Challenges and opportunities in community pharmacists’ identification and management of dry eye disease: a qualitative study
Bibliographic record
Abstract
OBJECTIVE: To explore Malaysian community pharmacists' (CP) challenges in identifying and managing dry eye disease (DED) and opportunities to optimize DED care, as previous studies reported inconsistencies in DED identification by community pharmacy staff, and few publications describe Malaysian CP views on DED management in community pharmacy settings. METHOD: Using the Social Ecological Theory for Community Health Promotion, individual in-depth interviews were conducted (May-June 2023) with 20 CP in Malaysia's Klang Valley. Participants with diverse DED management experiences were recruited using purposive and snowball sampling until data saturation. Interviews were audio-recorded, transcribed, independently coded by two researchers, and thematically analysed. KEY FINDINGS: CP faced 12 challenges in identifying and managing DED: patient-related (brand rigidity, 'quick fix' attitude, inadequate health literacy, and self-efficacy skills), provider-related (imprecise assessment, referral difficulties, knowledge gaps), therapeutics-related (short shelf life, affordability), and pharmacy-related (limited manpower, inadequate private consultation space, low eye health visibility). The 12 opportunities for optimizing DED care were community-related (eye health education, holistic approaches, public awareness), profession-related (decision-support mobile health applications integrated with evidence-based DED management protocols to streamline consultation processes, interdisciplinary collaborations), industry-related (pharmaceutical and medical device advancements, comparative data on medication value, promotion of proactive management), and organization-related (management-mandated resource allocation, ancillary staff education, and expanded products and services). CONCLUSION: Malaysian CP encountered challenges in identifying and managing DED. Knowledge sharing and collaborations with ophthalmologists improve DED management by CP, while clinicians can stay updated on medication-related recommendations and treatment adherence. The role of digital health in these processes requires further study.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".