Developing a Structured Framework for Pharmacist-Led Prescription Medication Counselling: A Scoping Review Integrating Structural Domains and Patient-Centered Operational Features.

Medication counselling is a core element of pharmaceutical care that supports safe, rational, and adherent medication use. However, despite its importance, medication counselling remains suboptimally implemented in routine practice. A clearer description of how counselling is structured in practice is therefore required. This study aimed not only to map existing practices but to develop a structured framework for pharmacist-led prescription medication counselling by integrating procedural components with patient-centered operational behaviors. The review followed the PRISMA Extension for Scoping Reviews checklist. MEDLINE, Embase, the Cochrane Library, and grey literature were searched for publications from January 2015 to January 2025. Fourteen sources, including both regulatory guidance documents and empirical studies, met the inclusion criteria. Using an adapted TIDieR framework, intervention components were deductively extracted and analyzed. Subsequently, content analysis was conducted to inductively synthesize them into structural domains and patient-centered operational features. Six structural domains were identified: patient identification and encounter framing; risk screening; information provision; understanding verification and engagement; adherence and self-management support; and documentation and referral or escalation. Four patient-centered operational features were also identified: patient context elicitation and prioritization; tailored communication adaptation; interactive understanding verification; and adherence support practices. Structural detail varied across sources, particularly for documentation and adherence-related elements.These operational features function as implementation-level elements within structural domains, linking procedural structure to observable patient-centered behaviors. This integrated framework conceptualizes medication counselling as an operationalized service and provides a foundation for its standardization, implementation, and evaluation in real-world practice.