Background: Medication review (MR) requires pharmacists to identify medication-related problems (MRPs)/drug-related problems (DRPs), assess their clinical significance, and implement appropriate interventions. However, structured MR training for community pharmacists in Japan remains limited. Objective: To describe Japanese community pharmacists’ self-assessed competencies in MR immediately after participating in a structured workshop based on the Australian ASK–ASSESS–ADVISE framework. Methods: A post-workshop cross-sectional survey was conducted among community pharmacists who attended a one-and-a-half-day MR workshop at four locations in Japan. Participants completed a 31-item self-assessment questionnaire covering four domains (knowledge of MRPs/DRPs and ASK, ASSESS, and ADVISE processes), using a five-point Likert-type scale. Descriptive statistics were used to summarize responses, and internal consistency was assessed using Cronbach’s alpha. Results: A total of 124 pharmacists participated in the survey (response rate: 91.9%). Self-assessed competencies varied across the four domains and individual items. Descriptively, the proportions of participants who rated themselves as confident in performing the tasks (responses of four or five) were lower in Domain 3 (ASSESS process) than in the other domains, particularly for Items 6–10, for which the proportions ranged from 53.2% to 58.9%. These items involved prioritizing MRPs/DRPs, justifying intervention decisions, developing and evaluating intervention plans, and developing monitoring plans. Conclusion: This study describes community pharmacists’ self-assessed MR competencies immediately after a structured workshop. The findings indicate variation in perceived competencies across MR tasks, with particular attention warranted for clinical assessment, intervention planning, and monitoring within the ASSESS process. These findings may help identify priorities for future MR education and objective competency assessment among Japanese community pharmacists.
As pharmacy curricula expand to integrate clinical content alongside the basic pharmaceutical sciences, the demands placed on students grow accordingly. Satisfaction with education and perceived academic workload are the constructs most often used to gauge the consequences, but are usually studied separately. This review brings them together. Articles identified in PubMed/PMC and ScienceDirect were selected based on whether they addressed three key questions: what predicts satisfaction within pharmacy education; what the sources and effects of academic workload are; and how the two relate. Key themes identified include structural determinants of satisfaction over content volume; the divergence between objective workload volume and subjective experience; psychological need satisfaction as the primary driver of burnout; and the counterintuitive stress patterns in integrated pre-clinical versus clinical training. Satisfaction is generally high and depends more on the structures surrounding teaching than on content. Workload is a leading stressor, but the distinction that matters is between objective volume and subjective experience: test anxiety tracks the perception of course load rather than its size; workload and co-curricular variables expected to predict burnout have failed to do so, and perceived overload is associated with surface rather than deep approaches to learning. Psychological need satisfaction, not workload volume, predicts burnout. Evidence from integrated curricula then complicates the assumption that clinical content is what burdens students: pre-clinical students report higher stress than those on clinical rotations, and integrated programmes show no year-on-year escalation. For curriculum designers the implication is that how demands are distributed and framed matters more than how much content a programme carries.
Continuous glucose monitoring (CGM) devices are becoming integral to diabetes care, and community pharmacists are well positioned to support patients using CGMs. However, limited training and time constraints may hinder integration of CGM services into community pharmacy practice. This study aimed to assess community pharmacists’ confidence and identify barriers in practice to inform educational strategies and care model development. A cross-sectional survey was distributed electronically to community pharmacists practicing in Austin, Texas, USA. The survey included questions on CGM-related knowledge, counseling comfort, training experiences, and educational preferences, and responses were summarized using descriptive statistics. A total of 28 pharmacists completed this exploratory survey. Respondents expressed moderate comfort with basic CGM competencies, such as describing device components, but reported lower confidence in advanced tasks such as integrating CGM data with clinical teams. Key barriers to providing CGM counseling included limited time (64.3%) and lack of access to demonstration devices (60.7%). Most respondents indicated that wearing a CGM themselves would improve their counseling effectiveness. While community pharmacists recognize the value of CGM counseling, many feel underprepared due to time limitations and lack of practical training. Targeted education, hands-on exposure, and institutional support may be needed to expand the role of pharmacists in technology-enhanced diabetes care.
Background: The geographic distribution of pharmacies reflects interactions between population needs, economic viability, professional regulation, and healthcare development. Historical analysis can clarify how territorial inequalities in pharmaceutical provision emerged. Methods: This retrospective historical study reconstructed the pharmacy network in Bihor before 1920 using archival records, contemporary pharmaceutical yearbooks, historical statistics, and published studies. Oradea was analysed separately from the extra-urban county territory. Independent establishments were distinguished from relocations and dependent units, and temporal, geographic, and population-to-pharmacy indicators were calculated and interpreted descriptively. Results: Outside Oradea, 31 historical pharmacy entries were identified between 1798 and 1915; 28 were independent establishments, two were relocations, and one was a dependent branch. Nineteen of the 28 independent establishments (67.9%) appeared after 1880, and 23 (82.1%) represented first pharmacies in previously unserved localities. By the end of the analysed period, pharmacy provision remained markedly more concentrated in Oradea than in the extra-urban territory. Conclusions: Pharmacy development in Bihor followed a centre–periphery pattern characterised by early urban concentration, delayed territorial diffusion, and selective local intensification, illustrating a lasting tension between economic viability and equitable geographical access to pharmacy services. The findings show that the numerical expansion of a pharmacy network does not by itself ensure equitable access, a challenge that remains relevant to contemporary pharmacy regulation and practice.
Background: The occurrence of hiccups has been described for several drugs, including corticosteroids. However, comprehensive pharmacovigilance data on corticosteroid-associated hiccups are limited. Objectives: This study aimed to characterize reports of corticosteroid-associated hiccups and identify disproportionate reporting signals using VigiBase, the World Health Organization (WHO) global pharmacovigilance database. Methods: A retrospective case/non-case pharmacovigilance study was performed using individual case safety reports (ICSRs) recorded in VigiBase. Reports containing a corticosteroid classified as “suspected” or “interacting” and the MedDRA Preferred Term “Hiccups” were identified. Both drug roles were included because they indicate that the drug was considered potentially relevant to the reported adverse event, whereas “concomitant” drugs were not. Demographic characteristics, time to onset, outcomes, and dechallenge and rechallenge information were analyzed. Disproportionality was assessed using the Bayesian Information Component (IC), with a positive IC0.25 indicating a disproportionate reporting signal. Results: A total of 6543 ICSRs, comprising 6642 drug–reaction pairs were analyzed. Most reports involved males (91.6%) and originated from Asia (79.4%). Hiccups occurred most frequently on the same day as corticosteroid administration (38.3%), followed by day one (24.9%) and day two (12.4%). Most outcomes were reported as “recovered” (51.7%) or “recovering” (28.3%). Nineteen corticosteroids or corticosteroid-containing drug combinations showed a disproportionate reporting signal. Dexamethasone was the most frequently reported corticosteroid (N = 4903) and showed the strongest signal (IC0.25 = 6.0). Conclusions: Corticosteroid-associated hiccups were reported predominantly in males and typically occurred within the first day. Nineteen corticosteroids demonstrated disproportionate reporting signals, with dexamethasone showing the strongest association. Increased awareness of this adverse effect may facilitate timely recognition and management, while further studies are needed to clarify underlying mechanisms and patient-specific susceptibility factors.
