We performed a comprehensive search of the Web of Science Core Collection (WoSCC), which encompasses the Science Citation Index Expanded (SCI-EXPANDED) and the Social Sciences Citation Index (SSCI), to identify relevant publications from inception through 6 February 2025. The search strategy utilized the term “TS = home pharmaceutical care,” and was limited to articles published in English. To refine the selection, we applied exclusion criteria that eliminated case reports, conference papers, meeting abstracts, duplicate publications, articles lacking keywords or author information, and studies not directly related to the topic (Figure 1).

We exported the selected articles in a plain text format, including full records and references. The data was then imported into CiteSpace 6.3.R1 for conversion and bibliometric analysis. The parameters in CiteSpace were set as follows: time slicing was configured from 1979 to 2025 with three-year intervals per slice; selection criteria were set to the top 10%; and pruning was performed using the pathfinder algorithm, with all other settings left at their default values. Additionally, we utilized CiteSpace to detect and extract keywords and references exhibiting citation bursts to forecast emerging trends in home pharmaceutical care. We used the algorithm of Log Likelihood Ratio (LLR) to clustering keywords and references.

We generated co-citation maps for authors, institutions, countries, keywords, and references, as well as clusters of keywords and references via CiteSpace. In the co-citation maps, different nodes represent various elements (e.g., authors, institutions, references), with the size of each node proportional to its citation count and frequency. Links between nodes indicate mutual citation relationships, while centrality serves as a key indicator of a node’s importance within the field. Nodes with higher centrality values are deemed more influential. The red areas in the tree rings of certain nodes highlight periods of citation or frequency bursts during the field’s development. Different colored points and lines on the map allow us to identify specific years of occurrence or collaboration (10, 11).

To evaluate clustering, we used silhouette (S) values to assess the average contour value of clusters and modularity (Q) values to evaluate the significance of the clustering structure. A silhouette value greater than 0.7 indicates efficient and reliable clusters, while a modularity value exceeding 0.5 signifies a significant cluster structure (12). Additionally, Journal Citation Reports (JCRs) for 2023 were used to obtain journal impact factors. To ensure the accuracy and reliability of the data, two researchers (QW, SZ) independently performed data extraction and analysis management.

No informed consent or ethical approval was required for this study, as all data and information were derived from secondary sources available in the open-access database (WoSCC).

After screening 812 publications from the Web of Science Core Collection (WoSCC), we included a total of 677 qualified publications on home pharmaceutical care in our analysis. As illustrated in Figure 2, these articles were published between 1979 and 2025, with an overall upward trend in annual publications over the past 40 years. This consistent growth indicates that the field of home pharmaceutical care holds significant potential for further development.

The visualization of the authors’ cooperation network is depicted in Figure 3, with the top three most prolific authors being Hughes, CM (7 articles), Nishtala, PS (5 articles), and Lapane, KL (5 articles). Figure 4 illustrates the distribution of publications by institution, where the Queen’s University Belfast emerges as the most productive, with 18 publications, followed by the University of London (14 articles) and the University of Sydney (13 articles). The cooperation network among countries is presented in Figure 5, highlighting that the United States leads with 200 articles, followed by the United Kingdom with 100 articles, and Australia with 55 articles. Notably, the publication count for the United Kingdom includes contributions from England, Scotland, Northern Ireland, and Wales, as manually calculated (Table 1). The United States demonstrates the highest centrality in the network (centrality = 0.46).

Keyword analysis reveals research hotspots in home pharmaceutical care. Figure 6 shows the keyword network with “pharmaceutical care” (104 records) “care” (81 records), and “management” (45 records) as the top three keywords (Table 2). Clustering identified 19 keyword groups (Figure 7), with the top clusters being #0 polypharmacy, #1 medication reconciliation, #2 drug-related problems. The clustering reliability was high (Q = 0.7035 S = 0.8909). Table 3 lists the top 10 keywords with the strongest citation bursts including “pharmaceutical services” (strength = 10.86, 1992–2008) and “health care” (strength = 7.43, 1992–2005).

Supplementary Figures 1, 2 display author and journal co-citation networks. The World Health Organization (WHO) was the most cited author (86 records). Among journals, Journal of the American Geriatrics Society (IF2023 = 4.3, 170 records) ranked first, followed by Journal of the American Medical Association (JAMA) (IF2023 = 63.1, 150 records) and PLOS ONE (IF2023 = 2.9, 147 records) (Supplementary Table 1).

Visualization analysis of references can also aid in identifying key research hotspots within this field. As illustrated in Supplementary Figure 3, the top three most co-cited references are authored by Alldred DP (2016), Moher D (2015), and Masnoon N (2017). We conducted cluster analysis (Supplementary Figure 4) and burst analysis (Table 4) on the cited literature, with the article by Alldred DP exhibiting the highest burst strength of 4.97.The most frequent co-cited reference (written by Alldred DP in 2016) was about that pharmacist-led interventions to optimize prescribing for elders in care homes had some function of identifying and solving some drug related problems, as well as improving drug appropriateness (13). There were three references (written by Masnoon N in 2017, Schluter PJ in 2016, Abbott RA in 2020) were the research hotspots with high citation burst in recent years (Table 4), which mainly researched into polypharmacy, COVID-19 and old people (14–16).

Over the past four decades, a growing body of research has focused on home pharmaceutical care, leading to a surge of contributions in this emerging field. Nine of the top 10 most productive countries were developed nations, with the United States demonstrating the strongest scholarly influence (centrality = 0.46). These findings underscore significant disparities in the advancement of home pharmaceutical care services between developed and developing economies. Family pharmacist services in foreign countries are mainly undertaken by community pharmacists, providing patients with a variety of medical and health-related items of pharmacy services, such as anticoagulation management, pain management, body quality management, drug counseling and so on, and a lot of studies have found that community pharmacists through home pharmaceutical services can improve patients’ medication adherence and therapeutic effects, reduce the expenditure of drug costs, and reduce the readmission rate of discharged patients, and so on. In UK, Pharmacists conduct home visits within 3 days of discharge to optimize medication use, collaborating with GPs in team meetings to develop personalized treatment plans. This model reduces hospital readmissions by 22% through improved medication adherence (NHS England, 2023). Some developing countries, on the other hand, are following the example of developed countries (e.g., conducting contracted teams of family pharmacists), but have not developed a system. But it’s worth mentioning, in recent years, several studies have shown that home pharmaceutical care can significantly reduce the number of medications and interactions in patients with overuse of multiple medications and high healthcare utilization in the developing countries (17).

Bibliometric analyses reveal the following key factors contributing to lagging development in developing countries:

The earliest literature on home pharmaceutical care dates to 1979 (United States), whereas developing countries, such as China (the highest contributor in publication volume), published their first research only in 2011.

Developing countries lack standardized training frameworks comparable to those in developed nations. Most community pharmacists in these regions cannot independently deliver home pharmaceutical care. For instance: Training systems in developing countries prioritize complex clinical education. In contrast, U.S. institutions implement experiential residency programs where pharmacy students lead transitional care for inpatients and outpatients, including medication reconciliation, discharge counseling, and post-discharge follow-ups. Such training equips graduates with patient communication skills and medication management expertise (18).

Community pharmacists in developed nations receive remuneration through government subsidies (e.g., NHS funding), medicare payment system, or third-party platforms. Conversely, most developing countries do not charge for home pharmaceutical services, resulting in limited financial incentives for pharmacists to transition into this field.

The scarcity of qualified professionals further exacerbates disparities. In China, for example, as of April 2016, China had 413,774 licensed pharmacists, with only 277,967 registered practitioners—a pharmacist-to-population ratio of 1:4,643. This ratio is substantially lower than in developed nations (e.g., the ratio of USA is 1:1,200), and fewer than 15% of licensed pharmacists practice in community settings, where demand for home pharmaceutical services is highest.

In conclusion, the combined effects of delayed initiation, insufficient training, inadequate incentives, and workforce shortages have resulted in marked gaps in both the quantity and quality of home pharmaceutical care services between developing and developed economies. Addressing these systemic challenges requires policy reforms, standardized training frameworks, and sustainable reimbursement models to align with global best practices.

Based on the visualization results by CiteSpace, we summarized the hot research on home pharmaceutical care.

This study was the first to use CiteSpace to analyze the research hotspots of home pharmaceutical care. We found that over time, research hotspots in this field have evolved from pharmaceutical services to specific medication reconciliation, polypharmacy, disease management for special populations, and so on. The progress of home pharmacy services in developing countries is relatively slow, but the development content and direction are basically similar to those in developed countries. It should be noted that, due to the spread of the COVID-19 epidemic, “personal care product” and “nonpharmaceutical intervention” emerged as new research hotspots in recent years (37–40).

A few limitations of this visualization analysis must be considered. All of our publications came from the Web of Science (WoS) Core Collection database, and articles published in other ways were excluded. Our findings in this study may not be comprehensive because of limited literature. Particularly, this may lead to a certain lag in our analysis of the development of family pharmacy services in non-English speaking countries. Secondly, the CiteSpace software does not clearly distinguish the first author from the corresponding author. Thirdly, the top 50 authors, countries, institutions, and keywords were selected as the selection strategy, which may have some bias. However, we argue that this study can be used to describe the hotspots and emerging trends in this field.