Objective: This study aimed to develop a consensus statement of competencies for community pharmacists in Thailand. Methods: A 2-round modified Delphi process was used to develop consensus among a panel of community pharmacy experts. A total of 18 experts from 6 stakeholders represented a panel of each pharmacy organization in Thailand. In the first experts were asked to rate their degree of agreement on whether a competency was essential using a 7-point Likert scale (1 = “not essential competency” to 7 = “the most essential competency”). Also, in the second round, they were asked to rate the competencies from a scale of “must be included” to “must be excluded.” Competencies considered “must be excluded” by a consensus of 80% or more of experts were removed from the community pharmacy competency list. Results: Nearly half the experts had experience in their position for more than 10 years. The expert panels were typically committee members of the Community Pharmacy Association (Thailand) and community pharmacy clerkship preceptors (29.4% and 23.5%, respectively). The number of community pharmacy competencies on the initial list was 55 competencies. None of them was eliminated after the first round. Of 55 competencies, 11 were eliminated after the second round. The final list of competency statements was 44 competencies divided into 4 domains: personal competencies, pharmacy professional competencies, patient care competencies, and management competencies. Conclusion: Community pharmacy competencies include having a positive attitude and being accountable for individual patient care, providing disease prevention and health promotion, and addressing morality and ethics in business.

Global health initiatives highlight the importance of having a skilled pharmacy workforce. Organizations like JCPP and WHO/FIP support better pharmacy education, which includes mandatory Medication Management System (MMS) clerkships in Thailand’s Pharm.D. program. However, variations in clinical placements and learning objectives make it difficult to provide the best training. This study aimed to redesign the assessment for the clinical pharmacy clerkship training program to enhance this compete

Introduction: Older patients are often exposed to medications with anticholinergic activity. Anticholinergic burden (ACB) from medicines is linked to adverse health outcomes. However, healthcare professionals’ familiarity with ACB remains poor, and there is a lack of research on knowledge, attitudes, or practices (KAPs) of ACB among Emergency department (ED) clinicians. Methods: A nationwide survey of ACB based on a pilot survey was developed using the KAP framework and assessed for face and content validity by ACB experts. It was distributed to ED physicians across the UK using REDCap through social media and professional networks. Results: Among the 108 ED physicians who responded, 54.6% (n = 59) were aware of the term ACB, but 54.2% (n = 32/59) of them were unable to describe it. Their mean scores for quantifying the ACB score and identifying side effects in older patients were 2.9 and 4.1 out of 10, respectively. 88.9% (n = 96) believed that ACB is an important consideration in older patients. 67.6% (n = 73) agreed that awareness of the consequences of prescribing anticholinergic medications to older patients is important. 50% (n = 54) emphasized the importance of being able to assess and quantify the ACB score. Of the 75 physicians who prescribed these medications, 40% (n = 30/75) were unaware of ACB. 38.7% (n = 29/75) rarely considered ACB, 30.7% (n = 23/75) never considered it, and only 1.3% (n = 1/75) always considered it. The majority of respondents (88.9%, n = 96) agreed that more education on ACB is needed in the ED. Conclusions: ED physicians in the UK have limited knowledge and awareness of ACB management and prescribing practices for older patients. However, they show positive attitudes towards their role in ACB management and a willingness to receive further education. The low response rate suggests that findings may reflect a motivated subset of clinicians. These results highlight the need for targeted education and further investigation into curricular coverage of prescribing safety and anticholinergic burden.

Introduction Older patients are often exposed to medications with anticholinergic activity. Anticholinergic burden (ACB) from medicines is linked to adverse health outcomes. However, healthcare professionals’ familiarity with ACB remains poor, and there is a lack of literature in knowledge, attitudes, or practices (KAP) of ACB among Emergency department (ED) clinicians. Methods A nationwide survey of ACB (using https://www.acbcalc.com) based on a pilot survey was developed using the KAP framework and assessed for face and content validity by ACB experts. It was distributed to ED physicians across the UK using REDCap through social media and professional networks. Results Among the 108 ED physicians who responded, 54.6% (n=59) were aware of the term ACB, but 54.2% (n=32/59) of them were unable to describe it. Their mean scores for quantifying the ACB score and identifying side effects in older patients were 2.9 and 4.1 out of 10, respectively. 88.9% (n=96) believed that ACB is an important consideration in older patients. 67.6% (n=73) agreed that awareness of the consequences of prescribing anticholinergic medications to older patients is important. 50% (n=54) emphasized the importance of being able to assess and quantify the ACB score. Of the 75 physicians who prescribed these medications, 40% (n=30/75) were unaware of ACB. 38.7% (n=29/75) rarely considered ACB, 30.7% (n=23/75) never considered it, and only 1.3% (n=1/75) always considered it. The majority of respondents (88.9%, n=96) agreed that more education on ACB is needed in the ED. Conclusion ED physicians in the UK have limited knowledge and awareness of ACB management and prescribing practices for older patients. However, they show positive attitudes towards their role in ACB management and a willingness to receive further education.

Background and Objectives: Anticholinergic burden (ACB) cumulatively leads to adverse outcomes and increased mortality. Taiwan's NHIRD prevalence studies indicate ~60% of elderly patients (≥65) annually receive anticholinergic medications. In those with polypharmacy, 60–80% were exposed to anticholinergic medications, which was linked to higher risks of pneumonia, myocardial infarction, and stroke. This study aims to survey physicians’ knowledge and attitudes on Anticholinergic Burden (ACB) in Taiwan, directly addressing a recognized gap in clinical practice. Materials and Methods: This nationwide, anonymized online 3-month survey (July–September 2025), used the KAP framework. Physicians from 92 hospitals across Taiwan were invited to participate via e-mail. The survey covered demographics, ACB knowledge, attitudes, practices, and feedback, utilizing branching logic. Data was analyzed and presented descriptively. Of 62 respondents, only 23% of physicians were aware of the term 'Anticholinergic Burden' (ACB). Knowledge of specific common medication ACB scores was low (average 1.86/10), and respondents showed significant uncertainty regarding the risks associated with high ACB. Despite 53% of physicians (33/62) rating ACB assessment as "Important/Very Important," this rarely translated into practice: most never calculated scores, and only one did so routinely. Fifty-six participants' overwhelming demand for increased ACB education emphasizes the critical need for training to close both the identified knowledge and knowledge-practice gaps. Conclusions: Physician’s knowledge of medicines with anticholinergic property is relatively low in Taiwan despite the awareness of its importance. There is a clear knowledge and knowledge-practice gap which can be addressed through targeted educational activities.

Maharaj Nakhon Chiang Mai University Hospital implemented a daily dose medication distribution system with an automated conveyor for safe and effective medication management. However, delays during peak hours and medication errors have been observed. To identify waste in the medication distribution process and analyze frequently co-prescribed medications using data mining and association rule techniques to suggest improvements. A quantitative analysis of prescription data from April 1, 2022, to March 31, 2023, used process flow mapping and WASTE analysis. Data mining and association rule discovery in RapidMiner Studio analyzed co-prescribed medications, identifying associations among pairs, triples, and quadruples. Key statistical measures, including support, confidence, and lift, were calculated. The study analyzed seven zones of medication cabinets, focusing on a conveyor belt that completes a rotation in 84 seconds and has five ejection stations. On average, 1,853 medication orders are processed daily, with 1,391 entering through the guided cabinets and conveyor. The study used Frequent Pattern Growth to identify 151 co-prescription rules and found high error rates, mainly under-prescribed quantities, in Zone EL2 (injectable medicine). It also showed all eight wastes of DOWNTIME, including defects in error reports and overproduction from pre-packaging excess medications. By managing these issues, we can reduce waste linked to wait times and unnecessary movement by staff refilling medications in short supply. This enables staff to focus on other important tasks. Additionally, transportation and extra processing waste can be recognized through unnecessary ejections. The study identified eight types of waste in the pharmaceutical dispensing system and emphasized the need for continuous quality improvement based on lean principles to reduce waste and enhance efficiency. By optimizing storage, workflow, and staffing, as well as recognizing commonly co-prescribed medications, the process can be better organized. Using data analysis is essential for managing medications more effectively and minimizing medication errors.