the pharmacists’ share in total reporting increased to 74% in 2023 compared to less than 10% in the previous 5 years. The results of this research will be used to make recommendations for further improvement of the pharmacovigilance system, as well as to create plans for continuing education (CE) of other health workers in the area of rational and safe use of medicines.