Clinical Pharmacy and Pharmacy Practice

Clinical pharmacy and pharmacy practice encompass the science and art of ensuring therapeutic optimisation, patient safety and cost-effective medication use across healthcare settings. Clinical pharmacists apply pharmacological expertise to individualise therapy, manage complex regimens and collaborate with physicians and other professionals. Pharmacy practice extends from the community pharmacy setting—where pharmacists counsel on self-care, chronic disease management and immunisations—to hospitals and specialised clinics, in which pharmacists oversee formulary management, sterile compounding, transitions of care and readmission prevention. Core responsibilities include medication reconciliation, adverse-event monitoring, antimicrobial stewardship and health-screening services. By integrating direct patient care with the logistics of procuring, compounding and dispensing medicines, modern pharmacy practice enhances adherence, prevents medication errors and contributes to public-health initiatives.

Research from Nature Portfolio

Large-scale analyses of nationwide health and genomic registries have shown that markers of social disadvantage—such as reliance on social assistance and immigrant status—are more strongly linked to lower adherence and persistence across multiple chronic medication classes than common genetic variants. These insights highlight the importance of targeted outreach and dispensing models that address economic and structural barriers in vulnerable populations. In parallel, researchers have applied ensemble learning and recurrent neural networks to millions of injectable medication events, achieving prediction accuracies above seventy percent for identifying patients at risk of non-adherence. Such predictive pipelines may enable pharmacists to prioritise adherence-promoting interventions and allocate resources more efficiently.

Clinical Pharmacy and Pharmacy Practice publication trend

The graph below shows the total number of articles in clinical pharmacy and pharmacy practice across all publications each year (not limited to Nature Index journals).

Technical terms

Medication adherence: The extent to which a patient’s dosing behaviour conforms to prescribed instructions in terms of timing, dosage and frequency.

Persistence: The duration of time a patient continues a prescribed therapy without interruption.

Reinforcement learning: A machine-learning approach that iteratively adjusts intervention content based on individual behavioural responses to optimise outcomes.

Necessity-Concerns Framework: A theoretical model positing that adherence depends on patients’ beliefs about their personal need for treatment balanced against concerns about adverse effects.

Antimicrobial stewardship: Coordinated interventions designed to promote the appropriate use of antibiotics, improve patient outcomes and reduce antimicrobial resistance.

References

1. Factors Contributing to Medication Adherence in Patients with a Chronic Condition: A Scoping Review of Qualitative Research. Pharmaceutics (2021).
2. The impact of using reinforcement learning to personalize communication on medication adherence: findings from the REINFORCE trial. npj Digital Medicine (2024).
3. Understanding Patients’ Adherence-Related Beliefs about Medicines Prescribed for Long-Term Conditions: A Meta-Analytic Review of the Necessity-Concerns Framework. PLOS ONE (2013).
4. Socio-demographic and genetic risk factors for drug adherence and persistence across 5 common medication classes. Nature Communications (2024).
5. Predicting medication adherence using ensemble learning and deep learning models with large scale healthcare data. Scientific Reports (2021).