Written by Hana Kim
Published on Vol 4 Issue 2, 2024
Hospital clinical-pharmacy services are commonly organised around wards, specialties, or fixed service lines because these structures support continuity, accountability, and integration with multidisciplinary teams. Yet medication-related demand is not spatially fixed. It can rise abruptly when organ function changes, high-risk treatment is initiated or intensified, interacting therapy is added, monitoring becomes inadequate, care transitions occur, or unresolved medication problems accumulate.
Written by Thomas Berger
Published on Vol 4 Issue 2, 2024
Total body weight is embedded in drug dosing because it is inexpensive, reproducible, and immediately available. Its convenience, however, can obscure the fact that a kilogram does not identify the biological quantity responsible for drug distribution or clearance. Adipose tissue, lean tissue, extracellular fluid, plasma volume, kidney function, hepatic metabolic capacity, transporter activity, and protein binding can change independently, sometimes in opposite directions. Consequently, patients
Written by Clara Dubois
Published on Vol 4 Issue 2, 2024
Deprescribing in frail adults is commonly framed as the removal of medicines whose harms or burdens exceed their likely benefits. That formulation is clinically useful but incomplete because discontinuation itself changes risk. Medication withdrawal can relieve adverse effects, administration burden, monitoring demands, drug interactions, and treatment workload, yet the same action may provoke physiological withdrawal, rebound phenomena, recurrence of the treated disorder, or loss of future prev
Written by Daniel Kim
Published on Vol 4 Issue 2, 2024
Antibiotic reassessment is often organized around fixed review points, yet the information needed to modify treatment rarely matures simultaneously. Microbiological evidence may justify spectrum narrowing while the patient still requires intravenous therapy; clinical recovery may permit oral treatment while uncertainty about total duration remains; conversely, negative cultures may provide little reassurance when the host trajectory remains concerning. This For Debate article argues that antibio
Written by Naledi Mokoena
Published on Vol 4 Issue 2, 2024
Predictive medication-safety systems are commonly evaluated as tools that identify patients, orders, or situations at elevated risk. Once embedded in clinical work, however, prediction becomes part of the system generating the outcomes on which later safety judgments depend. Recommendations can redistribute clinician attention, alerts can alter prescribing behavior, suppression and prioritization can change which hazards remain visible, and successful interventions can modify the labels and data
Written by Ahmed Al-Mansoori
Published on Vol 4 Issue 2, 2024
Pharmaceutical-care services are increasingly transferred across jurisdictions through policy borrowing, professional expansion, implementation programmes, and adaptation of established community-pharmacy models. Yet a service that is effective in one setting cannot be assumed to remain operationally equivalent when introduced into a health system with different professional authority, workforce capacity, medicine availability, financing arrangements, information infrastructure, and patient expe
Written by Laura Mendez
Published on Vol 4 Issue 2, 2024
Risk communication is usually treated as a prerequisite for informed medication use, yet the act of communicating risk can itself alter treatment experience. Side-effect warnings, numerical presentations, expressions of uncertainty, and the structure of treatment choice may influence expectations, symptom interpretation, perceived control, trust, and subsequent medication behavior. The relevant ethical problem is not whether material risks should be disclosed; they should. The problem is how acc
Written by Michael Tan
Published on Vol 4 Issue 2, 2024
Generative artificial intelligence can now produce fluent drug-information responses, therapeutic recommendations, explanatory prose, and answers to professional examination questions. This capability creates a specific problem for pharmacy education: a correct or persuasive response no longer establishes that the learner independently retrieved appropriate evidence, verified its authenticity and relevance, understood the pharmacological mechanism, integrated patient-specific information, recogn
Written by Emily Carter
Published on Vol 4 Issue 2, 2024
Medicines-access policy is commonly assessed through formulary inclusion, procurement, outlet availability, price or successful dispensing. These indicators are important, yet they can classify a medicine as accessible while an individual treatment episode is repeatedly disrupted. Stockouts may force patients to search across facilities or sectors; substitutions may preserve treatment or destabilize it depending on therapeutic fit and how the change is managed; medication information may fail to
Written by Lucas Meyer
Published on Vol 4 Issue 2, 2024
A medicine can represent good value for money and still create an adoption problem for a health system. Cost-effectiveness evaluates incremental costs and consequences relative to an alternative, whereas affordability depends on the scale and timing of expenditure, the population eligible for treatment, the resources required to deliver care, and the services displaced when additional resources cannot be obtained immediately. These quantities can move in different directions. A therapy with a fa
Written by Nina Larsen
Published on Vol 4 Issue 2, 2024
To develop a methodological approach for classifying treatment outcomes when biological or clinical markers improve while the work required to sustain treatment becomes difficult, disruptive, or unacceptable to patients. A construct-explicit methodological synthesis was undertaken across literature addressing treatment burden, patient work, patient-reported outcomes, medication adherence and persistence, surrogate endpoints, functional outcomes, patient preferences, and value assessment. Biologi
Written by David Park
Published on Vol 4 Issue 2, 2024
Long-acting injectable therapies extend pharmacological exposure beyond the administration event, but duration alone does not determine whether treatment remains safe, manageable, or less burdensome. Once a dose has been administered, residual exposure may continue while the patient and clinical service must manage scheduled visits, missed injections, adverse effects, monitoring, switching, and eventual discontinuation. These obligations become particularly important when a depot cannot be remov
Written by Sarah Mitchell
Published on Vol 4 Issue 2, 2024
Three-dimensional printing can vary drug dose, geometry, composition, internal architecture, release characteristics, and patient-facing features with a degree of flexibility that conventional mass manufacture rarely provides. Yet technical customizability does not by itself establish that a resulting medicine is patient-specific. A clinically individualized product must retain a defensible relationship between the patient's therapeutic requirement and the attributes deliberately changed dur
Written by Thomas Weber
Published on Vol 4 Issue 2, 2024
Pharmacists increasingly undertake medication review, prescribing and deprescribing, but medication-level improvement does not necessarily establish patient benefit. Effects may depend on pharmacist prescribing authority, whether medication is initiated, modified or withdrawn, comparator intensity, outcome definition and the extent to which treatment burden is measured directly. To determine whether pharmacist-led prescribing and deprescribing improve patient-important outcomes without increasin
Written by Anna Kowalska
Published on Vol 4 Issue 2, 2024
Medication-adherence technologies are often compared as though they measure the same behavior with different degrees of precision. In practice, pill counts, pharmacy dispensing records, electronic monitors, ingestible sensors, mobile applications, and passive digital traces observe different events and require different inferential steps before those observations can be interpreted as medicine taking. This review examined how distinct research traditions have defined adherence through technology
Written by Julia Berg
Published on Vol 4 Issue 2, 2024
Model-informed precision dosing (MIPD) integrates pharmacometric models with patient-specific information to individualize treatment. Increasing availability of Bayesian dosing software has made bedside use technically feasible, but model validation, clinical implementation, pharmacokinetic target attainment, and improvement in patient outcomes represent different evidentiary levels. This evidence-mapping review examined where MIPD progressed into real clinical decisions during 2017–2025 and whe
Written by Peter Nagy
Published on Vol 4 Issue 2, 2024
Drug-delivery innovation is commonly judged through formulation performance, pharmacokinetics, dosing interval, device functionality, safety, or therapeutic efficacy. These achievements are necessary for translation but do not establish that a technology can be delivered repeatedly within ordinary care. This critical interpretive synthesis examined how product requirements interact with patient capabilities and health-system conditions after credible technical or clinical performance has been de
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