Community Pharmacies Research Articles

Reconstructing pharmaceutical service competency framework: development of AI-informed competency indicators and localized practices in China

This study introduces an innovative method for reconstructing pharmaceutical service competency frameworks. The approach integrates artificial intelligence technologies with localization practices specific to the Chinese context. Employing a mixed-methods sequential exploratory design, we analyzed six major international competency frameworks using natural language processing and machine learning techniques to extract 4,782 unique competency statements, which were subsequently classified with 91.4% accuracy into relevant domains. The resulting preliminary integrated framework—comprising 5 domains, 24 competencies, and 103 behavioral indicators—underwent localization through a modified Delphi process involving 32 pharmaceutical stakeholders and verification via a national survey of 456 pharmacists across 18 Chinese provinces. Implementation across diverse healthcare settings resulted in significant improvements in service quality metrics, including a 23.7% reduction in medication errors (p<0.01) and an 18.6% increase in patient satisfaction. Cross-setting analysis revealed variable adaptability, with implementation feasibility scores ranging from 4.7/5 in tertiary hospitals to 3.2/5 in rural community pharmacies. Four critical success factors for effective framework adoption were identified: institutional leadership engagement, integration with existing quality systems, phased implementation, and dedicated training resources. The framework's distinctive features include competencies addressing the integration of traditional Chinese medicine with modern pharmacy practice and a modular structure enabling context-specific adaptation while maintaining core standards. This research contributes to bridging the gap between global standards and local realities in pharmaceutical competency development, demonstrating the potential of AI-informed approaches to enhance framework relevance, efficiency, and effectiveness across diverse healthcare contexts.

How can community pharmacy teams prevent prescription and over-the-counter opioid misuse in North East England? A qualitative study using the Capability, Opportunity and Motivation Behaviour (COM-B) model.

This study aims to identify factors that influence the role of community pharmacy teams in preventing prescription and over-the-counter (OTC) opioid misuse. Qualitative design using interviews; thematic analysis was used to generate themes mapped to the Capability, Opportunity and Motivation Behaviour (COM-B) model. Community pharmacies in North East England. 28 community pharmacy staff including 16 pharmacists, 1 pharmacy assistant, 10 dispensers and 1 pharmacy technician. Factors related to the capability component include communication skills, ability to identify service users who misuse OTC opioids, and education and training. Factors in the opportunity component include staff and funding, tools for identification and referral of service users at risk of opioid misuse, and relationship with other healthcare professionals. For the motivation component, attitude towards role, attitude of pharmacist or pharmacy manager, perception about commissioners and commissioned services, and attitude towards service users were identified. This study identified factors that could influence community pharmacists' roles in opioid misuse. A critical factor influencing community pharmacy teams preventing opioid misuse is access to a single system to record the use of both OTC and prescription opioids. This would enable teams to identify service users misusing or at risk of misusing opioids, while supporting staff education and training and regulatory compliance. Future research should focus on developing interventions using these identified factors to enhance community pharmacists' roles in opioid misuse prevention.

What do people really think about the RSV vaccine? Study of unsolicited text replies from adults over 60

A digital health intervention (DHI) using SMS precision nudging to drive RSV vaccine uptake among adults over 60 was launched with a large community pharmacy chain in 2023, two months after the vaccine’s FDA approval for adult administration in the United States. Tens of thousands of patients texted back. In this exploratory investigation, we employed thematic analysis and structural topic modelling to extract topics (e.g., Kind declines, Moral disgust, etc.), sentiment (negative to positive), and function (emotional to practical) expressed in the text replies in order to understand patient attitudes and behavioural determinants of RSV vaccination. The analyses reveal 10 topics from the thematic analysis and 30 more granular topics from the structural topic modelling. Expressed attitudes shifted over the course of the DHI, with less negativity later in the intervention. People who did not receive the flu vaccine and people with commercial insurance responded more frequently that they would not get vaccinated. Specific behaviour change techniques (BCTs) were associated with overall replies and specific topics. Framing intervention messages with information about emotional consequences elicited the highest proportion of replies; framing with anticipated regret elicited the lowest proportion. We extend previous work by leveraging unsolicited replies to analyse public attitudes toward a new vaccine, with implications for future RSV and other vaccine interventions at pharmacies and elsewhere.

Engaging community pharmacy in tuberculosis case detection (ENHANCE): a study protocol for an implementation study in Indonesia

IntroductionA significant number of possible tuberculosis (TB) missing cases are still reported globally. Pharmacies are reported as a significant first point of contact for people with TB. Unfortunately, the practice of TB detection in pharmacies is still lacking. Therefore, this study aims to implement and evaluate a community pharmacy program for TB case finding in a systematic and structural approach.MethodsAn implementation study will be piloted in Bandung City, Indonesia, from February to November 2025. The program will engage pharmacy personnel in screening, educating, and referring people with presumed TB to community health centers (CHCs) for further diagnostic work-up. This study will involve selecting 20 pharmacies and 4 CHCs. Sequential research activities will be performed, incorporating quantitative and qualitative approaches, i.e., (1) building a coalition, (2) developing a conceptual program, (3) program socialization and educational intervention, and (4) program implementation and evaluation. The program outcomes will be reached according to the sequential research activities: (1) a joint agreement among the key actors and implementers, (2) a conceptual program for implementation, (3) improved capacity of implementers and availability of practice aids and system for the implementation, (4) the effectiveness of the program implementation. The Consolidated Framework for Implementation Research will be used as a framework in this study. Descriptive and multivariable analyses will be used for quantitative data, while thematic analysis will be used for qualitative data. Finally, an implementation outcome will be comprehensively analyzed, considering the quantitative and qualitative data analyses for the key factors of the successful program.

Impact of generic antiretroviral drugs introduction on pharmaceutical expenditure patterns in the Netherlands: a six-year retrospective database analysis from 2016 to 2022

BackgroundIn the Netherlands, the annual expenditure on HIV care was reported as €202 million in 2019, with about 70% allocated to antiretroviral therapy (ART). The introduction of generic antiretroviral medications (ARVs) in 2017 has offered potential cost-saving opportunities in healthcare. Understanding the financial implications of incorporating generic ART into the Dutch healthcare system is crucial to determine its impact.MethodsWe used data from the Foundation for Pharmaceutical Statistics (SFK), covering 98% of all community and outpatient clinic pharmacies across the Netherlands. This dataset contained medication information from 2016 to 2022. Medication data were classified using the Anatomical Therapeutic Chemical Classification with Defined Daily Dose (ATC/DDD) system. Cost analysis was based on Dutch drug prices (www.medicijnkosten.nl) for a specified period, and the data were processed using IBM SPSS.ResultsIn the Netherlands, people with HIV receiving ART increased from 20,072 to 24,573 between 2016 and 2022. HIV medication expenditure was €190 million euros in 2016, with generic medication at 6% DDDs. After an increase in 2017, a subsequent decrease in total HIV medication expenditure led to an overall cost of €181 million in 2022 (-5.1% compared to 2016). Simultaneously, the proportion of DDDs dispensed as a generic increased to 16–32% over the years. This could be linked to 97% compliance with generic substitutions for ARVs where a generic equivalent was available. Notably, the cost per patient per year has declined from €9,488 in 2016 to €7,352 in 2022 (-22.5% compared to 2016). Some of the potential cost-savings through generic substitution were not utilized because of the 20% point increase in the use of novel branded single-tablet regimens (STRs).ConclusionsOur analysis showed high compliance with generic substitution of ARVs in the Netherlands. The increased use of generic ARVs was accompanied by an almost 10% reduction in overall expenditure on ART despite a significant increase in the number of patients in care in the Netherlands during this period. A significant contributing factor to ART costs appears to be the high percentage of prescribed patented Single-Tablet Regimens (STRs). These findings underscore the complex dynamics of pharmaceutical expenditures in the Dutch healthcare system.

Identifying pharmacy gaps: a spatiotemporal study of multimodal accessibility throughout the day

BackgroundAccessibility to community pharmacies is crucial for ensuring timely access to medications and essential health services. While accessibility to community pharmacies is critical, disparities driven by temporal and spatial factors persist, resulting in inequities in healthcare access. This study aims to comprehensively assess spatiotemporal and multimodal accessibility to community pharmacies in Lisbon, highlighting the influence of transport modes and time of day on accessibility disparities.Data and methodsThe study employed a methodology that considered five daily time slots and two modes of transport—walking and public transport—to evaluate accessibility to community pharmacies. Data was sourced from road and pedestrian networks, Google API, and GTFS data. Descriptive statistics and spatial analysis were utilized to assess travel time and accessibility disparities across different regions of Lisbon. The analysis focused on both the percentage of residents able to access pharmacies within 10 min and the total number of pharmacies accessible.Resultsndings reveal significant temporal variations in accessibility, with public transport consistently improving access compared to walking. Accessibility peaks in the evening (6–7 PM), when 83.3% of residential buildings are within a 10-min walking distance of a pharmacy, and 92.7% are reachable by public transport. In contrast, early morning hours (4–5 AM) show the lowest accessibility, with only 8.9% of buildings accessible by walking and 16.1% by public transport. During the daytime (8–9 AM), notable disparities emerge across the city: public transport enhances access in the southwest, northwest, and central areas, while limited pharmacy opening hours constrain accessibility in the north and southeast, where only 108 of 258 pharmacies are operational. Finally, travel time to pharmacy services for city residents highlight significant spatial and temporal disparities in pharmacy accessibility, emphasizing the role of transport modes and service hours in shaping urban healthcare access.ConclusionsThis study underscores the importance of addressing both temporal and spatial factors to ensure equitable accessibility to community pharmacies. The findings suggest the need for targeted policies to improve public transport services during off-peak hours and to extend pharmacy operating hours. Future research should focus on comparative studies across different urban contexts and incorporate more granular data to better understand accessibility to urban services.

Challenges and opportunities in community pharmacists’ identification and management of dry eye disease: a qualitative study

Abstract Objective To explore Malaysian community pharmacists’ (CP) challenges in identifying and managing dry eye disease (DED) and opportunities to optimize DED care, as previous studies reported inconsistencies in DED identification by community pharmacy staff, and few publications describe Malaysian CP views on DED management in community pharmacy settings. Method Using the Social Ecological Theory for Community Health Promotion, individual in-depth interviews were conducted (May–June 2023) with 20 CP in Malaysia’s Klang Valley. Participants with diverse DED management experiences were recruited using purposive and snowball sampling until data saturation. Interviews were audio-recorded, transcribed, independently coded by two researchers, and thematically analysed. Key findings CP faced 12 challenges in identifying and managing DED: patient-related (brand rigidity, ‘quick fix’ attitude, inadequate health literacy, and self-efficacy skills), provider-related (imprecise assessment, referral difficulties, knowledge gaps), therapeutics-related (short shelf life, affordability), and pharmacy-related (limited manpower, inadequate private consultation space, low eye health visibility). The 12 opportunities for optimizing DED care were community-related (eye health education, holistic approaches, public awareness), profession-related (decision-support mobile health applications integrated with evidence-based DED management protocols to streamline consultation processes, interdisciplinary collaborations), industry-related (pharmaceutical and medical device advancements, comparative data on medication value, promotion of proactive management), and organization-related (management-mandated resource allocation, ancillary staff education, and expanded products and services). Conclusion Malaysian CP encountered challenges in identifying and managing DED. Knowledge sharing and collaborations with ophthalmologists improve DED management by CP, while clinicians can stay updated on medication-related recommendations and treatment adherence. The role of digital health in these processes requires further study.

Community Pharmacy Staff Referral of Patients with Diarrhea to Medical Consultation: A Simulated Patient Study.

The objectives were (i) to assess the ability of community pharmacy staff in Jordan to identify diarrhea symptoms suggestive of bacterial gastroenteritis and advise patients to see a physician and (ii) to identify the factors influencing the referral decisions. The study used the simulated patient (SP) approach. Four SPs conveyed a symptom-based scenario of bacterial gastroenteritis. Each visit was assessed for three outcomes: appropriateness of the visit outcome (i.e. referral decision), pharmacist's information gathering behavior, and pharmacist's professional behavior. Factors influencing the referral behavior, information content, and professional behavior were also investigated. Sixty-one visits were conducted. For 52 (85%) visits, the SP was referred to a physician. This was spontaneous in 35 visits (57%) and prompted by the SP in 17 visits (28%). For 24 (39%) visits, the pharmacy staff unnecessarily dispensed an antibiotic. Younger pharmacy staff, those located in Amman, and those working during afternoon shifts were more likely to refer patients (all P-value < .05). A significant correlation was found between the referral score and the information gathering behavior (P = .014). The failure to identify the need to refer SPs with symptoms suggestive of a serious illness may result in treatment delays and compromised patient safety. The dispensing of unnecessary antibiotics can increase antimicrobial resistance. Further actions are required to optimize patient management in community pharmacy settings.

The role of community pharmacies in reducing digital exclusion among older adults through e-prescribing

Digital exclusion, especially among those aged over 65 years, poses significant challenges to healthcare delivery, including e-prescribing. This pilot study investigates the feasibility of community pharmacy staff in supporting digitally excluded over-65s with their prescriptions through the NHS App. The intervention was an incentivised two-stage conversation (establishing digital capability and digitally upskilling patients) by community pharmacy staff in the six boroughs of south-west London. A rapid evaluation approach based on a Donabedian evaluation framework was used to assess impact. Of 76 pharmacies trained, 61 actively participated. Between January and April 2024, 10698 interventions established digital capability and 1173 patients were digitally upskilled. Challenges included NHS App approval time, patients’ lack of confidence in technology and mistrust in data privacy. Through e-prescribing, community pharmacies can play a crucial role in promoting digital inclusion and health literacy among older adults.

Billing Deprescribing Interventions: Portrait of an Initiative in Québec, Canada

ABSTRACTBackgroundDeprescribing is a patient‐centred process in which a healthcare professional reduces or stops medications to improve health outcomes. Since late 2022, community pharmacists in Québec, Canada, have been able to bill for deprescribing interventions, enabling more robust deprescribing research in large cohort studies.ObjectiveThis study aimed to assess the prevalence of deprescribing claims in Québec community pharmacies from January 1, 2023, to November 30, 2024, and to identify the most commonly deprescribed medication classes.MethodsWe analysed the total number of deprescribing claims submitted by pharmacists during this period and categorized deprescribed medications using the American Hospital Formulary Service classification.FindingsOver 90 000 claims were submitted for deprescribing interventions, with most involving central nervous system medications. Although the number of claims increased over time, the overall volume remained modest.ConclusionWhile limitations remain, such as the gradual adoption of billing interventions, Québec's reimbursement model for deprescribing interventions provides an important framework for research, offering a mechanism to study deprescribing in real‐world settings.

Implications of pharmacy student involvement in collecting the best possible medication histories in hospital settings: A scoping review.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. To assess the current extent of pharmacy students' involvement in collecting best possible medication histories (BPMHs) in different hospital settings, as well as the accuracy and financial implications of the collected BPMHs. A scoping review methodology was conducted following best-practice Cochrane guidance with findings reported using the PRISMA Extension for Scoping Reviews. An appropriate search string was developed followed by a search across databases: PubMed, PubPharm, LIVIVO, PubMed Central, and Web of Science. All selected studies were published between 2000 and 2023 and met the predetermined inclusion criteria. After removing duplicates and independent screening of titles, abstracts, and full texts, 20 papers were retained. The highest number of original research papers originated from the US (n = 13, 72%). In these papers, the number of patients whose medication histories were collected ranged from 40 to 4,070 (mean, 504.6) and the number of pharmacy students who collected BPMHs ranged from 2 to 71 (mean, 17.8). Students obtained BPMHs alone or in a team with healthcare professionals (HCPs). Several papers described additional training for students. The information sources used were face-to-face patient interviews, data from community pharmacies, and interviews with HCPs and caregivers. Studies demonstrated that students can accurately collect BPMHs, identify unintentional discrepancies, and suggest healthcare interventions. Two studies identified notable cost savings from clinical interventions by pharmacy students. Pharmacy students can accurately collect BPMHs. The results of this scoping review can inform the development of pharmacy curricula to enhance students' competencies and student pharmacy services that can contribute to patients' safety.

Technology-enabled community pharmacies: qualitative evaluation of a framework for assessing technology solutions.

Optimal provision of pharmacists' professional services requires integrated digital health platforms and ideally an evaluation framework to guide implementation and adoption. The Technology Evaluation Key (TEK) framework, which combines three published models describing technology usage behaviour, had not been applied to identify technological needs for community pharmacists to enable practice. This research aimed to describe pharmacists' needs relating to information communication technology (ICT) platforms and apply the findings to refine the TEK framework. This study was conducted in Australia between June and July 2022 (approval number HRE2022-0249). A systematic scoping review, face and content validation, and field testing guided the development of the interview tool. Semi-structured online interviews were conducted with participants until data saturation, where no new themes emerged. Following Braun and Clarke's six-step reflexive thematic analysis, a deductive-to-inductive approach was utilised to identify themes, which were applied to the TEK framework to refine domains. Coding was conducted by [A.O.] and confirmed by consensus with the other authors. Twenty-four pharmacists were interviewed. Thematic analysis identified technological needs that included greater system integration, interoperability, and increased user access to nationally commissioned ICT systems. The TEK framework was refined from nine to eight domains accordingly (healthcare system, organisation, practitioner, ICT, user experience, logistics and operations, system integrity, and clinical impact). This study highlighted areas for improvement in implementing ICT platforms to meet the needs of community pharmacists as users of these technologies. The refined TEK framework can guide ICT development, implementation, and evaluation.

The Positive Pharmacy Care Law revisited: an area-level analysis of the relationship between community pharmacy distribution, urbanicity and deprivation in England.

(1) Determine geographical access to community pharmacy in England, (2) explore the relationship between community pharmacy access and urbanity and multiple deprivation and (3) understand any changes in access over time. An area-level spatial analysis study exploring the relationship between spatial access to and availability of community pharmacies over the past 10 years from 2014 to 2023, deprivation and urbanicity, using Geographic Information System and descriptive statistics on a Middle layer Super Output Area level. Availability per 10 000 people of a community pharmacy in their local area. For geographical access, in 2014, 91.3% of people lived within a 20-minute walk to a community pharmacy and, in 2023, this number increased to 91.7%. There was a positive relationship between geographical community pharmacy access and urbanity and geographical community pharmacy access and deprivation. For availability, the median number of community pharmacies per 10 000 people in 2014 was 1.60, while in 2023, the number reduced to 1.51 community pharmacies per 10 000 people. The most deprived areas were more likely to lose a pharmacy, compared with the least deprived areas (OR 1.65 (1.38, 1.98)). There is high access to community pharmacies in England with access to a community pharmacy greatest in the most deprived areas, showing that the 'positive pharmacy care law' remains. However, the 'positive pharmacy care law' is eroding as the availability of community pharmacies has reduced over time-particularly in deprived areas, with more people reliant on each community pharmacy.

Promoting outpatient medication safety in Finland: A mid-term review of a national medication safety programme for community pharmacies (2021-2026).

Promoting outpatient medication safety in Finland: A mid-term review of a national medication safety programme for community pharmacies (2021-2026).

Capabilities, opportunities and motivations within Australian community pharmacy to deliver clinical care standard-aligned care for knee osteoarthritis: A mixed-methods evaluation.

Capabilities, opportunities and motivations within Australian community pharmacy to deliver clinical care standard-aligned care for knee osteoarthritis: A mixed-methods evaluation.

A narrative literature review: Community pharmacy technician well-being and its implications.

A narrative literature review: Community pharmacy technician well-being and its implications.

Unravelling facilitation complexity in community pharmacy: A pragmatic tool for implementation strategy selection.

Unravelling facilitation complexity in community pharmacy: A pragmatic tool for implementation strategy selection.

Scoping review of entrepreneurship in community pharmacy: Bringing together education and practice.

Scoping review of entrepreneurship in community pharmacy: Bringing together education and practice.

The outcomes of pharmacist-led pharmaceutical care within community pharmacies: An overview of systematic reviews.

The outcomes of pharmacist-led pharmaceutical care within community pharmacies: An overview of systematic reviews.

Facilitation influence on community pharmacy practice transformation in the Flip the Pharmacy program.

Facilitation influence on community pharmacy practice transformation in the Flip the Pharmacy program.