Pharmacists & Outcomes

Publications | Pharmacists & Patient Outcomes

Pharmacist & Outcomes – ALL
- Nnenna Anyanwu

CONCLUSION: Increased prescribing of SGLT2i therapy in hospitalized patients with heart failure was observed following pharmacist-led education and prospective reviews with feedback. [...]

- Aubrey Baccari

Introduction: A patient's understanding, implementation of, and adherence to hospital discharge instructions are important in keeping them from being readmitted to the hospital within 30 days of discharge. The understanding of and ability to follow these instructions after the transition from hospital to home may be significantly supported by additional [...]

- Austin Steichen

Background: The Minnesota Community Measurement assesses health system performance for diabetes care based on five measures: blood glucose (A1c), blood pressure (BP), cholesterol (LDL), tobacco use, and aspirin use, aggregated and known as a "GAP score." Rural areas are negatively impacted by inadequate diabetes care. The positive impact of direct [...]

- Elena Patestos

Background: Hypertension and diabetes are prevalent chronic disease states. Pharmacists and dietitians collaborated to develop and implement employee benefit programs for hypertension and diabetes at a regional grocery store. The hybrid program included virtual education modules and check-in calls to monitor participants. Objectives: The primary objective of this study is [...]

- Tessa Rife-Pennington

Background: United States Veterans are disproportionately impacted by homelessness. Substance use, mental health conditions, and trauma increase the risk for homelessness and contribute to challenges in maintaining housing. Street Medicine utilizes a trauma-informed approach to provide low-barrier health and social services for those at risk for and experiencing homelessness. Limited [...]

- Karen Dahri

Background: Clinical pharmacists are a limited resource in British Columbia (BC). Few studies have been conducted to explore hospital clinical pharmacist allocation. It is unclear how pharmacy leaders prioritize the allocation of their pharmacist staff to provide clinical services at their sites. Objectives: To characterize how hospital pharmacy leaders allocate [...]

- Shervin Gorji

Purpose: This study evaluated the impact of pharmacist-initiated versus provider-initiated patient enrollment in the Meds to Beds program. The primary objective was to compare the number of high-risk readmission patients enrolled through pharmacist-initiated versus provider-initiated processes. Secondary objectives included comparing 30-day all-cause and heart failure readmission rates, number of prescriptions [...]

- Muhammad Ahmer Raza

The advancement of human space exploration presents unprecedented healthcare challenges, and heightens the need for specialized pharmaceutical care across the distinct timelines of a space mission. Despite growing interest in integrating pharmacists into space healthcare, their roles remain largely generalized, not tailored to the specific demands of pre-mission preparation, in-mission [...]

- Alyssa D Barnes

Rates of unintended pregnancy continue to remain high in the United States. Pharmacist-prescribed hormonal contraception offers an accessible option for preventing mistimed or unintended pregnancies, leading to better reproductive health outcomes. Specifically in Indiana, studies show patient interest in this service, however, overall pharmacy implementation and patient awareness has been [...]

- M Shawn McFarland

CONCLUSION: This study demonstrated improved access and improved guideline directed therapy outcomes for rural Veterans seen by a CPP. Integration of the CPP with a focus on the management of COPD can increase access to CMM and increase overall quality. [...]

- Muhammad Zahid Iqbal

CONCLUSION: Taken together, the findings indicate that involving pharmacists more directly in the medication management of individuals with chronic conditions leads to better clinical results and more favorable economic outcomes. These findings support the idea of involving pharmacists more closely within chronic-care teams. [...]

- Saad Saeed Alqahtani

CONCLUSION: Through increased medication adherence, better patient awareness, and support for lifestyle adjustment, pharmacist-led educational programs greatly reduce the risk of CVD and enhanced lipid profiles. To enhance the management of chronic diseases, clinical chemists must be integrated into multidisciplinary care teams. To optimise advantages, future research should focus on [...]

- Krisy-Ann Thornby

CONCLUSION: A bibliometric analysis of pharmacist-related outcomes describes pharmacist involvement in outcome-based practice at patient, system, and population levels. The research on pharmacist outcomes continues to grow and is clinically focused. Opportunities to address global and system-level health needs remain. [...]

- Zhao Mei

CONCLUSION: This grid-based precision ASP was associated with sustained reductions in antimicrobial use and costs, and improved clinical outcomes. It was also associated with changes in the temporal relationship between AUD and MDRO detection rates. These alterations suggest this approach may mitigate selective pressure driving resistance, although causality cannot be [...]

- Tirapada Kiatsangorn

CONCLUSION: This pilot service demonstrates that a pharmacist-led holistic smoking cessation model can be feasibly integrated into psychiatric care in a provincial Thai hospital. Further controlled studies are warranted to evaluate long-term effectiveness and scalability. [...]

- Taiga Ishikawa

Immune checkpoint inhibitors (ICIs) have significantly advanced cancer treatment, and their clinical indications continue to expand. At the same time, the importance of managing immune-related adverse events (irAEs) has been increasing, along with growing expectations for pharmacist involvement. Herein, we report a case in which prompt pharmacist intervention prevented the [...]

- Armin Pashaeimofrad

CONCLUSION: Pharmacist-led interventions at an FQHC substantially improved access to CGM devices for patients with uncontrolled diabetes. Through direct education, payor navigation, and device coordination, pharmacists mitigated common financial and logistical barriers to care. This model offers a potential scalable strategy to advance health equity in access to diabetes technology. [...]

- Tiernan McDonough

CONCLUSION: This meta-synthesis of the evidence regarding the perceptions of healthcare professionals on the role of pharmacists in aged care provides contextual information for individuals, organisations and policy-makers for future implementation. Pharmacists are perceived to improve stakeholder confidence, staff capacity and capability, and overall person-centred care. Embedded roles that foster [...]

- Miguel Ángel Amor García

The design and implementation of antimicrobial stewardship programs for patients admitted to intensive care units must consider the specific characteristics of this population, including infection severity, organ dysfunction, and pharmacokinetic/pharmacodynamic alterations. The creation of a multidisciplinary team and the establishment of clear, targeted objectives are essential to improve treatment appropriateness, [...]

- Simone Diamandis

CONCLUSIONS: The development and adoption of PPEAPSOP policies depend on alignment amongst policy actors, navigation of systemic constraints, strategic foresight of policy implications, and a narrative grounded in robust evidence, =contextualised to the policy environment. Current approaches to the development and adoption of PPEAPSOP policies highlight gaps, underscoring the need [...]

- Amr Ali Mohamed Abdelgawwad El-Sehrawy

The gut microbiome, a complex ecosystem of microorganisms, is now recognized as a key determinant of drug efficacy and toxicity, giving rise to the field of pharmacomicrobiomics. This review decodes the profound influence of the gut microbiome on treatment outcomes for hematologic malignancies. We explore the tripartite mechanistic pathways through [...]

- Masahide Karashima

CONCLUSIONS: These results suggest that a pharmacist-led GAIN approach improves patients' insight and medication attitudes, facilitating both the initiation and long-term maintenance of LAI therapy. In the context of burdened clinical settings, pharmacist involvement via task shifting represents an effective strategy for optimizing psychiatric pharmacotherapy. [...]

- Özge Özmen

Patients with renal dysfunction are highly susceptible to drug-related problems (DRPs) due to altered pharmacokinetics and polypharmacy. Clinical pharmacists(CP) play a key role in optimising pharmacotherapy and preventing medication errors in this vulnerable population. To evaluate the prevalence of DRPs in patients with renal dysfunction and to compare the effectiveness [...]

- Woei Jye Ong

BackgroundImmune checkpoint inhibitor (ICI) eligibility is primarily guided by tumor-centric biomarkers that do not fully account for the host's systemic immune competence. Emerging evidence suggests that readily available hematologic indices absolute lymphocyte count (ALC) and neutrophil-to-lymphocyte ratio (NLR) are associated with treatment outcomes in patients receiving ICIs, yet these markers [...]

- Haley Huddleston

CONCLUSIONS: Integrating pharmacists into care teams can enhance GLP-1 RA PA turnaround times while improving medication access, safety, and continuity of care. These findings support further research and policy development in pharmacist interventions in PA process and GLP-1 RA management. [...]

- Guirong Xiao

CONCLUSION: Inpatients demonstrated clear preferences for attributes of IPC, with variations by income, residence, and chronic disease status. Greater involvement of clinical pharmacists, tailored adjustment of consultation frequency and duration, and integration into hierarchical diagnosis and treatment and chronic disease management were encouraged. Price has limited influence on choices. We [...]

- Ting Liu

CONCLUSIONS: Pharmacist-led interventions may contribute to quality indicators, specifically treatment adherence and persistence in oral anticancer therapy management. While these improvements are associated with patient safety and treatment effectiveness, current evidence is insufficient to confirm a direct translation into superior clinical endpoints. Further studies are needed to confirm the effectiveness [...]

- Ai Ogawa

CONCLUSIONS: Pharmacist-led education on diabetic retinopathy did not increase ophthalmology visits or improve diabetes-related outcomes. Effective strategies to encourage ophthalmology visits are required. [...]

- Deborah L Pestka

CONCLUSIONS AND RELEVANCE: In this quality improvement study, pharmacist-led outreach was associated with increased initiation of SGLT2 inhibitors; however, limited intervention reach may have constrained the overall impact. Strategies to improve uptake are needed to enhance impact and inform broader SGLT2 inhibitor implementation in patients with CKD and type 2 [...]

- Elena Meishan Lee

CONCLUSION: The pharmacist-led DEMO program was non-inferior to standard physician consultation in achieving a BP target of 140/90mmHg within six months, with high usability and modest WTP. [...]

- Amy L Kiskaddon

CONCLUSION: The majority of antithrombotic interventions in critically ill children were in the PCICU and involved anticoagulation for thromboembolism treatment and prevention. Further research is warranted to evaluate pediatric pharmacist-driven clinical services and the impact on antithrombotic outcomes in critically ill children, particularly those with cardiac disease. [...]

- Mubai Ma

CONCLUSION: This study indicates that in patients treated with vancomycin under TDM, pharmacist interventions can promote the standardization of vancomycin TDM, reduce the incidence of acute kidney injury, and improve clinical outcomes. [...]

- Arinze Nkemdirim Okere

CONCLUSION: Community pharmacies are well positioned to expand CRC screening access. Addressing reimbursement, training, workflow, and coordination barriers through evidence-based strategies and supportive policy can enable pharmacist-delivered CRC screening to reduce disparities and improve population health outcomes. [...]

- Sophia Mancuso

Patients with low health literacy are at risk for comorbidities, including obesity. Pharmacists offer a unique position to improve health literacy amongst all patients, including those with obesity. The primary aim of this study was to assess change in health literacy using the HELIA assessment pre and post pharmacist intervention. [...]

- Mohammad Ali Al-Qarni

Background: Treatment-related problems (TRPs), including patient adherence, knowledge, and medication errors, affect hospitalized patients' outcomes worldwide. Effective clinical pharmacist communication is essential for proper patient counselling and medication safety. However, the effect of clinical pharmacist communication skills on TRPs has not been adequately studied. Objective: This study aimed to assess [...]

- Jonathan Penm

INTRODUCTION: Despite limited evidence of efficacy, opioid analgesics are frequently used by patients for chronic pain while awaiting total hip or knee arthroplasty (THA or TKA). Preoperative use of opioids is problematic as it increases the likelihood of postoperative opioid-related adverse drug events and postoperative complications and is the strongest [...]

- Bailey M Colvin

CONCLUSION: In patients with HM3 LVADs receiving warfarin, pharmacist-managed warfarin led to a higher TTR compared with UC. [...]

- Dayana El Nsouli

INTRODUCTION: Pharmacist prescribing has been introduced to alleviate pressures on hospital services and improve timely access to treatment. However, implementation in inpatient settings remains highly variable, with pockets of excellent practice alongside areas where prescribing roles are limited or absent. Traditional effectiveness reviews have demonstrated positive impacts of pharmacist prescribing [...]

- Beatriz Leal Pino

CONCLUSIONS: Pharmacist-led assessment of Y-site compatibility in pediatric TPN is essential for medication safety and good outcomes. The high proportion of drugs with unknown or conflicting information about compatibility highlights the need for further research to support clinical decision-making. [...]

- Iona Berger

CONCLUSIONS: Further research is needed to validate these ratios in various pediatric clinical pharmacy settings. [...]

- Kaitlyn E Watson

CONCLUSIONS: This study presents the validation of the first pharmacist-specific tool to measure engagement. The POWER Engagement Framework demonstrated good reliability and conceptual coherence to assess pharmacist engagement. Refinement for Well-being and Resources constructs could improve the model. [...]

- Rachael Ialacci

CONCLUSION: This workflow demonstrated that pharmacist interventions within the nurse BP workflow can contribute to improvement in BP without requiring a comprehensive pharmacist visit​. [...]

- Esteban Zavaleta-Monestel

Polypharmacy in older adults is associated with medication-related harm, including adverse drug events, drug-drug interactions, inappropriate prescribing, and hospitalization-related outcomes. This systematic review evaluated the effectiveness and safety of pharmacist-led deprescribing interventions in adults aged ≥65 years. The review was reported according to the Preferred Reporting Items for Systematic Reviews [...]

- Debbie Liang

CONCLUSION: Connect AF demonstrates how pharmacists can address SDOH-related care gaps and provides a scalable model for cross-sector collaboration to enhance patient care coordination. [...]

- Sarah E Wheeler

CONCLUSION AND RELEVANCE: A collaborative pharmacist care model in RHCs significantly improved glycemic control and increased utilization of guideline-directed medication therapy for diabetes and cardiometabolic comorbidities. These findings add to the growing body of literature demonstrating positive clinical outcomes of pharmacist services in rural clinics and underscore the need for [...]

- Amna Mohamed

CONCLUSION: Pharmacist-led interventions in hematology-oncology care improve medication management processes and may contribute to better adherence and medication safety. However, evidence for effects on clinical and economic outcomes remains limited and heterogeneous, highlighting the need for well-designed prospective studies using standardized outcome measures. [...]

- Asma Ben Romdhane

IntroductionThe complexity of chemotherapy protocols and the narrow therapeutic index of anticancer drugs make the risk of medication errors particularly high in oncology. This study analyzed and categorized pharmaceutical interventions related to chemotherapy prescriptions in a clinical hematology center.MethodsThis study was conducted in a specialized clinical hematology center over a [...]

- Alfonso Leiva

INTRODUCTION: Potentially inappropriate prescriptions (PIPs) in older adults, such as long-term use of benzodiazepines, proton pump inhibitors without indication or antipsychotics in dementia, are associated with adverse events and increased healthcare utilisation. Despite clinical guidelines discouraging their use, PIPs remain frequent in primary care. An audit and feedback (A&F) intervention [...]

- Kayla Sturtevant

Background: Obesity is a prevalent condition associated with numerous comorbidities. Weight loss medications reduce comorbidity burden, but barriers hinder access and titration. Clinical pharmacists play a key role in chronic disease management, but limited research exists on pharmacists managing weight loss. Objective: Evaluate the impact of a clinical pharmacist on [...]

- Amy J Kennedy

CONCLUSIONS: In this pilot implementation of same-day telemedicine PPMM, high rates of MOAD receipt were seen among referred Veterans. However, most Veterans with AUD/OUD seen in participating clinics were not referred. Further evaluation of barriers and/or facilitators to referral are needed to increase program uptake. [...]

- Lene Berge Holm

CONCLUSION: This pilot service evaluation suggests that pharmacist-led migraine counselling may represent a clinically relevant and potentially useful addition to community pharmacy practice. Responding patients reported positive consultation experiences and reported to be highly motivated to take their medication. The majority implemented at least one recommendation, and many reported perceived [...]

- Xiunan Yue

CONCLUSION: This pharmacist-led risk assessment tool has strong potential for accurately identifying high-risk β-lactam allergy patients and optimising antimicrobial stewardship in Chinese hospitals. Further large-scale validation is warranted. [...]

- Abdullah Faiz Zaihan

CONCLUSION: In this MTAC-supported cohort, polypharmacy and full GDMT were not associated with increased burden or reduced adherence. A modest positive association between medication count and QOL was observed. SGLT2i use was associated with lower adherence and QOL, although these findings are exploratory and may reflect differences in disease severity [...]

- Kathryn Cox

CONCLUSION: Inpatient and TOC pharmacist clinical review is associated with improved optimization of GDMT and may enhance value-based outcomes such as hospital readmissions. [...]

- Wenting Xie

CONCLUSION: Pharmacists' interventions exert a positive effect on asthma and COPD management outcomes, though improved research design and quality are still needed. [...]

- Sheridan Rodda

CONCLUSION: Our study established the feasibility, acceptability and implementation outcomes of a new pharmacist-led model of care for carvedilol dose optimisation. We provide practical insights to inform the implementation of similar technology enabled multidisciplinary models of care at scale for patients with cirrhosis. [...]

- Hui Liu

CONCLUSION: A clinical pharmacist-led multimodal ASP intervention significantly improved the appropriate use of perioperative antimicrobial prophylaxis for Class I incision surgeries, reducing unnecessary use and costs without increasing SSI risk. This approach represents an effective and replicable stewardship model for routine surgical care. [...]

- Zhenying Zhao

INTRODUCTION: To optimize pharmacist engagement in antimicrobial stewardship (AMS), this study assessed general surgeons' knowledge, practices, and perspectives on AMS and pharmacist interventions. Although antibiotic utilization density has decreased consistently over three years following the involvement of clinical pharmacists, challenges to AMS persist. [...]

- Samantha Linville

CONCLUSION: These findings suggest that pharmacist-led PEN-FAST implementation is a feasible strategy to identify low-risk penicillin allergies, but allergy delabeling and oral challenge rates remain low. Further efforts are needed to integrate PEN-FAST into clinical workflows and enhance antimicrobial stewardship. [...]

- Emre Kara

CONCLUSION: Pharmacist participation in multidisciplinary antifungal stewardship teams may be associated with improved antifungal utilization and adherence to guidelines in hospitalized adults. The findings support that pharmacists are important members of multidisciplinary teams in antifungal stewardship. [...]

- Xinyi Li

CONCLUSION: Pharmacist-led interventions in COPD may improve selected medication-related and patient-centered outcomes; however, the available evidence is heterogeneous and limited by study quality and inconsistent effects across outcomes. These findings should be interpreted cautiously, and well-designed, adequately powered trials with standardized outcomes are needed before robust conclusions regarding clinical effectiveness [...]

- Nawal Alsubaie

CONCLUSION: Clinical pharmacist-led antimicrobial stewardship programs (ASPs) significantly reduced antimicrobial exposure and healthcare utilization, improving the appropriateness of antimicrobial prescriptions and clinical outcomes. These findings highlight the importance of ASPs as an evidence-based strategy to address antimicrobial resistance and optimize patient care in HAP. [...]

- Samantha Liaw

CONCLUSION: The pharmacist-led telehealth TOC program significantly reduced hospital readmission rates. These findings support the implementation of pharmacist-led TOC programs and suggest the importance of risk stratification in targeting interventions. [...]

- Daniela Farzadfar

CONCLUSION: Successful implementation of the TOC program enabled continuity of care and optimized medication management following discharge, with the goal of improving patient outcomes. [...]

- Richard Lowrie

CONCLUSIONS: Pharmacy Homeless Outreach Engagement Non-medical Independent prescribing Rx community pharmacy pilot randomised controlled trial successfully achieved key progression criteria. If found to be effective and cost-effective in a subsequent definitive randomised controlled trial, it offers promise as an adaptable (United Kingdom and internationally) model of integrated care provision for [...]

- Viandro Borja

Psychotropic medicines are essential in managing mental illness but are associated with complex challenges, including off-label use, polypharmacy, drug interactions, adverse effects, and diverse safety profiles. Effective decision-making requires access to reliable, evidence-based, and context-specific medicines information. Medicines Information (MI) services, particularly those led by pharmacists, provide tailored, evidence-informed advice [...]

- Devin N Holden

CONCLUSIONS: 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. [...]

- Wendy Xia

CONCLUSION: The pharmacist-led intervention more than doubled the pharmacologic treatment rate for AUD in primary care. [...]

- Tracy L Van

CONCLUSION: The Pharm.D. resident on-call program was well-received and perceived to enhance physician resident education. Future efforts should focus on increasing program visibility, targeted specialty outreach, and enhancing pharmacists' responsibility and integration in physician residency training and education. [...]

- Caitlin Brown

CONCLUSION: EMP involvement in patient care during anticoagulation reversal of acute hemorrhages improved time to anticoagulation reversal agent administration. Larger scale, higher-quality studies are necessary to assess the value of EMPs in improving patient-centered outcomes. [...]

- Kimberly Ly

CONCLUSION: Pharmacist stewardship intervention significantly increased the appropriateness of prescribed antibiotics at discharge by 60% without compromising patient care. Because most antibiotics are meant to be completed post-discharge, these findings highlight that inpatient antimicrobial stewardship efforts overlook a significant number of patients on antibiotics. [...]

- Jillian Searle

CONCLUSIONS: The implementation of the LOW-TOC approach to CV team-based lipid management was associated with significantly increased optimizations compared with the standard process typically utilized in many health systems. These findings support the utility of pharmacists leading the CV team in optimizing lipid management using a population health model in [...]

- Chiranjeev Sanyal

CONCLUSIONS: The cost-utility analyses indicated that pharmacist-led deprescribing interventions are generally a cost-effective option compared with usual care. While these interventions appear promising from an economic standpoint, more long-term, population-based studies are needed to validate these findings. [...]

- Wendy L St Peter

CONCLUSIONS: This scoping review demonstrates an integral and direct role for pharmacists in improving outcomes for patients with CKM conditions in interprofessional settings. However, there is a need for more robust studies that investigate cardiovascular, kidney, and metabolic outcomes in these patients. [...]

- Lydia Jackson

CONCLUSION: CPPs provided MOUD care that was safe and effective, with outcomes comparable with those of physicians and nurse practitioners. Their increased use of risk mitigation tools such as PDMP underscores the value of CPP integration into MOUD programs, which can increase access to SUD care. [...]

- Büşra Ergen

CONCLUSION: Integration of a clinical pharmacist into a interprofessional audit and feedback process significantly improved antimicrobial appropriateness and reduced antimicrobial-related problems. An associated reduction in 30-day mortality was observed after adjustment for illness severity; however, this finding warrants confirmation in larger prospective studies. [...]

- Robert J DiDomenico

The American College of Clinical Pharmacy (ACCP) advocates for board certification of clinical pharmacists in one of the recognized specialties as a fundamental qualification and requirement for providing and supervising trainees in the provision of direct patient care. However, data linking pharmacist board certification to patient outcomes are limited, and [...]

- Mojdeh S Heavner

It is challenging to generate data sufficient to assess the complex relationships between pharmacist workload and patient outcomes. The purpose of this paper is to describe innovative methods of recruitment and retention in engaging health professionals as study participants in a multicenter effort to collect workload data for a large [...]

- Emily R Casey

CONCLUSIONS: Pharmacist-guided rapid titration accelerated attainment of therapeutic methadone doses and did not increase adverse events. Although the adjusted increase in the proportion achieving ≥60 mg TDD by discharge was not statistically significant, these findings demonstrate how inpatient clinical pharmacists can modernize inpatient OUD care. [...]

- Kaja Zorjan

CONCLUSION: In this retrospective study, the presence of unresolved drug-related problems following pharmacist-led comprehensive medication reviews was independently associated with four-fold higher odds of hospital readmission within 6 months. These findings highlight unresolved drug-related problems as a strong, independent marker of increased readmission risk. Prospective studies are needed to determine [...]

- Yohei Iimura

CONCLUSIONS: While ICIs have substantially improved survival outcomes, their immunomodulatory effects may amplify drug-specific dermatologic toxicities when used in combination regimens. Shared inflammatory pathways and immune cell recruitment to the skin likely underlie this interaction, underscoring the importance of anticipatory monitoring and optimized management strategies in combination therapy. [...]

- Katrina P Nguyen

This methods paper describes the development and implementation of a pharmacist-led, workplace-based diabetes prevention intervention tailored to hospitality workers in New Orleans. Grounded in the Social Ecological Model (SEM) and the Health Belief Model (HBM), this study integrated onsite diabetes risk screening, brief lifestyle education, provision of health-promoting tools, and [...]

- Jubilee Winar

CONCLUSION: This initiative demonstrates the value of pharmacist involvement in WLS care. Medication adherence remained high, and the strong acceptance of pharmacist recommendations supports the benefit of pharmacist led medication review. The minor decline in follow up adherence may reflect reduced post-WLS motivation. Controlled studies are needed to more clearly [...]

- Ikram Zoukh

Therapeutic inertia is a growing concern in diabetes management. Pharmacist interventions have shown mixed results in addressing this issue in ambulatory and primary care settings. This review aims to evaluate the impact of pharmacist interventions on therapeutic inertia and glycemic control among patients with diabetes in these settings. A systematic [...]

- Stacey Cutrell

CONCLUSION: This initiative resulted in a significant improvement in SGLT2 inhibitor use for patients with CKD and HF. The findings highlight the feasibility of using DCES-credentialed pharmacists in an interprofessional care team to initiate SGLT2 inhibitor therapy for patients with these conditions in the primary care setting. [...]

- Jessica Hudak

In 2021, North Carolina (NC) authorized pharmacists to initiate hormonal contraceptives. The objectives of this pilot study were to: (1) determine where hormonal contraception (HC) services were provided; (2) evaluate patient characteristics; and (3) describe pharmacist interventions. Pharmacists who completed training and prescribed HC between April 2022 and December 2023 [...]

- Muhammed Yasir Demirci

CONCLUSION: This intervention reduced 30-day cardiac readmission, but the effect was not statistically significant. According to findings of secondary outcomes, this behavioural theory-based discharge service at discharge might be effective in reducing healthcare utilisation in the long term and improving the short-term target for medication adherence in patients with acute [...]

- Guangjie Wu

CONCLUSION: Clinical pharmacist-led antimicrobial stewardship can reduce the antibiotic use intensity among patients undergoing VATLS in thoracic surgery, decrease the use of broad-spectrum antibiotics and shorten the duration of antibiotic therapy. [...]

- Pu En Ow Yong

Background Patients receiving maintenance hemodialysis experience a high burden of infectious morbidity, and vaccination is a key preventive strategy in this population. Despite international guideline recommendations, vaccination uptake and immune response in this population remain suboptimal. Aims The study aimed to evaluate hepatitis B virus (HBV) vaccination completion and seroprotection, [...]

- Fahim Faruque

Background: Collaboration between nurse practitioners (NPs) and pharmacists is essential for comprehensive patient care, especially in telehealth settings where communication is often asynchronous. Generative artificial intelligence (AI) offers a novel tool to enhance interprofessional coordination and improve patient outcomes. Objective: To evaluate the impact of an AI-enabled NP-pharmacist collaboration model [...]

- Ziad Sadik

CONCLUSION: Low-dose slow and ultraslow alteplase thrombolytic regimens demonstrated favorable clinical outcomes in patients with symptomatic PVT within a real-world clinical setting. Despite limitations inherent to a retrospective observational design and small sample size, these findings support pharmacologic thrombolysis as a potential alternative to surgery in selected patients. Larger prospective [...]

- Jiao Yang

CONCLUSION: This prediction model effectively identifies MHD patients with pneumonia at high risk of developing IPFI, demonstrating robust predictive performance. This tool can facilitate early risk stratification by clinical pharmacists in ward decision-support and stewardship consultations, optimizing the prophylactic and targeted use of antifungal agents and promoting rational drug therapy. [...]

- Unyime Israel Eshiet

CONCLUSION: The intervention was associated with a significant improvement in the perception and willingness to pay for adult vaccines among the participants. Infodemic management interventions can effectively improve uptake of adult vaccines. [...]

- Jiali Niu

BACKGROUND Patients with acute ischemic stroke receiving intravenous thrombolysis require intensive secondary prevention; however, poor medication adherence and inadequate lipid control in real-world practice often compromise long-term outcomes. This study evaluated the effects of a clinical pharmacist-led medication management program on medication adherence, lipid control, and functional outcomes in patients [...]

- Vivek Patil

BackgroundBreast cancer treatment with chemotherapy often affects patients' quality of life despite therapeutic benefits. This study evaluated the impact of a standardized Chemotherapy Order Template on quality of life in breast cancer patients using the FACT-G questionnaire.MethodA prospective randomized controlled study in a tertiary care hospital included 168 breast cancer [...]

- Lauren Jenkins

CONCLUSIONS: In a setting where HAV and HBV vaccination guidelines remained consistent over time, the pharmacist-led MMC model was associated with higher vaccination and screening rates compared with the traditional care model, and these associations remained robust after adjustment for age, sex, genotype, and fibrosis stage. The model may have [...]

- Joana Ribeiro

INTRODUCTION: With health systems facing increasing challenges, it is important to define new care models that may release some of the burden on the workforce, whilst maintaining quality and improving patient convenience. The objective of this study was to create a taxonomy of pharmacist-led interventions aimed at supporting improved health [...]

- Tongtong Li

CONCLUSION: The closed-loop stewardship model effectively improved meropenem target concentration attainment by systematically reducing drug loss through degradation and metabolism. This optimized exposure profile correlated with improved eradication rates of Gram-negative sensitive bacteria. [...]

- Stephanie W K Teoh

(1) Background: Medication-related problems (MRPs) are a significant burden on health care systems. Pharmacists play an important role in preventing and reducing MRPs through clinical review, education, and policy governance. This study analyzed pharmacist interventions within a 92-bed neonatal clinical care unit to better understand MRPs and guide targeted medication [...]

Pharmacist & Outcomes – Open Acess (Free PDF)
- Saad Saeed Alqahtani

CONCLUSION: Through increased medication adherence, better patient awareness, and support for lifestyle adjustment, pharmacist-led educational programs greatly reduce the risk of CVD and enhanced lipid profiles. To enhance the management of chronic diseases, clinical chemists must be integrated into multidisciplinary care teams. To optimise advantages, future research should focus on [...]

- Muhammad Zahid Iqbal

CONCLUSION: Taken together, the findings indicate that involving pharmacists more directly in the medication management of individuals with chronic conditions leads to better clinical results and more favorable economic outcomes. These findings support the idea of involving pharmacists more closely within chronic-care teams. [...]

- Zhao Mei

CONCLUSION: This grid-based precision ASP was associated with sustained reductions in antimicrobial use and costs, and improved clinical outcomes. It was also associated with changes in the temporal relationship between AUD and MDRO detection rates. These alterations suggest this approach may mitigate selective pressure driving resistance, although causality cannot be [...]

- Tirapada Kiatsangorn

CONCLUSION: This pilot service demonstrates that a pharmacist-led holistic smoking cessation model can be feasibly integrated into psychiatric care in a provincial Thai hospital. Further controlled studies are warranted to evaluate long-term effectiveness and scalability. [...]

- Taiga Ishikawa

Immune checkpoint inhibitors (ICIs) have significantly advanced cancer treatment, and their clinical indications continue to expand. At the same time, the importance of managing immune-related adverse events (irAEs) has been increasing, along with growing expectations for pharmacist involvement. Herein, we report a case in which prompt pharmacist intervention prevented the [...]

- Miguel Ángel Amor García

The design and implementation of antimicrobial stewardship programs for patients admitted to intensive care units must consider the specific characteristics of this population, including infection severity, organ dysfunction, and pharmacokinetic/pharmacodynamic alterations. The creation of a multidisciplinary team and the establishment of clear, targeted objectives are essential to improve treatment appropriateness, [...]

- Simone Diamandis

CONCLUSIONS: The development and adoption of PPEAPSOP policies depend on alignment amongst policy actors, navigation of systemic constraints, strategic foresight of policy implications, and a narrative grounded in robust evidence, =contextualised to the policy environment. Current approaches to the development and adoption of PPEAPSOP policies highlight gaps, underscoring the need [...]

- Amr Ali Mohamed Abdelgawwad El-Sehrawy

The gut microbiome, a complex ecosystem of microorganisms, is now recognized as a key determinant of drug efficacy and toxicity, giving rise to the field of pharmacomicrobiomics. This review decodes the profound influence of the gut microbiome on treatment outcomes for hematologic malignancies. We explore the tripartite mechanistic pathways through [...]

- Özge Özmen

Patients with renal dysfunction are highly susceptible to drug-related problems (DRPs) due to altered pharmacokinetics and polypharmacy. Clinical pharmacists(CP) play a key role in optimising pharmacotherapy and preventing medication errors in this vulnerable population. To evaluate the prevalence of DRPs in patients with renal dysfunction and to compare the effectiveness [...]

- Guirong Xiao

CONCLUSION: Inpatients demonstrated clear preferences for attributes of IPC, with variations by income, residence, and chronic disease status. Greater involvement of clinical pharmacists, tailored adjustment of consultation frequency and duration, and integration into hierarchical diagnosis and treatment and chronic disease management were encouraged. Price has limited influence on choices. We [...]

- Haley Huddleston

CONCLUSIONS: Integrating pharmacists into care teams can enhance GLP-1 RA PA turnaround times while improving medication access, safety, and continuity of care. These findings support further research and policy development in pharmacist interventions in PA process and GLP-1 RA management. [...]

- Ai Ogawa

CONCLUSIONS: Pharmacist-led education on diabetic retinopathy did not increase ophthalmology visits or improve diabetes-related outcomes. Effective strategies to encourage ophthalmology visits are required. [...]

- Elena Meishan Lee

CONCLUSION: The pharmacist-led DEMO program was non-inferior to standard physician consultation in achieving a BP target of 140/90mmHg within six months, with high usability and modest WTP. [...]

- Deborah L Pestka

CONCLUSIONS AND RELEVANCE: In this quality improvement study, pharmacist-led outreach was associated with increased initiation of SGLT2 inhibitors; however, limited intervention reach may have constrained the overall impact. Strategies to improve uptake are needed to enhance impact and inform broader SGLT2 inhibitor implementation in patients with CKD and type 2 [...]

- Mubai Ma

CONCLUSION: This study indicates that in patients treated with vancomycin under TDM, pharmacist interventions can promote the standardization of vancomycin TDM, reduce the incidence of acute kidney injury, and improve clinical outcomes. [...]

- Arinze Nkemdirim Okere

CONCLUSION: Community pharmacies are well positioned to expand CRC screening access. Addressing reimbursement, training, workflow, and coordination barriers through evidence-based strategies and supportive policy can enable pharmacist-delivered CRC screening to reduce disparities and improve population health outcomes. [...]

- Mohammad Ali Al-Qarni

Background: Treatment-related problems (TRPs), including patient adherence, knowledge, and medication errors, affect hospitalized patients' outcomes worldwide. Effective clinical pharmacist communication is essential for proper patient counselling and medication safety. However, the effect of clinical pharmacist communication skills on TRPs has not been adequately studied. Objective: This study aimed to assess [...]

- Jonathan Penm

INTRODUCTION: Despite limited evidence of efficacy, opioid analgesics are frequently used by patients for chronic pain while awaiting total hip or knee arthroplasty (THA or TKA). Preoperative use of opioids is problematic as it increases the likelihood of postoperative opioid-related adverse drug events and postoperative complications and is the strongest [...]

- Dayana El Nsouli

INTRODUCTION: Pharmacist prescribing has been introduced to alleviate pressures on hospital services and improve timely access to treatment. However, implementation in inpatient settings remains highly variable, with pockets of excellent practice alongside areas where prescribing roles are limited or absent. Traditional effectiveness reviews have demonstrated positive impacts of pharmacist prescribing [...]

- Rachael Ialacci

CONCLUSION: This workflow demonstrated that pharmacist interventions within the nurse BP workflow can contribute to improvement in BP without requiring a comprehensive pharmacist visit​. [...]

- Kaitlyn E Watson

CONCLUSIONS: This study presents the validation of the first pharmacist-specific tool to measure engagement. The POWER Engagement Framework demonstrated good reliability and conceptual coherence to assess pharmacist engagement. Refinement for Well-being and Resources constructs could improve the model. [...]

- Esteban Zavaleta-Monestel

Polypharmacy in older adults is associated with medication-related harm, including adverse drug events, drug-drug interactions, inappropriate prescribing, and hospitalization-related outcomes. This systematic review evaluated the effectiveness and safety of pharmacist-led deprescribing interventions in adults aged ≥65 years. The review was reported according to the Preferred Reporting Items for Systematic Reviews [...]

- Debbie Liang

CONCLUSION: Connect AF demonstrates how pharmacists can address SDOH-related care gaps and provides a scalable model for cross-sector collaboration to enhance patient care coordination. [...]

- Amna Mohamed

CONCLUSION: Pharmacist-led interventions in hematology-oncology care improve medication management processes and may contribute to better adherence and medication safety. However, evidence for effects on clinical and economic outcomes remains limited and heterogeneous, highlighting the need for well-designed prospective studies using standardized outcome measures. [...]

- Alfonso Leiva

INTRODUCTION: Potentially inappropriate prescriptions (PIPs) in older adults, such as long-term use of benzodiazepines, proton pump inhibitors without indication or antipsychotics in dementia, are associated with adverse events and increased healthcare utilisation. Despite clinical guidelines discouraging their use, PIPs remain frequent in primary care. An audit and feedback (A&F) intervention [...]

- Kayla Sturtevant

Background: Obesity is a prevalent condition associated with numerous comorbidities. Weight loss medications reduce comorbidity burden, but barriers hinder access and titration. Clinical pharmacists play a key role in chronic disease management, but limited research exists on pharmacists managing weight loss. Objective: Evaluate the impact of a clinical pharmacist on [...]

- Lene Berge Holm

CONCLUSION: This pilot service evaluation suggests that pharmacist-led migraine counselling may represent a clinically relevant and potentially useful addition to community pharmacy practice. Responding patients reported positive consultation experiences and reported to be highly motivated to take their medication. The majority implemented at least one recommendation, and many reported perceived [...]

- Xiunan Yue

CONCLUSION: This pharmacist-led risk assessment tool has strong potential for accurately identifying high-risk β-lactam allergy patients and optimising antimicrobial stewardship in Chinese hospitals. Further large-scale validation is warranted. [...]

- Abdullah Faiz Zaihan

CONCLUSION: In this MTAC-supported cohort, polypharmacy and full GDMT were not associated with increased burden or reduced adherence. A modest positive association between medication count and QOL was observed. SGLT2i use was associated with lower adherence and QOL, although these findings are exploratory and may reflect differences in disease severity [...]

- Wenting Xie

CONCLUSION: Pharmacists' interventions exert a positive effect on asthma and COPD management outcomes, though improved research design and quality are still needed. [...]

- Hui Liu

CONCLUSION: A clinical pharmacist-led multimodal ASP intervention significantly improved the appropriate use of perioperative antimicrobial prophylaxis for Class I incision surgeries, reducing unnecessary use and costs without increasing SSI risk. This approach represents an effective and replicable stewardship model for routine surgical care. [...]

- Zhenying Zhao

INTRODUCTION: To optimize pharmacist engagement in antimicrobial stewardship (AMS), this study assessed general surgeons' knowledge, practices, and perspectives on AMS and pharmacist interventions. Although antibiotic utilization density has decreased consistently over three years following the involvement of clinical pharmacists, challenges to AMS persist. [...]

- Xinyi Li

CONCLUSION: Pharmacist-led interventions in COPD may improve selected medication-related and patient-centered outcomes; however, the available evidence is heterogeneous and limited by study quality and inconsistent effects across outcomes. These findings should be interpreted cautiously, and well-designed, adequately powered trials with standardized outcomes are needed before robust conclusions regarding clinical effectiveness [...]

- Nawal Alsubaie

CONCLUSION: Clinical pharmacist-led antimicrobial stewardship programs (ASPs) significantly reduced antimicrobial exposure and healthcare utilization, improving the appropriateness of antimicrobial prescriptions and clinical outcomes. These findings highlight the importance of ASPs as an evidence-based strategy to address antimicrobial resistance and optimize patient care in HAP. [...]

- Yohei Iimura

CONCLUSIONS: While ICIs have substantially improved survival outcomes, their immunomodulatory effects may amplify drug-specific dermatologic toxicities when used in combination regimens. Shared inflammatory pathways and immune cell recruitment to the skin likely underlie this interaction, underscoring the importance of anticipatory monitoring and optimized management strategies in combination therapy. [...]

- Katrina P Nguyen

This methods paper describes the development and implementation of a pharmacist-led, workplace-based diabetes prevention intervention tailored to hospitality workers in New Orleans. Grounded in the Social Ecological Model (SEM) and the Health Belief Model (HBM), this study integrated onsite diabetes risk screening, brief lifestyle education, provision of health-promoting tools, and [...]

- Guangjie Wu

CONCLUSION: Clinical pharmacist-led antimicrobial stewardship can reduce the antibiotic use intensity among patients undergoing VATLS in thoracic surgery, decrease the use of broad-spectrum antibiotics and shorten the duration of antibiotic therapy. [...]

- Pu En Ow Yong

Background Patients receiving maintenance hemodialysis experience a high burden of infectious morbidity, and vaccination is a key preventive strategy in this population. Despite international guideline recommendations, vaccination uptake and immune response in this population remain suboptimal. Aims The study aimed to evaluate hepatitis B virus (HBV) vaccination completion and seroprotection, [...]

- Ziad Sadik

CONCLUSION: Low-dose slow and ultraslow alteplase thrombolytic regimens demonstrated favorable clinical outcomes in patients with symptomatic PVT within a real-world clinical setting. Despite limitations inherent to a retrospective observational design and small sample size, these findings support pharmacologic thrombolysis as a potential alternative to surgery in selected patients. Larger prospective [...]

- Jiao Yang

CONCLUSION: This prediction model effectively identifies MHD patients with pneumonia at high risk of developing IPFI, demonstrating robust predictive performance. This tool can facilitate early risk stratification by clinical pharmacists in ward decision-support and stewardship consultations, optimizing the prophylactic and targeted use of antifungal agents and promoting rational drug therapy. [...]

- Unyime Israel Eshiet

CONCLUSION: The intervention was associated with a significant improvement in the perception and willingness to pay for adult vaccines among the participants. Infodemic management interventions can effectively improve uptake of adult vaccines. [...]

- Jiali Niu

BACKGROUND Patients with acute ischemic stroke receiving intravenous thrombolysis require intensive secondary prevention; however, poor medication adherence and inadequate lipid control in real-world practice often compromise long-term outcomes. This study evaluated the effects of a clinical pharmacist-led medication management program on medication adherence, lipid control, and functional outcomes in patients [...]

- Lauren Jenkins

CONCLUSIONS: In a setting where HAV and HBV vaccination guidelines remained consistent over time, the pharmacist-led MMC model was associated with higher vaccination and screening rates compared with the traditional care model, and these associations remained robust after adjustment for age, sex, genotype, and fibrosis stage. The model may have [...]

- Joana Ribeiro

INTRODUCTION: With health systems facing increasing challenges, it is important to define new care models that may release some of the burden on the workforce, whilst maintaining quality and improving patient convenience. The objective of this study was to create a taxonomy of pharmacist-led interventions aimed at supporting improved health [...]

- Tongtong Li

CONCLUSION: The closed-loop stewardship model effectively improved meropenem target concentration attainment by systematically reducing drug loss through degradation and metabolism. This optimized exposure profile correlated with improved eradication rates of Gram-negative sensitive bacteria. [...]

- Stephanie W K Teoh

(1) Background: Medication-related problems (MRPs) are a significant burden on health care systems. Pharmacists play an important role in preventing and reducing MRPs through clinical review, education, and policy governance. This study analyzed pharmacist interventions within a 92-bed neonatal clinical care unit to better understand MRPs and guide targeted medication [...]

- Xiongbing Sun

CONCLUSION: Clinical pharmacist interventions can significantly enhance the rational use of perioperative antimicrobial drugs in hysteroscopic surgery, leading to notable clinical outcomes and economic benefits. [...]

- Xi Huang

CONCLUSION: This case demonstrates that a full-course pharmaceutical care model enables timely detection and management of complex ADRs, optimizes therapeutic outcomes, and supports multidisciplinary decision-making. The model illustrates the pivotal role of the clinical pharmacist in improving medication safety and efficacy in ABPA, offering a replicable framework for promoting integrated, [...]

- Daniel Amante

CONCLUSIONS: The DCC program was associated with directional improvements in clinical, health care utilization, and cost outcomes and was cost-neutral due to savings and associated revenue. With approximately one-third of participants having Medicaid insurance, the sustainability of such programs increases through leveraging the 340B program to enhance care for economically [...]

- Joshua D Bennetts

CONCLUSIONS: A post-discharge nurse-pharmacist telehealth service is a feasible and well-accepted MoC. The inclusion of a routine MedRec post-discharge may enhance continuity of care, improve medication safety, and support HF management. [...]

- Shih-Yu Liu

CONCLUSION: This trial will evaluate the effectiveness of pharmacist-led education in improving DOAC adherence and treatment outcomes over a 6-month follow-up period. The findings will inform the development and implementation of future pharmacist-led care models. [...]

- Timothy S Anderson

CONCLUSIONS: A primary care embedded virtual intervention involving pharmacist-led tapering and mindfulness-informed CBT sessions to support benzodiazepine deprescribing is feasible, acceptable, may reduce older adults' benzodiazepine use, and warrants multi-site testing. [...]

- Joshua M Pevnick

CONCLUSIONS AND RELEVANCE: Among older adults with polypharmacy, no reduction overall in 30-day unplanned hospital and ED utilization from a pharmacist-led TOC intervention was detected, but a reduction was found among patients with low medication adherence and literacy, suggesting benefit for this subgroup. [...]

- Jie Xiao

CONCLUSIONS: These findings suggest that the physician-pharmacist collaborative model could improve the long-term quality and efficiency of T2D management and reduce medical costs in underresourced areas globally. Patients with T2D, especially those with central obesity or high cardiovascular risk, may benefit more from collaborative clinics. [...]

- Gerald Cochran

CONCLUSIONS: This underpowered study found no evidence of pain differences between ABI-MTM and SMC, tentatively suggesting possible alcohol-opioid co-use improvements associated with the intervention without worsening pain. [...]

- Edward Christopher Portillo

CONCLUSIONS: This evaluation furthers what is understood regarding barriers to implementing care bundles within rural healthcare contexts. Our findings suggested that clinicians in rural settings felt constrained in their ability to take on new tasks and expand their practice models due to staffing shortages and heavy workload demands. Some clinicians [...]

- Ahmed Hassan Ali

CONCLUSIONS: This study identified priority outcomes for evaluating the impact of pharmacist prescribing and their measurability, encompassing clinical, safety, economic, and patient perspectives. [...]

- Jennifer Ko

CONCLUSION: Spanish-speaking patients exposed to clinical pharmacist care observed significant improvements in glycemic control and timely preventative care screening. [...]

- Yu-Jui Chiu

Despite the broad coverage offered by Taiwan's National Health Insurance system, attention-deficit/hyperactivity disorder (ADHD) care continues to face a critical "leaky pipeline" problem. There is a clear gap between diagnostic prevalence and long-term treatment retention. This perspective article applies the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) framework [...]

- Duaa Raad Sadiq

CONCLUSIONS: This pilot study underscores the critical role of pharmacist-led education for patients with primary open-angle glaucoma in improving treatment outcomes, particularly in achieving IOP targets and therby reducing the risk of vision loss. Future research involving larger cohorts and longer follow-up is necessary to further validate these findings. [...]

- Masaki Maehara

CONCLUSIONS: The brief pharmacist-led intervention was effective in improving attitudes toward medication and behavioral adherence among patients receiving antipsychotic treatment in our study group. These findings underscore the importance of active pharmacist engagement for supporting medication adherence. [...]

- Jan Busby-Whitehead

CONCLUSIONS AND RELEVANCE: This cluster randomized trial found that a centralized consultant pharmacist model was feasible, integrated well into primary care workflows, and resulted in high practitioner acceptance of recommendations; however, it did not significantly reduce opioid or benzodiazepine prescribing or falls within 1 year. These results suggest that more [...]

- Dylan Bonnan

CONCLUSION: Pharmacist-led interventions in interprofessional primary care settings contributed to the appropriateness of pharmacotherapy and satisfaction of older adults under evaluation for or living with a NCD after a six-month follow-up. [...]

- Ryo Iketani

CONCLUSIONS AND RELEVANCE: This large-scale cohort study found that the use of an FPS was not associated with lower risk of death or hospitalization from any cause. However, the results generated a clinically important hypothesis that FPS use may be associated with slightly lower risk of death among older patients [...]

- Edward C Portillo

CONCLUSION: This evaluation demonstrated the impact of clinical pharmacists serving as prescribers in improving COPD management in rural settings. The sustainment factors identified can be utilized to inform the expansion of similar, team-based healthcare programs across rural settings. [...]

- Tingting Li

CONCLUSIONS: Our study demonstrates that comprehensive machine learning optimization can achieve strong predictive performance for identifying patients who would benefit from pharmacist intervention. The clinical prediction model, trained exclusively on clinical variables, provides a robust framework for personalized TB treatment resource allocation. Supportive transcriptomic analyses provide biological context but are [...]

- Weronika Guzenda

CONCLUSIONS: Pharmacist-developed educational leaflets can support short-term knowledge acquisition and are perceived positively by women across age groups. These findings highlight the potential role of community pharmacies in delivering accessible written health education, while underscoring the need for future studies to assess long-term knowledge retention, behavioral outcomes, and topic-specific, targeted [...]

- Lisa K Gilliam

CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, adding proactive, protocol-driven clinical pharmacist outreach into collaborative team-based care improved medication optimization and patient outcomes. This approach provides an evidence-based strategy for reducing the risk of developing severe hypoglycemia in individuals with T2D at high risk, enhancing patient safety, and potentially [...]

- Keren Dopelt

Background/Objectives: Older adults with chronic kidney disease (CKD) are particularly vulnerable to polypharmacy-related adverse outcomes due to altered pharmacokinetics, multimorbidity, and increased susceptibility to medication-related harm. Polypharmacy in CKD is associated with falls, hospitalizations, and functional decline. Clinical pharmacist-led medication reviews may mitigate these risks; however, access barriers limit their [...]

- Xiaohong Wu

CONCLUSIONS: The clinical pharmacist-led MDT model enhances carbapenem-prescribing appropriateness and fosters interprofessional collaboration. Its implementation was associated with shorter hospital stays and improvements in key clinical indicators, including reduced ICU admission and mortality. However, the observed shifts in resistant pathogen epidemiology underscore that antimicrobial stewardship strategies must be integrated with [...]

- Takumi Umemura

Antimicrobial resistance (AMR) undermines clinical care. Thus, ensuring appropriate antimicrobial therapy is crucial in global and national AMR countermeasures. This narrative review aimed to summarize pharmacist-led antimicrobial stewardship interventions in Japan and discuss their practical and clinical significance across inpatient, outpatient, and community settings. In inpatient care, antimicrobial stewardship programs [...]

- Ruping Ni

BACKGROUND: Venous thromboembolism (VTE) is a common and potentially fatal complication in orthopedic trauma patients, particularly following lower limb and hip-related fractures. While pharmacological prophylaxis is the cornerstone of prevention for patients at moderate to high risk, its use is a balance between efficacy and bleeding risk. Clinical pharmacists play [...]

- Chunyan Wang

CONCLUSIONS: A pharmacist-led PST intervention with ongoing education and counselling led to improved TTR and clinical outcomes in patients with MHV in China. [...]

- Clara Salom-Garrigues

CONCLUSIONS: In the ATDOM program, patients with polypharmacy and DRPs associated with various factors are quite prevalent. These patients could be prioritized for pharmacist-led clinical medication review within multidisciplinary teams. An ongoing clinical trial will assess the effectiveness of medication review in reducing polypharmacy and DRPs. [...]

- Joyce Y Lee

CONCLUSION: This scoping review highlighted emerging but heterogeneous use of CGM metrics in CGM-integrated pharmacists' services in diabetes care. While reported outcomes were consistently positive, most studies focused on clinical parameters, particularly A1C. Future research should place greater emphasis on evaluating humanistic and economic outcomes of CGM on pharmacist-involved diabetes [...]

- Neil Powell

CONCLUSIONS: PADL delivered by non-allergy nurses in the outpatient setting is safe and effective at removing low-risk penicillin allergy records. [...]

- Wassan L Zarei

CONCLUSION: The factors identified in this study can be used to develop potential strategic plans to improve existing PMAC services and extend their implementation across the country. Future research should aim to quantify the effectiveness of PMAC services on patients' clinical/non-clinical outcomes. Positive findings could provide further evidence of the [...]

- Nobuaki Sampa

Piperacillin/tazobactam (PIPC/TAZ) and vancomycin (VCM) are frequently used in combination (PTV) to manage severe healthcare-associated infections, but are also associated with an increased risk of acute kidney injury (AKI). In 2019, Ogaki Municipal Hospital implemented pharmacist-led interventions aimed at reducing PTV use and mitigating AKI. This study evaluated the impact [...]

- Thomas G H Kempen

CONCLUSION: Preparing pharmacists for prescribing roles in the Netherlands requires integrating several new or expanded competencies into pharmacy education. Regardless of the prescribing model to be introduced, assuming responsibility for prescribing decisions and outcomes appears essential. [...]

- Mohamed Y Abdelgaied

CONCLUSION: Pharmacists' activities, the extent of collaboration and outcomes of collaborative care varied. This information may help to support the implementation of new COPD-focused services. Further rigorously designed research is needed to explore the effect of collaborative community pharmacist-physician care in COPD management. [...]

- Yu Dong

CONCLUSION: Pharmacist-led MTM plays a crucial role in optimizing cancer pain management by reducing DRPs, improving adherence, minimizing adverse drug reactions, and enhancing patient satisfaction. It is an essential component of comprehensive, individualized care that ultimately improves the clinical outcomes and quality of life of patients with cancer. [...]

- Jaclyn Costello

CONCLUSION: 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. [...]

- Carlos Eduardo Estrada-De La Rosa

CONCLUSIONS: In this outpatient pain and palliative-care population, benzodiazepine-related dependence phenomena were common: 59.7% of patients met the criteria for dependence based on the pharmacist-led EMR review. The involvement of the pharmacist was essential, as this systematic evaluation would have been difficult to perform within routine medical consultations. The pharmacist's [...]

- Xiaolan Ye

The management of hyperphosphatemia is of critical significance given its high prevalence among hemodialysis (HD) patients and its strong association with worse outcomes. Clinical pharmacists can play a crucial role in medication management, but there is a critical shortage. Currently, there is rarely study evaluating how pharmacists in different roles [...]

- Angela S Choi

CONCLUSION: Patients and clinicians were generally supportive of potential pharmacist prescribing in the hemodialysis unit, contingent on several considerations for implementation. Interviews with additional stakeholders in other dialysis care settings could further inform strategies for broader adoption. [...]

- Mirna Momčilović

Optimising medication adherence is essential for effective heart failure (HF) management, yet nonadherence remains common, particularly among hospitalised and advanced-stage patients. This study evaluated the internal consistency reliability and score association of the Medication Adherence Report Scales, MARS-5 and MARS-10, self-report questionnaires in clinical pharmacist-led adherence assessments in hospitalised HF [...]

- Annette Haerdtlein

BACKGROUND: Appropriate deprescribing of psychotropic, sedative, and anticholinergic potentially inappropriate medication (PSA-PIM) in older adults with polypharmacy can reduce the risk of adverse drug reactions, but is inconsistently implemented in primary care. The PARTNER intervention was designed to address challenges in PSA-PIM deprescribing at both provider and patient levels. [...]

- Zelalem Tilahun Tesfaye

CONCLUSION: Pharmacist-led deprescribing reduces inappropriate medication use in targeted settings, while pooled effects on total medication count and hard clinical outcomes remain uncertain. Variability in study designs and outcomes underscores the need for larger, thoroughly designed trials with standardized protocols, longer follow-up, and comprehensive evaluations of clinical, economic, and patient-reported [...]

- Yong Wang

Prehabilitation has emerged as a proactive, multimodal strategy in perioperative care, aiming to enhance functional capacity and resilience before surgery through medical optimization, exercise, nutrition, and psychological support. Despite their multidisciplinary nature, pharmacists are underutilized in this evolving field. Pharmacists are uniquely positioned to advance prehabilitation by applying Medication Therapy [...]

- Dang Yi

CONCLUSION: Machine learning-guided pharmacist interventions improved TB treatment outcomes and reduced costs. Future multicenter studies should validate subtype-specific benefits. [...]

- Dolapo S Awobusuyi

Background: Piperacillin-Tazobactam (PTZ) is often used to treat community-acquired intra-abdominal infections (CA-IAIs) despite common causative pathogens being susceptible to more narrow-spectrum agents. However, susceptibility to PTZ among these predominant pathogens has been declining. Antibiotic de-escalation to non-antipseudomonal beta-lactams whenever possible is an important strategy to prevent the development of resistance [...]

- Balazs Adam

Despite their expanding patient-facing roles and increased involvement in mental health services, pharmacists' interactions with clients remain largely medicines-focused. This limitation is compounded by a reported lack of pharmacists' confidence and inadequate training in both mental health conditions and communication skills. The interrelated concepts of person-centredness, therapeutic alliance, and empathy [...]

- Alvaro Monje

Background: Asymptomatic bacteriuria (ASB) is frequently overtreated in emergency departments (EDs), contributing to antimicrobial resistance without improving clinical outcomes. The rapid pace of clinical decision-making and high patient turnover in the ED further predispose clinicians to unnecessary antibiotic prescribing. Methods: A quasi-experimental study was conducted in the ED of a [...]

- Greta Kaspute

Background: Antimicrobial resistance (AMR) is accelerating globally, driven by widespread inappropriate antibiotic use and diagnostic uncertainty in primary care. Pharmcist-led point-of-care testing (POCTs) has emerged as a promising model to optimize antibiotic prescribing, improve triage, and strengthen antimicrobial stewardship (AMS). Methods: This scoping review synthesizes current evidence, regulatory models, and [...]

- Moteb Khobrani

CONCLUSION: Clinical pharmacist-led interventions significantly enhance medication adherence and quality of life and may reduce relapse risk among patients with BD-I. However, given the limited number of studies and small pooled sample sizes, the overall evidence remains preliminary, and the findings should be interpreted cautiously rather than as definitive conclusions. [...]

- Magali L A Heijkoop

CONCLUSIONS: Educational podcasts can improve medical students' attitude towards physician-pharmacist collaboration, particularly when introduced early in the curriculum. Podcasts offer a flexible and scalable format to enhance role understanding and promote interprofessional awareness among students. [...]

- Hisato Fujihara

Fujihara H, Kishimoto M, Kose E, Shinonaga H, Tanaka E, Nakamichi M, Mizokami F. The impact of pharmacist intervention on FIM gain in patients with musculoskeletal disorders in Kaifukuki rehabilitation wards. Jpn J Compr Rehabil Sci 2025; 16: 53-59. [...]