Background: A community pharmacist represents the most accessible healthcare provider in many countries, and community pharmacies are suitable places for patient counselling, addressing simple health issues, managing chronic diseases, offering support for non-pharmaceutical treatment, making recommendations for safe medication use, and preventing further drug-related problems. Objective: This review aims to summarise the types of advanced care interventions pharmacists make in community pharmacies, explore their feasibility and benefits for patients and public health, and assess the impact of these interventions on the continued development of pharmaceutical practice in community pharmacies. Methods: The search for relevant studies was conducted on PubMed using keywords related to pharmaceutical services in community pharmacies and excluding studies in hospital pharmacies and clinical pharmacy interventions. Results: This review encompasses a variety of pharmaceutical services tailored to patients/clients with diverse types of diseases. Historically, first data about advanced pharmaceutical services in community pharmacies were related to interventions for patients with cardiovascular (CV) diseases and asthma. They remained the most prevalent, and their clear positive benefits were well-documented. Scientifical investigations of other advanced services were less extensive with tangible advantages but mainly depended on the intervention duration and physicianpharmacist cooperation. Conclusions: Advances in pharmaceutical services and their outcomes documented in scientific literature represent a shift towards addressing individual patient needs alongside the traditional roles of pharmacists. However, the field’s vastness and less consistent research hinder the formulation of universally applicable recommendations or guidelines. Particularly, interventions focused on CV diseases are strong candidates for internationally valid recommendations in community pharmacies.

The aim of this study was to analyse characteristics of paediatric antibiotic use in ambulatory care in Hungary. Data on antibiotics for systemic use dispensed to children (0–19 years) were retrieved from the National Health Insurance Fund. Prescribers were categorised by age and specialty. Antibiotic use was expressed as the number of prescriptions/100 children/year or month. For quality assessment, the broad per narrow (B/N) ratio was calculated as defined by the European Surveillance of Antimicrobial Consumption (ESAC) network. Paediatric antibiotic exposure was 108.28 antibiotic prescriptions/100 children/year and was the highest in the age group 0–4 years. Sex differences had heterogenous patterns across age groups. The majority of prescriptions were issued by primary care paediatricians (PCP). The use of broad-spectrum agents dominated, co-amoxiclav alone being responsible for almost one-third of paediatric antibiotic use. Elderly physicians tended to prescribe less broad-spectrum agents. Seasonal variation was found to be substantial: antibiotic prescribing peaked in January with 16.6 prescriptions/100 children/month, while it was the lowest in July with 4 prescriptions/100 children/month. Regional variation was prominent with an increasing west to east gradient (max: 175.6, min: 63.8 prescriptions/100 children/year). The identified characteristics of paediatric antibiotic use suggest that prescribing practice should be improved.

Polypharmacy is a common issue in patients with chronic diseases. Eastern-European countries and Iran are exploring possibilities for implementing the Medication Use Review (MUR) as a measure for optimizing medication use and ensuring medication safety in polypharmacy patients. The aim of this study was to gain insights into the development of the community pharmacy sector and map facilitators and barriers of MUR in Eastern Europe and Iran. The representatives of the framework countries received a questionnaire on community pharmacy sector indicators, current and future developments of pharmacies, and factors encouraging and hindering MUR. To answer the questionnaire, all representatives performed document analysis, literature review, and qualitative interviews with key stakeholders. The socio-ecological model was used for inductive thematic analysis of the identified factors. Current community pharmacist competencies in framework countries were more related to traditional pharmacy services. Main facilitators of MUR were increase in polypharmacy and pharmaceutical waste, and access to patients’ electronic list of medications by pharmacists. Main barriers included the service being unfamiliar, lack of funding and private consultation areas. Pharmacists in the framework countries are well-placed to provide MUR, however, the service needs more introduction and barriers mostly on organizational and public policy levels must be addressed.

Background/Objectives: Opioid consumption analysis in Hungary, particularly through ambulatory and hospital sales data, including regional information, is lacking. This study examines opioid use in both sectors, explores regional variations, and identifies influencing factors. Methods: A cross-sectional analysis was conducted using sales data from ambulatory and hospital care, quantifying opioid consumption in defined daily doses (DDD) per 1000 inhabitants (DID) and per day, or DDD per 100 patient days (DHPD) at national and regional levels. Correlations between opioid utilisation and regional variables were assessed using Spearman’s rank test. Results: Total opioid use has risen from 4.73 DID in 2012 to 6.75 DID in 2021, with weak and oral opioids being the most used. Ambulatory care experienced significant increases in weak (61.48%) and oral opioid use (60.01%). Hospital care experienced a decline in DID and stagnation in DHPD. Tramadol combinations grew notably in ambulatory care, with tramadol-paracetamol rising from 0.37 DID to 2.17 DID (484.61% increase) and tramadol-dexketoprofen from 0.12 DID to 0.91 DID (650.27% increase). Interregional differences showed a maximum to minimum ratio of 1.79 in ambulatory and 3.03 in hospital care in 2021. Positive correlations were found between opioid use and geriatric population percentage (r = 0.475; p = 0.035) and, also, unemployment rate (r = 0.546; p = 0.014). A moderate negative correlation was observed between the number of general practitioners (r = −0.458; p = 0.043) and ambulatory care opioid use. Conclusions: Opioid use is increasing in Hungarian ambulatory care while remaining steady in the hospital sector. Regional variations are possibly linked to demographic and economic factors in ambulatory care.