BackgroundTB is a potentially fatal infection with a rising incidence in the UK. Curative treatment is available but requires prolonged courses of multiple medications (particularly during the initial phase treatment). Adherence to therapy is critical to success. Fixed-dose combination (FDC) products combine multiple medications into a single pill to maximize adherence and are used first-line. However, shortages of FDCs have plagued UK supply chains leading to a National Patient Safety Alert in July 2025. Supplying individual component medications in small amounts (1 month maximum) poses a risk to adherence and optimal outcomes. This is particularly concerning as many TB patients already have risk factors for poor adherence.Objectives(i) Quantify impact of FDC shortages on pill burden and quantities of medication supplied by Sandwell and West Birmingham NHS Trust from 1st July 2025. (ii) Contrast pill burden of dispensed therapy with an optimal FDC based regimen.MethodsDispensing records held within the hospital pharmacy computer system were accessed for all patients receiving rifampicin or a rifampicin containing medication between 1 July 2025 and 17 Sept 2025 (all available data). Patients not being treated for TB were excluded. The details of the medication dispensed (product, strength, dose, quantity) were recorded in Microsoft Excel and pill burden calculated. A pharmacist used hospital records to determine the appropriate first-line FDC regimen and calculate the pill burden of this hypothetical treatment.ResultsWe identified 94 relevant prescriptions for 62 patients. Of these, 32 patients were still in the initial phase of TB treatment during the shortage. All 32 patients received multi-product regimens instead of the first-line rifampicin with ethambutol, isoniazid and pyrazinamide FDC. However, one received partial treatment with the first-line FDC and 13 received a multi-product regimen which included a rifampicin with isoniazid FDC. The median pill burden across all prescriptions was 7 (IQR 4.75–11). The median pill burden of optimal regimen was 3 (IQR 2–5). The median supply duration was 28 days (IQR 28–56 days) but with significant outliers (min 7 days, max 168 days). Patients did not always receive the same regimen for the entire phase of treatment; 18 had a different combination of products for subsequent prescriptions.ConclusionsShortages of FDCs have more than doubled median pill burden for our patients. This is despite mitigation with unlicensed imports of rifampicin with isoniazid FDCs. Patients are required to reattend more frequently than usual to collect further supplies. Furthermore, there is no guarantee that a consistent combination of medication will be provided from one prescription to the next. These factors all contribute to an increased risk of poor adherence which is associated with treatment failure, onward transmission and increased drug resistance. Robust supply chains are critical to effective TB treatment.

Prioritization of Factors Affecting Sustainable Pharmaceutical Supply Chain Management in Hospital Pharmacies: Evidence from Yazd, Iran

Telepharmacy in hospital pharmacy: Implementation, challenges, and future directions

Objective: This study aims to survey the pattern of skin diseases through hospital deployment software based on Google Meet and Facebook Messenger. Materials and methods: A descriptive study of dermatological diseases through virtual examination from May 2021 to March 2022 through the "Online Consultation" Program by Hue University of Medicine and Pharmacy Hospital. Data on online examinations were compared with in-person visits during the same period, as well as those before the epidemic, collected from May 2019 to March 2020. Results: Teledermatology visits accounted for a much higher rate than other specialties. There were 1,014 teledermatological examinations, 2,242 in-person visits during the epidemic, and 6,370 in-person examinations before the epidemic. Females made up a higher proportion than males. Age group 16 - 30 was examined online, accounting for 73.1%, and two groups examined in person, less than 50%. There were roughly 45% of patients calling because of acne vulgaris, other disease groups did not show any difference during or before the epidemic. Conclusions: This pattern of online skin diseases reveals the health problems that patients are concerned about. Virtual consultation brings many benefits to patients, improving the hospital overload situation.

Introduction: Several studies have indicated that the rs1333040 polymorphism of the ANRIL gene is associated with the severity of coronary artery stenosis; however, data remain inconsistent, particularly among patients with chronic coronary syndrome. Objective: To determine the characteristics of the rs1333040 polymorphism of the ANRIL gene and its association with the severity of coronary artery stenosis. Materials and methods: This cross-sectional descriptive analytical study was conducted on 79 patients diagnosed with chronic coronary syndrome treated at Can Tho University of Medicine and Pharmacy Hospital, Can Tho Central General Hospital, and Can Tho Cardiovascular Hospital from June 2024 to June 2025. Results: The mean age of the 79 patients included in the study was 67.35 ± 8.86 years, with the majority aged ≥ 60 years. The gender distribution was nearly equal. Regarding lifestyle, more than two-thirds of patients were sedentary, and half reported tobacco smoking. Hypertension was common among patients; approximately half were overweight or obese, had dyslipidemia, and one-third had diabetes mellitus. Genotype frequencies were 41.3% TT and 58.7% TC. The T and C allele frequencies were 72.2% and 27.8%, respectively. The TT genotype group exhibited significantly higher proportions of moderate (84.8% vs. 65.9%) and severe (14.3% vs. 0%) Gensini scores compared to the TC genotype group (p < 0.001). Similarly, the T allele was associated with significantly higher rates of moderate and severe Gensini scores compared to the C allele (p = 0.012). Conclusion: The T allele and TT genotype of the rs1333040 polymorphism in the ANRIL gene were significantly associated with higher proportions of moderate and severe coronary artery stenosis according to the Gensini score compared with the C allele and TC genotype in patients with chronic coronary syndrome.

To evaluate the physicochemical and microbiological stability of preservative-free losartan potassium (LP) eye drops (0.8 mg/mL) prepared using balanced salt solution (BSS), normal saline (NS) or glucose saline (GS) and stored in sterile polypropylene eye drop bottles under different temperature conditions for 30 days. Three independent batches of each formulation (BSS, NS and GS) were aseptically prepared in a laminar flow cabinet and stored under three conditions: room temperature (25±4°C), refrigeration (4±3°C) and freezing (-20±5°C). Three samples from each batch were analysed for each condition and time point. LP concentrations were measured on days 0, 7, 15, 22 and 30 using high-performance liquid chromatography with photodiode-array detection (HPLC-DAD) and ultraviolet (UV) - visible spectrophotometry. Visual inspection was performed to identify macroscopic changes and physicochemical parameters - including pH, osmolality and refractive index - were evaluated. Microbiological quality was assessed on days 0, 10, 20 and 30. BSS and NS formulations maintained 90-110% of their initial LP concentration under all storage conditions. The GS formulation remained stable when refrigerated or frozen but showed a marked decline at 25°C, with turbidity and concentrations falling below 50% by day 20. pH, osmolality and refractive index remained within acceptable physiological ranges for ophthalmic solutions. All samples tested negative for microbial growth. LP eye drops prepared with BSS or NS were stable in closed sterile eye drop bottles for at least 30 days under all tested conditions. Frozen and refrigerated conditions are preferred for storage. Because the formulation does not contain preservatives, its use is recommended for no longer than 7 days after opening. GS-based formulations are not recommended for ophthalmic use. The conducted stability study provides hospital pharmacies with data supporting the safe preparation, storage and use of non-commercial ophthalmic formulations.

Background/objectivesOptimal nutrition in very low birth weight (VLBW) infants is associated with improved clinical outcomes. When parenteral nutrition (PN) with a marketing authorisation is not appropriate, hospital pharmacies can prepare more suitable PN preparation. This corresponds to standard preparations (i.e., available at any time with a fixed composition) or individualised ones (i.e., available after a period of prescription, preparation, and pharmaceutical control). In France, 12 standard formulas to be compounded were proposed by a national consortium in 2018. The objective of the present study was to evaluate whether individualised PN preparations ordered in our hospital are substitutable by one of the 12 standard formulas.MethodsAll PN prescriptions for VLBW infants made in 2021 in our hospital were retrospectively extracted. For each prescription, the theoretical intakes that an infant would have received if a standard preparation had been administered were calculated. Standard and individualised preparations were compared using the Mann-Whitney U test for each component. Secondly, the relative difference between the expected intakes and effectively intakes was calculated for each component.Results/DiscussionOver the study period, 1708 prescriptions were identified (corresponding to 1708 PN individualised preparations). Most infants were extremely low birth weight infants. Based on the methods of comparison, none of the 12 standard formulas fitted with targeted intakes achieved with individualised PN preparations ordered, whereas prescriptions did fit with international guidelines.ConclusionThe study highlights how it is difficult to establish nationally standard PN formulas for VLBW infants; the development of local standard formulas seems therefore relevant.

Audits of medication charts conducted by Royal Hobart Hospital Pharmacy revealed that dose omission was the most common medication error experienced by patients. Investigation of these errors also found that nurses spend significant time organising medication for inpatients. To address the issues contributing to these problems, an alternative model of medication management was implemented and tested. This model of bedside medication management involves medication supply managed by ward pharmacy technicians who review charts daily for changes to medicines and obtain the medicines needed for each patient. Outcomes on two intervention wards showed that the model, combined with technician involvement in controlled medicines stock management, resulted in 29.78 h of nursing time released to patient care per 20-bed ward per week, for an investment of 22.28 h of ward pharmacy technician time; a 75% reduction in delayed doses; a 44% reduction in missed doses; and an average decrease of two hours in the turnaround time for supply of inpatient medication. Introducing bedside medication management and controlled medicines stock management activities can release 1.34 h of nursing time to patient care for every hour of ward pharmacy technician time (at a lower hourly salary cost), decrease dose delays and omissions, and improve patient safety.

Background: The pharmacy workforce in Vietnam is rapidly evolving, but little is known about how gender and socioeconomic factors shape career intentions and sector preferences of students. Understanding these determinants is essential for healthcare workforce planning. Objective: To investigate how gender and socioeconomic determinants influence intention of pharmacy students to pursue a career and their preferred sector in Vietnam. Methods: A cross-sectional survey was conducted among 462 students from 2nd to 5th year at a Vietnamese university. Demographic data, socioeconomic background, and career intentions were analyzed using chi-squared tests, multinomial logistic regression, and binary logistic regression. Results: Of 462 respondents, 71.9% intended to pursue a pharmacy career, 2.6% reported no, while 25.5% were unsure. Gender differences were evident but did not reach statistical significance (p = 0.083). Female students were more likely to choose clinical, hospital pharmacy or regulation, whereas male students showed higher preference for community, industry and academia. Binary logistic regression revealed that urban origin (OR = 1.34, 95% CI = 1.01–1.78, p = 0.041) and family encouragement (OR = 2.53, 95% CI = 1.60–3.99, p < 0.001) significantly predicted career intention, while gender and income were non-significant. Conclusions: Family encouragement and urban upbringing influence pharmacy career pursuit, while gender may shape sectoral preferences. Policies should address gender equity and enhance support for students from rural or disadvantaged backgrounds.

Prevalence and factors associated with prolonged length of stay at pediatric emergency department, Southwest Ethiopia: A cross-sectional study.

Best practices to reduce microbial contamination during media-fill testing process in hospital pharmacies: a scoping review of literature.

Context: Patient satisfaction with health insurance–covered medication dispensing is an essential indicator of outpatient service quality. Aims: To evaluate the impact of a multi-component service intervention on patient satisfaction at the outpatient insurance pharmacy of a Vietnamese public hospital from May 2023 to April 2024. Methods: An interventional, cross-sectional descriptive study was conducted from May 2023 to April 2024. Satisfaction was measured using a Vietnamese-adapted SERVPERF questionnaire. Results: Overall satisfaction increased from 79.22% pre-intervention to 98.43% post-intervention. Improvements were observed in empathy, reliability, and responsiveness. Age and education were significantly associated with satisfaction (p&lt;0.05). Conclusions: Targeted interventions significantly improved patient satisfaction in medication dispensing. Continuous staff training and infrastructure improvements are recommended.

Plasminogen-cyclodextrin aerosol for ARDS: activity retention in simulated oxygen therapy and inflammation-triggered clot lysis.

Translated article] Development of the mobile application Guide to medication reconciliation in the critically ill patient.

Expert opinion on extrusion-based pharmaceutical 3D printing from the European Society of Hospital Pharmaceutical Technology (GERPAC).

BackgroundAntimicrobial consumption (AMC) measures the level and types of antibiotics consumed in a specific setting. Monitoring AMC is critical component of antimicrobial resistance (AMR) containment strategies. However, AMC data at both facility and national-levels are scarce in Africa, which limits our understanding of the rate, patterns and drivers of antibiotic consumption, and prevents the establishment of evidence-based antimicrobial stewardship.MethodsWe determined facility and national-level rates and patterns of AMC from data retrospectively collected between 2016 and 2019 in 327 pharmacies from 14 countries AMC data collection followed a backfilling strategy leveraging from public and private central medical stores, wholesalers, distributors or import services as data sources. Participating hospital and community pharmacies were selected based on their location in or proximity to hospitals capable of producing AMR data. Levels of AMC were determined as defined daily dose (DDD) and DDD per inhabitant (DID). AMC patterns were analysed according to the WHO Access, Watch, and Reserve (AWaRe) Categories, the Anatomical Therapeutic Chemical (ATC) classes and the individual antibiotic molecules included in the Drug Utilisation 75% (DU75). The availability of antibiotics was examined against the WHO and the National Essential Medicine Lists (EML).ResultsNational AMC data was available in 11 of the 14 participating countries, revealing a collective AMC of 8.42 DID varying from 2.8 to 115.5 at individual country level. AMC was also determined in 327 hospital and community pharmacies. Nine of 11 (82%) countries with national data available, and 219 of the 327 (72%) participating pharmacies achieved the WHO AWaRe target of at least 60% of antibiotic consumption from Access drugs. Eighty percent of country-level AMC was accounted for by five ATC sub-classes classes of antibacterial for systemic use. Facility-level antibiotic consumption was dominated by a narrow scope of less than five drugs, taking advantage of only 10% of all possible WHO-recommended Access drugs within ATC classes. Collectively, the 14 national EML included 70% of Access, 60% of Watch and less than 5% of Reserve antibiotics listed in the WHO EML. Forty-eight uncategorized and 50 categorized non-WHO-recommended drugs were included in national EMLs or documented to be circulating in countries.InterpretationThe relatively low AMC and the poorly diversified subset of antibiotics available in countries underscores that strategies to expand equitable access to adequate treatment of bacterial infections should complement current efforts to promote the judicious use of antimicrobials. Interventions to increase the volume of analysable data on AMU, AMC and AMR, should be prioritized in national AMR action plans as well as in wider infrastructural and economic development plans.

Objectives: The primary objective of this study was to examine medication adherence, health-seeking behavior, and quality of life among informal caregivers of diabetic patients in Can Tho City, Vietnam, and to explore relationships among these variables. Methods: A cross-sectional descriptive-correlational design was conducted among 270 informal caregivers recruited by purposive sampling at Can Tho University of Medicine and Pharmacy Hospital. Research instrument: Morisky Medication Adherence Scale, adapted Barriers to Care Evaluation, and World Health Organization Quality of Life - Brief Version. Data were analyzed using descriptive statistics, Pearson correlation, multiple regression, and path analysis. Results: Findings revealed that caregivers reported low levels of medication adherence (48.15%), low barriers to health-seeking behavior (55.19%), and moderate quality of life (47.8%). Significant positive correlation was found between medication adherence and quality of life (r = 0.55, p &lt; 0.001), while health-seeking barriers were negatively associated with quality of life (r = -0.29, p &lt; 0.001). Path analysis confirmed that medication adherence partially mediated the relationship between health-seeking behavior and quality of life with a significant direct effect (β = -0.154, p &lt; 0.05), indirect effect (β = -0.137, p &lt; 0.001), and total effect (β = -0.291, p &lt; 0.001) Conclusions: Nursing professionals and health educators should implement targeted interventions that enhance medication adherence and reduce barriers to health-seeking behavior among caregivers.

Pharmacogenomics (PGx) tailors drug treatments to an individual's genetic profile and contributes to improved efficacy and reduced adverse drug reactions. Community pharmacists have shown interest in PGx, and Dutch pharmacists have been early adopters in applying PGx guidelines, particularly through integration of the Dutch Pharmacogenetics Working Group recommendations. Despite growing evidence of its benefits, large-scale implementation in community pharmacies remains limited. This raises an important question for global stakeholders: if PGx adoption is constrained even in a system with robust infrastructure and guidelines, what lessons can be drawn for broader implementation? To examine current PGx practices in leading Dutch community pharmacies and to identify key barriers, facilitators, and implementation strategies for integrating PGx into routine pharmacy care. A cross-sectional survey was conducted among Dutch pharmacy professionals with experience in PGx implementation. Participants were categorized as key opinion leaders (KOLs), involved in national PGx policymaking, research, or representing academia or professional organizations, or local champions (LCs), defined as practicing pharmacists directly involved in local PGx implementation in hospital or community pharmacies. The questionnaire was retrospectively mapped to Consolidated Framework for Implementation Research domains. Quantitative data were analyzed descriptively and qualitative responses were inductively thematically grouped to contextualize findings. Of the 67 invited professionals, 46 completed the questionnaire (response rate: 69%). Among respondents, 70% were LCs and 30% KOLs. Among KOLs (n = 14), the most frequently cited barriers included costs (79%, n = 11/14), inadequate Information and Communication Technology (ICT) support (29%, n = 4/14), and legal or regulatory uncertainty (29%, n = 4/14). A positive view on the clinical value of PGx was reported by 81% of LCs (n = 26/32) and 93% of KOLs (n = 13/14). Suggested facilitators by LCs included improved ICT infrastructure (56%, n = 18/32), enhanced education and training (44%, n = 14/32), and stronger interdisciplinary collaboration (25%, n = 8/32). PGx implementation in Dutch pharmacies is hindered by structural barriers such as fragmented ICT and lack of reimbursement, despite strong professional support. Embedding PGx into pharmacy workflows and aligning policy, infrastructure, and education are essential. These findings may inform broader efforts to integrate PGx into pharmacies across diverse systems.

Study Objectives: Our study objectives were to test pharmacists’ and physicians’ knowledge and attitude towards deprescribing in Saudi Arabia. Methods: A survey-based cross-sectional study was performed to answer our research question. We collected study data through a validated survey assessing deprescribing knowledge and attitude, including all pharmacists and physicians who care for older adults or have an interest in this patient population. Data were analyzed using IBM SPSS v27.0. Continuous variables were reported as mean ± SD, and categorical variables were reported as percentages and frequencies. Knowledge level (high vs. low–moderate) was compared across gender, experience quartile, academic degree, and professional role using χ² tests with Cramer’s V and a Bonferroni-corrected α = 0.0125, while attitude was modeled with a forced-entry multiple linear regression including knowledge, age, years of experience, and gender. Results: In total, 238 participants (pharmacists and physicians) completed the survey. The majority were male (65%) and had 4 years’ experience (53%). In addition, 31% worked in community pharmacy, 25% in hospital pharmacy, while physicians represented 31% of study participants. We found a significant positive correlation between knowledge and attitude towards deprescribing, and the majority of participants demonstrated moderately positive attitudes, aligning with the observed knowledge–attitude relationship. Conclusion: Our findings indicate that the majority of healthcare provider participants had a low to moderate level of knowledge about deprescribing.

Abstract Context: Diabetes is a global health concern, and effective glycemic control relies on the rational use of antidiabetic agents, which can be evaluated through drug utilization studies to ensure cost-effective pharmacotherapy. Aims: The aim of the study was to analyze the costs and drug utilization pattern in diabetic patients with the objectives of direct cost analysis of drugs, indirect cost analysis, and cost index. Measurement of WHO prescribing core indicators, patient care indicators, and facility indicators, prescribed daily dose (PDD)/defined daily dose (DDD) ratio. Settings and Design: Participants were recruited from the Non-communicable disease and medicine OPD, and the study design was cross-sectional, observational, according to STROBE guidelines. Subjects and Methods: The study began after institutional review board approval, with data collected from 250 participants following informed consent. A total of 1500 prescriptions were analyzed using appropriate parameters for cost analysis and WHO core drug use indicators. Drugs were categorized under anatomical, therapeutic, and chemical/DDD system, and the PDD/DDD ratio was calculated. Statistical Analysis Used: Descriptive statistics in Microsoft Excel 2021. Results: The study results found that the hospital covered most costs (481.1 INR per encounter), while participants bore 102.1 INR for anti-diabetic drugs and 234.35 INR in indirect costs monthly. An average of 2.68 antidiabetic drugs per prescription, with 95.60% prescribed by generic name and 33.46% involving injections. Metformin was the most prescribed drug (88.1%). A total of 12 drugs had a PDD/DDD ratio of 1. Conclusions: The study met WHO prescribing, patient care, and facility indicators, adherence to guidelines, and key drugs dispensed from the hospital pharmacy, reducing direct costs to the hospital pharmacy and participants.