Leukemia treatment has evolved rapidly over the past decade, with the introduction of targeted therapies, immunotherapies, and increasingly complex pharmacotherapeutic regimens. Many antileukemic agents and supportive medications exhibit substantial pharmacokinetic variability and have narrow therapeutic windows. Therefore, therapeutic drug monitoring (TDM) has emerged as an important strategy for optimizing individualized pharmacotherapy, improving treatment efficacy, and reducing drug-related toxicity. However, the overall research landscape, development trajectory, and emerging trends of TDM in leukemia have not been systematically evaluated. This study aimed to systematically analyze global research trends and hotspots in TDM for leukemia between 2001 and 2025 using bibliometric methods and to provide insights into future research directions and clinical pharmacotherapy applications. Publications related to TDM in leukemia published between January 1, 2001, and December 31, 2025, were retrieved from the Web of Science Core Collection database. A topic-based search strategy was used to identify the relevant articles. Bibliometric analysis and visualization were conducted using VOSviewer and CiteSpace to evaluate publication output, collaboration networks among countries, institutions, and authors, journal distribution, highly cited publications, citation bursts, and keyword co-occurrence. A total of 859 papers were retrieved, with the highest output (58 papers) observed between 2024 and 2025. The United States and China contributed the most publications. The University of Texas MD Anderson Cancer Center ranked first among the institutions. Highly cited papers primarily focused on pharmacotherapy for hematologic malignancies, pharmacodynamics and pharmacokinetic studies, and pre-transplant medication regimens. Burst analysis indicates that TDM in leukemia treatment has progressively evolved from early preliminary studies on exposure–response relationships to the implementation of precision dosing strategies and clinical guidelines, continuously expanding to cover an increasing number of therapeutic agents in leukemia treatment. Current research hotspots include tyrosine kinase inhibitors (particularly Bcr-Abl inhibitors), asparaginase, drug interactions, and safety management issues. From 2001 to 2025, research activities on TDM in leukemia treatment have shown continuous growth, with substantial expansion in both scope and depth. TDM is gradually becoming an increasingly important component of leukemia pharmacotherapy and may play a key role in supporting precision medicine and optimizing treatment outcomes in leukemia patients.
Naloxone is an opioid overdose reversal drug that is available for free without a prescription via participating community pharmacies in Australia. To investigate Australian community pharmacists’ knowledge, attitudes, practices, and provision of naloxone and overdose prevention, and identify barriers to and correlates of naloxone provision. Data were collected between January and April 2025 via an anonymous, cross-sectional questionnaire among Australian community pharmacists who were recruited using a randomised representative sampling approach. Data pertaining to pharmacy and pharmacist-related characteristics, pharmacists’ knowledge and attitudes towards naloxone, overdose prevention, and provision of naloxone, including barriers to provision, were captured. Multivariable logistic regression was conducted to determine the pharmacy (including jurisdiction, geographic location, pharmacy type, and provision of other harm reduction services) and pharmacist (including gender, years of experience, knowledge of, and attitudes towards naloxone and overdose prevention) characteristics associated with stocking naloxone. Of the 730 pharmacists who completed the online questionnaire, approximately three-quarters (n = 534, 73.2
The types and causes of dispensing errors vary across the stages of the complex dispensing process in community pharmacies. Notably, the analysis of near-miss reports may facilitate improvements in healthcare environments and operational practices. We aimed to identify the characteristics of the factors contributing to near-miss errors at each stage of the dispensing process and to determine which factors require priority action. We conducted a secondary analysis of near-miss dispensing errors voluntarily reported by community pharmacies through the near-miss reporting system of the Japan Council for Quality Health Care. The associations between various types of near-miss errors and their contributing factors were estimated using multivariate logistic regression models. Among the 45,483 near-miss incidents, most were reported during the dispensing and accuracy-checking stages (n = 35,384, 77.8
Deprescribing is the planned withdrawal or dose reduction of medicines when harms outweigh benefits or when they are no longer required. Following publication of the Clinical Practice Guideline for Deprescribing in Older People in September 2025, supporting its uptake into routine practice is a critical next step. This study aimed to identify implementation strategies, informed by stakeholder-perceived barriers, to support the implementation of deprescribing guidelines. A qualitative analysis was undertaken of open-text responses collected during the guideline public consultation (24 April–31 May 2025). Inductive thematic analysis identified implementation barriers, which were then deductively mapped to the Consolidated Framework for Implementation Research (CFIR). Relevant CFIR constructs were entered into the CFIR-Expert Recommendations for Implementing Change (ERIC) Matching Tool to generate implementation strategies. Strategies were ranked by cumulative percentage endorsement and grouped using ERIC concept-mapping clusters. Of 313 survey respondents, 248 provided responses relevant to implementation. Three barrier themes were shared across consumer and professional/policy stakeholder groups. Theme 1: ‘Knowledge gaps, beliefs, and limited readiness to deprescribe’ describes gaps in consumers’ and clinicians’ knowledge, beliefs about medication use and deprescribing, and limited confidence or willingness to engage in deprescribing. Theme 2: ‘Communication, hierarchy, or social influences limiting deprescribing’ describes communication gaps, entrenched prescribing norms, power imbalances, and social influences that limited shared decision-making. Theme 3: ‘System-level structures misaligned with deprescribing practice’ describes broader healthcare system barriers, including financial, policy, workforce, organisational, and information-related constraints. Consumers additionally highlighted a lack of person-centred and adaptable approach for deprescribing, while professional/policy stakeholders identified barriers related to medicine formulations and guideline format and usability. Barriers mapped predominantly to the CFIR Inner Setting domain. The highest-ranked implementation strategy was ‘Identify and prepare champions’, within the ‘Develop stakeholder interrelationships’ cluster. Deprescribing barriers were largely situated within the Inner Setting domains. Recommended strategies emphasised stakeholder engagement and local champions, supporting locally led, relationship-based implementation approaches. Future work should evaluate the feasibility, acceptability, and effectiveness of these strategies in practice.
Clinician-led post-discharge telephone follow-up programs are effective in resolving medication-related problems (MRPs) in older adults. Our hospital offers a post-discharge telephone service, Talk-To-You-Tomorrow (TTYT), to general medicine patients to support medication management following hospital discharge. However, little is known about the the types of interventions used to address MRPs between clinicians within post-discharge telephone services. To compare the types of interventions utalised (pharmacists versus non-pharmacist clinicians) in addressing MRPs for general medicine patients identified through a post-discharge telephone follow-up (TFU) service. A retrospective cohort study investigated interventions provided to general medicine patients between June 2022 to May 2023 who underwent TTYT in a large metropolitan health service. Contemporaneous records were used to identify patients with MRPs and there corresponding interventions. MRPs were categorised using the Drug Evaluation Tools (NESA: necessity, effectiveness, safety and adherence). Interventions were classified using The Swiss Society of Public Health Administration and Hospital Pharmacists tools (patient-level, prescriber-level, drug-level and other interventions). Primary outcome was the difference in interventions (pharmacists versus non-pharmacist clinicians). Secondary outcome was the types of MRPs identified by different clinicians. Outcomes were evaluated using the Pearson’s χ2 test. Odds of MRP identification by clinician group were estimated with an adjusted odds ratio (OR) and 95
Consensus on essential clinical activities of psychiatric pharmacists is currently unavailable. Agreement on core non-clinical roles relating to research, education, leadership and management is also unavailable. Consensus on the core clinical and non-clinical functions of psychiatric pharmacists is urgently required to standardise the training of specialist pharmacists in psychiatric pharmacy and ensure the provision of high-quality patient care. The European Society of Clinical Pharmacy (ESCP) Mental Health Special Interest Group (SIG) aimed to develop a pan-European consensus-based core competency framework outlining clearly defined clinical and non-clinical competencies of psychiatric pharmacists. A modified two-round e-Delphi method was used. Experts were purposively recruited and were eligible if they had at least three years of clinical experience in psychiatric pharmacy and were currently employed in a hospital-based clinical pharmacy service. Initial criteria were informed primarily by the International Pharmaceutical Federation Mental Health Care Handbook and elements of the College of Mental Health Pharmacy Advanced Pharmacist Mental Health Curriculum, and were adapted for the European context. Consensus was defined a priori as ≥ 80
Transitions from the emergency department (ED) to home are high-risk periods for medication-related harm. Pharmacist-led interventions may improve medication safety and care continuity, however, co-designed approaches to developing such interventions remain limited. This study aimed to co-design a pharmacist-led transition-of-care (ToC) program to improve medication management for adults discharged from the ED, with the intention of subsequently evaluating it in a pilot randomized controlled trial. A two-phase qualitative study was undertaken at a general teaching hospital in Qatar within a Participatory Health Research (PHR) framework. Phase I involved one-to-one interviews and focus groups with patients, pharmacists, physicians, and nurses. Phase II consisted of a co-design workshop with decision makers, including departmental leaders and hospital administrators, followed by structured refinement through additional stakeholder meetings and an electronic prioritization survey. Data were analyzed using an inductive-deductive approach, guided by two theoretical frameworks, the Theoretical Domains Framework and the Care Transitions Framework. Five proposed interventions were evaluated against the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Safety, Equity) criteria, and identified barriers were mapped to corresponding intervention functions and implementation strategies. Phase I, comprising three focus groups with physicians (n = 6), nurses (n = 7), and clinical pharmacists (n = 6), and four interviews with two patients and two Patient and Family Advisory Council (PFAC) representatives, identified barriers, enablers, and stakeholder priorities related to medicines management that informed the Phase II co-design workshop. Stakeholders rated the five proposed interventions: discharge medication reconciliation, prescription review, patient counseling and education, pharmacist-to-pharmacist handover, and post-discharge follow-up with medication review, as highly feasible (mean 83
Primary care health services face workforce pressures internationally. Greater multidisciplinary working is seen as a solution. In Scotland, pharmacists are embedded within primary care teams. General Practice Clinical Pharmacists (GPCPs) deliver medicines-related services, including independent prescribing, medicines optimisation and medication review. However, GPCPs’ clinical experience and training vary considerably. A structured preceptorship programme was developed to support role development. To evaluate the impact of a preceptorship programme for GPCPs on self-assessed training needs, competence and confidence within routine primary care practice. A prospective repeated-measures survey and medication review activity analysis were conducted with GPCPs in one health board between January 2024 and March 2025. Reported using the Checklist for Reporting of Survey Studies (CROSS). Preceptees, identified using eligibility criteria, completed a 32-item Hennessy-Hicks Training Needs Analysis questionnaire pre- and post a 12-week preceptorship programme, rating tasks for importance, self-perceived performance and confidence. Matched pre-post questionnaire responses were analysed using the Wilcoxon signed-rank test. Routinely recorded medication review activity was extracted from electronic clinical systems for six months pre- and post-programme and summarised descriptively. Fifty-three GPCPs enrolled; 51 (96
Oral anticoagulants are frequently associated with preventable hospital admissions, and patient education is essential to their safe and effective use. Patients increasingly use large language models (LLMs) for medication information, yet few studies have compared AI-generated outputs with regulatory materials or examined oral anticoagulants, a class in which misunderstanding can cause bleeding or thrombosis. To assess the informational quality, usability, readability, and output reproducibility of AI-generated patient information leaflets (PILs) for oral anticoagulants compared with FDA-referenced patient materials. PILs for five oral anticoagulants (warfarin, apixaban, dabigatran, rivaroxaban, and edoxaban) were generated by ChatGPT, Gemini, and DeepSeek using a standardised zero-shot prompt based on FDA labelling templates; FDA-approved leaflets served as the comparator. Materials were anonymised and brand-blinded. Three clinical pharmacists independently evaluated each PIL using the Patient Education Materials Assessment Tool for Print Materials (PEMAT-P) and a modified DISCERN (mDISCERN), which assess informational quality, understandability, and actionability, but not pharmacological accuracy or clinical safety. Readability was assessed using seven validated indices. Output reproducibility was examined within the same day and at Day 1, 14, and 28. ChatGPT produced PILs of informational quality similar to FDA-referenced materials, both achieving a median mDISCERN score of (41/65); DeepSeek (34/65) and Gemini (33/65) scored significantly lower than ChatGPT; Gemini also scored significantly lower than the FDA-referenced materials. Understandability was acceptable for all sources, whereas actionability was limited, including in FDA materials, with no leaflet providing a patient summary or decision-support tool. All materials exceeded the recommended sixth- to eighth-grade range on most indices, with FDA leaflets the most complex. Output was stable across generations, with no significant within-model differences and the largest mean difference of 0.23 points. Among the evaluated models, ChatGPT most closely matched FDA-referenced materials in the assessed informational domains and demonstrated stable output over 28 days. Shared deficiencies across AI-generated and FDA leaflets suggest broader limitations in written health information. This comparability was limited to the assessed informational domains and does not establish equivalence in pharmacological accuracy, clinical correctness, or patient safety. AI-generated PILs may serve as clinician-reviewed supplementary materials and should not be used as standalone tools without independent professional review and verification of clinical content.
Antidepressants are commonly prescribed in athletes with depressive disorders, yet their potential effects on physical performance and perceived exertion remain unclear, and existing evidence is limited and inconsistent. This systematic review and meta-analysis aimed to evaluate the effects of antidepressant use on objective physical performance and perceived exertion in athletes. A systematic literature search was conducted in PubMed, the Cochrane Library, Web of Science, and SPORTDiscus through March 2025. Eligible studies were randomised controlled trials (RCTs) published in English that enrolled elite, competitive, or recreational athletes; compared antidepressant administration with placebo or no treatment; and reported at least one objective or subjective performance-related outcome. Meta-analyses were performed using random-effects models, and pooled mean differences with 95
Polypharmacy is often associated with adverse clinical outcomes and increased medication management complexity. However conventional analyses of medicine burden and polypharmacy using administrative data are limited to oral medicines (i.e. tablets and capsules), potentially underestimating overall medicine exposure. These products may significantly increase the burden of medication management and therefore risk to patients. This study compared traditional measures of polypharmacy with a measure incorporating all modes of medicine administration and examined how these differences impacted estimates of polypharmacy prevalence among adults aged > 65 years in Western Australia (WA) from 2012/13 to 2018/19, between two independent cohorts: community-dwelling and residential aged care home populations. Linked medication dispensing data were used to classify and compare medicines between community-dwelling and residential aged care populations in Western Australia. Conventional medicine capture was extended to include medicines via various modes of administration, including creams, ointments, patches, and eye and ear drops. Medicines were classified into five categories: 0, 1, 2–4, 5–8, 9 + medicines, and counts were compared across care settings to assess changes in observed medicine burden and measures of polypharmacy. Comparative analysis was performed between two methods: Method 1 (conventional medicine capture) and Method 2 (all medicines including non-oral preparations). Inclusion of medicines via mode of administration increased observed medicine burden in both subpopulations, with a greater relative increase in residential aged care. This approach notably contributed to total medicine counts, revealing previously unrecognised medicine exposure. This resulted in absolute increases in the 5 + medicine category of 4.0
Endothelin receptor antagonists are important therapies for pulmonary arterial hypertension, but differences in efficacy, safety, monitoring requirements, drug interactions, costs, and accessibility complicate treatment selection. To compare endothelin receptor antagonists across safety, efficacy, economic value, suitability, accessibility, and innovation, and to develop a multidimensional framework for clinical pharmacy decision-making and formulary management. A structured framework was developed through a two-round Delphi process involving 19 multidisciplinary experts. Indicators were classified as quantitative or qualitative and organized into six domains. Consensus was assessed using the authority coefficient, coefficient of variation, and Kendall’s coefficient of concordance. Weights were determined using the analytic hierarchy process and integrated through multi-criteria decision analysis. Quantitative evidence was derived from regulatory sources, randomized trial meta-analysis, national pricing databases, and hospital procurement records. Qualitative indicators, including monitoring requirements, drug interactions, adherence-related factors, accessibility, and innovation, were scored using predefined criteria. Economic value was evaluated in the Chinese healthcare context using annual drug acquisition costs, affordability ratios, and cost per metre improvement in 6-min walk distance. The Delphi process established a framework comprising six domains, 13 subdomains, and 32 indicators, with good reliability and consistency: authority coefficient 0.82, Cronbach’s alpha 0.864, and Kendall’s W 0.412. Twelve randomized controlled trials were included in the quantitative synthesis. All endothelin receptor antagonists improved exercise capacity and hemodynamic outcomes, although the magnitude varied. Ambrisentan showed comparatively larger improvements in 6-min walk distance and a trend toward lower odds of adverse drug reactions. Annual drug acquisition costs were ¥24,600 for ambrisentan, ¥17,820 for bosentan, and ¥57,240 for macitentan. The corresponding costs per metre improvement were ¥140.12/m, ¥142.38/m, and ¥1470.71/m, and annual cost-to-income ratios were 87.15
Pharmacist involvement in the emergency department (ED) and early in a patient’s hospital stay improves clinical outcomes and reduces medication errors. Because EDs are high-pressure settings with limited pharmacist staffing, pharmacists cannot review every patient. Instead, they must focus on identifying and prioritising patients who may be at risk of potential medication-related harm. To establish and prioritise consensus-based medication management criteria to identify patients with potential medication-related harm within the ED setting for early pharmacist review. We used Nominal Group Technique (NGT) methodology to rank the most important criteria for identifying whether a patient’s presentation may be due to medication-related harm or whether they may be at risk of developing medication-related harm in the ED. Participants were purposively recruited ED clinicians including pharmacists, doctors and nurses who worked at the ED of either the Gold Coast University Hospital or Robina Hospital on the Gold Coast, Queensland, Australia, during May–June 2025. A total of 14 participants comprising six pharmacists, five nurses and three doctors participated in two 1-h NGT workshops. Participants ranked 12 criteria from a list of 34 during NGT Round 1. They subsequently ranked six criteria from the list of 12 during NGT Round 2. The weighted rankings of the criteria across both groups were combined to determine the top six criteria which were, in order from 1 to 6 (1 = most relevant): (1) medication-related admission or thinks medicine responsible for admission; (2) bleeding and falls; (3) poor historian (unable to provide reliable history)/suspected non-adherence or poor compliance; (4) carbidopa/levodopa (entacapone), co-beneldopa; (5) unverified medicines; and (6) medicines requiring therapeutic drug monitoring/medicines with narrow therapeutic index. The first four criteria were ranked within the top six in both NGT workshops. This study has provided a concise list of six medication-related criteria that expert consensus agreed were the most important for prioritising patients with potential medication-related harm. This forms the basis for the development of information gathering strategies to be incorporated into clinicians’ workflows early in patients’ ED journey.
The introduction of biologics marked a paradigm shift in the treatment of numerous life threatening and life limiting diseases such as cancer. Addressing cost effectiveness in medical oncology is necessary as cancer cases are expected to increase globally by nearly 60
Piperacillin/tazobactam (TZP) is widely used in hospitalised adults. Real‑world data suggest a higher risk of hypokalaemia than previously recognised. To investigate incidence, severity and risk factors of TZP‑induced hypokalaemia, and to develop and externally validate a nomogram for individualised risk prediction. This retrospective study included hospitalised adults receiving TZP (2021–2025). TZP‑induced hypokalaemia was defined as serum potassium < 3.5 mmol/L ≥ 48 h after TZP initiation. Logistic regression identified predictors. A nomogram was constructed. Model performance was assessed by discrimination (area under the ROC curve, AUC), calibration (Hosmer‑Lemeshow test, calibration intercept/slope), Brier score and decision‑curve analysis (DCA), with internal and external validation. Among 643 patients, 122 (19.0
Spontaneous adverse drug reactions (ADRs) are underreported. Digital reporting systems are increasingly used to address this issue; however, limited knowledge exists about the barriers and facilitators influencing their use by consumers. To explore facilitators and barriers influencing consumers’ use of digital tools for ADR reporting, and to identify the factors, expectations and preferences that affect their engagement with these tools. An exploratory qualitative descriptive study using semi-structured in-depth interviews was conducted among Australian adults who self-reported having experienced an ADR. Interviews were conducted face-to-face or via Zoom, audio-recorded, transcribed verbatim, and analysed inductively using reflexive thematic analysis. Themes were mapped onto domains of the Combined Technology Acceptance Model and Theory of Planned Behaviour (C-TAM-TPB) framework. Fourteen participants were interviewed. Consumers expressed positive intentions to use online ADR reporting tools. Identified facilitators included user-friendly and accessible tools that are simple to complete, the use of images to aid comprehension, integration with existing patient health records, the ability to submit reports to both healthcare professionals and regulators, and a tool designed specifically for consumers using layperson language. Identified barriers included lack of awareness that consumers could report ADRs using online tools, the need for registration, complex medical terminology, compulsory fields, and the absence of feedback after submission. Consumers were willing to use online ADR reporting tools but were largely unaware of their existence. Enhancing usability through user-friendly design, and reporting forms specifically designed for consumers may increase engagement. Addressing barriers such as lack of awareness, registration requirements, medical jargon, and lack of feedback may improve usability and contribute to strengthening pharmacovigilance systems.
Medication incident reporting systems enable healthcare professionals to report incidents and their analysis may help prevent reoccurrences. While previous research has primarily focused on medication errors in general, incidents involving unintentional medication discrepancies remain unexplored. Therefore, this study aimed to identify the causes of voluntarily reported medication incidents describing unintentional medication discrepancies occurring in care transitions. The secondary objective was to characterise the reported medication incidents regarding type of incident, medication involved, whether the incident reached the patient, and the transfer moment involved. This cross-sectional study used data from the National Medication Incident Reporting database of the Dutch Institute for Rational Use of Medicine. This database contains medication incidents, mainly reported by healthcare professionals in hospitals. Incidents were included if they described an unintentional medication discrepancy in a care transition. The primary outcome was the cause of the reported incident independently determined by two researchers using the Prevention and Recovery Information System for Monitoring and Analysis model (PRISMA-Medical). Secondary outcomes were the incident type (e.g., omissions or dose discrepancies), the medication involved, whether the incident reached the patient, and the transfer moment. Descriptive statistics were used for data-analysis (frequencies and percentages). A total of 32,261 incidents were reported in the study period, of which 992 (3.1
Guideline-directed medical therapy (GDMT) improves outcomes in heart failure, yet many patients remain undertreated or are not titrated to optimal doses. International evidence shows pharmacist-led heart failure clinics improve GDMT prescribing and reduce hospitalisations, but data in Australian settings are limited. To evaluate whether incorporating a collaborative pharmacist medication prescribing model within a heart failure service improved optimisation of guideline-directed medical therapy (GDMT) in patients with heart failure and ejection fraction < 50
Pharmacist-led medication reviews are increasingly recognised for generating cost savings within the hospital. However, no cost-analysis has investigated the budget impact of junior pharmacists conducting medication reviews under supervision of clinical pharmacists, nor included recommendations to start-, increase-, or monitor medications. To assess the budget impact of medication reviews by supervised junior pharmacists across hospital wards, explore budget impact differences between drug classes, and identify patient predictors that potentially influence the budget impact. Data of medication reviews were collected over a 19-month period in patients with polypharmacy (≥ 5 medications) who had at least one additional risk factor. We developed a cost model over a one-year horizon, from the hospital perspective. Intervention costs were derived from measured labour time per medication review and salary of junior- and clinical pharmacists. Cost avoidance from potential preventable medication-related readmissions were based on admission time, admission costs and an estimate of preventable medication-related admissions (4.8
Demand for attention-deficit hyperactivity disorder (ADHD) services has increased substantially across health systems, placing pressure on specialist services and contributing to prolonged waiting times and inconsistent medication monitoring. Pharmacists have established expertise in medicines optimisation and, in some settings, are authorised to prescribe. Yet their role within ADHD care pathways remains poorly characterised.Kindly check and confirm the inserted city name in affiliations 3, 5, 6 and country name in affiliation 6 are correct and amend if necessary.Changes have been made, where necessary. This scoping review aims to map the existing empirical evidence on pharmacist involvement in ADHD services, synthesise reported roles and impacts, and identify key evidence gaps to inform future research and service development. A scoping review was conducted in accordance with the Arksey and O’Malley framework and reported using PRISMA-ScR guidance. Six databases (PubMed, PsycINFO, Embase, CINAHL, Scopus, and Web of Science) were searched from inception to December 2025. Empirical studies evaluating implemented pharmacist involvement in ADHD services were included, irrespective of study design. Data were charted and synthesised narratively across domains relating to clinical care, service delivery, economic outcomes, and barriers to implementation. Thirteen studies were included, published between 2008 and 2025, primarily from the United States and the United Kingdom. Most were service evaluations or pre-post studies, with one randomised trial. Pharmacists were involved in a broad range of activities, including medication initiation, titration, monitoring, follow-up, patient education, and service governance, often as independent prescribers or within collaborative multidisciplinary models. Reported impacts included improved adherence to recommended monitoring standards, increased service capacity, reduced waiting times, and more efficient workforce utilisation, with some evidence of potential cost savings. However, outcome measures varied widely, and patient-reported outcomes, comparative effectiveness, and implementation processes were inconsistently examined. This review identifies a small but expanding evidence base indicating potential roles for pharmacists in ADHD services, particularly in medicines management and service delivery. However, the absence of clearly defined service models and limited comparative and implementation-focused evidence constrain wider adoption across health systems. Further research is needed to inform scalable and sustainable approaches to pharmacist integration in ADHD care.
