Emerging from the other end: Key measures for a successful COVID-19 lockdown exit strategy and the potential contribution of pharmacists

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.

Experiences and learnings of pharmacists, students, and clinical assistants working collaboratively in a COVID-19 vaccination clinic: a qualitative study

Background

The involvement of pharmacists and pharmacy clinical assistants (CAs) in hospital clinics has demonstrated benefits for improving medication safety and care delivery. Internationally, pharmacy staff played a crucial role in the safe storage, provision and administration of vaccines, as well as reinforcement of pharmacovigilance efforts during the COVID-19 pandemic. In Australia, healthcare providers collaborated to rapidly facilitate a phased COVID-19 vaccination program. The perspectives of the pharmacy team, including pharmacy students, involved in implementing novel health services are underexplored in the literature.

Objective

To describe the key learnings in how a team of pharmacists, CAs and pharmacy students contributed to the COVID-19 vaccine service, and to explore their preparedness and experiences working at a vaccination clinic within a quaternary hospital.

Method

This study involved semi-structured interviews with pharmacy students, CAs and pharmacists. All pharmacy staff who worked in the clinic were invited to participate in the study and a snowball strategy was used to maximise recruitment. The interviews were audio-recorded, transcribed, and analysed using inductive thematic techniques to identify major themes.

Results

A total of 11 participants were interviewed including: four pharmacists, four CAs and three undergraduate students. Using thematic analysis, five main themes were identified: (1) Potential for student value and experiential learning; (2) Adaptive procedures and work practices in a rapidly changing environment; (3) Clear leadership, with role clarity, role expansion and interchangeability; (4) Supportive learning environment and (5) Stakeholder drivers for service delivery and to optimise societal benefit. These five themes often interacted with each other, highlighting the complexities of implementing and operating the service.

Conclusions

The vaccine clinic service provided a novel and valuable opportunity for students, CAs, and pharmacists to work collaboratively, extending their scope of practice to contribute to better national health outcomes. Participants expressed their support for future initiatives involving pharmacy students and healthcare staff collaborating in hospital settings.

COVID-19 health policy evaluation: integrating health and economic perspectives with a data envelopment analysis approach

The COVID-19 pandemic is a global challenge to humankind. To improve the knowledge regarding relevant, efficient and effective COVID-19 measures in health policy, this paper applies a multi-criteria evaluation approach with population, health care, and economic datasets from 19 countries within the OECD. The comparative investigation was based on a Data Envelopment Analysis approach as an efficiency measurement method. Results indicate that on the one hand, factors like population size, population density, and country development stage, did not play a major role in successful pandemic management. On the other hand, pre-pandemic healthcare system policies were decisive. Healthcare systems with a primary care orientation and a high proportion of primary care doctors compared to specialists were found to be more efficient than systems with a medium level of resources that were partly financed through public funding and characterized by a high level of access regulation. Roughly two weeks after the introduction of ad hoc measures, e.g., lockdowns and quarantine policies, we did not observe a direct impact on country-level healthcare efficiency, while delayed lockdowns led to significantly lower efficiency levels during the first COVID-19 wave in 2020. From an economic perspective, strategies without general lockdowns were identified as a more efficient strategy than the full lockdown strategy. Additionally, governmental support of short-term work is promising. Improving the efficiency of COVID-19 countermeasures is crucial in saving as many lives as possible with limited resources.

Knowledge, Attitude, and Practices (KAPs) of Community Pharmacists Regarding COVID-19: A Cross-Sectional Survey in 2 Provinces of Pakistan

OBJECTIVE

The 2019 coronavirus disease (COVID-19) is a global pandemic with no therapy, and pharmacists being a part of the health care system have a vital role in the management of COVID-19. The purpose of this study is to assess the knowledge, attitude, and practices of community pharmacists (CPs) regarding COVID-19.

METHOD

An online survey was conducted among 393 CPs in 2 provinces of Pakistan during the lockdown period. A validated questionnaire (Cronbach's alpha, 0.745) was used for data collection. All statistical analyses were analyzed by using SPSS, version 21 (IBM Corp, Armonk, NY).

RESULTS

Among 393 participants, 71.5% (n = 281) had good knowledge, 44% (n = 175) had a positive attitude, and 57.3% (n = 225) had good practices regarding COVID-19. Social media (45.29%, n = 178) were reported as the main source to seek information of COVID-19. Good knowledge, age ≥ 26 years, and a PhD degree level were the substantial determinants (P = < 0.05) of a good attitude. Similarly, a CP with experience of > 5 years, a PhD degree, good knowledge, and a good attitude has higher odds of having good practices as compared with reference categories (P = < 0.05).

CONCLUSION

In short, a majority of the CPs had good knowledge but had a poor attitude and practice toward the management of COVID-19. Standard-structured educational and counseling programs for CPs regarding COVID-19 are needed for effective management.

SaliVISION: a rapid saliva-based COVID-19 screening and diagnostic test with high sensitivity and specificity

The Coronavirus disease 2019 (COVID-19) pandemic-caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)– has posed a global threat and presented with it a multitude of economic and public-health challenges. Establishing a reliable means of readily available, rapid diagnostic testing is of paramount importance in halting the spread of COVID-19, as governments continue to ease lockdown restrictions. The current standard for laboratory testing utilizes reverse transcription quantitative polymerase chain reaction (RT-qPCR); however, this method presents clear limitations in requiring a longer run-time as well as reduced on-site testing capability. Therefore, we investigated the feasibility of a reverse transcription looped-mediated isothermal amplification (RT-LAMP)-based model of rapid COVID-19 diagnostic testing which allows for less invasive sample collection, named SaliVISION. This novel, two-step, RT-LAMP assay utilizes a customized multiplex primer set specifically targeting SARS-CoV-2 and a visual report system that is ready to interpret within 40 min from the start of sample processing and does not require a BSL-2 level testing environment or special laboratory equipment. When compared to the SalivaDirect and Thermo Fisher Scientific TaqPath RT-qPCR testing platforms, the respective sensitivities of the SaliVISION assay are 94.29% and 98.28% while assay specificity was 100% when compared to either testing platform. Our data illustrate a robust, rapid diagnostic assay in our novel RT-LAMP test design, with potential for greater testing throughput than is currently available through laboratory testing and increased on-site testing capability.

Digital pharmacists: the new wave in pharmacy practice and education

Pharmacists now face the biggest challenges in the history of the profession: the use of digital technologies in pharmacy practice and education and the outbreak of coronavirus disease 2019. Worldwide, pharmaceutical care and pharmacy education via digital technologies have significantly increased and will be incorporated into patient care and the teaching–learning process, respectively. Thus, in this new era of pharmacy practice and education, curricula should promote the development of specific competencies for the cognitive, conscious, and effective use of digital tools. This requires the training of “disruptive” educators, who are capable of using teaching–learning methods adapted to the digital environment and educational processes suitable for stimulating the use of effective disruptive technologies. This commentary argues that the pharmacy profession can no longer wait for the slow integration of digital technologies into pharmacy practice and education.

Exit strategies from lockdowns due to COVID-19: a scoping review

INTRODUCTION

In response to the ongoing COVID-19 pandemic, countries have adopted various degrees of restrictive measures on people to reduce COVID-19 transmission. These measures have had significant social and economic costs. In the absence of therapeutics, and low vaccination coverage, strategies for a safe exit plan from a lockdown are required to mitigate the transmission and simultaneously re-open societies. Most countries have outlined or have implemented lockdown exit plans. The objective of this scoping review is to (a) identify and map the different strategies for exit from lockdowns, (b) document the effects of these exit strategies, and (c) discuss features of successful exit strategies based on the evidence.

METHODS

A five-step approach was used in this scoping review: (a) identifying the research question and inclusion/exclusion criteria; (b) searching the literature using keywords within PubMed and WHO databases; (c) study selection; (d) data extraction; (e) collating results and qualitative synthesis of findings.

RESULTS

Of the 406 unique studies found, 107 were kept for full-text review. Studies suggest the post-peak period as optimal timing for an exit, supplemented by other triggers such as sufficient health system capacity, and increased testing rate. A controlled and step-wise exit plan which is flexible and guided by information from surveillance systems is optimal. Studies recommend continued use of non-pharmaceutical interventions such as physical distancing, use of facemasks, and hygiene measures, in different combinations when exiting from a lockdown, even after optimal vaccination coverage has been attained.

CONCLUSION

Reviewed studies have suggested adopting a multi-pronged strategy consisting of different approaches depending on the context. Among the different exit strategies reviewed (phase-wise exit, hard exit, and constant cyclic patterns of lockdown), phase-wise exit appears to be the optimal exit strategy.

Pharmacy interventions on COVID-19 in Europe: Mapping current practices and a scoping review

Background

The COVID-19 pandemic has put community pharmacists at the frontline of prevention, preparedness, response, and recovery efforts. Pharmacies had to reorganize and implement several different interventions and measures within a very short time frame.

Objectives

1) To map the current reported practice and trends and to review the literature on pharmacy-based interventions on COVID-19 provided in Europe; 2) To identify knowledge gaps and future avenues for pharmacy research, policy, and practice in response to public health emergencies.

Methods

We used a mixed methods approach combining country mapping of current practices of pharmacy interventions on COVID-19 reported by pharmacy associations in Europe with a scoping review of published literature.

Results

We mapped current practices on 31 pharmacy interventions on COVID-19 in 32 countries in Europe. Almost all preventive measures to reduce health risks have been provided in most countries. Other frequent interventions reflected preparedness for stockpiling, increased demand for services and products, and important patient care interventions exceeding dispensing role. Expanded powers granted to pharmacies and legislation passed in view of COVID-19 enabled services that improve access to medicines and relevant products, patient screening and referral including point-of-care antigen testing, support to vulnerable patients, and COVID-19 vaccination. We identified 9 studies conducted in pharmacies in 7 countries in Europe. Most studies are cross-sectional and/or descriptive. Pharmacy associations played an important supporting role by developing and updating guidance and emergency plans to assist community pharmacists.

Conclusions

A wide array of pharmacy interventions on COVID-19 was implemented in several countries within a very short time frame. Research on pharmacy interventions on COVID-19 is still in its infancy but confirmed the wide array of interventions provided and expanded powers granted to pharmacies. These findings may provide a significant impact to improve pharmacy research, policy, and practice in response to future public health emergencies in Europe and globally.

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.

Predicting COVID-19 cases using bidirectional LSTM on multivariate time series

To assist policymakers in making adequate decisions to stop the spread of the COVID-19 pandemic, accurate forecasting of the disease propagation is of paramount importance. This paper presents a deep learning approach to forecast the cumulative number of COVID-19 cases using bidirectional Long Short-Term Memory (Bi-LSTM) network applied to multivariate time series. Unlike other forecasting techniques, our proposed approach first groups the countries having similar demographic and socioeconomic aspects and health sector indicators using K-means clustering algorithm. The cumulative case data of the clustered countries enriched with data related to the lockdown measures are fed to the bidirectional LSTM to train the forecasting model. We validate the effectiveness of the proposed approach by studying the disease outbreak in Qatar and the proposed model prediction from December 1st until December 31st, 2020. The quantitative evaluation shows that the proposed technique outperforms state-of-art forecasting approaches.

Rapid realist review of the role of community pharmacy in the public health response to COVID-19

INTRODUCTION

Community pharmacists and their teams have remained accessible to the public providing essential services despite immense pressures during the COVID-19 pandemic. They have successfully expanded the influenza vaccination programme and are now supporting the delivery of the COVID-19 vaccination roll-out.

AIM

This rapid realist review aims to understand how community pharmacy can most effectively deliver essential and advanced services, with a focus on vaccination, during the pandemic and in the future.

METHOD

An embryonic programme theory was generated using four diverse and complementary documents along with the expertise of the project team. Academic databases, preprint services and grey literature were searched and screened for documents meeting our inclusion criteria. The data were extracted from 103 documents to develop and refine a programme theory using a realist logic of analysis. Our analysis generated 13 context-mechanism-outcome configurations explaining when, why and how community pharmacy can support public health vaccination campaigns, maintain essential services during pandemics and capitalise on opportunities for expanded, sustainable public health service roles. The views of stakeholders including pharmacy users, pharmacists, pharmacy teams and other healthcare professionals were sought throughout to refine the 13 explanatory configurations.

RESULTS

The 13 context-mechanism-outcome configurations are organised according to decision makers, community pharmacy teams and community pharmacy users as key actors. Review findings include: supporting a clear role for community pharmacies in public health; clarifying pharmacists' legal and professional liabilities; involving pharmacy teams in service specification design; providing suitable guidance, adequate compensation and resources; and leveraging accessible, convenient locations of community pharmacy.

DISCUSSION

Community pharmacy has been able to offer key services during the pandemic. Decision makers must endorse, articulate and support a clear public health role for community pharmacy. We provide key recommendations for decision makers to optimise such a role during these unprecedented times and in the future.

Development of a Remote Public Health Advanced Pharmacy Practice Experience in Response to COVID-19

OBJECTIVES

In order to meet the needs of the COVID-19 public health crisis and to actively engage students in patient care opportunities, the University of Tennessee Health Science Center College of Pharmacy in partnership with the Tennessee Health Department, developed a remote Public Health Advanced Pharmacy Practice Experience (APPE) Elective. The objectives of this paper are to describe the development of and students' experiences and learning outcomes during the elective. Faculty preceptor and experiential administrator's perspectives are also described.

METHODS

This month-long APPE was developed in mid-March and delivered in April and May of 2020. The students volunteered in-person with the State of Tennessee COVID-19 Hotline call centers and conducted topic discussions and assignments virtually with a remote preceptor.

RESULTS

A total of 16 students completed this rotation experience. Student ratings of the experience were positive, and their knowledge improved in all topic areas. Students collectively completed approximately 700 hours manning the COVID-19 hotline and logged over 1,000 phone calls.

CONCLUSIONS

In a time of unprecedented disruption to experiential learning, the development of this unique public health APPE directly benefited the college, the students, and the citizens of our state. The APPE described in this paper could be replicated in additional waves of the pandemic or adapted for similar disaster response.

The pharmacist informatician: providing an innovative model of care during the COVID-19 crisis

OBJECTIVES

The global coronavirus pandemic has expedited digitisation in every industry, especially healthcare, and has highlighted the potential for informatics pharmacists to provide valuable input into crisis management. Informatics pharmacists can combine their clinical and information technology skills to help provide essential patient safety services related to medication management, procurement and analytics. The objective of this study was to determine the key opportunities for a pharmacist informatician to improve patient care and outcomes during the COVID-19 pandemic.

METHODS

Fourteen expert informatics professionals involved in the provision of digital health in Queensland, Australia, were invited to participate in a brief semistructured interview. Transcripts were manually coded, through iterative readings of the text to identify participant responses related to opportunities for a pharmacist informatician to assist during COVID-19. Inductive thematic analysis as described by Braun and Clarke, was used to identify groups of text related to the provision of digital health, informatics and change of practice during a pandemic. The relevant codes were then grouped into themes to help answer the research question.

KEY FINDINGS

Twelve experts agreed to participate, they included nine informatics pharmacists and three digital health experts from hospital and community. Two key themes and 13 codes related to enabling safer and more efficient workflow and use of data analytics to optimise care were identified. The first theme related to 'social distancing without compromising care' for example, by using the electronic capabilities of digital hospitals and telehealth services. The second theme related to the use of real-time data streaming to optimise patient flow and timely medication procurement and management. Examples of quotes from transcripts were used to provide context and answer the research question.

CONCLUSIONS

The experts interviewed identified areas where informatics pharmacists have the potential to assist with maintaining high quality patient care during this pandemic, and in future disasters. Improving awareness, training, and the integration about informatics roles as a result of this global pandemic will likely assist with future patient management in the event of future disasters.

Healthcare Workers' Knowledge, Attitude, and Practice Regarding Personal Protective Equipment for the Prevention of COVID-19

PURPOSE

Adequate knowledge, positive attitude, and proper practice of personal protective equipment by healthcare workers are necessary to get protection from COVID-19 infection. But this area is yet to be explored. Hence, we aimed to assess the knowledge, attitude, and practice (KAP) regarding personal protective equipment (PPE) among healthcare workers, along with a survey of the possible determinants.

SUBJECTS AND METHODS

For this cross-sectional study, online and offline surveys were conducted among a sample of 393 healthcare workers from five different districts of Bangladesh. A validated self-administered questionnaire comprising five sections (socio-demography, work-related information, knowledge, attitude, and practice) was used for data collection. Multivariate stepwise forward logistic regression was applied to find significant factors associated with good attitude, and practice using SPSS version 25.

RESULTS

The average age of the 393 participants was 28.9±5.2 years with a male-female ratio of one. Of them, 99.5% (n=391) had good knowledge, 88.8% (n=349) had positive attitude and 51.7% (n=203) had good practice regarding PPE. Results revealed that being a physician and living at home were significantly associated with a positive attitude. While being a non-physician, having lower education, working in private hospitals, and using office transport were associated with good practice regarding PPE.

CONCLUSION

The findings demonstrated that the healthcare workers had an overall good knowledge and a positive attitude but a poor practice regarding PPE. This study also highlighted the factors influencing KAP towards PPE that must be addressed in future education, awareness, and counseling programs.

Pharmacist's Role and Pharmaceutical Care During the COVID-19 Pandemic

Pharmacists play a vital role in public health during the COVID-19 pandemic. In this chapter, we present the most significant contributions that pharmacists could make to communitarian and hospital settings. It includes the provision of essential services, such as continuous access to medication and supplies, support to medical services, education and information to the population and the health team to reduce the misuse of medications, patient monitoring and follow-up, and the detection and referral of suspected cases of COVID-19. The chapter ends with a discussion over certain elements related to innovation needs, such as telepharmacy services.

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.

Multilevel Engagements of Pharmacists During the COVID-19 Pandemic: The Way Forward

Severe acute respiratory syndrome caused by the novel coronavirus (SARS-CoV-2) was first reported in China in December 2019 which was later declared to be a public health emergency of international concern by the World Health Organization (WHO). This virus proved to be very contagious resulting in life-threatening respiratory intricacies posing overall public health and governance challenges. Amid the coronavirus pandemic and the unprecedented increase in healthcare demands, only inventive and adaptive practice among healthcare professionals is the need of the hour. Pharmacy services are an important mainstay in the public health and have considerable potential to combat the coronavirus disease 2019 (COVID-19) pandemic. Pharmacists working in several localities and health facilities are linked to patients either directly or indirectly. They can act swiftly in public health response such as drafting professional service guidance to pharmacists working in various healthcare facilities, ensuring effective medicine supply system, monitoring and resolving drug shortage issues, establishing and promoting remote pharmacy services, counseling the public on infection prevention basics, educating about proper use of personal protective equipment, discouraging self-medication, participating in clinical trials, small-scale manufacturing of sanitizers and disinfectants, busting the prevailing myths, and conducting drug evaluation and active surveillance. These interventions will help ease unprecedented burden on healthcare facilities during the ongoing pandemic and eventually will add value to patients and the healthcare system. The current manuscript accentuates the potential roles and activities that pharmacists can initiate in various healthcare facilities to help in relieving pressure on the overwhelmed healthcare system. The information and suggestions offered in this review could help in the restructuring of existing pharmacy services by governments, public health bodies, and policy makers in response to the COVID-19 pandemic. Moreover, this manuscript will underscore any unrealized potential among pharmacists working in various sectors including community, hospital, industry, and drug regulatory authorities.

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.

Drive-thru pharmacy services: A way forward to combat COVID-19 pandemic

Countries around the globe have responded to pandemic preparedness and developed strategies to cope with the COVID-19 crisis. In this context, the role of healthcare professionals is of paramount importance. Pharmacists are playing a vital role in dealing, preparedness, prevention, protection, promoting access to medicines and to improve health outcomes during this crisis. In this context, “Drive-thru” pharmacy services improve access to medicines while ensuring the preventive measures suggested by the World Health Organization. This commentary provides an overview of opportunities and challenges related to the implementation of “drive-thru pharmacy services” and their role in improving public health during this crisis.

Caring for patients with diabetes during COVID-19 pandemic: Important considerations for pharmacists

The current pandemic of the COVID-19 infection, coupled with the increased global burden of diabetes, has imposed significant challenges to the healthcare providers in providing effective and sustained care to patients with diabetes during the ongoing pandemic. It is, therefore, important for healthcare providers to understand and follow the recommended changes in the delivery of care, lifestyle modifications, and pharmacotherapy to ensure optimal care to the patients during and post-pandemic era. This commentary aims to discuss the impact of COVID-19 on diabetes care and the important considerations for pharmacists during this pandemic.