Objectives The roles of pharmacy staff have expanded to include public health functions, such as delivering harm reduction services for people who use drugs (PWUD), particularly unregulated substances and non-medical drug use, in response to an ongoing drug overdose crisis. Nonetheless, their involvement across the full spectrum of harm reduction services remains underexplored. This study mapped existing research describing or evaluating the implementation of harm reduction services for PWUD provided by pharmacy staff.Design Scoping review.Data sources MEDLINE, EMBASE, CINAHL, Web of Science, Scopus and Cochrane Library (inception to July 2025).Study selection Studies reporting on the description or evaluation of harm reduction services for PWUD provided by pharmacy staff.Data extraction Two team members screened studies for eligibility and extracted the data. The data were analysed primarily to describe harm reduction services and the role of pharmacy staff.Results 43 articles were included. The most frequently reported harm reduction services were sexually transmitted and blood-borne infection care (33%), needle and syringe programmes (21%), naloxone distribution (19%) and medication treatment for opioid use disorder (19%). Pharmacy staff were integrated into multidisciplinary teams (79%), with their roles varying from education to medication prescribing. Included studies reported harm reduction services for PWUD delivered by pharmacy staff as effective, feasible and safe. However, implementations were not tailored to equity-deserving populations. Services primarily addressed opioid-related harms, while strategies focusing on the use of non-opioid substances were limited.Conclusion This scoping review highlights the diverse roles pharmacy staff play in delivering harm reduction services for PWUD. Positioned at the intersection of accessibility and healthcare delivery, pharmacy staff are ideally situated to expand access to equitable care. To fully harness this potential, future research and practice should embed harm reduction as a core philosophy, extending beyond individual interventions to support the creation of person-centred, non-judgmental and low-barrier services.

Background Despite increasing policy and funding requirements related to the integration of sex, gender, and intersectional approaches in health research, structured methods of developing training initiatives for researchers are rarely reported in sufficient detail. Here we describe the process of developing, implementing, and evaluating the 2025 Canadian Institutes of Health Research Institute of Gender and Health (CIHR-IGH) Summer Institute on Sex and Gender+ Science. Methods We applied evidence-informed, contemporary educational program development principles to design, implement, and evaluate the training institute. During the development phase, guided by Kern's Six-Step approach, equity-oriented curriculum design principles, GREET reporting standards, and the SAGER Guidelines, we conducted a trainee needs assessment to identify knowledge gaps and learning objectives, which informed curriculum design and delivery. During the implementation phase, trainees participated in a five-day bilingual (English/French) program incorporating lectures, workshops, case-based discussions, applied learning activities, and mentorship. During the evaluation phase, trainees completed a post-program questionnaire assessing satisfaction, perceived learning, achievement of learning objectives, and anticipated application of knowledge. Quantitative and qualitative feedback informed program evaluation and future recommendations. Results Thirty-two graduate trainees from across Canada representing diverse health research disciplines were selected to attend the Institute. They completed a needs assessment that identified five priority learning areas: methodology and analysis of sex and gender+, inclusive and equitable research practices, healthcare systems and practices, knowledge mobilization and policy, and other (i.e., COVID-19 impacts on women’s health and politics surrounding sex and gender+ science). The post-program survey response rate was 75%. Most respondents reported that the program aligned with their learning needs (58%) and facilitated meaningful connections with mentors and peers (71%). Qualitative feedback endorsed diversity of topics, access to resources, and opportunities for open discussion and knowledge exchange. Trainees recommended lower session density, more networking opportunities, and greater inclusion of and sensitivity to Indigenous and gender-diverse perspectives. Feedback informed recommendations to the CIHR-IGH and highlighted the importance of interdisciplinary collaboration, knowledge-user engagement, and iterative curriculum refinement in future program development and delivery. Conclusion This study provides a practical and adaptable model for further developing, implementing, and evaluating sex-and-gender+-informed research training to advance research, knowledge translation, and capacity building.

Background Sexually transmitted and blood-borne infections (STBBI) pose significant public health challenges globally. Pharmacist-led testing programs may overcome barriers and improve access and equity. The APPROACH 2.0 study aimed to assess implementation factors associated with developing and implementing a pharmacist-led testing program for human immunodeficiency virus (HIV), hepatitis C virus (HCV), and syphilis infections in community pharmacies across three Canadian provinces. Methods We utilized a mixed-method exploratory cross-sectional design, offering participants a choice of point-of-care (POC) testing for HIV and HCV and/or dried blood spot (DBS) testing for HIV, HCV, and syphilis available at community pharmacies and outreach events. Pharmacists completed a comprehensive training program prior to recruitment. We used the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework to guide evaluation, with focus on reach, effectiveness and implementation. Results Between December 2022 and April 2024, 399 participants aged 18-75 years were tested. The study reached participants who had not been tested previously (35% HIV, 43% HCV, and 62% syphilis) despite many reporting risk behaviours supporting STBBI testing. In total, 1424 tests were performed including 598 HIV tests (386 participants), 555 HCV tests (349 participants), and 271 syphilis tests (271 participants). While some participants reported no preference for type of testing (36%), 79% reported the importance of having test results immediately, some indicating that they would not go elsewhere (15%) or were unsure if they would go elsewhere (32%) if pharmacist testing was not available that day. Twenty-five participants received reactive results with four active HCV infections and two active syphilis infections confirmed. Overall, protocols were delivered as intended and length of testing visit was feasible. Conclusions Our findings demonstrate the potential of a pharmacist-led HIV, HCV, and syphilis testing service to reach untested populations. Implementing pharmacist-led testing tailored to individuals’ varied needs and preferences may reduce barriers, allow for earlier detection and linkage to care, and contribute to improved public health outcomes. Future research should explore implementation factors to optimize reach to priority populations, integration into existing pharmacy workflow, provincial public health systems and community, and maintenance to support scale and sustainability. Trial Registration This study was registered with ClinicalTrials.gov (NCT05534633).

Psychoactive substance use represents a significant global public health challenge, leading to diverse health, social, and environmental harms. Traditional punitive and commercial approaches have faced criticism for potentially worsening these harms and overlooking potential benefits. Consequently, there is an increasing global call for a comprehensive public health approach to address psychoactive substances, focusing on both supply and demand reduction. However, the core components of a public health approach remain unclear. We aimed to conceptualize a public health approach to psychoactive substances and describe its core values, goals, and activities. We used a two-step process to develop a coherent and comprehensive conceptual framework. First we conducted a scoping review of academic and practice literature on a public health approach to psychoactive substances published between 1950 and 2023 (n = 230 English language records). We then conducted an iterative team-based synthesis of the review findings and expert public health knowledge to address gaps in extant literature using a structured conceptual framework development approach. This conceptual framework includes core values (i.e. social justice, health equity, evidence-informed), activities (i.e. legal and regulatory action, supports and services, prevention and education, advocacy, and research, monitoring, and evaluation), and goals (e.g. improving population health; addressing determinants of substance use, substance harms and substance policy related harms; countering carceral logics) that are central to a public health approach to psychoactive substances. Our coherent and comprehensive framework incorporates international literature and is informed by contemporary values and goals with the aim of promoting a consensus understanding of this critical practice area. This framework can guide efforts to design, implement, and evaluate public health interventions that maximize benefits and mitigate harm associated with psychoactive substances.

INTRODUCTION:The disparities and risk trajectories experienced by people who use drugs (PWUD) highlight the critical need for equity-oriented strategies. Pharmacy staff (pharmacists, pharmacy technicians and assistants) make essential contributions to public health, and their role in the response to the drug overdose crisis can be understood as an extension of their public health role. Their involvement in overdose prevention strategies, such as take-home naloxone programmes and prescribed opioid medication management, has been documented. Still, their role in harm reduction services for PWUD has yet to be mapped. This gap has led to challenges when implementing harm reduction services in pharmacy-related settings. This review aims to summarise literature that focuses on the implementation of harm reduction services for PWUD provided by pharmacy staff. METHODS AND ANALYSIS:This scoping review will adhere to the Arksey and O'Malley framework for conducting scoping reviews. The electronic databases MEDLINE, Embase, CINAHL, Web of Science Core Collection, SCOPUS and Google Scholar were searched on 4 June 2024, using terms related to pharmacy staff, PWUD and harm reduction services. This review will consider peer-reviewed literature in English, Spanish and French focused on describing or evaluating the implementation of harm reduction services for PWUD by pharmacy staff. Two independent reviewers will screen titles and abstracts and conduct the full-text screening to determine eligibility. Findings will be presented as a narrative summary and supported by tabular and graphical formats. Knowledge partner engagement will guide all steps in this study. ETHICS AND DISSEMINATION:Formal ethical approval is not required, as primary human or animal data will not be collected. A manuscript summarising the results will be written and submitted to a peer-reviewed journal for publication. Other outlets for dissemination will include local presentations and conference presentations. TRIAL REGISTRATION DETAILS:Open Science Framework (https://osf.io/vn6ht).

Access to comprehensive sexual and reproductive health (SRH) services remains a challenge worldwide. Describing community pharmacists' SRH services in countries with different scopes of practice will aid in understanding how pharmacists view their roles and how to support them in providing needed services. A cross-sectional web-based survey was administered to pharmacists working in community pharmacies in Japan, Thailand, and Canada. The survey covered 7 SRH categories: pregnancy tests, ovulation tests, contraception, emergency contraception, sexually transmitted and blood-borne infections, maternal and perinatal health, and general sexual health. Descriptive statistics were used to analyze the data. A total of 922 eligible responses were included in the analysis (Japan = 534, Thailand = 85, and Canada = 303). Most Thai and Canadian participants reported dispensing hormonal contraceptives (Thailand = 99%, Canada = 98%) and emergency contraceptive pills (Thailand = 98%, Canada = 97%). Most Japanese participants provided patient education on barrier contraceptives for men (56%) and information on the safety of medications in pregnancy (74%) and breastfeeding (76%). The majority of participants expressed interest in additional training and expanding their roles in SRH. Sharing international experiences can guide challenges faced by the evolution of pharmacists' practice in SRH. Providing pharmacists support could help their readiness for this role.

Background:Pharmacists in many countries have long been involved in some aspect of assisted dying. Since 2016, when Canada enacted legislation permitting medical assistance in dying (MAiD), the number of patients seeking the procedure has increased yearly. Despite the global nature of pharmacists' involvement, little is known about how they experience MAiD practice.Objective:To study how pharmacists experience the practice of caring for patients who seek MAiD.Methods:This qualitative study used semistructured interviews with pharmacists who had cared for patients seeking MAiD. Interviews, conducted between June 2019 and October 2020, were audio-recorded and transcribed verbatim. Data were examined using a modified framework analysis approach. Data were coded and sorted using Quirkos and Microsoft Excel software. Themes were defined through an iterative process involving constant comparison.Results:Nineteen hospital pharmacists representing a range of practice settings in Alberta participated in the study. The experience of caring for patients seeking assistance in dying brought to light 3 themes: finding a place in the process, serving in a caring role, and bearing emotional burdens. Pharmacists' experiences were personal, relational, emotional, and dynamic.Conclusions:Each of the pharmacists experienced MAiD practice in a unique way. Although their roles in MAiD were primarily medication-focused, their experiences highlighted the centrality of patient choices, autonomy, and needs. The results of this study will inform pharmacists (including those not yet engaged in MAiD practice) about the role, and will also be valuable for pharmacy organizations and educators seeking to support pharmacists and the profession, as well as policy-makers seeking to expand pharmacists' roles in MAiD.

Background: In many countries, pharmacists' scope of practice enables the delivery of professional pharmacy services related to sexual and reproductive health (SRH). Studies exploring practices and perspectives regarding a wide range of SRH professional pharmacy services and the extent to which pharmacists are involved in prescribing or administering injections are limited. Objectives: This study aimed to explore SRH professional pharmacy services provided by pharmacists, evaluate pharmacists' self-reported confidence in providing SRH education and determine preferences for additional training. Methods: A cross-sectional Web-based survey was administered to pharmacists working in community pharmacies in Alberta, Canada. The survey was sent via e-mail and was open for 8 weeks between June and August 2020. Descriptive statistics were used to analyze the data. Results: Most of the 303 participants were female (66%) and received their first pharmacy degree in Canada (69%). Approximately two-thirds had additional prescribing authorization (APA), and 97% had injections authorization; 90% and 94% of participants reported administering injectable contraceptives and human papillomavirus vaccine, respectively, and more than 95% renewed prescriptions for oral contraceptives. Of the participants with APA, approximately 40% reported providing initial prescribing services for contraceptive products. Overall, participants reported confidence in providing SRH education for most topics. Most selected topics for additional training were related to sexually transmitted and blood-borne infections; sexual health concerns of lesbian, gay, bisexual, transgender, queer or questioning; and abortion medications. Conclusion: Pharmacists in Alberta reported providing a wide range of SRH services and are interested in expanding their SRH role. These findings highlight opportunities to improve access and reduce inequities in the delivery of SRH services through community pharmacies. However, pharmacists' training needs should be considered. (C) 2022 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.

The provision of sexual and reproductive health (SRH) services is an important part of a community pharmacist’s role in many countries. However, such services are not traditionally provided by pharmacists in Japan. We surveyed the practice and attitudes regarding the provision of SRH services among Japanese community pharmacists with a focus on reproductive health (RH) topics. The participants were asked about the provision of RH services, attitudes toward their role as SRH providers, and self-reported confidence in providing education to patients on RH topics. We obtained 534 effective responses. About half of the participants reported providing RH services, and only 21% were involved in dispensing emergency contraception pills. Although the proportion of pharmacists providing education on these topics was considerably lower, about 80% recognized the importance of their role as SRH advisors. Confidence in providing patient education about RH topics depended on their experience in providing such services. Most participants were interested in additional SRH training (80%). Our results suggest that training programs could help to expand Japanese community pharmacists’ roles as SRH providers and increase their confidence in the education of patients. This study provides useful insights to expand pharmacists’ roles in Japan as providers of comprehensive SRH services.

Objectives Pharmacists are increasingly providing patient-focused services in community pharmacies, including in the area of sexual and reproductive health (SRH). Specific SRH areas have been the focus of research, but a broader perspective is needed to position pharmacists as SRH providers. This review explored research that described and evaluated professional pharmacy services across a broad range of SRH areas.Design Scoping reviewData sources Medline, EMBASE, CINAHL, Web of Science, Scopus and Cochrane Library (January 2007–July 2020).Study selection Studies reporting on the description and evaluation of professional pharmacy SRH services provided by community pharmacists.Data extraction Two investigators screened studies for eligibility, and one investigator extracted the data. Data were analysed to primarily describe professional pharmacy services and intervention outcomes.Results Forty-one studies were included. The main SRH areas and professional pharmacy services reported were sexually transmitted and bloodborne infections (63%) and screening (39%), respectively. Findings showed that pharmacists’ delivery of SRH services was feasible, able to reach vulnerable and high-risk groups, and interventions were highly accepted and valued by users. However, integration into daily workflow, pharmacist remuneration, cost and reimbursement for patients, and policy regulations were some of the barriers identified to implementing SRH services. Studies were primarily in specific areas such as chlamydia screening or hormonal contraception prescribing, while studies in other areas (ie, medical abortion provision, long-acting reversible contraception prescribing and vaccine delivery in pregnant women) were lacking.Conclusion This scoping review highlights the expansion of pharmacists’ roles beyond traditional product-focused services in a number of SRH areas. Given the potential feasibility, users’ acceptability and reach, pharmacists are ideally situated to enhance SRH care access. Future research describing implementation and evaluation of professional pharmacy services in all SRH areas is needed to promote access to these services through community pharmacies and position pharmacists as SRH providers worldwide.