Abstract Background Women with a short cervix are at increased risk of preterm birth (PTB), a major contributor to neonatal morbidity and mortality globally, leading to significant financial and emotional burdens for families and healthcare systems. Cerclage or vaginal progesterone is effective for reducing PTB, but the benefits of combining both interventions remain unclear and nonconclusive. Aim This scoping review aimed to critically appraise current evidence on the effectiveness of combining cerclage and vaginal progesterone in managing short cervix in singleton pregnancies to prevent PTB. Design PubMed and Embase were searched for studies published between 2018–2024. The authors independently performed screening and data extraction. Studies that included singleton pregnancies with short cervix (defined as cervical length <25 mm) and comparing combination therapy (cerclage and vaginal progesterone) versus either intervention alone were included. This review followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for scoping reviews (PRISMA‐ScR) guidelines and applied the Arksey and O'Malley framework. Results A total of 923 studies were identified and 12 studies were included. Most studies had a retrospective design ( n = 10). Combination of cerclage and vaginal progesterone showed a trend towards improved maternal and neonatal outcomes, including prolonging pregnancy period particularly in high‐risk populations with cervical length ≤10 mm; however, five studies did not demonstrate statistically significant benefits. Conclusion This review highlighted the need for larger, well‐designed studies to evaluate the efficacy and cost‐benefit analysis of cerclage and vaginal progesterone in the prevention of PTB in singleton pregnancies with short cervix as compared to either intervention alone.
Abstract Background Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy with potential sequelae including hypovolaemia, electrolyte imbalance, and malnutrition, which can result in adverse maternal–foetal outcomes. Aim To explore Australian women's experiences and perceptions regarding the pharmacological management of HG. Method An online, cross‐sectional survey, conducted in Australia from July–September 2020, captured data on participant demographics, experience of HG, and use and experience of medication treatments. Three survey questions included free‐text response fields. One hundred and eighty‐nine women provided free‐text responses to at least one of these three questions, which provided qualitative data that were thematically analysed. Ethical approval was granted by Adelaide University Human Research Ethics Committee (Reference no: H‐2020‐090) and the study conforms to Australian National statement on ethical conduct in human research . Informed consent was obtained from all participants via the distribution of project information to potential participants indicating their involvement was voluntary and anonymous. Participants confirmed their consent through completion of the survey. Results Three major themes were identified. Theme 1: ‘inadequate recognition and management of HG’ indicated women reported many clinicians lacked suitable training to diagnose patients, were either not aware of, or were not following clinical HG management guidelines, and were not apprised of current safety and side effect profiles of common antiemetic medications. Theme 2: ‘challenging inequities in HG healthcare’ revealed educational and financial status may influence treatment outcomes, and systemic barriers to effective management exist in the Australian healthcare system. Finally, Theme 3: ‘the extensive and unrelenting burden of HG’ demonstrated the severe nature of HG can lead to extreme debility and impaired quality of life, and results in psychological trauma that can extend beyond birth and affect future family planning. Conclusion Opportunities exist to improve experiences and outcomes for women with HG. Well‐structured strategies, such as improved education for health practitioners, changes to the Pharmaceutical Benefits Scheme, and expansion of outpatient care modalities could result in improved recognition and management of HG.
Abstract Background Since 2015, pharmacists have become increasingly involved in primary care and interdisciplinary healthcare teams. Subsequently, literature related to pharmacist interventions in primary care has grown rapidly and there is a need to systematically map this research to understand how the profession's clinical focus has evolved and conceptually matured. Aim This study aimed to identify research concerning pharmacist interventions in primary health care, published from January 2015 to 26 January 2026, and use bibliometric mapping to identify core research themes and trends and assess the maturity of these themes. Method A total of 691 relevant documents were retrieved using Scopus and analysed. Advanced bibliometric techniques were employed using VOSviewer, Biblioshiny, OpenRefine and biblioMagika software to conduct performance mapping and author keyword co‐occurrence analysis. Network, density and thematic maps were generated to visually demonstrate thematic maturity, topic saturation and the evolution of the research domains over time. Ethics approval was not required for this research article as it utilised published data and did not contain human participants or data. Results Research output related to pharmacist interventions in primary care exhibited sustained, exponential growth, peaking in 2025. The core literature remained robustly anchored in community pharmacy settings. Co‐occurrence and thematic mapping identified five highly interconnected clusters. The key terms ‘comprehensive medication management’ and ‘patient‐centred care’ represented a rapidly emerging, rather than declining, research trajectory. Conclusion The literature analysed reflected a mature, global transition towards proactive, multidisciplinary pharmacist‐led care. To further advance the pharmacy profession, future research must examine settings beyond community pharmacy to address critical gaps, such as specialised ambulatory care and psychosocial interventions, and ultimately optimising macro‐level population health outcomes.
