Earticle

Background: Chronic and acute pain places a significant burden on public health systems, yet management often remains suboptimal. Community pharmacists are well-positioned to optimize pain care through medication management and patient counseling. This systematic review aims to evaluate the types and effectiveness of community pharmacist-led pain management services and to provide evidence for developing effective service models. Methods: A systematic literature review was conducted following PRISMA guidelines. Major electronic databases, including PubMed, Embase, and the Cochrane Library, were searched for studies published between January 2000 and December 2023. This review encompassed literature investigating the clinical, humanistic, and economic ramifications of pharmacist-delivered pain care services within community pharmacy environments. Results: Sixteen studies were identified, encompassing chronic conditions such as osteoarthritis and headache, as well as acute conditions like sore throat. Pharmacist interventions primarily included medication review, structured patient education, and clinical triage using validated assessment tools. In chronic pain management, these interventions significantly improved pain intensity, physical function, and quality of life. In acute pain settings, pharmacist-led point-of-care testing and triage algorithms enhanced antibiotic stewardship and ensured appropriate medical referrals. Additionally, these services contributed to healthcare resource efficiency by reducing unnecessary physician visits. Conclusions: Community pharmacists effectively function as gatekeepers and managers in pain care, improving clinical outcomes and ensuring patient safety. The implementation of standardized assessment tools and institutional support are essential for establishing successful pharmacy-based pain management models.

Background: Helicobacter pylori (H. pylori) is a significant risk factor for gastric cancer (GC), and proton pump inhibitors (PPIs) are commonly used as part of H. pylori eradication regimens. This study aims to systematically synthesize existing evidence on the efficacy and risks of PPI use in GC prevention. Methods: Individual studies were extracted from relevant systematic reviews published between 2020 and 2024, identified through searches in PubMed, Embase, and Web of Science, and an updated search was conducted to include original articles published between 2022 and August 2025. A random-effects model was used to estimate the overall effect size of PPI-containing regimens compared to non-PPI regimens. A network meta-analysis was conducted to compare the efficacy and risks among various PPIs. Results: Total of 60 original studies were included in the final analysis. Meta-analysis showed that H. pylori eradication was associated with a 43% reduction in GC (pooled OR/HR=0.57, 95% CI=0.49-0.66). In network meta-analysis, triple therapies with lansoprazole and esomeprazole exhibited the highest treatment efficacy. In contrast, overall PPI use was associated with a 62% increased risk of gastric cancer GC (pooled OR/HR=1.62, 95% CI=1.13-2.31), particularly with long-term use. In treatment ranking, overall PPI use ranked less favorably; however, among individual regimens, lansoprazole appeared to show comparatively lower gastric cancer risk relative to other PPIs. Conclusions: This study highlights the importance of careful selection of PPI regimens, particularly those based on lansoprazole, for H. pylori eradication and GC prevention, while also considering the potential risks associated with prolonged PPI use.

Background: As Korea transitions into a super-aged society, preventing influenza and its complications in older adults is essential to reduce morbidity, mortality, and healthcare costs. This study evaluated the cost-effectiveness of high-dose trivalent influenza vaccine (HD-TIV) versus MF59-adjuvanted trivalent influenza vaccine (aTIV) in adults aged ≥65 years, in line with updated WHO recommendations. Methods: A decision-tree model was developed from the Korean healthcare payer perspective to compare HD-TIVs and aTIVs under two scenarios: respiratory events and cardio-respiratory events. Relative vaccine effectiveness (rVE) was derived from randomized controlled trials comparing each vaccine with standard-dose TIVs. The model estimated lifetime direct medical costs, quality-adjusted life years (QALYs), and life years (LYs). Deterministic (DSA) and probabilistic sensitivity analyses (PSA) were performed to assess uncertainty. Results: HD-TIV was cost-effective across all scenarios and age groups. In adults aged ≥65 years, the ICER for the cardio-respiratory scenario was KRW 5.42 million per QALY, well below willingness-to-pay thresholds. Assuming an aTIV price of KRW 30,000, the cost-effective ceiling price for HD-TIV exceeded twice that of aTIV. Among those aged ≥75 years, higher efficacy of HD-TIV (rVE 32.4%) translated into 14,760 fewer hospitalizations, with an ICER of KRW 1.47 million per QALY, confirming robust cost-effectiveness even at prices up to approximately seven times that of aTIV. Conclusions: HD-TIV demonstrates consistent cost-effectiveness compared with aTIV in Korean older adults and may improve individual outcomes while reducing healthcare utilization and alleviating the broader public health and economic burden of influenza.

Background: Community pharmacists are essential providers in primary healthcare, yet high turnover among employed community pharmacists (i.e., non-owner pharmacists) poses challenges to workforce stability and service quality. This study was conducted to examine the associations between job satisfaction, job stress, and social support with turnover intention among employed community pharmacists in Korea. Methods: A cross-sectional online survey was conducted targeting employed community pharmacists. Data were collected using a structured questionnaire and analyzed using t-tests, ANOVA, Pearson correlation, and multiple regression analyses. Results: A total of 120 respondents were included. The mean scores were 3.41 for turnover intention, 3.86 for job satisfaction, 2.26 for job stress, and 3.28 for social support. Turnover intention was lower among employed pharmacists earning ≥7 million KRW than those earning 4-5 million KRW. Job satisfaction was higher among males, higher-income groups, and those working at a single pharmacy. Peer support was higher in pharmacies with four or more pharmacists. Turnover intention showed negative correlations with social support (r= –0.601) and job satisfaction (r= –0.386), and a positive correlation with job stress (r=0.534). In multiple regression analysis, social support (β= –0.425) and job stress (β= 0.216) remained significantly associated with turnover intention, whereas job satisfaction was not statistically significant. Conclusion: Turnover intention among employed community pharmacists was more strongly associated with job stress and social support than with job satisfaction. Workplace-level interventions aimed at reducing job stress and strengthening supportive relationships may help improve retention and enhance the stability of community pharmacy services.

Background: Rare digestive system cancers, including cholangiocarcinoma and other low-incidence malignancies, have limited treatment options and often harbor alterations in the RAS–RAF–MEK–ERK pathway. MEK inhibitors have shown preclinical activity, but clinical efficacy remains unclear. This systematic review and meta-analysis evaluated the therapeutic impact of MEK inhibitors in rare digestive cancers. Methods: Following PRISMA guidelines, MEDLINE, Cochrane Library, and ClinicalTrials. gov were searched for randomized phase II or III trials investigating MEK inhibitors in rare cancers. Data extraction and riskof- bias assessment were performed independently by two reviewers. Pooled odds ratios (OR) were calculated using randomor fixed-effects models depending on heterogeneity. Results: Total of 522 records screened, four phase II trials (n=210) met inclusion criteria, evaluating selumetinib, trametinib, and cobimetinib. MEK inhibitor therapy did not improve ORR compared with control (OR 0.93; 95% CI 0.35-2.48; I2=0%). No complete responses were reported. Most studies demonstrated high performance and detection bias due to open-label design, and overall certainty of evidence was rated low. Conclusions: MEK inhibitors showed limited clinical activity in rare digestive system cancers and the current evidence remains insufficient to confirm their efficacy as either monotherapy or in combination therapy. Future trials should incorporate biomarker-selected populations and rational combination strategies to overcome pathway resistance.

In 2024, the U.S. Food and Drug Administration (FDA) Center for Drug Evaluation and Research (CDER) approved 50 “novel” drugs, either as new molecular entities under New Drug Applications, or as new therapeutic biologics under Biologics License Applications. These drugs have never been approved or marketed in the U.S. This review presents a focused discussion on selected novel drugs used in disease conditions designated by American College of Clinical Pharmacy (ACCP) pharmacotherapy didactic curriculum toolkit. The discussed novel drugs include: vadadustat for anemia in chronic kidney disease; aprocitentan for refractory hypertension; landiolol for supraventricular tachycardia; deuruxolitinib for alopecia areata; lebrikizumab for atopic dermatitis; donanemab for both mild cognitive impairment and Alzheimer's disease; xanomeline-trospium chloride, an antipsychotic agent for schizophrenia; and ensifentrine as a maintenance therapy for COPD. This review aims to provide essential clinical pharmacology and therapeutic insights to support the pharmacy education and clinical decision-making regarding these newly approved agents.