BACKGROUND:Australia's Aged Care Onsite Pharmacist program aims to support quality use of medicines in residential aged care homes. This is a novel role introduced into existing teams in a complex environment. Factors associated with successful integration since implementation are currently unknown. AIM:This study aims to explore the perspectives of pharmacists and other stakeholders within aged care homes regarding successful integration of the novel aged care pharmacist service into healthcare teams. METHODS:A qualitative approach, using interpretive descriptive methodology, was used to explore perspectives. Semi-structured focus groups and interviews with pharmacists, nursing and care staff, allied health professionals, general practitioners, residents, and family members were undertaken. Data were collected via Zoom™, audio- and video-recorded, and transcribed verbatim. Two researchers undertook inductive thematic analysis to identify key themes. RESULTS:30 participants across focus groups, focus-group interviews, interviews, and member-checking processes contributed. An overarching theme of proactivity and showing a genuine interest in others underpinned three key themes. Theme 1: Pharmacists needed to be seen, through physical presence and availability, as well as developing a distinct identity. Theme 2: Pharmacists needed to build trust, through collaboration in real time and demonstrating value. Theme 3: Pharmacists needed to develop an understanding of the aged care home environment, including social and contextual norms, as well as procedures, routines and roles. DISCUSSION:This research complements existing understandings of interprofessional collaboration and teamwork amongst healthcare professionals. Themes were interlinked; we used a sensitising framework, social cognitive theory, to present and explain the findings and interactions that can support pharmacist integration into existing teams. Aged care services should structure onboarding to prioritise early visibility, clarify roles and organisational needs, and foster in-person collaboration. Pharmacists should demonstrate proactivity and an authentic interest in all staff, residents and families.
BACKGROUND:The Roter Interaction Analysis System (RIAS) is the gold standard for medical communication analysis, but its automated coding remains underexplored due to imbalanced code distributions. This study developed an automated RIAS classification system using Japanese transformer-based models and evaluated AI-based data augmentation to mitigate class imbalance. METHODS:Five transformer models were fine-tuned for 44-class RIAS classification using medication counseling dialogues. To enhance generalizability, we employed AI-based data augmentation and evaluated performance using both AI-augmented and real-data-only test sets. Assessment metrics included accuracy, macro F1, and weighted F1. FINDINGS:The dataset comprised 17,391 utterances (39.4% AI-generated). In the real-data-only (primary) test set, ELECTRA achieved the highest accuracy (0.7875), macro F1 (0.6561), and weighted F1 (0.7835). All models performed worse under the real-data-only condition than under the AI-augmented condition, mainly for minority-class categories. Error analysis showed semantically ambiguous and context-dependent categories, including domain-adjacent counseling topics and affective expressions, remained challenging, indicating linguistic transparency and definitional distinctiveness influence classification beyond training frequency. CONCLUSION:This proof of concept shows that AI-based augmentation can mitigate class imbalance in automated RIAS classification of medication counseling dialogues. While robust for prototypical expressions, nuanced affective categories remain challenging for text-only approaches. These findings support the feasibility of automated RIAS analysis for pharmacy education while suggesting that multimodal approaches are needed to capture subtle emotional dynamics. By complementing manual coding with quantitative insights, this system may support timelier and objective feedback and ultimately contribute to patient-centered care.
PURPOSE:To evaluate the effectiveness of a structured interprofessional smoking cessation intervention delivered by pharmacists and dentists. METHODS:A single-arm quasi-experimental, pre-post interventional study was conducted among adult smokers attending a university dental clinic. The program combined behavioral counseling (WHO 5A's and motivational interviewing), optional Nicotine Replacement Therapy (NRT), dental reinforcement, and digital follow-up via WhatsApp. Participants were followed at 3 and 6 months. Outcomes included smoking cessation or reduction, nicotine dependence (Fagerström Test), and biochemical verification using exhaled carbon monoxide (CO) and salivary cotinine (COT). Statistical analyses included chi-square, paired t-tests, Wilcoxon signed-rank and Mann-Whitney U tests with effect size = r; significance was set at p < 0.05. RESULTS:One-hundred-forty participants enrolled in the program. At 3 months, 34 participants achieved abstinence and 21 reduced smoking; at 6 months, 30 achieved abstinence and 28 reduced smoking. Mean CO levels decreased significantly from 17.42 ± 10.90 ppm to 13.56 ± 12.21 ppm at 6 months (p < 0.001; r = 0.58). Nicotine dependence scores declined from 4.91 ± 2.69 to 4.16 ± 2.99 at 6 months (p = 0.042; r = 0.27). Among reducers, daily cigarette consumption decreased by over 50% at both follow-ups (p < 0.001; r = 0.88). At 6 months, cessation and reduction rates were significantly higher with counseling + NRT compared to counseling alone (p = 0.019; r = 0.31). CONCLUSION:This program utilizing complementary interprofessional roles of pharmacists and dentists was associated with improvements in smoking cessation outcomes, particularly when combining behavioral and pharmacological approaches. This model offered a plausible strategy to overcome individual professional barriers to enhance tobacco cessation, and supported integrating pharmacists into non-traditional clinical settings.
INTRODUCTION/OBJECTIVES:Competency-Based Pharmacy Education (CBPE) is a strategic priority for preparing graduates to meet evolving healthcare needs. However, efforts to implement CBPE can stall due to behavioral challenges among faculty, administrators, preceptors, and learners. This study aimed to apply Stage 1 of the Behavior Change Wheel (BCW) to identify stakeholder-specific behaviors and associated determinants needed to implement the five core components of CBPE. METHODS:A multi-method approach grounded in the BCW, the Capability, Opportunity, Motivation - Behavior (COM-B) model, and the Theoretical Domains Framework (TDF) was used. Data were gathered through (1) targeted literature review; (2) structured focus groups with competency-based education experts and pharmacy education stakeholders; and (3) an iterative consensus process. Behaviors were mapped to the five CBPE components: (1) defined competencies, (2) developmental progression, (3) tailored instruction, (4) authentic experiential learning, and (5) programmatic assessment, and then mapped to COM-B and TDF constructs. RESULTS:Over fifty stakeholder-specific behaviors were identified and specified across the CBPE framework. This revealed shared barriers such as limited instructional design knowledge (psychological capability), insufficient assessment of infrastructure (physical opportunity), and misaligned professional identity (reflective motivation). Key TDF domains included knowledge, environmental context, beliefs about capabilities, and professional roles. The behavioral problem statements, specifications, and determinants were identified to support future intervention planning. CONCLUSION:This Stage 1 analysis provides a behaviorally grounded foundation for CBPE implementation by identifying stakeholder behaviors and conditions that enable change. These findings will inform the development of readiness-to-change assessments and targeted interventions (BCW Stages 2 and 3), supporting scalable and sustainable CBPE transformation in pharmacy education.
BACKGROUND:Type 2 diabetes mellitus is a major chronic disease requiring long-term glycemic control and patient self-management. Community pharmacists may contribute to diabetes care through structured educational interventions. OBJECTIVE:To evaluate the impact of a pharmacist-led diabetes education program delivered in community pharmacies on capillary blood glucose levels and diabetes-related self-efficacy among adults with type 2 diabetes mellitus. METHODS:This prospective controlled quasi-experimental study was conducted in a single community pharmacy in Erzurum, Türkiye. Adults with type 2 diabetes mellitus receiving oral antidiabetic therapy and/or insulin were assigned to either a pharmacist-led education group or a control group receiving standard pharmacy care. The intervention consisted of monthly face-to-face educational sessions over six months. Capillary blood glucose levels were recorded at baseline, 3 months, and 6 months. Diabetes-related self-efficacy was assessed using the Diabetes Management Self-Efficacy Scale. RESULTS:Eighty participants completed the study (intervention n = 40; control n = 40). Mean capillary glucose levels decreased in the intervention group from 253 ± 62 mg/dL at baseline to 168 ± 31 mg/dL at six months, whereas the control group showed a modest reduction from 204 ± 52 mg/dL to 200 ± 50 mg/dL. Between-group comparisons demonstrated lower glucose levels in the intervention group. Diabetes-related self-efficacy also improved significantly in the intervention group compared with the control group (mean change 11.95 ± 5.33 points vs. 2.07 ± 2.18 points). CONCLUSION:Structured pharmacist-led diabetes education delivered in community pharmacies improved glycemic control and diabetes-related self-efficacy compared with standard care.
