Pandemic preparedness of community pharmacies for COVID-19

Crisis management in community pharmacies during a pandemic

BACKGROUND

Although the COVID-19 pandemic required community pharmacies to implement several adaptation strategies to ensure medicines' and services' availability, related empirical research based on crisis management theory is lacking.

OBJECTIVE

This study sought to holistically depict crisis management in Finnish community pharmacies and explore whether (1) pre-existing crisis plans, (2) crisis teams, (3) shared decision-making or (4) collaboration and communication with external stakeholders can protect staff resilience, pharmacy owners' resilience, organisational cohesion ('team spirit') and pharmacies' resources or finances during the pandemic.

METHODS

A cross-sectional survey was developed based on the crisis management process model and sent to Finnish community pharmacy owners (n = 602) during the pandemic's second wave in October-November 2020. Descriptive statistics were calculated, and logistic regression analysis was performed to explore effects of crisis management efforts. Open-field responses were analysed qualitatively using deductive content analysis.

RESULTS

In total, 221 (36.7 %) pharmacy owners participated in the study. Pharmacies responded to the pandemic with increased order volumes and new suppliers, home deliveries and remote consultations, hand sanitiser production and additional customer counselling concerning the COVID-19. Shared decision-making with pharmacy colleagues (p = 0.025) and collaboration with peers or stakeholders in the supply chain (p = 0.015) protected pharmacy owners' resilience during the pandemic. Additionally, shared decision-making protected pharmacies' finances (p = 0.040). Crisis teams or collaboration with social and healthcare operators did not provide advantage to pharmacies. However, pre-existing pandemic plans associated with reduction of pharmacies' resources (p = 0.006).

CONCLUSIONS

Community pharmacies responded to the COVID-19 pandemic with several measures to ensure the continuity of pharmaceutical services and care and the availability of medicines, disinfectants and personal protective equipment. Developing shared decision-making in pharmacies and active collaboration with peers and supply-chain stakeholders could improve pharmacies' finances and their owners' resilience in future crises.

Iranian Pharmacist's Experiences of COVID-19 Pandemic: A qualitative study

BACKGROUND

Since the 2019 COVID-19 pandemic is not the first and will not be the last, pharmacists' experiences during this period can be used to establish a more efficient healthcare system to face future pandemics.

OBJECTIVE

This study aims to explore Iranian pharmacists' experiences in pharmacies using the content analysis method.

METHODS

In this qualitative study, a conventional content analysis approach was applied. Ten male and female pharmacists working in community pharmacies in Birjand, Iran participated using a purposeful sampling method. Semi-structured interviews were carried out for data collection. The data were analyzed using Graneheim and Lundman's method.

RESULTS

Four categories and ten subcategories were extracted as follows: Multifaceted concerns of pharmacists (familial, economical, professional, and personal concerns), Non-compliance with protocols from occurrence to cause (facing non-compliance with protocols by clients, obstacles to complying with protocols in the pharmacy), Prevention from COVID-19 (protective equipment usage, designing protection rules), and Double reactions to COVID-19 (emotional and; practical reactions).

CONCLUSIONS

Pharmacists dealt with different concerns and challenges during the COVID-19 pandemic. They are one of the main primary care providers and need to be supported by the authorities to maintain their standard level of services.

Experience and Learning from the COVID-19 Pandemic in Portugal: Perceptions of Community Pharmacy Professionals

Background

During the COVID-19 pandemic, community pharmacy (CP) professionals were among those who experienced the greatest risk of contracting SARS-CoV-2, which forced major adaptations.

Objectives

The objectives of the study were to describe the changes implemented in CP professionals during the pandemic, understand the perception of professionals about their experience, and explore changes to remain.

Methods

An observational and cross-sectional study was conducted via an online questionnaire (June-September 2020). The target population was CP professionals working in Portugal for >2 years and serving the public during the pandemic.

Results

Of a total of 353 participants, 84% were female (mean age of 37.6 years), and 81% were pharmacists (mean professional experience of 12.9 years). In the management and organizational dimensions, the most mentioned changes were adaptation to legislative changes (90%), fluctuations in the treasury (82%), and reduction of working hours (46%). Only 2% resorted to simplified layoff. In the back office, there was a need to adapt stock management (93%) and purchase personal protective equipment (99%). In the front office, there was a change in service policies - wicket or conditional opening (92%), routes of the arrival of user requests (91%), and home delivery (82%). Physical changes occurred in 100% of pharmacies. The most frequently implemented procedures were the use of protection systems and PPE, articulation with hospital pharmacies for dispensing in proximity (75%), and training in this area (55%). Regarding interpersonal climate, improvements in the connection between team members are evident: increase in mutual help (57%), solidarity (54%), and group cohesion (50%); in the relationship with clients, the majority indicated the replacement of the usual user by third parties (71%), and changes in communication channels (increase in use of technological means 68%).

Conclusions

Results illustrate the profound impact of the pandemic on CP professionals, both professionally and personally. It also highlights the importance of their roles in proximity and community support.

Global overview of pharmacist and community pharmacy actions to address COVID-19: A scoping review

Introduction

Pharmacists and community pharmacies play an important role in managing, identifying and preventing the spread of the COVID-19 outbreak.

Objectives

To characterize the global panorama of action by pharmacists and community pharmacies in facing the COVID-19 pandemic.

Methods

The scoping review was based on the search for scientific articles in the databases: PubMed; Scopus; ScienceDirect and Web of Science. The search was carried out on August 31, 2021. The selection process was divided into 3 phases: i) title analysis; ii) analysis of study abstracts; iii) analysis of the full texts of the studies selected in the previous step. Studies were independently selected by two investigators and discrepancies resolved by consensus during focus group discussions led by a third reviewer.

Results

The final search yielded 36 articles for the review. The main strategies for coping with COVID-19 were grouped into 4 categories defined by consensus between the authors: (1) services for providing care to the patient; (2) product management; (3) infection prevention and control practices in community pharmacy; (4) preparation, sources of information used and training offered/received. Through these, the aim was to involve technical managerial, technical assistance and pedagogical technical actions adopted, as well as structure and process indicators that allowed the continuity of the offer of services.

Conclusion

During the pandemic, pharmacists and community pharmacies have been providing essential health services to communities. The results of this review may help to identify the changes adopted to face the COVID-19 pandemic and may contribute to improving the quality of practices in these establishments during the pandemic and after it, in similar situations.

Adaptations in the role of pharmacists under the conditions of the COVID-19 pandemic: a systematic review and meta-analysis

BACKGROUND

Community pharmacists actively engage in managing the health of local residents, but the COVID-19 pandemic has necessitated rapid adaptations in practice activities.

OBJECTIVES

We sought to identify the specific adaptations in practice and the expanded roles of community pharmacists in response to the COVID-19 pandemic.

METHODS

We conducted a systematic review of published studies reporting the tasks of pharmacists in community pharmacies or who were involved in pharmacy practices addressing the pandemic. Two investigators independently searched PubMed (December 2019-January 2022) for eligible articles. We conducted a meta-analysis to measure the frequencies of practical activities by pharmacists in response to COVID-19.

RESULTS

We identified 30 eligible studies. Meta-analysis of these studies found that the most commonly reported adaptation in pharmacist practice activities was modifying hygiene behaviors, including regular cleaning and disinfection (81.89%), followed by maintaining social distance from staff and clients (76.37%). Educating clients on COVID-19 was reported by 22 studies (72.54%). Telemedicine and home delivery services were provided to clients by 49.03 and 41.98% of pharmacists, respectively.

CONCLUSIONS

The roles of community pharmacists in public health activities have adapted and expanded in response to COVID-19, notably by incorporating public health education activities.

Impact of the COVID-19 pandemic on pharmacy practice and on the provision of pharmaceutical care: A cross-sectional study among community pharmacists

Background:

Community pharmacists played an essential role in the control and management of the COVID-19 pandemic; both pharmaceutical care and community pharmacists were affected, given that, patients’ needs and demands increased due to the fear of lockdowns and shortage of medication throughout the pandemic.

Objectives:

This study was based in Lebanon and aimed to assess the impact of the COVID-19 pandemic on (1) pharmacists, including infection rates, pay, and working hours, and (2) pharmacy practice, including medicine and personal protective equipment (PPE) shortages.

Design:

A cross-sectional study involving 120 community pharmacists was carried out between August and November 2021.

Methods:

Data were collected using an online survey filled out by pharmacists working in Lebanon.

Results:

Most participants (71.7%) reported an increase in their income during the pandemic, and 60% reduced their working hours. A significant association was noted between being previously infected and marital status, level of education, work position, and salary of the participants. Most participants (95.8%) encountered a shortage of medications during the pandemic leading to high home storage of medication, searching for other sources of medicines, and decreased patient/pharmacist interactions.

Conclusion:

The COVID-19 pandemic imposed new challenges on pharmacists and the provision of pharmaceutical care. It affected pharmacists’ daily routines, putting them at risk of infection with limited availability of medicines and PPE. This study suggests that establishing effective crisis management plans to increase community pharmacists’ resilience during similar outbreaks.

Communication openness and nosocomial infection reporting: the mediating role of team cohesion

BACKGROUND

The states of IPC (Infection Prevention and Control) is serious under the COVID-19 pandemic. Nosocomial infection reporting is of great significance to transparent management of IPC in regard to the COVID-19 pandemic. We aimed to explore the relationship between communication openness and nosocomial infection reporting, explore the mediating effect of team cohesion in the two, and provide evidence-based organizational perspective for improving IPC management in the hospitals.

METHOD

A questionnaire was used to collect data on communication openness, team cohesion and nosocomial infection reporting in 3512 medical staff from 239 hospitals in Hubei, China. Structural Equation Model (SEM) was conducted to examine the hypothetical model.

RESULT

Communication openness was positively related to nosocomial infection reporting (β = 0.540, p < 0.001), and was positively related to team cohesion (β = 0.887, p < 0.001). Team cohesion was positively related to nosocomial infection reporting (β = 0.328, p < 0.001). The partial mediating effect of team cohesion was significant (β = 0.291, SE = 0.055, 95% CI = [ 0.178,0.392 ]), making up 35.02% of total effect.

CONCLUSION

Communication openness was not only positively related to nosocomial infection reporting. Team cohesion can be regarded as a mediator between communication openness and nosocomial infection reporting. It implies that strengthening communication openness and team cohesion is the strategy to promote IPC management from the new organizational perspective.

Readiness and willingness of Malaysian community pharmacists in providing vaccination services

Background

Vaccination is an effective public health intervention in reducing morbidity and mortality of infectious diseases. Compared to other countries where community pharmacists (CPs) administer vaccines, CPs in Malaysia are not authorised. This study aimed to assess CPs' readiness and willingness to provide vaccination in Malaysia, identify potential barriers to and factors supporting the provision of this service.

Methods

A cross-sectional study was conducted among Malaysian CPs from April to June 2021. A validated online questionnaire was distributed through social media, instant messaging, email, and pharmacy societies.

Results

Of 492 CPs recruited throughout Malaysia, 439 (89.2%) expressed willingness to provide vaccination services to the public, 403 (81.9%) agreed with the accessibility of community pharmacies to the public, and 73.4% agreed that their role in vaccination could help to improve the overall vaccination coverage rate. The lack of pharmacist training in vaccination and concerns on maintaining patient safety were identified as barriers to CPs' implementation of vaccination services, with 52.8% and 47.8% of them agreeing, respectively. Training sessions and operational guidelines on providing vaccination services are required to overcome the barriers.

Conclusion

CPs in Malaysia were ready and willing to provide vaccination services to the public. However, the implementation demands training workshops and re-evaluation of CPs in public vaccination programmes by Malaysian healthcare policymakers.

Development and validation of a lockdown preparedness scale: Understanding lockdown preparedness through a social vulnerability perspective

Millions of people around the world were subjected into nationwide or community wide lockdowns in response to the COVID-19 pandemic. Scientists also predict that as we enter into a new normal, another pandemic is not impossible, and that lockdowns may be implemented again. Therefore, examining factors affecting lockdown preparedness (LDP) is important. Through a survey of 800 adult residents in Singapore during the pandemic, this study proposed and tested an LDP scale and found that quality of social interactions, news consumption, as well as education and income affect the extent of psychological and emotional preparedness for lockdowns.

Smart face shield for the monitoring of COVID-19 physiological parameters: Personal protective equipment (PPE) for health-care workers (HCW’s) and COVID-19 patients

The COVID-19 pandemic has triggered instabilities in various aspects of daily life. This includes economic, social, financial, and health crisis. In addition, the COVID-19 pandemic with the evolution of different virus strains such as delta and omicron has led to frequent global lockdowns. These lockdowns have caused disruption of trade activities that in turn have led to the shortage of medical supplies, especially personal protective equipment’s (PPE’s). Health-care workers (HCW’s) have been at the forefront of the fight against this pandemic and are responsible for saving millions of lives worldwide. However, the PPE’s available to HCW’s in the form of face shields and face masks only provide face and eye protection without encapsulating the ability to continuously monitor vital COVID-19 parameters including body temperature, heart rate, and SpO2. Hence, in this study, we propose the design and utilization of a PPE in the form of smart face shield. The device has been integrated with the MAX30102 sensor for measuring the heart rate and oxygen saturation (SpO2) and the DS18B20 body temperature measuring sensor. The readings of these sensors are analyzed by a NodeMCU ESP8266 and measurements are displayed on a laptop screen. Also, the Wi-Fi module of NodeMCU ESP8266 enables compatibility with the ThingSpeak mobile application and permits HCW’s and patients recovering from COVID-19 to keep a track of their physiological parameters. Overall, this PPE has been observed to provide reliable readings and the results indicate that the designed prototype can be used for monitoring COVID-19 essential parameters.

Cross-sectional questionnaire study of the experiences of community pharmacists in Northern Ireland during the early phases of the COVID-19 pandemic: preparation, experience and response

OBJECTIVES

To examine the views and experiences of community pharmacists in Northern Ireland (NI) regarding changes in community pharmacy practice/processes in preparation for, and response to, the COVID-19 pandemic.

DESIGN

Cross-sectional telephone-administered questionnaire.

SETTING AND PARTICIPANTS

Geographically stratified representative sample of 130 community pharmacists in NI between March and May 2021.

OUTCOME MEASURES

Community pharmacists' responses to questions focusing on their preparation, experience and response to the COVID-19 pandemic. Descriptive analysis was conducted including frequencies and percentages. Free-text comments were summarised using thematic analysis.

RESULTS

One hundred and thirty pharmacists completed the questionnaire. Pharmacists responded comprehensively to implementing infection control measures, for example, management of social distancing in the shop (96.2%), making adjustments to premises, for example, barriers/screens (95.4%), while maintaining medicines supply (100.0%) and advice to patients (93.1%). Newly commissioned services were provided, for example, emergency supply service (93.1%), influenza vaccination for healthcare workers (77.7%) and volunteer deliveries to vulnerable people (54.6%). Pharmacists were least prepared for the increased workload and patients' challenging behaviour, but the majority (96.9%) reported that they felt better prepared during the second wave. Pharmacists agreed/strongly agreed that they would be able to re-establish normal services (87.7%), were willing to administer COVID-19 vaccines (80.7%) and provide COVID-19 testing (60.8%) in the future.

CONCLUSIONS

Community pharmacists remained accessible and maintained supply of essential medicines and advice to patients throughout the pandemic. Provision of modified and additional services such as vaccination reinforced the clinical and public health role of pharmacy.

Telepharmacy service experience during the COVID-19 pandemic in the Republic of Srpska, Bosnia and Herzegovina

The COVID-19 pandemic exerted a profound impact on health systems worldwide. Moreover, significant concerns were raised in terms of middle- and long-term consequences of postponing care in non-COVID patients. The primary aim of the study was to describe the remote pharmaceutical care service (telepharmacy) during the COVID-19 pandemic in the Republic of Srpska (RS), Bosnia and Herzegovina. The secondary aim was to identify service users' needs and concerns and to describe community pharmacists' interventions. Ten community pharmacists were appointed by the Pharmaceutical Society of the RS to deliver telepharmacy services. After obtaining users' verbal permission, pharmacists documented issues discussed with them. The prospective data collection included the period from April 13 to May 21, 2020. Descriptive and statistical analysis was performed using IBM SPSS Statistics software (ver. 22). A total of 71 service users' charts were analyzed. Telepharmacy users were on average 61.31 ± 13.27 years of age, with almost equal gender distribution. Patients with chronic or acute/subacute conditions were predominant with a share of 84.5%. Chronic diseases were the main reason for searching pharmacists' consultation (74.6%), 7% had a complaint about worsening of a chronic condition, 9.9% reported only acute/subacute conditions as ambulatory conditions, whereas 15.5% asked information about coronavirus or COVID-19. The vast majority of patients' and users' needs were addressed by a pharmacist during counseling and only 15.5% of the patients required immediate referral to a doctor for refill/prescribing purposes. Remote pharmaceutical care service (telepharmacy) is deemed a convenient model in the RS during the COVID-19 pandemic. Patients and users presented with explicit and specific needs and concerns, both COVID- and non-COVID-related, which should not be neglected. Community pharmacists showed a high level of resilience and ability in addressing patients' needs.

Emergency Preparedness for the COVID-19 Pandemic: Social Determinants Predicting the Community Pharmacists’ Preparedness and Perceived Response in Malaysia

Background: Pandemic preparedness of healthcare providers helps to mitigate future threats such as spread and fatality rates, as well as the management of the disease. Pharmacists are key partners with public health agencies, and the role of community pharmacists is becoming increasingly recognised in this COVID-19 pandemic. The study aimed to explore the emergency preparedness of community pharmacists (CPs) for COVID-19. Methods: A cross-sectional study was performed among community pharmacists using cluster sampling followed by convenient sampling. A self-administered questionnaire was formulated using references from the previous literature and the WHO preparedness checklist. Descriptive analysis was undertaken for the participants’ socio-demographic characteristics. All the data collected were entered into the Statistical Package for Social Sciences version 24 (SPSS V.24), (IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp.) for analysis. Results: Most of the CPs had five or fewer years of practice experience, and they had all the mandatory information relating to the needs of their communities regarding the disease. The participants knew where to acquire these resources whenever needed. They were able to recognise the signs and symptoms of the disease. Most participants felt that they were confident to provide patient education and carry out their duties during these challenging times. There was a strong position correlation between preparedness and the perceived response of the participants. Conclusion: The community pharmacists in Malaysia are prepared enough for COVID-19 pandemic management and perceive that they can respond during any unprecedented situations, such as COVID-19. Community pharmacists were aware of the challenges that they need to face in their community regarding COVID-19.

Experiences of and response to the COVID-19 pandemic at private retail pharmacies in Kenya: a mixed-methods study

OBJECTIVES

To assess experiences of and response to the COVID-19 pandemic at community pharmacies in Kenya.

DESIGN, SETTING AND PARTICIPANTS

This was a mixed-methods study conducted from November 2020 to April 2021, targeting service providers in three counties (Nairobi, Mombasa and Kisumu), selected purposively to represent the main urban centres; pharmacies were selected randomly from a list of licensed pharmacies.

RESULTS

Of 195 sampled pharmacies, 108 (55%) completed a questionnaire and 103 (53%) received a simulated client call; 18 service providers were interviewed. The initial weeks of the pandemic were characterised by fear and panic among service providers and a surge in client flow. Subsequently, 65 (60%) of 108 pharmacies experienced a dip in demand to below prepandemic levels and 34 (31%) reported challenges with unavailability, high price and poor quality of products. Almost all pharmacies were actively providing preventive materials and therapies; educating clients on prevention measures; counselling anxious clients; and handling and referring suspect cases. Fifty-nine pharmacies (55% (95% CI 45% to 65%)) reported receiving a client asking for COVID-19 testing and a similar proportion stated they would support pharmacy-based testing if implemented. For treatment of simulated clients, most pharmacies (71%, 73 of 103) recommended alternative therapies and nutritional supplements such as vitamin C; the rest recommended conventional therapies such as antibiotics. While 52 (48%) of 108 pharmacies had at least one staff member trained on COVID-19, a general feeling of disconnection from the national programme prevailed.

CONCLUSIONS

Private pharmacies in Kenya were actively contributing to the COVID-19 response, but more deliberate engagement, support and linkages are required. Notably, there is an urgent need to develop guidelines for pharmacy-based COVID-19 testing, a service that is clearly needed and which could greatly increase test coverage. Pharmacy-based COVID-19 programmes should be accompanied with implementation research to inform current and future pandemic responses.

A cross-sectional investigation of the impact of COVID-19 on community pharmacy

Background

Objectives

Methods

Results

Conclusions

Assessing the pharmaceutical care provision to suspected COVID-19 patients in community pharmacies: a simulated patient study

BACKGROUND

In the wake of COVID-19, community pharmacists (CP) were called upon to free up healthcare providers to treat more serious conditions and alleviate overcrowded healthcare centers. CPs were placed under tremendous pressure, where many patients primarily sought their health advice. This situation raised concerns about the preparedness of CPs in facing these challenges. Therefore, this study aimed to assess the appropriateness of pharmaceutical care provided by CPs to patients with suspected COVID-19 and to investigate their communication skills.

METHODS

A simulated patient (SP) study was conducted among randomly selected community pharmacies in Beirut, Lebanon. Each pharmacy was visited by the SP who complained of fever and loss of smell sensation. Interactions between the attending pharmacist and the suspected COVID-19 patient were documented directly after each visit in a standardized data collection form.

RESULTS

More than half of the CPs (56%) did not retrieve any relevant information to assess the patient's condition. While pharmacists' responses were limited to one to two recommendations, with the majority recommending the patient to perform the PCR test (90%). Inappropriate recommendations made by the CPs included mainly the confirmation that the patient had COVID-19 without prior testing (9%), and prescribing either an antimicrobial drug (5%) or dietary supplements (20%), claiming that the latter are essential to boost the patient's immunity. As for the pharmacist-patient communication skills, the mean total score was 2.25 ± 0.79 (out of 4), displaying nonoptimal and ineffective communication.

CONCLUSION

An unsatisfactory and suboptimal provision of pharmaceutical care to a suspected COVID-19 case was evident. This may be a public health threat, particularly for developing countries that lack an efficient and unified healthcare system. The findings should alert health authorities to support and guide community pharmacists in assisting suspected COVID-19 patients.

J. Khojah H, Susan Dewey R. Spontaneous adverse drug reaction reporting by community pharmacists: preparedness and barriers

Background

Adverse drug reactions (ADRs) are undesired, unintended responses to drugs, and are significantly underreported. Pharmacists are drug experts recognized as custodians of drug safety, who are expected to be prepared for and knowledgeable about ADR reporting.

Objectives

To identify Egyptian community pharmacists’ preparedness for and perceived barriers to spontaneous ADR reporting.

Methods

This cross-sectional study recruited a sample of community pharmacists across Egypt, who were invited to complete a self-administrated questionnaire during April 2020.

Results

A total of 923 pharmacists across Egypt responded to the questionnaire. Most pharmacists were knowledgeable about the definition of ADRs (93.9 %) and indicated they felt reporting ADRs benefits the patients (82.2%). Despite recognizing their public health value, only a small percentage of participants conveyed familiarity with the reporting process for both paper (19.2%) and electronic (30.4%) forms, indeed 56.6% of participants did not remember what the ADR report form looked like. Moreover, 75.4% of respondents said they felt that community pharmacies are not the right place for reporting, with 49% suggesting that reporting was the responsibility of physicians. However, only 32.1% reported having insufficient time being a barrier to ADR reporting.

Conclusions

Community pharmacists in Egypt are not well prepared for spontaneous ADR reporting due to a lack of knowledge about the formal process and not acknowledging their responsibility, although time was not a major barrier. Therefore, this highlights a clear opportunity for improvement likely involving targeted education.

Barriers to Community Pharmacists Referring Patients With Suspected COVID-19 Symptoms

Background

With the necessary skills available to community pharmacists, they are well equipped to relieve pressure on hospitals and general practices by providing referral services for symptomatic patients for COVID-19 testing.

Objective

The assessment of potential barriers that limit the successful implementation of a community pharmacy referral service for patients with suspected COVID-19 symptoms.

Methods

A questionnaire comprising of 100 questions was administered to one pharmacist by interview in 1023 working community pharmacies in 4 regions of Egypt between May 17 and May 30th 2020.

Results

Forty-five barriers were identified. Respondents (79%, n = 803) had difficulty obtaining an accurate patient history. Patient data confidentiality was a significant issue for pharmacists who had not received referral training, with these respondents being significantly (P = .010) less able to differentiate between COVID-19 and similar conditions. Respondents (68.8%, n = 698) were not confident in determining whether COVID-19 was the cause of the patient’s presenting symptoms. A large majority (73.7%, n = 747) of respondents were worried about referring misdiagnosed patients and were concerned about the negative implications of proceeding with such a referral, including legal consequences. Of Respondents (71.7%, n = 727) reported that online referral was not easy, and 71.6% (n = 722) were unable to locate paper referral forms. Only a small number of pharmacists (11%, n = 112) preferred to report a referral in their own name.

Conclusions

This study has demonstrated the potential of the community pharmacist’s role as a point of referral for COVID-19 testing, and identified some major barriers to implementation of this. The lack of pharmacists’ education, legal support, availability of referral forms, clarity of responsibility and unsupportive management teams are key obstacles that must be overcome for the successful implementation of a COVID-19 referral service.

Knowledge, Attitude, and Practices Regarding Preventive Measures of COVID-19 Pandemic during Ramadan 2020 and Quarantine in Some Egyptian Governorates

BACKGROUND: The coronavirus disease 2019 (COVID-19) is a global crisis. The month of Ramadan has coincided with the COVID-19 crisis in 2020. AIM: The aim of this study is to investigate knowledge, attitude, and practices (KAP) toward the preventive measures during Ramadan 2020 and quarantine, among the Egyptian population. METHODS: This cross-sectional study is conducted among Egyptians ≥15 years of age. A convenience sample of 1150 responders is taken, over the period of the month of Ramadan 2020. An online self-administrated questionnaire is used and shared through social networks. KAP toward preventive measures for COVID-19 during Ramadan are assessed. RESULTS: Results show that mean scores of KAP are higher among participants >20 years, mean ± SD (3 ± 1.1, 5.6 ± 1.4, and 11.2 ± 2.6, respectively). A significant difference is found between KAP scores and age with p-values (0.012, 0.002, and 0.000, respectively). Furthermore, there is a significant difference between practices score and gender (p = 0.010). Greater Cairo has the highest KAP mean scores, in comparison with other regions, mean ± SD (3.3 ± 1, 5.8 ± 1.2, and 11.6 ± 2.5, respectively). A significant difference is recorded between urban and rural areas, regarding KAP with p-value (0.000, 0.050, and 0.000, respectively). CONCLUSION: In conclusion, low KAP scores are recorded among participants below the age of 20, and in rural areas and regions outside Greater Cairo. Low practices are associated more with males than females. The present study recommends raising awareness through the use of mass media, and health education programs that are to be directed to male members of the population, people under 20 years old, and to people residing in rural areas and in regions outside Greater Cairo, such as Upper and Lower Egypt, and border regions.

Mapping the resilience performance of community pharmacy to maintain patient safety during the Covid-19 pandemic

Background

The first UK wave of the Covid-19 pandemic in 2020 placed unprecedented stress on community pharmacy. Various policies and initiatives were announced during this period to support community pharmacy to continue to perform in a manner that prioritised patient safety. However, little is understood about how these policies and initiatives were implemented by staff working in community pharmacy, and the system adaptions and responses that were initiated to maintain patient safety.

Objective

The study aimed to investigate how staff working in UK community pharmacy during the first waves of the COVID-19 pandemic in 2020 responded and adapted to system stressors to maintain patient safety.

Methods

We adopted a qualitative interview approach, underpinned by Resilient Healthcare theory, with interview data collected between July 2020 and January 2021. Data were synthesised and analysed using Framework Analysis.

Results

23 community pharmacy staff from England and Scotland were interviewed. We identified five themes supported by between two and six sub-themes: 1. Covid-19, an impending threat to system; 2. Patient safety stressors during the first waves of Covid-19; 3. Altering the system, responding to system stressors; 4. Monitoring and adjusting and 5. Learning for the future.

Conclusion

Privileging the accounts of community pharmacy staff working on the frontline during the pandemic illuminated how responses and adaptions were developed and deployed, how continual monitoring occurred, and the factors that supported or hindered system resilience. The key learning derived from this study can serve to shorten the gap between ‘work as imagined’ and ‘work as done’, and in doing so, support the future resilience performance of community pharmacy during future outbreaks of Covid-19 or similar events.

Shedding the light on Pharmacists' roles during COVID-19 global pandemic

INTRODUCTION

(Background)The role of pharmacists revolves around providing the highest levels of care to society and ensuring the provision of medicine to all patients. However, with the spread of coronavirus disease 2019 (COVID -19), pharmacists as a very important part of healthcare professionals' team are responsible for fighting against the disease regardless of their setting of practice. The role of pharmacists will undergo a little change to extend and include other roles in order to ensure the safety of the community and limit the virus spread. Also, they will be required to obtain information from reliable sources, and to be up to date, so they can be reliable advisors to the community and raise their awareness.

OBJECTIVES

The purpose of this review is to highlight community and hospital pharmacists' roles during (COVID-19) global pandemic, and to clearly illustrate how they are contributing to maintain pharmacy services continuity, supporting other healthcare professionals, and facilitating the patient's education.

SUMMARY

Clinical pharmacists provide direct patient care through monitoring adverse drug reactions, ensuring individualized treatment, performing evidence-based practice, and evaluating drugs in clinical trials. On the other hand, community pharmacists which are the most accessible healthcare providers by the community increase their awareness regarding the preventive measures, balance medicines supply and demand, provide drive-thru and home delivery services, offer telehealth counselling, psychological support, refer suspected COVID-19 patients, and provide vaccination when available.

CONCLUSION

Innovative pharmacists' roles have emerged to adapt to changes during COVID-19 pandemic, however, they may be needed in the post COVID-19 world as well.

Integration of community pharmacy in primary health care: The challenge

Community pharmacies and pharmacists predominantly operate in a retail environment independently of other health care providers, and they are not often viewed as an integral member of the healthcare team. Thus, they remain overlooked or excluded during integration processes of health care systems. At the same time, there are calls by the profession at national and international levels for community pharmacy to be integrated within primary care systems. The COVID-19 pandemic appears to have further stimulated this desire. When pressing for integration, various terms, such as integration, integrated care, or interprofessional collaboration, are used in an interchangeable manner leading to lack of clarity, ambiguity and confusion for health care policy makers, planners, and other healthcare professionals. The literature was reviewed to identify critical components for community pharmacy to consider for integration. From the five selected articles describing integration of community pharmacies, four different constructs were identified: consensus, connectivity, communication and trust. The integration of community pharmacy into the health system may translate into better access for patients to primary care services, contribute to cost effectiveness, and promulgate the sustainability of the system. However significant political, economic, social, and practice change would be required by all stakeholders. Further research is needed to underpin a consensus for a definition, the type of integration, and the model optimally suited to integrate community pharmacy into primary care. These models, specific and adaptable to each national health care system and political environment, would need to be consensus-based by principal stakeholders to overcome a variety of barriers, including government resistance. Mere calls or demands by the pharmaceutical profession, although laudable, will not be sufficient to overcome the historical, cultural, and economic challenges.

Extent of and Factors Associated with Self-Medication among Clients Visiting Community Pharmacies in the Era of COVID-19: Does It Relieve the Possible Impact of the Pandemic on the Health-Care System?

Background

Self-medication is one aspect of self-care that has been shown to benefit primary health care. When done correctly, it provides significant benefits to customers, such as self-reliance and cost savings. Inappropriate methods, on the other hand, such as incorrect self-diagnosis and therapy selection, can be disastrous. The COVID-19 pandemic context may benefit the community in easing the burden on the health system. There have been no studies conducted on this possibility in the context of COVID-19 in a selected area, hence the purpose of this study was to determine the extent of and factors associated with self-medication among clients visiting community pharmacies in west Harerghe, Ethiopia from June 1 to 30, 2020.

Methods

This institution-based cross-sectional study used a systemic random sample of 416 community-pharmacy clients. To collect data, face-to-face interviews were conducted using pretested semistructured questionnaires modified from established techniques. EpiData 3.1 was used to enter data and SPSS 24 for analysis. To determine factors associated with self-medications, bivariate and multivariate logistic regression analyses were performed. AORs with 95% CIs are used to report associations, and the level of significance was set at P<0.05.

Results

The proportion of people self-medicating was 73.6% (95% CI 69.2%–77.9%). Self-medications were significantly associated with age 18–24 years (AOR 9.28, 95% CI 3.56–24.21) and 25–34 years (AOR 3.54, 95% CI 1.35–9.27), Amhara ethnicity (AOR 1.72, 95% CI 1.01–2.94), current single status (AOR 0.28, 95% CI 0.15–0.51), government employment (AOR 0.31, 95% CI 0.12–0.82), and limited knowledge (AOR 2.31, 95% CI 1.40–3.79).

Conclusion

Three in four participants practiced self-medication in the era of COVID-19. Repetition was significantly associated with age, ethnicity, current marital status, type of occupation, and knowledge about self-medications. An alternative medical care–delivery system by all health-care providers and increasing community awareness should be promoted.

Expanded roles of community pharmacists in COVID-19: A scoping literature review

Background

Coronavirus disease 2019 (COVID-19) has affected the world health care system adversely, but it has also brought out innovative roles for health care professionals to cater to growing health care needs. Community pharmacists provide community pharmacy services and can play a vital role in fighting the pandemic by taking on novel roles that complement their pre-existing roles.

Objectives

This study aimed to provide a scoping review of current and emerging literature about the novel roles adopted by community pharmacists during the COVID-19 pandemic.

Methods

Online databases such as Google Scholar and PubMed were searched systematically using the keywords “COVID-19,” “pharmacist,” and “community.” Articles were selected based on availability of full text in English language, with time limit from December 1, 2019, to October 31, 2021; case reports, cross-sectional studies, literature reviews, qualitative studies, and systematic reviews were included, whereas commentary reviews and editorials were excluded from the search methodology. An independent review of the articles was conducted for inclusion based on relatability to study subject; those chosen were screened for references to find additional gray literature. Findings were arranged in themes, and the results were organized accordingly.

Results

Novel roles for community pharmacists were found in relation to maintenance of drug-supply chains, delivery of telepharmacy and telehealth services, provision of ambulatory pharmacy services, use of digital software to coordinate medication delivery for patients with chronic conditions, dispelling of misinformation, and roles in research and clinical trials. Roles in a post-COVID world regarding immunization of population and involvement in lifting lockdown strictures alongside other stakeholders were also explored.

Conclusion

Although COVID-19 has challenged the health care system, it has also provided an opportunity for development of novel and innovative roles that can ultimately have profound consequences for the health care system. Community pharmacists, despite facing multiple challenges in the community, should be facilitated to adapt with these new roles, which can be beneficial in achieving mass immunization and better health care in a post-COVID world.

Community pharmacy cognitive services during the COVID-19 pandemic: A descriptive study of practices, precautions taken, perceived enablers and barriers and burnout

OBJECTIVE

The objectives of this study were to identify community pharmacist (CP)-led cognitive services and CPs' precautions taken related to COVID-19, perceived enablers and barriers related to pharmaceutical services and burnout levels during the COVID-19 pandemic.

METHOD

In this descriptive study, the survey was administered online to CPs in all regions of Turkey. The frequency of their provision of patient counselling, provision of medication information and practices towards precautions during the pandemic were evaluated based on CP self-reports. The Turkish version of the Burnout Measure Short Form was used, and a 30-item questionnaire based on the 12-domain Theoretical Domains Framework was developed to determine CPs' perceived enablers of and barriers to pharmaceutical service delivery during the COVID-19 pandemic. Data were collected using convenience sampling methods. Besides internal consistency reliability, principal component analysis, and correlation analysis, Mann-Whitney U-test was conducted in group comparisons.

RESULTS

A total of 1098 complete responses were received, for a response rate of 4.11% among 26 747 CPs. The CPs' median burnout score was 3.3 (2.5-4.2). More than half of the CPs (54.5%) referred probable patients with COVID-19 to the hospital. Commonly delivered cognitive CP-led services included preventive health services (89.5%) and medication information services (86.3%). Perceived barriers to delivering pharmaceutical services were a lack of environmental resources and support and a lack of innovation in pharmaceutical services. Perceived enablers were CPs' knowledge, skills, self-confidence, actions, impacts, emotions and perceived behavioural control.

CONCLUSION

To increase the preparedness of pharmacists for future pandemics or disasters, this study highlighted CP-led cognitive services, precautions taken related to COVID-19, perceived enablers and barriers and burnout during the COVID-19 pandemic. Pharmaceutical services guidelines that could be followed during a pandemic or other disaster should be designed by addressing these findings.

Community pharmacists' needs, education, and readiness in facing COVID-19: Actions & recommendations in Egypt

INTRODUCTION

Coronavirus disease 2019 (COVID-19) outbreak is considered one of the most important public health crises all over the world and in Egypt. Community pharmacists represent the third largest health care professional group after physicians and nurses. Community pharmacists are expected to be fully prepared at the frontline of defending their community needs by limiting the spread of COVID-19 via different pharmaceutical care services.

AIM

This study aimed to evaluate the sources of knowledge and readiness of community pharmacists in facing COVID-19 early outbreak in Egypt.

METHODS

A descriptive cross-sectional study was performed via a self-administered online google form questionnaire during the early period from 14 April to 3 June 2020. The questionnaire focused on; evaluating education level, sources of information, and readiness of Egyptian community pharmacists in the COVID-19 pandemic crisis.

RESULTS

A total of 318 community pharmacists from Egypt participated in this questionnaire. About half of the surveyed pharmacists reported that they were frequently consulted and that their patients were seeking consultation regarding COVID-19 management more than 10 times per day. More than half of the pharmacists reported using social media as a source of information and knew the right social distancing recommendations. Regarding protective measures, only a quarter of pharmacists disclosed the availability of personal protective equipment (PPE). Nevertheless, the majority of pharmacists significantly reported some initial lack of support either inform of recommendations or PPE supply.

CONCLUSION

The study revealed the dependence of community pharmacists on social media as the main source of information and the lack of early awareness of evidence-based practice resources. Community pharmacists were in need of more initial support to achieve better satisfaction, patient counselling and infection control. Corrective measures were promptly undertaken to support and satisfy the Egyptian community pharmacists' initial awareness and readiness facing COVID-19.

Healthcare Optimization, Medication Management and Preparedness in Retail Pharmacy Industry during the Covid-19 Pandemic in India

BODY: Coronavirus (COVID-19) pandemic is a health crisis,which has almost impacted every industry, causing steep inroadsinto the global economy, and the pharmaceutical industryis no exception. Retail pharmacists are the most approachableand immediate healthcare aid to the general public. Pharmacistscan implement guidance and best practices in responseto the rapidly changing COVID-19 pandemic to ensure patientand staff safety and the approaches pharmacy teams acrossthe country. Social distancing and lockdown measures taken bythe Indian government have been greatly affected by the retailpharmacy industry, leading to disruption in the supply chainof medicines and other precautionary equipment. Medicationmanagement, necessary safety equipment, and preparednessfor handling drug shortages are the focus points for the retailpharmacy industry in these times of the pandemic. As the retailpharmacy comes under essential services and is operatingcontinuously during the lockdown period, there is a need tohighlight and gauge the preparedness and preventive measuresundertaken by pharmacists in India during this medicalemergency.AIM: This research aims to analyze the retail pharmacy administrationin India towards essential medication, to check adherenceto key preventative measures and activities performed ininpatient counseling for self-management and safe dispensingof medicines in COVID-19 & lockdown period and the barriersfaced/concerns towards these measures.METHODOLOGY: This study is based on methods of quantitativeanalysis from retail pharmacies in India. The survey questionnairewas drafted on Google forms and sent to various retailpharmacy outlets. The data pertains to various medications’storage and consumption pattern, concerns over day-to-dayactivities in the pharmacy, and preventive measures implementedby pharmacists towards COVID-19 preparedness.RESULT: 167 pharmacists addressed the questionnaire acrossvarious regions of the country by different types of pharmacy:community pharmacy (66.5%), retail pharmacy section in a private(14.4%) and public hospital (11.4%), and clinical pharmacy(7.8%). The statements developed for the study are closely related,and a good Cronbach’s alpha value of 0.881 was achieved.One-way ANOVA testing determined that out of 12 statementson the preparedness of pharmacy, nine statements showed asignificant difference concerning the types of pharmacy implementingthe preventive measures.

Predicting Pharmacist Intention to Contribute to COVID-19 Management at the Community Level: A Cross-Sectional Survey Study

Introduction: The role of pharmacists in public health management is expected to grow into a key player in the continuing measures of managing the COVID-19 pandemic, especially in the community setting. However, their intention to provide essential public health services for combating the pandemic and the impact of their attitude and beliefs are largely unknown. This study aimed to investigate the intention-to-practice COVID-19-related responsibilities of pharmacists based on the theory of planned behavior (TPB), identify the key factors predicting their intention, and explore the usefulness of the TPB model in predicting such an intention. Methods: A cross-sectional, self-administered questionnaire was completed by pharmacists in Macao between May and August 2020. Quantitative responses regarding intention-to-practice COVID-19-related duties, and the four TPB variables [attitude (A), subjective norms (SN), perceived behavioral control (PBC), and past behavior (PB)] were measured. Cronbach's alpha and composite reliability were used to determine the reliability and validity of the tool. In addition to descriptive statistics, Pearson's correlation was used to determine the strengths of the association, and multiple linear regression was used to predict the association between the intention and the four key variables. Results: More than half of the pharmacists practicing in Macao completed the questionnaire (296/520) giving a response rate of 56.9%. Among them, 75% were 26-40 years old and 56% were female. The majority of the participants (91.9%) demonstrated a positive intention to contribute to the COVID-19 infection management (mean = 4.19 ± 0.51). The mean scores for A, SN, PBC, and PB were 4.06 ± 0.52, 3.71 ± 0.58, 3.76 ± 0.65, and 4.03 ± 0.54, respectively. A (β = 0.671), SN (β = 0.608), PBC (β = 0.563), and PB (β = 0.829) were all positively correlated with intention (all P < 0.001). It was found that 72.5% of the variance in the intention-to-practice COVID-19-related duties could be explained by the TPB model using the four key variables with A and PB being two possible predictors. Conclusion: Pharmacists showed favorable A, SN, PBC, and intention in participating in COVID-19 management in the community setting. Specific training, enhanced stakeholder communication, and improved pharmacy management are essential to increase the willingness of pharmacists to take part in the COVID-19 pandemic and other public health emergencies alike in the future.

Assessing the scale of adoption of sustainability practices by community pharmacies in Spain in the time of COVID-19

Community pharmacies play a critical societal role and are well placed to enable the progress of national health systems towards sustainability. Nevertheless, there is a dearth of research which has been set up to understand sustainability practices adopted by community pharmacies and evaluate the drivers behind their adoption. This study undertook an exploratory analysis of 95 community pharmacies in Spain, measured their engagement with sustainability practices and assessed these practices in light of the COVID-19 pandemic. The results demonstrated the room for improvement in the adoption of green procurement practices in pharmacies and in their engagement with the community. Moreover, the study showcased that, during the COVID-19 crisis, the pharmacies with the largest extent of adoption of sustainability practices implemented preventative measures against the pandemic in a more diverse number during the first weeks of the lockdown, compared to their less sustainable counterparts. This indicates that, to build resilience to future (health) crises, the implementation of sustainable practices in community pharmacies should be encouraged by both policy makers and pharmaceutical firms.

Antibiotic misuse and compliance with infection control measures during COVID-19 pandemic in community pharmacies in Egypt

BACKGROUND

Globally, antibiotics misuse by the public has been reported in the era of COVID-19, despite the discouraging instructions of the World Health Organization, especially for mild cases.

OBJECTIVE

Is to describe this antibiotic misuse and its contributing factors. Also, to measure the pharmacists' application of infection preventive practices during the pandemic.

METHODS

A cross-sectional study was conducted among randomly selected Egyptian community pharmacists (Center, East, Delta, and Upper Egypt) using a questionnaire and direct interviews from 1 to 30 August 2020. The questionnaire consisted of two parts, the first covered pharmacist's demographic data and their application of basic infection preventive practices (eg, wearing face masks, regular hand sanitization, etc), and the other part was related to antibiotic dispensing patterns. Data were descriptively analyzed and the impact of participant experience on the responses was evaluated using the χ² test.

RESULTS

From 480 randomly selected Egyptian community pharmacists, 413 (87%) consented to participate in the study. 86.7% of the participants were keen to wear face masks (n = 358) and 86.2% kept regular hand sanitization (n = 356); whereas, 46.9% (n = 194) maintained adequate antibiotic stock supply during the pandemic. Nearly 67% (n = 275) of the pharmacists reported that patients were more likely to be given antibiotics for showing any sign or symptom of COVID-19 infection, and 82% (n = 74 278) of the dispensed antibiotics were given upon physician recommendation. Azithromycin, Ceftriaxone, and Linezolid were the major antibiotics dispensed to COVID-19 presumptive patients Azithromycin was given to ~40% of presumptive patients showing only mild or moderate symptoms for 5-10 days. Additionally, antibiotic combinations were given to 74% (n = 62 479) of home-isolated patients for a maximum of 2 weeks.

CONCLUSIONS

Pharmacists applied suitable sanitation and infection control protocols. Meanwhile, antibiotics were dispensed heavily during this pandemic without proper clinical indication and for long durations supporting the idea of antibiotic misuse.

Análise da produção científica sobre os serviços farmacêuticos comunitários no enfrentamento da pandemia pelo coronavírus

RESUMO Esta revisão buscou sintetizar as práticas em serviços farmacêuticos relacionadas ao gerenciamento e às atividades clínicas em distintos contextos para a prevenção e a assistência durante a epidemia da Covid-19. Trata-se de uma revisão da literatura sobre políticas públicas de saúde para a reorganização da assistência farmacêutica em países atingidos pela Covid-19 realizada nas bases de dados Web of Science, Science Direct e Biblioteca Virtual em Saúde. Foram selecionados 9 artigos, sendo todos publicados em 2020. Destes, 90% foram publicados pelo periódico ‘Research in Social an Administrative Pharmacy’ e tiveram como local de realização de estudo países de três continentes. Foram relatadas e debatidas experiências sobre a atuação do profissional farmacêutico e o papel da farmácia comunitária no contexto da pandemia da Covid-19, e sobre a reorganização destes serviços, evidenciadas no contexto de crise, tanto no que tange à oferta de serviços quanto ao próprio espraiamento da doença. O modelo adotado pelos países para o enfrentamento da Covid-19, no âmbito dos serviços farmacêuticos comunitários, baseou-se em atividades para a garantia da qualidade e logística de insumos e medicamentos, triagem e monitoramento de pacientes, acompanhamento farmacoterapêutico, educação em saúde e informações sobre o uso de medicamentos.

Pharmacists' role, work practices, and safety measures against COVID-19: A comparative study

Background

The coronavirus disease 2019 (COVID-19) pandemic poses a great challenge to health systems and their most accessible assets—community pharmacies. Pharmacists faced many challenges such as incorporating safety measures, changes in working schedule and workload, and meeting specific patients’ needs.

Objectives

This study aimed to explore and compare the community pharmacists’ roles, practices, implemented safety measures, and psychological toll in Croatia and Serbia during the COVID-19 pandemic.

Methods

A cross-sectional study employing an online survey was conducted in 2 countries over a period of 6 weeks during 2020. The survey consisted of 65 items that explored sociodemographic characteristics of participants and their workplaces, including safety measures, pharmaceutical care, and their psychology while working during the COVID-19 pandemic.

Results

In total, 574 pharmacists participated in the study, of which, 90% were female, with a mean age of 38 years (interquartile range 30.5–47). The study identified new pharmacists’ roles that evolved during the COVID-19 pandemic: manufacturing hand sanitizers in community pharmacies, online patient counseling, and home delivery of medicines. Croatian and Serbian pharmacists exhibited disparities in their incorporated safety measures (higher for Croatia; P ≤ 0.001) and satisfaction with work organization and counseling activities (higher for Serbia; P < 0.001). Serbian participants were less satisfied with the public perception of their role during the pandemic, and overall satisfaction was low, with a negative impact on mood and productivity.

Conclusions

The study revealed the implications for community pharmacists during the pandemic in both countries. The extent of systematic and logistical support provided to them during the pandemic could be an explanation for the highlighted differences. It is imperative to develop a more effective strategy to counter potential health crises to ensure a better response from primary care pharmacists in the future.

Pharmacy practice research priorities during the COVID-19 pandemic: Recommendations of a panel of experts convened by FIP Pharmacy Practice Research Special Interest Group

Across the globe, pharmacists on the frontline continue to fight COVID-19 and its continuously evolving physical, mental, and economic consequences armed by their knowledge, professionalism, and dedication. Their need for credible scientific evidence to inform their practice has never been more urgent. Despite the exponentially increasing number of publications since the start of the pandemic, questions remain unanswered, and more are created, than have been resolved by the increasing number of publications. A panel of leading journal editors was convened by the International Pharmaceutical Federation (FIP) Pharmacy Practice Research Special Interest Group to discuss the current status of COVID-19 related research, provide their recommendations, and identify focal points for pharmacy practice, social pharmacy, and education research moving forward. Key priorities identified spanned a wide range of topics, reflecting the need for good quality research to inform practice and education. The panel insisted that a foundation in theory and use of rigorous methods should continue forming the basis of inquiry and its resultant papers, regardless of topic area. From assessing the clinical and cost effectiveness of COVID-19 therapies and vaccines to assessing different models of pharmaceutical services and education delivery, these priorities will ensure that our practice is informed by the best quality scientific evidence at this very challenging time.

Pharmacists' roles in emergency and disasters: COVID-19 as an example

Background

Emergencies and disasters are major threats to health care systems. Coronavirus Disease 2019 (COVID-19) is at the center of a recent emergency situation that requires increased attention from health care professionals, including pharmacists. This study was aimed at providing an overview of pharmacists’ roles in disasters and formulating a definition of expected roles and tasks through which they can perform these roles properly.

Methods

A systematic review was conducted utilizing a literature search performed on the Medline, EMBASE and PubMed databases. The last search occurred on 14 July 2020. Data were extracted and recorded on a data extraction sheet by the reviewers, then categorized using the prevention, preparedness, response, and recovery (PPRR) model. Study quality was evaluated using the Critical Appraisal Skills Program (CASP) checklist.

Results

Fifteen articles addressing pharmacists’ roles in disasters were included. Of these, three addressed pharmacists’ roles during the COVID-19 pandemic. Pharmacists’ roles in the prevention of emergencies, including COVID-19, are focused on chronic disease medication supply and education. Regarding pharmacists’ preparedness to perform their roles in disasters, they were more focused on health policy and population health planning, especially regarding the COVID-19 pandemic. Direct patient care continues to support patients through medication availability, and pharmacists’ clinical roles are examples of their response to disasters. In addition, pharmacists have an important role in disaster recovery that involves several activities, such as restocking emergency kits and reestablishing normal stock. Studies were generally of a reasonable quality. However, some limitations were noted among studies, and higher quality studies that contribute to existing knowledge are needed.

Conclusion

Health care systems’ utilization of pharmacists’ new roles can result in a well-prepared disaster response, as observed during the COVID-19 pandemic. Pharmacists’ engagement in decision-making processes and adequate demonstration of pharmacists’ nontraditional roles in the literature can facilitate the health care community’s acceptance of such roles.

Knowledge, awareness and preparedness regarding coronavirus disease 2019 pandemic among community pharmacy practitioners working in Kathmandu, Nepal: A pilot study

Good knowledge, awareness and preparedness regarding coronavirus disease 2019, among community pharmacy practitioners (CPPs), will enable them to provide correct information and support to patients, convey instructions from the public health authorities and protect their own health.

Objective

The aim of this study was to determine knowledge, awareness and preparedness regarding coronavirus disease 2019 among CPPs working in Kathmandu, Nepal.

Methods

A cross-sectional study was conducted using a convenience sampling method from 10 February to 25 March 2020. Data were analysed descriptively, and one-sample independent t-test and one-way analysis of variance were used to compare scores among different subgroups of respondents (p < 0.05). Post hoc analyses (following analysis of variance) were done using the Bonferroni test.

Results

A total of 81 CPPs participated. Mean ± standard deviation age was 26.70 ± 5.29 years. Majority of the respondents were male (64.2%). Many CPPs (40.7%) had work experience between 1 and 5 years. Almost half (45.7%) had an educational qualification of Diploma in Pharmacy. Significant differences in knowledge (p = 0.022) and preparedness (p < 0.001) were found among individuals with differing levels of work experience. Similarly, a significant difference was found between knowledge-preparedness and work experience (p = 0.022 and p < 0.001), location of pharmacy (p < 0.001) and educational qualification (p = 0.031). Awareness (p < 0.001) and preparedness scores (p = 0.049) were different among community pharmacies with the different number of medicines available.

Conclusion

Knowledge was found to be higher in CPPs with a work experience of more than 5 years. CPPs working at larger community pharmacies were more aware and prepared. CPPs' knowledge, awareness and preparedness should be evaluated more widely and strengthened.

Community pharmacy services and preparedness during COVID-19 outbreak in Madinah, Saudi Arabia

BACKGROUND

Wearing facial masks, hand hygiene, and social distancing are highly recommended preventive measures against COVID-19. Masks and disinfectants are usually sold in community pharmacies that are supposed to undertake extreme precautions to avoid cross infection among clients. It is also their responsibility to play a prominent role in educating the community regarding this outbreak.

OBJECTIVES

To investigate the preparedness of private community pharmacies in Madinah, Saudi Arabia, for the COVID-19 outbreak with regard to safety measures, customer education, and quality of preventive aids sold by them.

METHODS

One hundred pharmacies were visited by simulated clients. The availability of free hand disinfectants, masks, gloves, and customer educational aids as well as the measures employed to ensure maintenance of safe distances between customers were documented. The adherence of pharmacists and customers to safety precautions and the behavior of pharmacists against violators of regulations were also observed. Finally, the availability and quality of facial masks and hand disinfectants sold by these pharmacies was documented.

RESULTS

Fifty-five pharmacies offered free hand disinfectants but only in three of them all customers used them. Only two pharmacies offered free disposable masks and temperature screening was available in only one pharmacy. Educational aids were found in 31 pharmacies and only 53 pharmacies used visual indicators for social distancing. Violation of wearing masks by pharmacy personnel and customers was seen in 34 and 87 pharmacies, respectively. Social distancing was violated in 64 pharmacies and intervention by staff was seen in only three of them. Finally, facial masks were available for sale in only 35 pharmacies, and in 23 of these, the quality was questionable; hand disinfectants were available in 84 pharmacies, and in 14 of these, the quality was unknown.

CONCLUSIONS

Community pharmacies in Madinah were short of registered, high-quality facial masks during the survey. Means to control the transmission of infection inside pharmacies were unsatisfactory. Society has shown poor compliance to preventive measures against COVID-19 infection and the role of community pharmacists in promoting compliance was found to be poor. The study reveals an unsatisfactory level of preparedness of Madinah community pharmacies for the pandemic.

Implementation of a novel home delivery service during pandemic

Introduction

During the COVID-19 pandemic, measures have been put in place to adapt to patients’ needs during home quarantine, such as “telehealthcare”. With this service, hospital pharmacists develop a distinct role via the implementation of pharmacovigilance services and pharmaceutical care plans for patients with comorbidities, and for special populations as immunosuppressed patients.

Methods

Cross-sectional study involving hospital and community pharmacists actively practising during the COVID-19 pandemic. Patients who could not come to the hospital pharmacy department were provided with a delivery service to the community pharmacy of their choice.

Results

A total of 1186 patients requested this service. Erythropoiesis-stimulating agents were the most in-demand medication, followed by rheumatoid arthritis and antiretroviral drugs. 125 patients responded to the telephone survey, most of whom stated that they would use the delivery service again, and expressed their desire to continue doing so.

Discussion

Without a doubt, telepharmacy and medication delivery services have provided multiple benefits during home quarantine. The delivery service enabled us to provide drugs to patients in their immediate environment through a service that was free for both the patient and the hospital pharmacy service. However, at present, the available evidence of the impact of telepharmacy models is sparse.

Conclusions

This medication delivery service has provided multiple benefits to patients during home quarantine. Although the users of this service seem to be satisfied with the current model, in the future, we should consider which patients would benefit most from this service and shape it to individual needs.

The Role of Hospital and Community Pharmacists in the Management of COVID-19: Towards an Expanded Definition of the Roles, Responsibilities, and Duties of the Pharmacist

Since late December 2019, a novel, emerging coronavirus was identified as the infectious agent responsible for a generally mild but sometimes severe and even life-threatening disease, termed as "coronavirus disease 2019" (COVID-19). The pathogen was initially named as "2019 novel coronavirus" (2019-nCoV) and later renamed as "Severe Acute Respiratory Coronavirus type 2" (SARS-CoV-2). COVID-19 quickly spread from the first epicenter, the city of Wuhan, province of Hubei, mainland China, into neighboring countries, and became a global pandemic. As of July 15th 2020, the outbreak is still ongoing, with SARS-CoV-2 affecting 213 countries and territories. The coronavirus has caused a dramatic toll of deaths and imposed a severe burden, both from a societal and economic point of view. COVID-19 has challenged health systems, straining and overwhelming healthcare facilities and settings, including hospital and community pharmacies. On the other hand, COVID-19 has propelled several changes. During the last decades, pharmacy has shifted from being products-based and patient-facing to being services-based and patient-centered. Pharmacies have transitioned from being compounding centers devoted to the manipulation of materia medica to pharmaceutical centers, clinical pharmacies and fully integrated "medical-pharmaceutical networks", providing a significant range of non-prescribing services. Moreover, roles, duties and responsibilities of pharmacists have paralleled such historical changes and have known a gradual expansion, incorporating new skills and reflecting new societal demands and challenges. The COVID-19 outbreak has unearthed new opportunities for pharmacists: community and hospital pharmacists have, indeed, played a key role during the COVID-19 pandemic, suggesting that a fully integrated, inter-sectoral and inter-professional collaboration is necessary to face crises and public health emergencies. Preliminary, emerging evidence seems to suggest that, probably, a new era in the history of pharmacies ("the post-COVID-19 post-pharmaceutical care era") has begun, with community pharmacists acquiring more professional standing, being authentic heroes and frontline health workers.

FIP's response to the COVID-19 pandemic: Global pharmacy rises to the challenge

The International Pharmaceutical Federation (FIP), as the global leadership body for pharmacists, pharmaceutical scientists and pharmaceutical educators, coordinated and produced as of January 2020 an international response to the COVID-19 pandemic. FIP's response included professional guidance, a programme of digital events and other resources, as well as advocacy and policy tools to support national pharmacists' associations and academic institutions, as well as individual practitioners, in their response at country level. This article describes the strategy adopted by FIP in collaboration with an international group of experts to support the valuable service that pharmacists and their teams provide to communities throughout the pandemic, and their important contribution to easing the huge strain being placed on health systems around the world.

Personal protective practices and pharmacy services delivery by community pharmacists during COVID-19 pandemic: Results from a national survey

Introduction

Coronavirus disease (COVID19) has adversely affected the delivery of various health services. Little is known about the impact of COVID19 on pharmacy services across the United Kingdom (UK). We surveyed community pharmacists across the UK to understand their protective practices, professional and general well-being, and the delivery of pharmacy services during the COVID19 pandemic.

Methods

Community pharmacists were invited to participate in a cross-sectional survey via the nationwide weekly newsletter of Pharmaceutical Services Negotiating Committee and the local pharmaceutical committees during the second week of May 2020. The survey remained open for 4 weeks.

Results

A total of 206 pharmacists responded to the survey with representations from England, Northern Ireland, Scotland, and Wales. The majority of pharmacists (>75% or above) reported an increase in customer traffic to their pharmacy and were asking relevant questions from patients with flu-like symptoms before signposting them to the appropriate care. Most pharmacists (>85%) were maintaining a safe distance of 2 m from customers and 72% were wearing an N95 protective mask and 28% were using protective gloves and apron in addition to safe distancing and protective masks. Ninety-nine percent of pharmacists reported drug shortages with 38% and 26% reported significant drug shortages and critical drug shortages causing disruptions beyond over the counter medicines. Eighty-nine percent pharmacists reported inappropriate behaviour from patients or carers with 31% and 16% reported it to be a regular or frequent problem, respectively. Fifty-three% of pharmacists were willing to offer their assistance for mass testing of COVID19 antibodies if adequate training and reimbursement are provided.

Conclusion

Community pharmacists in the UK are facing considerable challenges in terms of personal protection and the delivery of pharmacy services. Inappropriate behaviour from patients and carers towards community pharmacists require urgent attention to ensure a safe working place for all community pharmacists.

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Coronavirus Disease 2019 (COVID19) has resulted in critical drug shortages in the United Kingdom.

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Community pharmacists are enforcing careful precautionary measures to prevent COVID19 transmission.

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Inappropriate consumer behaviour is reported by community pharmacists.

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Future planning of COVID19 should seek inputs to establish needs of community pharmacists.

Impact of the COVID-19 epidemic on the provision of pharmaceutical care in community pharmacies

Background

Community pharmacists and their teams are easy accessible healthcare providers with an important role in primary care. As a consequence of the COVID-19 epidemic, (pharmaceutical) care and specifically communication between patients and healthcare providers is compromised.

Objective

To describe the impact of the COVID-19 epidemic on the provision of pharmaceutical care in the Netherlands.

Methods

A cross-sectional study with an online questionnaire was sent to community pharmacies in the Netherlands. The questionnaire covered the following main topics: changes in pharmacy setting and logistic procedures, communication about medication and baseline characteristics.

Results

Pharmacies implemented hygiene measures and minimized direct patient-provider contact, e.g. by delivering medication at home to a wider range of patients (47.0%), temporarily not conducting medication reviews (55.8%) and only performing inhalation instructions via telephone (22.3%). Only a small number of pharmacies used telepharmacy, such as video calling during patient education and counseling. A total of 76.7% of the participants expressed concerns towards the pharmaceutical care for vulnerable patients.

Conclusions

Our results show considerable impact of the COVID-19 epidemic on both logistic procedures and services regarding patient education and counseling. Pharmacies should be stimulated to implement telepharmacy or remote service to optimally support patients during the COVID-19 epidemic.