Background Accessibility and affordability of medicines are key for patients’ effective treatment. However, drug prices are soaring, and patients are looking for cheaper medications in Europe and beyond. This study aimed to evaluate European pharmacists’ perceptions and attitudes about the impact of global inflation and the military conflict setting in Ukraine on patients’ buying medicines behaviours. A secondary objective comprised the problem of buying medicines from illegal online sources like social media or non-regulated marketplaces. Methods An observational cross-sectional study was conducted from April 2023 to April 2024 using an anonymous and self-designed questionnaire consisting of 11 questions. The survey was created using Google Forms. The survey link was shared mostly by e-mail amongst practising pharmacists from five European countries. Results Events of the recent years, such as inflation, the COVID-19 pandemic, or the war in Ukraine were perceived by the pharmacists as contributing to patients looking for better medicines prices, mostly related to online purchases. The most important factors influencing online purchase of medicines beyond price were convenience of shopping anytime, and fast and free delivery. There is a perceived growing interest in buying medicines from online facilities other than e-pharmacies, such as local websites, social media or global marketplaces (e.g., aliexpress.com). Pharmacists do not actively inform their patients about the possible risks of buying medicines from unverified online sources. Conclusion International disruptions seem to contribute to patients’ looking for better prices of medicines. There is a need for societal education about the risks related to the possibility of counterfeited medicines online, as well as pharmacists’ training to prioritize patient information and counselling on the hazards of medication acquisition from non e-pharmacies. There is an urgent need for global amendments to the pharmaceutical law to protect patients from illegal e-sources of medicines while keeping in-person services and offline purchases.

Hospitals can gain valuable insights into their current level of organizational health literacy (OHL) by using self-assessment tools. OHL self-assessment tools can serve as useful instruments for supporting the planning and implementation of OHL interventions aimed at promoting health equity and improving patient outcomes. This explorative study aimed to pilot the International Self-Assessment Tool for Organizational Health Literacy (Responsiveness) of Hospitals (OHL-Hos) among hospitals across six countries. The OHL-Hos, grounded in a comprehensive theoretical framework consisting of eight standards, 21 sub-standards and 141 indicators, was piloted in seven hospitals: one in Austria, Germany, the Czech Republic, Norway and Serbia, and two in Italy. In each hospital, the feasibility of using the OHL-Hos was investigated regarding acceptability, implementation, practicality, and integration, identifying strengths and areas for improvement using descriptive analyses. The self-assessment process included individual rating of an interdisciplinary and inter-hierarchical assessment team regarding OHL-Hos indicators from their personal perspectives, followed by a joint assessment to reach a consensus on different ratings. The process and experiences were documented in semi-structured forms, while the ratings on the indicators were documented numerically. All hospitals successfully self-assessed their OHL, identifying strengths and areas for improvement. The self-assessment process varied slightly among countries. While the tool was considered important but lengthy and complex, introductory workshops facilitated successful implementation. The self-assessment process raised awareness and stimulated discussions on improving OHL, highlighting the tool’s potential for organizational development. The OHL-Hos can serve as a useful tool to identify strengths and areas for improvement in OHL in hospitals. The overall experience with the tool was positive and the joint assessment with the tool was found to foster consensus and enable reflection on OHL, but its comprehensive nature poses challenges to its implementation, leading to recommendations for developing a shortened version of the tool with simple language. Certain indicators require specific knowledge, suggesting different professional groups should address relevant parts.

Food waste is a pressing global problem with significant environmental, economic and social impacts. This review examines the state of food waste management in Serbia and contextualizes the challenges and opportunities in a global and EU framework. In the Republic of Serbia, an estimated 247,000 tons of food is wasted annually, indicating critical gaps in waste management infrastructure, consumer awareness and missing legislation. While existing policies address general waste management, there is a lack of targeted measures for food waste prevention and resource recovery. The overview recommends aligning Serbian policy with an EU legislative frame, introducing extended producer responsibility and promoting public–private cooperation to improve food donation and recycling. This is the first comprehensive study specifically addressing food waste management in Serbia and assessing its compliance with European and global best practices. By comparing Serbia’s current status with established international models, this paper identifies critical gaps and proposes actionable strategies to improve the efficiency and sustainability of the food waste management system in Serbia. These include investment in infrastructure, public awareness campaigns and the use of innovative digital tools to reduce waste and support a circular economy.

The college years are critical to students' health as they face various challenges, including social influences and unhealthy lifestyles. Limited access to health services in residence halls increases the risk of unhealthy behaviours. The aim of this study was to investigate students' attitudes towards public health services for primary prevention in dormitories and to make suggestions for improvement. A cross-sectional study was conducted using a questionnaire among students living in halls of residence. The survey explored students' views on healthcare and the availability of preventive services for students living away from home. A total of 996 students participated (response rate 99.1%). Most were unemployed (83.9%). The most frequent preventive visits were to dentists (34.4% twice a year, 24.7% once a year), while 37.7% never visited a gynaecologist/urologist. The majority (68.6%) stated that a pharmacy was necessary in their dormitories. Basic health services include general practitioners (82.3%) and psychologists (21.4%). Attitudes towards health centres varied significantly by place of residence (p<0.001). Primary prevention should be improved by health centres with student-friendly opening hours and additional activities that promote access to healthcare and awareness of prevention.

From patients' perspective, the use of antibiotics to treat urinary tract infections (UTIs) in Serbia is unexplored, and therefore the aim of this study is to examine antibiotic use among these patients. An online cross-sectional study using snowball sampling was conducted during the winter of 2020/21 using a validated Google Docs questionnaire. The study included 236 female patients with a mean age of 34.9 ± 14.2 years. Most of the patients perceived UTI symptoms as severe (62.3%) and disruptive for their daily routines (51.3%). The majority of the patients (77.1%) used antibiotics by doctors' prescriptions. Other patients used antibiotics on their own and their selection. Self-treatment with antibiotics was associated with perceived symptom severity (p=0.006) and residence (p=0.017). In total, 17 different antibiotics were reported as being used for UTI treatment and the most frequent were fluoroquinolones (30.3%), cephalosporins (21.2%), and sulfonamides (15.7%). The highest consistency with national and European guidelines in doctors' decisions on antibiotic therapy was observed for treating UTIs in pregnant women (80.0%). These findings emphasize the need for education of healthcare professionals and clinical practice improvement in making rational antibiotic prescribing decisions.

Customer satisfaction reflects the quality of pharmaceutical services and depends on various factors, such as the quality of services, pharmacists' skills and customer' demographic characteristics. Positive experiences strengthen customer trust and loyalty. Research into user satisfaction is an important tool for improving services. The aim of the work was the analysis of user satisfaction with pharmacy services in Serbia over the last twelve years. Annual reports on user satisfaction in pharmacies from 2013 to 2024 were analyzed. Based on key indicators, a report was prepared comparing satisfaction over the years, taking into account various factors and service quality. With the exception of 2020, public, private and health center pharmacies participated every year. The highest response rate was recorded in 2015. More than 60% of users visit a pharmacy more than five times a year, usually waiting less than five minutes. The highest level of satisfaction with the availability of medicines was recorded in 2021, while overall satisfaction with services peaked in 2022. User satisfaction has remained stable, indicating good availability and quality of pharmaceutical services. The results may contribute to further improvement in practice.

Venous leg ulcers (VLUs) account for most lower extremity wounds. Wound management include cleansing, debridement, infection control and applying wound dressing. There exist various types of dressings which can maintain adequate moisture, offer protection, and support the reepithelization of VLUs. The aim of this study is to evaluate the cost-effectiveness of the antimicrobial wound dressing containing ionic silver (Aquacel® Ag+Extra™) in the treatment of VLUs compared to conventional gauze dressing in Serbia. The data regarding the effectiveness and frequency of dressings for both the Aquacel® Ag+Extra™ and conventional dressing were obtained from literature sources. Only direct costs were considered, and values were taken from the published price list of health services or procurement procedures. Sensitivity analyses were performed. The total cost per patient for Aquacel® Ag+Extra™ was 34,178.76 RSD, while the total cost for gauze was 82,800.90 RSD. Besides lower costs, antimicrobial wound dressing shows higher effectiveness than the gauze, implying that Aquacel® Ag+Extra™ is the dominant strategy. The sensitivity analysis supports the robustness of the results. The use of antimicrobial wound dressing containing ionic silver is the preferred option for the treatment of VLUs due to lower costs and the higher curing rate of the wounds.