Community pharmacists' perceptions of their work-related quality-of-life: Implications for pharmacists' well-being, compassionate patient care, and relationships.

This service development and evaluation explored the Reliever Reliance Test's application in community pharmacies. It examined specifically: usability, perceived benefits, and potential areas for additional consideration, in adult asthma care. Using a four-stage programme, a support pathway was designed, then delivered, and evaluated in community pharmacies between November 2022 and March 2023. Pharmacists and patients reported that the pathway was useable and helpful for improving patient understanding of their treatment. Limitations to use included remuneration, patient engagement, and language issues. The pathway could be used routinely by community pharmacies to support patients, but some aspects require further consideration.

Providing patients with a delayed prescription for antibiotics to treat acute otitis media (AOM) or pharyngitis may result in decreased antibiotic use. To characterize antibiotic prescribing for patients discharged from a pediatric emergency department (PED) with AOM or pharyngitis and to determine the percentage of delayed antibiotic prescriptions dispensed prematurely by a community pharmacy. This study was completed by linking provincial administrative data on prescriptions dispensed from community pharmacies and a retrospective chart review at a single PED. The study included any pediatric patient who was seen in the PED between March 2019 and February 2021, given a diagnosis of AOM or pharyngitis, and discharged with a prescription for an antibiotic. Patient data were collected from scanned medical records. The chart review was linked to records for dispensed antibiotics in the provincial drug information system. Results were summarized and reported descriptively. A total of 1569 (53.3%) of the 2945 patients seen in the PED with the diagnoses of interest received a prescription for an antibiotic. Delayed prescriptions were given in 21.2% (332/1569) of these encounters. An antibiotic was dispensed within 7 days of the PED visit for fewer than half of the patients (40.4%, 134/332) who received a delayed prescription. About a third of caregivers filled delayed prescriptions within 48 hours (30.1%, 100/332), and 16.9% (43/254) did so earlier than advised. Caregivers who were given a discharge prescription for a delayed antibiotic generally adhered to guidance provided by prescribers and waited to fill the prescription. This strategy may reduce overuse of antibiotics.

Background The high cost of asthma management in low- and middle-income nations contributes to poor disease control. This study evaluated the prices, availability, and affordability of selected asthma medicines in Enugu State, Nigeria. Methods This cross-sectional survey (February 2024 – March 2024) was conducted in community pharmacies in Enugu State, Nigeria using the Medicine Price Data Collection Form. Data were obtained for Originator Brands (OB) and Lowest-Priced Generics (LPG) of 23 asthma medicines. Median Price Ratios (MPR) was calculated using South Africa’s International Reference Unit Prices (IRP). Results Ninety survey forms were completed. MPRs were calculated for 10 medicines; six exceeded one. The OB of salbutamol 100 mcg inhaler was 5.2 times the reference price. Average availability across OBs (3.1%), LPGs (13.3%), and all medicines (8.2%) was below the 80% benchmark. All OBs and most LPGs (78.6%) cost more than a day’s wage. Managing asthma with salbutamol inhaler required 7.5 days’ wages for OB and 4.0 days for LPG. Salmeterol/fluticasone (50/250 mcg) Diskus ® required 42.0 days’ wages. Conclusion Asthma medicines in Enugu State were costly, scarce, and unaffordable. Expanding health insurance, providing subsidies, and promoting local production are essential to improve access and control outcomes.

Background : Unintended pregnancy remains a major public health problem worldwide, and access to effective emergency contraception is essential for reducing unsafe abortion and maternal morbidity. Although the World Health Organization recommends emergency contraceptive pills (ECPs) for over-the-counter availability, evidence on women’s knowledge, attitudes, and use of ECPs in Kosovo is limited. Objective : To assess knowledge, attitudes, and practices regarding emergency contraceptive pill use among women in Kosovo and to analyze the influence of sociodemographic and social factors on access and utilization. Methods : A descriptive cross-sectional study was conducted in Kosovo from June to August 2025. A self-administered questionnaire was distributed online and in community pharmacies to women of reproductive age who had previously used emergency contraceptive pills. The survey collected data on demographics, usage patterns, sources of information, side effects, and attitudes toward ECP use. Participation was voluntary and anonymous. Results : Most participants were aged 18–30, highly educated, and living in urban areas. The majority used ECPs no more than once per month, and 77% obtained the pill without a prescription. No significant association was found between non-prescription access and frequent use ( p = 0.9181). Knowledge scores were significantly higher among women who received information from pharmacists (M = 6.02) and doctors or clinics (M = 5.86) than among those who relied on the Internet or Google (M = 3.33) or social media (M = 2.83) ( F = 90.91, p < 0.001). Rural residence was associated with higher odds of shame-related avoidance when requesting ECPs (OR = 2.60, 95% CI: 1.39–4.89) and with a stronger influence of cultural and family norms on ECP use (OR = 4.57, 95% CI: 2.20–9.49). Commonly reported side effects included menstrual irregularities, abdominal pain, headache, and nausea. Conclusion : Emergency contraceptive pills in Kosovo are generally used responsibly, even when accessed without a prescription. However, major knowledge gaps and social stigma persist, particularly among women in rural areas and those relying on unverified online sources for information. Strengthening professional counseling in pharmacies and clinics, establishing national OTC guidelines, and expanding sexual education programs are essential to improve the safe and informed use of emergency contraception.

Extended pharmacy services (EPS) encompass comprehensive healthcare interventions beyond traditional medication dispensing, representing a paradigmatic shift toward patient-centered pharmaceutical care. While well-established internationally, EPS implementation remains limited in Pakistan due to regulatory gaps and insufficient public awareness. This study evaluated current EPS provision in Pakistani community pharmacies and identified key implementation barriers. A cross-sectional mixed-methods survey was conducted between July toOctober 2024 in Karachi, Pakistan. Data collection utilized online and in-person questionnaires comprising 12 structured items addressing EPS knowledge, perceptions, and demographic characteristics among 220 community pharmacy professionals. The Questionnaire's reliability was validated using Cronbach's alpha coefficient (α = 0.705). Among 220 respondents (127 pharmacists, 93 pharmacy technicians), Medication Therapy Management emerged as the most frequently offered extended service (45.5%). Primary implementation barriers included workload and time constraints (56.4%), insufficient staffing (44.1%), and medication shortages (47.3%). While 43.6% demonstrated EPS familiarity, 49.5% reported no specialized training. Most respondents perceived EPS as valuable healthcare additions (65.5%) and anticipated significant future expansion (58%). Study findings reveal Pakistan's community pharmacy practice remains predominantly dispensing-focused despite growing recognition of expanded pharmacist roles nationwide. Barriers reflect significant systemic challenges requiring coordinated multisectoral interventions across regulatory, educational, and infrastructure domains to enable sustainable EPS implementation. Extended pharmacy services present significant opportunities for Pakistani healthcare advancement but require comprehensive paradigmatic shifts through legal frameworks, enhanced professional training, and increased stakeholder awareness to successfully transform community pharmacists into fully recognized clinical healthcare providers nationwide.

Objectives: To assess public knowledge, attitudes, and disposal practices for unused/expired medicines and to identify preferred channels for improving community awareness. Methods: A community-based, cross-sectional survey was conducted using a pre-tested, structured questionnaire (18 items). The minimum sample size was estimated using a single-proportion approach with relative precision (α=0.05; p=0.774; ε=0.05), yielding n=449; ultimately, 472 respondents completed the survey. Descriptive statistics were reported as frequencies and percentages. Results: Most respondents believed expired medicines become toxic (64.6%) and routinely checked expiry dates before purchase or use (94.3%). Despite this awareness, only 2.3% reported following a recommended disposal method, whereas 94.5% did not. Disposal in household trash was the most common practice (60.6%), whereas 2.1% reported flushing medicines in a toilet or sink. Although 95.8% reported storing expired medicines separately, 68.9% did not remove personal information from packaging before disposal. Responsibility for safe disposal was perceived as shared between government and healthcare personnel (83.5%). Awareness of formal take-back programs was limited (37.7%), yet willingness to participate was high (77.0%). Internet-based platforms were the most preferred route for education (79.9%), followed by electronic media (58.1%) and pharmacists (48.1%). Conclusion: The community demonstrates good awareness of expiry-related risks but exhibits major gaps in safe disposal behaviors and program awareness. The high willingness to join take-back initiatives indicates the feasibility of community–pharmacy–government partnerships. Targeted risk communication, clear disposal guidance at dispensing points, and accessible take-back options are urgently needed to mitigate this public health and environmental issue.

Is there a principal-agent problem between large retail-chain pharmacy corporations and community pharmacists?

Introduction: In 2023, 339,000 Minnesota residents (3.8% of the state’s population) lacked healthcare insurance. In that same year, approximately 32% of 1,400 Minnesota residents surveyed who earned less than US$50,000 indicated that they did not get a prescription filled, split tablets, or skipped doses due to the cost of their medications. RoundtableRx, Minnesota’s medication repository program regulated by the Minnesota Board of Pharmacy, receives unopened, in-date, no-longer-needed medications donated by healthcare facilities and individuals. These medications are distributed to local RoundtableRx partner repositories (pharmacies or clinics), repackaged and dispensed at low cost/no cost to patients unable to afford the medication. As of the time of this report, of RoundtableRx’s 42 local repositories, 15 are located in Minnesota’s 49 rural counties. RoundtableRx desired to expand its services to additional rural counties, particularly areas of the state defined as Pharmacy Deserts, located 10 or more driving miles (16 kilometers) from the nearest pharmacy. Most local repositories are recruited through in-person visits by RoundtableRx leaders. To efficiently plan visits to potential repository partners in Minnesota’s most socially vulnerable rural areas, interactive Geographic Information System (GIS) mapping was employed to identify existing rural RoundtableRx partner repositories, rural pharmacies not currently participating with RoundtableRx, rural pharmacy deserts, and clinics within those rural pharmacy deserts. Methods: RoundtableRx partnered with University of Minnesota’s (UMN) U-Spatial, two UMN first-year (PGY1) pharmacy residents and the UMN College of Pharmacy to generate a map of pharmacy deserts in socially vulnerable Minnesota rural counties. Community and hospital pharmacies located in rural Minnesota were identified through a list from the Minnesota Board of Pharmacy. Pharmacy deserts were defined as rural areas either 10 miles (16 kilometers) by road or 30 minutes driving time from the nearest pharmacy. Outlets of national chain pharmacies were included in identifying pharmacy deserts; however, these pharmacies were not considered as potential partners due to lack of corporate responsiveness to earlier RoundtableRx overtures to recruit repository sites in either rural or urban communities. Clinics located within rural pharmacy deserts were identified through an internet search for primary care clinics in Minnesota. The University of Wisconsin’s Area Deprivation Index (ADI) was used to determine an area’s level of social vulnerability instead of the USA Centers for Disease Control and Prevention’s (CDC) Social Vulnerability Index (SVI). The ADI more explicitly addresses measures of socioeconomic status than does the SVI. Staff from U-spatial incorporated each of the above data sets as individual layers in a web-based interactive GIS map that the team used to interrogate the data. Findings: The resulting GIS map was used by RoundtableRx leaders to efficiently plan driving trips to rural pharmacies or clinics that might be recruited as RoundtableRx local repositories in Minnesota’s most socially vulnerable counties. Conclusions: GIS mapping enabled Minnesota’s prescription drug repository program to efficiently plan in-person visits to potential RoundtableRx local repositories in socially-vulnerable rural communities. The map also suggests that a mail-order pharmacy option would further increase prescription drug access for patients living in rural Minnesota’s medically-underserved pharmacy deserts.

The Measure of Job Satisfaction (MJS) has been recognized as a questionnaire having good psychometric quality and adequate content validity for evaluating job satisfaction in healthcare settings. This study aimed to validate the Danish translation of the MJS for pharmacy staff. The MJS was translated into Danish and adapted for pharmacy staff applying the Principles of Good Practice for the Translation and Cultural Adaptation of Outcome Measures. Links to the Danish MJS, alongside demographic and profession-related questions, were distributed to Danish community and hospital pharmacies' institutional emails and selected Facebook groups. The structural validity was assessed through confirmatory factor analysis (CFA). Internal consistency reliability was evaluated by calculating Cronbach's alpha. Responses from 500 respondents with complete entries were analyzed. Most respondents worked in a community pharmacy (81.4%), were pharmacy technicians (53.0%), were female (88.6%), and were between 25 and 44years old (59.8%). CFA revealed an acceptable seven-factor construct [Goodness of Fit (GFI) = 0.766, Adjusted Goodness of Fit (AGFI) = 0.736, Normed Fit Index (NFI) = 0.805, Tucker Lewis Index (TLI) = 0.838, Comparative Fit Index (CFI) = 0.982, Root Mean Square Error of Approximation (RMSEA) = 0.073, Root Mean Square Residual (RMR) = 0.087]. Standardized regression weight values for items loading onto their respective factors ranged from 0.441 to 0.860. Correlations between the factors ranged from 0.360 to 0.810. The internal consistency reliability, Cronbach's alpha for the entire scale was 0.962, and for the subscales it ranged from 0.764 to 0.935. The Danish MJS exhibited an acceptable seven-factor structure with high internal consistency. It can serve as a tool for assessing job satisfaction among pharmacy staff in Denmark, facilitating international comparisons of job satisfaction among pharmacy and other healthcare staff.

Antimicrobial resistance (AMR) disproportionately affects low- and middle-income countries (LMICs), where community pharmacies frequently serve as the first point of care for common infections. Inappropriate antibiotic dispensing, limited stewardship integration, regulatory weaknesses and gaps in pharmacy education contribute to suboptimal antibiotic use. To highlight why and how antibiotic pharmacotherapy should be promoted and strengthened within community pharmacy settings in LMICs. Community pharmacists are uniquely positioned to optimise antibiotic selection, dosing and duration; however, their stewardship potential is constrained by insufficient training, limited access to locally adapted guidelines, and inadequate decision-support tools. Strengthening antibiotic pharmacotherapy requires targeted education and continuing professional development, integration of AMS competencies into pharmacy curricula, local adaptation of evidence-based resources (e.g. AWaRe-informed tools), and scalable "train-the-trainer" models. Global North-South collaborations and sustainable financing mechanisms are essential to support implementation and scale-up. Empowering community pharmacists with the knowledge, skills, competencies, and resources required to deliver evidence based antibiotic pharmacotherapy should be recognised as a core policy priority for antimicrobial stewardship in LMICs. Embedding structured pharmacy-targeted pharmacotherapy guidance within national AMR action plans and WHO-aligned frameworks is critical to reducing inappropriate antibiotic use, strengthening health system resilience, and preserving antimicrobial effectiveness.

Pharmacists are integral to advancing equitable healthcare, implementing culturally safe practices that address power imbalances, racism, and institutional barriers. Ethnicity-based eligibility criteria (EBEC) have improved treatment access in some settings, but little is known about how community pharmacists experience and implement these criteria in practice. This study aimed to explore pharmacists' perceptions of (i) applying EBEC in community pharmacy; (ii) the extent to which the provision of education or resources would be useful in the future. A descriptive cross-sectional survey of registered and pre-registrant pharmacists in Aotearoa, New Zealand, was conducted. Participants were recruited via professional and researcher networks, with data collected anonymously using a piloted survey on Qualtrics®. Quantitative responses were analysed with descriptive statistics, and qualitative data were inductively coded and refined through team consensus to identify themes. Two hundred and eighteen pharmacists (median age band 36-45years, median of 20years pharmacy experience) completed the survey. Although most pharmacists felt comfortable applying EBEC, half felt implementation would have been better supported if training or resources were available. Participants had limited experience discussing ethnicity with patients and wanted to be better equipped to discuss eligibility with those who were eligible, and with those who opposed the use of EBEC. Resources needed to focus on evidence-based justification of EBEC, definitions of ethnicity, and role modelled conversations. When implementing new types of eligibility criteria for community pharmacy services, pharmacists need sufficient and appropriate training and resources for effective implementation.

A community pharmacy vaccination nudge intervention: Final results of a nationwide study.

Integrating immunization-trained pharmacy technicians into pharmacy workflow: A qualitative analysis of best practices.

Introduction: Community pharmacies are among the most accessible points of care for patients seeking healthcare advice and services. With escalating out-of-pocket healthcare expenditure and a burgeoning Over-The-Counter (OTC) drug market in India, there is a substantial opportunity for community pharmacists to evolve from product-oriented service providers to patient-centred care providers. This transition has the potential to reduce healthcare costs and improve patient outcomes. Aim: To explore community pharmacists’ perspectives and practices regarding Patient-Centred Services (PCS) and to motivate them to apply pharmacoeconomic principles in patient care. Materials and Methods: An exploratory study design with a qualitative approach, employing both purposive and convenience sampling, was used to explore the perspectives of community pharmacists from urban areas in the vicinity of BGS Global Institute of Medical Sciences, Bangalore, from November 2022 to January 2023. Face-to-face interviews using a semi-structured interview guide were conducted with 25 pharmacists who held a minimum qualification of a Diploma in Pharmacy and who consented to participate. The entire study was planned and executed in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) studies guidelines. Audio recordings were transcribed verbatim, and the transcripts were thematically analysed using a content analysis approach. Descriptive statistics were used to represent the emerging themes and subthemes that were coded and categorically grouped. Upon completion of the study, a selfprepared and pre-validated awareness manual was distributed to the participants. Results: A total of 25 qualified community pharmacists (19 males and 6 females), aged between 22 and 60 years, with professional experience ranging from four months to 35 years, were interviewed. Six major themes-prescription handling; patientcentred services beyond drug dispensing; barriers to offering PCS; practices related to OTC dispensing; understanding of pharmacoeconomic principles; and perceived roles in improving the Indian healthcare system-along with eleven subthemes, were identified. Eighty percent of participants expressed a positive outlook towards offering patient-centred services and reducing overall healthcare costs. However, time constraints and a lack of recognition and support from consumers and doctors were major concerns reported by more than 76% of respondents. Conclusion: The present study highlights community pharmacists’ readiness and acceptance of expanded professional roles and establishes that they are indispensable yet underutilised healthcare professionals. With appropriate support and recognition, community pharmacists can significantly contribute to improving the Indian healthcare system.

Aboriginal and Torres Strait Islander people can experience inequitable access to health services. Thisstudy assessed the effectiveness of a culturally responsive medication management service (referred to as IMeRSe). This is a pre-post single-arm study involving Aboriginal and Torres Strait Islander health services and community pharmacies. Participants had a chronic condition, were pregnant or postpartum within 2 years. Pharmacists wrote a collaborative Medicines Plan and made recommendations to clinicians. The primary outcome was serious medication-related problems 6-months post-IMeRSe. Secondary outcomes included medicationadherence. For 255 participants, mean serious medication-related problems reduced from 4.11 to 3.85 per 6 months at risk (incidence rate ratio, 0.93; 95% confidence interval, 0.86-1.01), although rates of potentially preventable medication-related hospitalisations remained similar. Significant improvements in medication adherence were observed. General practitioners accepted 709 of 762 pharmacist recommendations. A culturally responsive medication management service delivered by community pharmacists can contribute to reduced serious medication-related problems, improved medication adherence and consumer empowerment.

Pharmacy access and shingles vaccinations in the US: a propensity score matching analysis.

Barriers and facilitators to pneumococcal vaccination in rural community pharmacy: A qualitative study

Community pharmacists (CPs) are accessible healthcare providers with the potential to support care for tuberculosis infection (TBI). However, their role remains limited and poorly integrated into national TB programs. Despite global recognition, no study in Indonesia has explored how CPs can be engaged as direct service providers. This study aims to identify the challenges and develop strategies for involving CPs as direct providers of TB services to improve TB preventive treatment outcomes. A qualitative case study was conducted in West Java, Indonesia. Data collection involved group interviews (GIs) and in-depth interviews (IDIs) with providers from community health centers (CHCs) and community pharmacies, as well as with patients with TBI. Participants responded to a proposed collaborative model scenario during the interviews, where CPs would provide direct support for TBI treatment. Data were deductively analyzed using ATLAS.ti version 9, employing a thematic analysis approach guided by the Tailored Implementation for Chronic Diseases (TICD) framework to identify challenges and strategies across seven domains. The findings are reported in accordance with the 32-item COREQ checklist. A total of 27 participants were enrolled from CHCs and pharmacies, including TB programmers, medical doctors, community pharmacists, and individuals with TBI. We identified several challenges, including the absence of specific guidelines; limited knowledge and skills among CPs; patient preferences; limited professional interaction between CPs and healthcare workers; the lack of an incentive scheme; and insufficient regulatory support from national and local governments. In response to these challenges, various strategies can be implemented, including providing systematic guidelines, improving CPs' capacity, building a communication system between CPs and related healthcare workers, implementing an incentive scheme, and advocating for regulatory support from national and local governments. To implement collaborative practice effectively, it is essential to address the identified challenges and, alongside coordinated efforts among all TB stakeholders, develop strategies to establish a sustainable, impactful practice model in real-world settings.

Primary care is critical for supporting health, yet access to family physicians and nurse practitioners is less than ideal in many countries. One solution to improve access to primary care is to expand the scope of practice for other primary healthcare professionals, such as pharmacists. Building on this approach, some countries have created community pharmacy care clinics to further improve access to primary care services provided by pharmacists working to full scope of practice. As the role of pharmacists in primary care increases and community pharmacy care clinics become more prevalent, it is important to assess the effect on health service utilization and health outcomes. While the emergency department visit rate is a widely accepted indicator for access to primary care, there is currently no framework to evaluate the impact of pharmacists on emergency department visits. Frameworks based on International Classification of Diseases codes provide health services researchers with a standardized approach to present and analyze administrative health data. In this commentary, we describe the development of a framework to identify and classify emergency department visits that may be impacted by pharmacists providing primary care services in a community pharmacy care clinic. The framework covers three mutually exclusive groups of conditions: a subset of primary care sensitive conditions that can be managed by community pharmacists, conditions attributable to an adverse medication event, and conditions attributable to medically appropriate referrals to an emergency department. The conditions included within these groups provide a broad overview of potential benefits and unintended harms that may occur when pharmacists are involved in providing primary care services. This framework can be used to characterize changes in health service utilization and health outcomes that may occur as pharmacists become more actively involved in providing primary care services.