Background: Traditionally pharmacists were mainly involved in dispensing medications, however their role has significantly changed and expanded in the past couple of years and now includes patient education, chronic disease management and supporting patients in making informed healthcare decisions. With these expanded responsibilities, pharmacists require not only strong clinical knowledge, but also advanced communication and consultation skills. This has led to a growing focus on patient-centred care. A postgraduate education course can help develop consultation skills. It involves formal university qualifications and is a method to provide high-quality education in a new and specific area.
Aim: This study aimed to explore healthcare professionals’ development of patient-centred consultation skills through a postgraduate education course. Specifically, it sought to examine whether such educational interventions can support the development of more effective patientcentred consultations.
Methodology: This study used a qualitative approach and data was acquired through semistructured interviews with the course participants. Data collection was done by a researcher with minimal involvement in teaching the course and the interviews were conducted online via Microsoft Teams. All interviews were transcribed verbatim and analysed using the framework method, a thematic analysis. A fellow research student coded about 10% of the interviews separately, to ensure consistency and the results were further discussed with two research fellows, involved in developing the course, which also helped ensure consistency in the coding and thematic analysis.
Results: 13 Interviews were conducted with different healthcare professionals that participated in the postgraduate education course. Four themes were identified as patient-centred approaches to care by the participants. They included patient involvement and empowerment, adaptive, patienttailored communication, a comprehensive understanding of patient care and lastly the importance of interprofessional collaboration in patient care.
Conclusion: Overall, participation in the course was associated with a broader and more reflective understanding of patient-centred care, characterised by shifts in communication style, professional role perception, and approaches to collaborative care. Collectively, these findings suggest that the postgraduate course may have supported the development of not only specific consultation skills, but also a patient-centred approach of care. The identified themes indicate that patient-centred consultation skills extend beyond information provision alone and involve relational, adaptive, holistic, and collaborative competencies that shape clinical practice.
Background: Pharmacists’ roles have evolved from mainly dispensing medication towards a more patient-centred approach. Today, pharmacists are actively involved in a wide range of patient-centred activities, including support in minor ailments, chronic disease management and patient education across various settings. Central to this development is patient-centred care in pharmacy consultations, which focuses on the individual patient and their unique preferences and needs. Patient-centred skills, such as effective communication and shared decision-making are important in areas including chronic disease management, such as diabetes, adherence and polypharmacy. This expansion of these responsibilities highlights the increasing need for postgraduate education to prepare pharmacists for their evolving roles.
Aim: The aim of this study is to explore patient-centred consultation skills of health professionals who have completed postgraduate education.
Methods: In this quantitative cross-sectional study, students enrolled in the postgraduate diabetes education course at the University of Western Australia were recruited via email, the learning management system and social media prompts. Data were collected over one month using an anonymous online questionnaire consisting of 66 items, including mainly five-point Likert-scale questions and a few open-ended questions. The survey was originally developed as a course evaluation and only items relevant to the study aim were included in the analysis. Data were analysed using descriptive statistics.
Results: Data from 33 participants met the eligibility criteria and were included in the analysis. Overall, responses showed consistently high agreement with low variability across perceived approaches, impact and confidence following the postgraduate education course. Median scores were primarily 5 across all domains. Regarding perceived approaches, patient involvement and communication were highly rated (median=5), while recognising emotional impact on management was slightly lower (median=4). Perceived impact was rated uniformly high (median=5). Confidence was also high overall, with median 5 for goal-setting conversations and median 4 for confidence in diabetes self-management education.
Conclusion: Overall, this study highlights the potential value of postgraduate education in supporting the development and improvement of patient-centred consultation skills. However, further research is needed to determine whether these perceived improvements translate into sustained changes in clinical practice and patient outcomes.
Introduction: Patients differ in their response to medications and in their experience of pain. Inherited
genetic variants partly may explain these differences and may influence both pain perception and analgesic metabolism. Pre-emptive pharmacogenetic panel testing identifies these variants before drug exposure and supports prescribing decisions in the perioperative period as well as in later treatment. Roboticassisted transabdominal preperitoneal (rTAPP) inguinal hernia repair is a standardised elective procedure with a defined perioperative medication regimen and frequent postoperative pain. No previous study has examined whether this surgical population would benefit from pre-emptive panel testing. This thesis examined the proportion of pharmacogenetically relevant variants and actionable medications under current guidelines, as well as the association between three selected pain-related genetic markers and postoperative pain intensity at six weeks, in patients undergoing rTAPP inguinal hernia repair.
Methods: We conducted the prospective, multicentre, observational association (P)Gx-PIP study at two
Swiss hospitals between July 2024 and April 2026 and present its complete case analysis in this thesis. We enrolled adult patients scheduled for elective rTAPP repair of a primary inguinal hernia and performed genetic testing for 14 pharmacogenetic markers. We recorded medications taken peri- and postoperatively and classified each substance according to the guidelines of the Clinical Pharmacogenetics Implementation Consortium and the Dutch Pharmacogenetics Working Group based on each patient's genotype. Patients reported pain intensity using the European Hernia Society Quality-of-Life pain domain score at five different timepoints. We tested the association between each genetic marker and pain intensity at six weeks by univariate analysis of covariance.
Results: The analysis included 112 patients, who were predominantly male (94.6%) and of European
ethnicity (83.9%), with a median age of 61 years. Across all analysed markers, 105 patients (93.8%) carried at least one pharmacogenetically relevant variant, with a median of three variants per patient. The study population took 107 different substances in total; 14 of these (13.1%) had a pharmacogenetic guideline. Ninety-three patients (83.0%) took at least one such substance, and 36 patients (32.1%) received an actionable drug–gene classification. None of the three investigated pain-related markers showed a statistically significant association with pain intensity at six weeks, catechol-O-methyltransferase (COMT) rs4680, cytochrome P450 2D6 (CYP2D6), and μ-opioid receptor 1 (OPRM1) rs1799971.
Conclusion: A high proportion of this study population carried pharmacogenetically relevant variants, and roughly one third received an actionable drug–gene recommendation under current guidelines. These observations suggest that pre-emptive pharmacogenetic panel testing may be worth considering in patients undergoing rTAPP inguinal hernia repair. The association between the three candidate markers and postoperative pain intensity at six weeks remained inconclusive, as the present sample size did not reach the predefined threshold for the primary analysis. The association between genetic markers and postoperative pain intensity requires confirmation in larger studies.
Objectives and Background: Ketamine is officially approved as an anesthetic and for the treatment of severe depression. According to reports, recreational use of Ketamine seems to be on the rise in Switzerland’s club and party scene. Despite this trend. Little is currently known about the user motivations, subjective experiences and clinical perspectives regarding recreational ketamine use. This study aimed to explore user motivations, subjective effects, and clinical awareness regarding nonprescribed ketamine use.
Methods: This study followed a qualitative research design. A non-systematic literature review and semi-structured interviews were conducted with five current or former ketamine users receiving treatment at the Outpatient Addiction Treatment Center of the University Psychiatric Clinics Basel, as well as two active physicians. Transcribed interviews were analyzed using the reflexive thematic approach, as outlined by Braun and Clarke.
Results: The findings suggested that motivations for ketamine use often changed over time. Initial curiosity often shifted toward a desire for emotional regulation, escape, stress management, or antidepressant effects. Participants described desired effects, such as emotional numbness, energization, dissociation and psychedelic experiences. Further, adverse effects, such as a rapid tolerance development, psychological dependence, lower urinary tract symptoms and gastrointestinal cramping were mentioned. Both patients and experts reported a lack of knowledge regarding the addictive potential and long-term consequences of ketamine use. Furthermore, experts expressed uncertainty about withdrawal management and emphasized the lack of knowledge regarding harmful thresholds of the substance.
Discussion and Conclusion: The study highlights the ambivalent nature of recreational ketamine use. It further emphasizes the importance of substance-specific education, harm reduction measures, and increased clinical awareness. Further research is needed to better understand the prevalence of recreational ketamine use in Switzerland, user awareness, dose-response relationships, and potential health risk thresholds associated with recreational ketamine use.
Introduction: Medication-related harm is a recognised risk during the transition from hospital to home, especially in geriatric patients with multimorbidity. Hospital-based medication reconciliation does not capture discrepancies that arise after discharge. Transitional care models aim to stabilise this vulnerable period of transition. The AdvantAGE is such a project, developed and implemented at the University Department of Geriatric Medicine Felix Platter (UAFP). One of their interventions was the structured Brown-Bag Review (BBR), conducted by an Advanced Practice Nurse (APN) at the patient's home shortly after discharge. This thesis evaluated the type, frequency and criticality of medication discrepancies detected after discharge, as well as predictors of medication discrepancies and readmissions within 90 days.
Method: This quantitative retrospective secondary analysis used real-world data from the BBRs of geriatric, multimorbid patients resident in the canton of Basel-Stadt. The varying levels of data completeness defined three analysis cohorts: Cohort 1 (n = 245) for characterisation of the discrepancies and time-to-readmission analysis; Cohort 2 (n = 218) for predictor analyses of discrepancies and readmissions; and Cohort 3 (n = 196) for discrepancy rates within specific ATC classes. Discrepancies between discharge prescription and home medication were categorised using the Anatomical Therapeutic Chemical (ATC) classification and the medication discrepancy taxonomy (MedTax). Descriptive statistics characterised cohorts and discrepancies, negative binomial regression identified predictors of discrepancy count and 90-day readmission and Kaplan-Meier estimation visualised time to readmission. Candidate predictors were age, gender, number of prescribed medications at UAFP, Clinical Frailty Scale (CFS) score, type of medication management (with or without support), and number of medication discrepancies.
Results: At least one medication discrepancy occurred in 95% of patients, with a median of four per patient. Drug omissions, additional medications not prescribed via UAFP, and generic substitutions together accounted for approximately three-quarters of all discrepancies. After excluding generic substitutions, laxatives, vitamins, and psychotropic drugs ranked as the most frequently affected ATC classes. Cardiovascular drugs, diuretics, and centrally acting drugs formed a critical subgroup. The number of prescribed medications was the strongest predictor of discrepancy count (IRR 1.10 per additional drug). Patients with supported medication management had a 22% lower discrepancy rate (IRR 0.78). Roughly one in five patients experienced readmission within 90 days, most within the first 30 days. The CFS score was the only significant predictor of readmission.
Conclusion: Medication discrepancies after discharge occur in nearly all geriatric patients and frequently involve critical drug classes. The BBR systematically detects discrepancies that affect correct use and adherence to newly prescribed medications. Polypharmacy and absence of supported medication management by family, pharmacy or an outpatient care provider serve as simple triage criteria for directing reconciliation resources. Frailty remains the dominant predictor of early readmission. The results support integrating structured, home-based BBRs into future Swiss transitional-care models for geriatric multimorbid patients.
Introduction: An increasing number of people in Switzerland are living in nursing homes. The combination of chronic conditions, the use of multiple medications (polypharmacy), and the need for inpatient care increases the risk of drug-related problems among older adults. Medication reviews are an effective strategy for optimizing medication use and improving health outcomes. Pharmacists can contribute their pharmacotherapeutic expertise through medication reviews. Working together with physicians and nurses in an interprofessional team, interventions can be discussed to ensure patient-centered medication care. A structured evaluation of these interventions makes it possible to demonstrate the benefits and impact of medication reviews.
Objective and Methods: The study was conducted at a nursing home in German-speaking Switzerland. The objective of this mixed retrospective-prospective observational study was to gain insights from data on an already established process (retrospective) and to conduct structured medication analyses (prospective) to investigate the potential effect of interprofessional, sometimes repeated, medication reviews. As part of a descriptive analysis, the study aimed to: (1) record and classify interventions using PharmDISC tool, (2) describe the most common interventions, (3) assess their clinical, economical, and organizational impacts using the CLEOde tool, and (4) identify the drug classes involved. In addition, (5,6) structured medication reviews were to be conducted after prioritizing residents using the sMARTA risk tool, and (7) the results of repeated medication reviews were to be compared in terms of the type and acceptance of the interventions.
Results: Polypharmacy involving more than nine medications affected 92.5% (n=86) and 88.0% (n=22) of residents, respectively. (1) Drug-related problems frequently concerned the efficacy or risk of treatment. (2) The most common interventions included providing clarification, discontinuing therapy, and adjusting dosages. (3) Positive clinical outcomes were observed in 77.2% (n=186) (retrospectively) and 63.5% (n=40) (prospectively) of the interventions; cost reductions in 57.7% (n=139) and 46.0% (n=29), respectively; and improvement in treatment quality in 54.5% (n=131) and 46.0% (n=29), respectively. (4) Problems in the nervous system and alimentary system drug classes led to interventions particularly frequently. (5,6) In the sMARTA risk tool, at least one risk factor was identified in 20 of 25 residents; prioritized residents had more interventions (3.7 ± 2.2 vs. 3.0 + 2.2). (7) Repeated medication analyses showed a similar number of interventions but shifts in the type and classification of interventions.
Discussion and Conclusion: Interprofessional medication reviews made it possible to improve medication safety among the nursing home residents studied. Information gaps in patient records were addressed during the interprofessional consultation, thereby accelerating the discussion-making process. The identified positive clinical, economical, and organizational impacts support the added value of interprofessional medication reviews and can promote acceptance as well as long-term implementation. The descriptive data collection provides the foundation for further developing the process in the nursing home studied and for utilizing the findings to implement the approach in other nursing homes.
Abstract: Pharmacogenetics (PGx) studies genetic variability and its impact on drug responses. PGx is expected to enhance drug safety and efficacy. Limited knowledge exists regarding the long-term use of PGx information, therefore, the Pharmaceutical Care Research Group at the University of Basel founded the PGx cohort study to assess the longitudinal use of PGx information and contributing factors impeding its routine use. Within the PGx cohort study yearly interviews are conducted over three years. The aim of this master thesis was to analyse preliminary data of the PGx cohort study (Project A) and to optimize the case report form (CRF) of the PGx cohort study to enhance patient-friendliness andreduce ambiguity by conducting cognitive interviews (Project B). Project A: A REDCap SciCORE project was developed based on the CRF of the PGx cohort study, and all existing paper-based CRFs were digitized. Descriptive statistical analysis, as well as several subgroup analyses, were conducted using Microsoft Excel. Project B: The CRF was revised based on identified difficulties in participant responses during digitization and Follow-up interviews of the PGx cohort study. An interview guide with predefined assessment categories was developed, and the revised CRF was evaluated through cognitive interviews. Qualitative analysis included the review and summarization of participants’ responses. Project A: PGx information was applied in the long term, although in only 29.3% of medication changes, with no substantial difference between Follow-up 1 and Follow-up 2. Therapeutic subgroups most associated with PGx utilization included antidepressants and drugs for peptic ulcer and gastrooesophageal reflux disease (GORD). Medical specialists used PGx information most frequently. The main reasons identified impeding the routine use of PGx in clinical practice were insufficient knowledge and awareness among healthcare practitioners, as well as dependence on patient initiative. Project B: Three questionnaire items of the CRF were identified and subsequently revised. Limited comprehension of PGx remained the main challenge for participants in responding to the CRF, even following the revision. A brief explanatory summary of PGx was found to support PGx literacy. Overall, the revised questionnaire items were deemed suitable and understandable. Project A: The relatively low utilization rate of PGx information indicates considerable challenges hindering its long-term application in clinical practice. To support its long-term use strategies to improve awareness and knowledge among healthcare practitioners, as well as patient education will be essential. It is necessary to generate more robust data regarding the long-term use of PGx while also developing specific strategies addressing these challenges. Project B: Overall, the revision of the CRF improved patient-friendliness and reduced its ambiguity. A potential strategy to support PGx literacy would be to provide a brief explanation of its concept and clinical application prior to the Follow-up interview of the PGx cohort study. Future studies should focus on further evaluating and revising the CRF as needed.
Background: Behavioural skills, including communication, information gathering, and decision-making, are essential to safe and effective pharmacy practice. While digital simulation is increasingly used in pharmacy education, previous research has mainly focused on technical skills. The development and assessment of behavioural skills using digital simulation remain relatively underexplored.
Aim: This study aimed to explore the assessment and acquisition of BhS among pharmacy students using the AI-based virtual platform SimFlow, and to evaluate students’ perceptions of its usability and design.
Methods: A cross-sectional observational study involved 50 first-year Master of Pharmacy students at the University of Basel, Switzerland. Participants completed randomly assigned voice-based virtual patient scenarios in SimFlow. Their perceptions were measured using the System Usability and the Simulation Design Scales. The quantitative data were summarised descriptively. Open-ended responses were examined through thematic analysis. To identify behavioural skills demonstrated during virtual consultations, transcripts were evaluated using an abductive thematic analysis with an inductive approach.
Results: Students generally viewed SimFlow positively and found it useful for independent learning and exam preparation. The platform showed above-average usability. Positive perceptions of the simulation design were primarily observed in the objectives and information, feedback and guided reflection, and realism. Responses regarding behavioural skills showed more variation. Students highlighted realistic patient interactions but suggested improvements in conversational flow, technical aspects, and feedback. Finally, transcript analysis identified behavioural skills related to communication, information gathering, decision-making, and patient support and safety.
Conclusion: SimFlow was generally well received by first-year Master of Pharmacy students and showed potential to support the development of behavioural skills in pharmacy education. Although technical improvements are needed, this platform may represent a complementary learning tool to traditional teaching. Future research comparing AI-based virtual simulation with physical objective structured clinical examinations (OSCEs) may provide further insight into its educational role in pharmacy education.
Background and Objective: Although pharmacogenetic testing (PGx) has the potential to reduce adverse drug reactions by up to 30%, only 0.09% of patients in Switzerland undergo such testing. One of the key barriers to implementation is the communication of PGx test results. It has also been shown that the majority of patients do not suniciently understand
PGx test results and are unable to convey their results to other healthcare professionals in the future. To date, there are no established communication frameworks to support PGx consultations. The aim of this master’s thesis was to develop a PGx-specific communication framework based on existing literature recommendations.
Methods: Recommendations relevant to communication identified through a narrative literature review were deductively mapped to the “Medication-Related Consultation Framework.” Where no such mapping was possible, new categories were developed inductively. Building on this, a systematic literature review was conducted, including abstract screening,
in accordance with the PRISMA guidelines in PubMed/Medline, Embase, and Cochrane.
Results: Ten publications were included in the narrative literature review. The frameworkbased analysis yielded 120 statements, which were assigned to eleven categories. The two most frequently assigned categories were: “Explain PGx test result” (42 statements, 9 out of 10 publications) and “Relate information to patient’s illness & treatment beliefs” (24
statements, 9 out of 10 publications). The former involves the recommendation to replace technical terms such as “intermediate metabolizer” with everyday language, while the latter involves contextualizing the results, for example by taking the patient’s current health status into account. Eight categories were adopted unchanged from the MRCF; two categories
had to be newly formed inductively, and one category was refined. The developed framework is divided into four phases: “Pre-test Counseling,” “Result Delivery,” “Patient Understanding,” and “Post-test Counseling.” The systematic literature search yielded 5,900 hits after deduplication. After title and abstract screening, 82 publications remained for fulltext screening.
Discussion: The results show that the clear explanation of test results is a core competency, supported by the teach-back method and language accessible to laypeople. The categories also align with the requirements of Switzerland’s Federal Act on Genetic Testing in Humans
(GUMG). Conclusion: For the first time, a PGx-specific communication framework has been developed that organizes eleven categories into four phases. It fills a research gap by providing a structure for patient-centered PGx consultations.
Introduction: Non-recreational prescription medicine sharing involves borrowing or lending prescription medicines for medical purposes. Research on this topic in the Irish context remains limited. This study aimed to determine the prevalence, patterns, and reasons for such sharing among adults in Ireland.
Methods: An anonymous online cross-sectional survey was conducted among adults aged 18 years or older residing in Ireland. Data were collected via the Qualtrics® XM platform from March 11 to April 20, 2026. Descriptive statistics were calculated using IBM SPSS Statistics for Windows, version 29.0.2.0.
Results: A total of 124 participants were included in the final analysis. Of those who provided gender information, 55.7% (59/106) identified as female. The median age was 46 years (IQR: 35–60), and 73.1% (76/104) had completed third-level or university-level education. Most respondents considered the practice of non-recreational medicines sharing to be unacceptable and reported a low likelihood of sharing. The prevalence of non-recreational prescription medicine sharing in the past year was 37.6% (41/109). The most commonly shared medications were those for pain (44.7%), allergies (26.3%), and ulcers, heartburn, or constipation (26.3%). The most frequently reported reasons for sharing were urgent situations (36.8%), lack of medicine (34.2%), and the need for only a few doses (34.2%).
Conclusion: Despite generally negative attitudes toward non-recreational prescription medicine sharing, this practice was common among adults in Ireland. These findings highlight the need for interventions, including increasing public awareness of the risks of sharing prescription medicines; encouraging healthcare professionals to address sharing behaviors during routine consultations; and promoting the safe disposal of leftover medicines.
Background: Patients with HR+/HER2- breast cancer are candidates for an oral treatment with cyclin-dependent kinase 4/6 (CDK4/6) inhibitors, palbociclib, ribociclib and abemaciclib. Sequential drug administration to the patient allows treatments to be adapted to patients’ responses, through dose reductions and temporary treatment interruption. Consequently,
treatment trajectories with these drugs may exhibit wide inter-individual variability. However, data on the patterns of use of these drugs in real-world care settings remain limited. The objective of this study was to identify patterns of use and quantify treatment persistence with CDK4/6 inhibitors in women residing in Valle d’Aosta (Italy).
Methods: A retrospective cohort study was conducted on women residing in Valle d’Aosta who received their first prescription of CDK4/6 inhibitors between January 1 2018 and November 1 2025 and who completed therapy before November 1 2025. Time to treatment discontinuation (TTD) was defined as a gap between the starts of consecutive cycles
of 60 days or more and it was calculated using Kaplan Meier curves. Treatment trajectories were analyzed using state sequence analysis of individual data. All analyses were performed using R software.
Results: Dispensing data from 79 women with a median age of 62 years (IQR 55–70) were analyzed. Palbociclib was the most commonly used drug (n = 47), followed by ribociclib (n = 23) and abemaciclib (n = 16), with seven (8.9%) patients having switched from one drug to another at least once. The median TTD was 563 days for abemaciclib (IQR 28-727),
427 days for palbociclib (IQR 142-880) and 406 days for ribociclib (IQR 146-761) with no statistical significance p=0.28. Patients who underwent at least one dose reduction had a considerably longer median TTD to those who did not with 689 days (IQR 375-880) and 193 days (IQR 62-461) respectively (p <0.001).
Discussion and Conclusions: Despite the small sample size, several points of potential interest emerged. Treatment persistence with CDK4/6 inhibitors among the study population was suboptimal. No drug reached a median treatment persistence of at least two years, which is the goal for abemaciclib in early breast cancer. The considerably longer treatment
persistence observed in patients with dose reductions supports current recommendations favouring dose reductions over treatment discontinuations as the preferred response to adverse events.
Abstract
Manufacturer switching of antiseizure medication (ASM) remains a sensitive topic in epilepsy treatment. Although current research suggests bioequivalence between generic and brand-name ASMs and a switching is considered safe, concerns regarding seizure control, narrow therapeutic index (NTI), and nocebo effects may complicate the substitution process in daily practice in community pharmacy practice. This cross-sectional exploratory study investigates the experiences and challenges faced by community pharmacies in daily practice when switching from one ASM manufacturer to another with the same active substance in epilepsy treatment. The active substances of interest are lamotrigine, levetiracetam, topiramate, zonisamide, and lacosamide. A voluntary anonymous online survey was conducted between March 24th and April 21st, 2026, and was distributed via email to community pharmacies in the German- and French-speaking regions of Switzerland. The survey was sent out to community pharmacies ordering from the blistering center conducting the portfolio optimization. The data was analyzed descriptively. Of 112 community pharmacies, a total of 55 were included in the analysis and 40 completed the survey. Community pharmacies reported that manufacturer switching was more accepted in new therapy initiations, while substitution in stable patients was generally avoided. Communication and acceptance regarding substitution appeared to vary depending on the treating physician and the patient’s clinical situation. Stable patients were perceived as less accepting of a manufacturer switch than patients initiating a new therapy. Additional workload resulted from physician consultations, patient communication, and administrative tasks. Overall, the optimization process was perceived as burdensome in daily practice. Challenges associated with ASM manufacturer switching are not only related to pharmacological knowledge, but also involves communication, coordination and workflow-related aspects in everyday practice.
Introduction: Manufacturer switches of Antiseizure Medications (ASMs) involving the same active substance are increasingly relevant in the context of worldwide supply shortages. Current evidence is largely based on outpatient settings, while inpatient management practices remain
underexplored. This study therefore aimed to investigate how hospital pharmacies manage switches in adult hospitalized patients with well-controlled epilepsy.
Methods: An international, anonymous, web-based cross-sectional survey of hospital pharmacies was conducted between March and April 2026. We descriptively analyzed the survey questions (n=33), addressing processes and protocols for ASM administration, switching practices through predefined categories, and post-switch outcomes.
Results: A total of 71 hospitals across four continents participated in the survey, with the majority located in Europe (85.9%, n=61). Switch policies varied according to the availability of epilepsy care, while responsibility for switch decisions was predominantly carried interdisciplinary. Standardized internal protocols were largely absent, both at the level of the switch process itself and at the level of communication with patients and Healthcare Professionals (HCPs). Implementation of switch practices varied across ASMs: switches of phenobarbital and phenytoin were generally avoided, while levetiracetam was predominantly switched without restrictions. Lamotrigine, valproic acid, and carbamazepine were categorized variably. Over 60% of the responding pharmacists reported being unaware of clinical outcomes following switches.
Conclusion: This survey provides previously undescribed insights into ASM switching practices in hospital settings, revealing a general absence of standardized protocols. This highlights the need for evidence-based switching guidance in hospital settings to improve patient care and support HCPs in clinical practice.
Background and Aim: Missed medication doses are common in clinical practice, yet patient information leaflets and summaries of product characteristics rarely provide concrete guidance on how to handle them. Existing research has focused mainly on interventions to prevent missed doses, with less attention to how they are managed once they have occurred. Within the MMEDIC study (Missed Medication Experience and Decisions in Care), this thesis aimed to explore how healthcare professionals in Switzerland perceive, interpret, and manage missed doses in their counselling practice.
Methods: An exploratory qualitative study was conducted using semi-structured interviews. Participants were recruited in the German-speaking part of Switzerland through purposive sampling and gatekeepers. Data were analysed using inductive thematic analysis according to Braun and Clarke. The themes were then mapped deductively onto the domains of the Common-Sense Model of Self-Regulation.
Results: Fifteen interviews were conducted with nine physicians, two pharmacists, three pharmacy technicians, and one home-care nurse. The thematic analysis yielded six themes. Interpretations of the terms “soon” and “missed” ranged from two to 24 hours. Most participants shared the same understanding of the instruction “do not double the dose”. Participants followed no fixed procedure for missed doses and decided individually based on the medication, indication, and situation. The Swiss drug compendium was the most frequently named source of information, complemented by artificial intelligence (AI) tools. Most participants felt confident in counselling, particularly with increasing professional experience. Missed doses were rarely brought up in routine counselling. Participants expressed a need for earlier patient education at first prescription, improved interprofessional communication, and more specific guidance in the summaries of product characteristics.
Discussion and Conclusion: Participants had the clinical knowledge to manage missed doses, but the topic rarely came up in routine counselling. Earlier education at first prescription, clearer wording in patient information leaflets, and more concrete recommendations in the summaries of product characteristics could help healthcare professionals address the topic more frequently and more consistently. These findings provide the basis for a planned quantitative follow-up study within the same research project.
Background and Aim: A missed medication dose is part of everyday life for many patients. What to do afterwards often remains unclear, and many patient information leaflets give no clear guidance. Previous research has focused mainly on why and how often doses are missed. How patients experience a missed dose, by contrast, has rarely been studied. The Missed Medication Experience and Decisions in Care (MMEDIC) study aimed to capture how patients deal with missed doses in everyday life. This thesis examines that behavior from the patients' perspective.
Methods: The study followed a qualitative, exploratory design. Patients from the German-speaking part of Switzerland were recruited through purposive sampling. The data were analyzed inductively using the thematic analysis of Braun and Clarke. All transcripts were independently double-coded. The themes were then assigned deductively to an adapted common-sense model of self-regulation.
Results: Twelve interviews were conducted with participants aged 20 to 65 years. The understanding of a missed dose was inconsistent. The terms "almost" and "soon" used in patient information leaflets caused uncertainty and were interpreted differently depending on the dosing schedule, ranging from one hour to several days. Subsequent
behavior varied, from making up the dose after a short delay to skipping it completely. Information sources included health professionals, patient information leaflets, the internet, and artificial intelligence. When uncertain, patients turned to a health professional. Confidence in the decision varied. Patients with long-term therapy or counselling experience felt more confident. Proactive counselling was mostly absent. Most patients wanted clearer patient information and counselling when a medicine is first dispensed.
Conclusion and Outlook: Patients often do not know how to proceed after a missed dose. They are left on their own, as clear instructions are lacking. Health professionals rarely raise the topic and focus on overall adherence. Clear patient information and
proactive counselling at the start of therapy could close this gap and increase patients'confidence. The findings are based on a small, qualitative sample and will be tested in a national or international quantitative study.
Background and aim: Given the moderate influenza vaccination rates, public pharmacies are becoming increasingly important as a low-barrier access point to influenza vaccination in Switzerland. As vaccinations are already offered in over two-thirds of Swiss pharmacies, there is a growing focus on their long-term integration and the role of pharmacy technicians. The aim of this study was to examine vaccination services in Swiss community pharmacies regarding the current state of implementation, the involvement of pharmacy technicians, barriers to implementation and digital support in the vaccination process.
Methods: As part of a contextual analysis guided by the Basel Approach for coNtextual ANAlysis (BANANA), a nationwide quantitative cross-sectional study was conducted using an anonymous web-based survey of pharmacy staff in German and French. Participation was open for approximately four weeks via a public survey link. The questionnaire was designed using the Framework for the Implementation of Services in Pharmacy (FISpH). The data were analysed descriptively, selected group comparisons were carried out and open-text responses were categorised thematically.
Results and discussion: Of the total of 1,120 participants who started the survey, 971 were included in the analysis. 60% of pharmacy technicians reported a very high level of motivation to administer vaccinations. Among pharmacy technicians qualified to administer vaccinations, 59% had already administered vaccinations once or several times per week in the previous six months. Nevertheless, 30% of all participants reported that, despite having cantonal authorisation, no pharmacy technicians are currently administering vaccinations in their pharmacies, mainly due to a lack of trained staff. At the same time, there was broad support for delegating vaccine administration: over half of the participants supported unrestricted vaccine administration by pharmacy technicians, whilst others preferred a limited scope under certain conditions. The generally low ratings of the assessed barriers suggest good feasibility of the vaccination service. Remaining barriers mainly concerned limited staff resources (40%) and the time required (29%). Digital support was viewed positively: around half of the participants were already using digital vaccination documentation and 86% could envisage using a tool such as pharMe to improve efficiency, structure processes and enhance safety.
Conclusion: The motivation and vaccination activity of the surveyed pharmacy technicians indicate their potential for the further integration of vaccination services. However, this integration depends in particular on the legal framework, staffing resources and organisational processes. Digital support tools such as pharMe could help to optimise and further strengthen vaccination services in routine pharmacy practice.
Background: The generic substitution of anticonvulsants remains controversial due to concerns about breakthrough seizures and new adverse effects. Consequently, switching clinically stable patients is generally discouraged, despite new studies showing the high bioequivalence of new-generation anticonvulsants. However, there are limited real-world studies
regarding how generic switching of anticonvulsants is managed in clinical practice.
Aim: This work aimed to evaluate the switching rates of zonisamide, topiramate, levetiracetam, and lamotrigine. Additionally, it examined how different strength regimens and treatment regimens, such as monotherapy vs. combination therapy, influenced the switching rates.
Methods: Data provided by a Swiss blister center was analyzed by using R. The dataset included patients who received at least one of the specific anticonvulsants between January 2023 and January 2026. The switching rate analysis was restricted to patients who had been stable on the brand-name drug for a period of three months prior to the switch. Following the switch, the three-month generic persistence rate was examined.
Results: The results showed significant differences (p <0.001) in the switching rates between the active ingredients. Zonisamide with 73.2% (n = 30) and topiramate with 69.6% (n = 39) demonstrated the highest switching rates, followed by lamotrigine with 65.8% (n = 96). Levetiracetam showed the lowest switching rate at 42.1% (n = 99). Furthermore, 52.6% (n=
268) of the patients on monotherapy switched to a generic, showing a significantly higher switching rate than patients on combination therapy. 13 out of 47 (27.7%) patients on combination therapy switched one active ingredient and only one patient out of 47 (2.1%) switched both active ingredients. However, there was no significant difference in switching rates between patients on one strength regimen and patients on multiple strength regimens. Additionally, high generic persistence rates were observed across all active ingredients, patients on one and multiple regimens, patients on monotherapy and combination therapy.
Conclusion: The analysis of this study indicates that the willingness to switch stable patients to a generic anticonvulsant depends on the specific active ingredient. While the strength regimen is less critical, the clinical challenges of combination therapy tend to increase caution
when switching. However, high generic persistence rates indicate that switching is generally safe.