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Uren A, Dawson S, Cotterill N, Williams A, McLeod H, Chandler D, Watson M. The role of community pharmacy in the promotion of continence care: A systematic review. Res Social Adm Pharm 2024; 20:689-696. [PMID: 38772839 DOI: 10.1016/j.sapharm.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 02/09/2024] [Accepted: 04/17/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVES Community pharmacies are convenient healthcare settings which provide a wide range of services in addition to medicine supply. Continence care is an area where there is an opportunity for the implementation of new innovations to improve clinical and service outcomes. The objective was to systematically evaluate evidence for the effectiveness, safety, acceptability and key determinants of interventions for the promotion and implementation of continence care in the community pharmacy setting. METHODS The protocol was registered in the International Prospective Register of Systematic Reviews database (PROSPERO: CRD42022322558). The databases Medline, Embase, PsycINFO and CINAHL were searched and supplemented by grey literature searches, according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist. In total, 338 titles and abstracts were screened, 20 studies underwent full-text screening and four studies met the inclusion criteria and underwent quality assessment. The results are reported narratively due to the heterogeneity of study designs. RESULTS There was some evidence for the effectiveness of interventions, resulting in increased provision of consumer self-help advice and materials, referrals to other care providers, and an increase in staff knowledge and confidence in continence care. Evidence was inconclusive for clinical outcomes due to small sample sizes and poor follow-up rates. Acceptability of interventions to both pharmacy staff and consumers was generally positive with some frustrations with reimbursement procedures and time constraints. Facilitators of a successful pharmacy-based continence service are likely to include staff training, high-quality self-care resources, increased public awareness, and the establishment of effective referral pathways and appropriate reimbursement (of service providers). CONCLUSIONS There is a paucity of evidence regarding the contribution of the community pharmacy sector to continence care. The development of a new pharmacy bladder and bowel service should involve patients, healthcare professionals and policy stakeholders to address the potential barriers and build upon the facilitators identified by this review. PATIENT SUMMARY We identified research that had explored how community pharmacy (chemist) personnel might support people with continence problems (e.g. bladder and bowel leakage). Only four studies were identified, however, they reported that training for pharmacy personnel and providing self-help advice about continence can be successful and was well-received by patients.
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Affiliation(s)
- Alan Uren
- School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Blackberry Hill, Bristol, UK; Bristol Urological Institute, Southmead Hospital, Bristol, UK.
| | - Shoba Dawson
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nikki Cotterill
- School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Blackberry Hill, Bristol, UK
| | | | - Hugh McLeod
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Margaret Watson
- Watson Research and Training Limited, Aberdeen, AB15 8FL, UK; Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 160 Cathedral Street, Glasgow, G4 0RE, UK
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Babar ZUD. Building an effective medicines optimisation model: a health system approach. Int J Clin Pharm 2024:10.1007/s11096-024-01765-3. [PMID: 38896393 DOI: 10.1007/s11096-024-01765-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024]
Abstract
This commentary narrates on the building of an effective and innovative medicines optimisation model. It discusses the essential features, emphasizes the need, and considers the strong health and pharmacy system as a prerequisite before such a model could be built. The paper argues that it is important to strengthen the health system before the elements of pharmaceutical care and medicine optimisation can take shape. It discusses the discourse and interplay between medicine use and medicine access research. The other important elements to include are the "selection of medicines by health technology assessment", "economic evaluation of pharmacy services", "pharmacists' remuneration by the government", "Health system strengthening status", "quality use of generic medicines programmes", "rationale prescribing", "access to medicines and medicines pricing", "medicines advertising" and the "state of pharmacy practice and the development of the pharmacist's role". A set of different high-, middle- and low-income countries are used to provide examples of the status of the health system and the subsequent development of pharmacy practice and medicines optimisation. The countries include the UK, Australia, New Zealand, Pakistan, Türkiye, Malaysia, India, and Pakistan.
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Thomas D, Abdalla A, Hussein S, Joury J, Elshamy A, Khalifa S, Saleh Z. Pharmacists' readiness and willingness to vaccinate the public in United Arab Emirates community pharmacies: A cross-sectional study. F1000Res 2024; 12:292. [PMID: 38774308 PMCID: PMC11106594 DOI: 10.12688/f1000research.131153.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 05/24/2024] Open
Abstract
Background Pharmacist-administered vaccination is currently implemented in many countries worldwide. It has contributed to increased vaccine access and vaccine uptake. This observational cross-sectional study assessed community pharmacists' willingness, and readiness to administer vaccines to the public in the United Arab Emirates (UAE) and relate it to national and international policies on vaccination. Methods This research was an online survey of 24-questions that was made available to community pharmacists via social media and WhatsApp. The survey was open for six weeks (from April to June 2022). Descriptive and inferential analysis was performed. Results The questionnaire was completed by 374 of 575 (65%) respondents. More than half (64.2%) of the respondents agreed or strongly agreed that pharmacists should be able to vaccinate and 68.4% responded that they were willing to administer vaccines if local regulations allowed them to vaccinate. Most (81.8%) expressed willingness to complete training required to be able to administer vaccines in their pharmacies. Logistic regression showed that pharmacists defined as having high readiness were significantly more willing to undergo all essential training to start a vaccination service in their pharmacies than were pharmacists with poor readiness (OR 2.647; 95% CI: 1.518-4.615; p=0.001). High readiness was also significantly associated with agreement on safety of pharmacy-based vaccination (p=0.027). Conclusions The majority of community pharmacists surveyed showed readiness to commence pharmacy-based vaccination services. Those with high readiness characteristics are amenable to receiving essential training and consider that vaccination in the community pharmacy setting would be safe.
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Affiliation(s)
- Dixon Thomas
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | | | - Saeed Hussein
- Global Medical Solutions, Abu Dhabi, United Arab Emirates
| | - Jean Joury
- Pfizer Gulf FZ LLC, Dubai, United Arab Emirates
| | - Amin Elshamy
- Ministry of Health and Prevention (MOHAP), Dubai, United Arab Emirates
| | - Sherief Khalifa
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Ziad Saleh
- Al Ain Pharmacy Group, Al Ain, Abu Dhabi, United Arab Emirates
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Angibaud M, Jourdain M, Girard S, Rouxel L, Mouhib A, Nogueira A, Rat C, Huon JF. Involving community pharmacists in interprofessional collaboration in primary care: a systematic review. BMC PRIMARY CARE 2024; 25:103. [PMID: 38561676 PMCID: PMC10983710 DOI: 10.1186/s12875-024-02326-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 02/28/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND The World Health Organization supports interprofessional collaboration in primary care. On over the past 20 years, community pharmacists had been taking a growing number of new responsibilities and they are recognized as a core member of collaborative care teams as patient-centered care providers. This systematic review aimed to describe interprofessional collaboration in primary care involving a pharmacist, and its effect on patient related outcomes. METHODS A systematic review of randomized controlled trials cited in the MEDLINE, EMBASE, PsycInfo and CINAHL in English and French was conducted from inception to November 2022. Studies were included if they described an intervention piloted by a primary care provider and included a pharmacist and if they evaluated the effects of intervention on a disease or on patient related outcomes. The search generated 3494 articles. After duplicates were removed and titles and abstracts screened for inclusion, 344 articles remained. RESULTS Overall, 19 studies were included in the review and assessed for quality. We found 14 studies describing an exclusive collaboration between physician and pharmacist with for all studies a three-step model of pharmacist intervention: a medication review, an interview with the patient, and recommendations made to physician. Major topics in the articles eligible for inclusion included cardiovascular diseases with blood pressure, diabetes, dyslipidemia, and risk of cardiovascular diseases. Positive effects concerned principally blood pressure. CONCLUSIONS Collaboration involving pharmacists is mainly described in relation to cardiovascular diseases, for which patient-centered indicators are most often positive. It underscores the need for further controlled studies on pharmacist-involved interprofessional collaboration across various medical conditions to improve consensus on core outcomes measures.
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Affiliation(s)
- Morgane Angibaud
- Primary Care Federative Department, Faculty of Medicine, Nantes Université, Nantes, France.
- National Institute for Health and Medical Research, INSERM U1302 Team 2, INCIT, Team 2, Nantes, France.
| | - Maud Jourdain
- Department of General Practice, Faculty of Medicine, Nantes Université, Nantes, France
| | - Solene Girard
- Department of General Practice, Faculty of Medicine, Nantes Université, Nantes, France
| | - Louise Rouxel
- Department of General Practice, Faculty of Medicine, Nantes Université, Nantes, France
| | - Adam Mouhib
- Clinical Pharmacy Unit, Faculty of Pharmacy, Nantes Université, Nantes, France
| | - Antoine Nogueira
- Department of General Practice, Faculty of Medicine, Nantes Université, Nantes, France
| | - Cédric Rat
- National Institute for Health and Medical Research, INSERM U1302 Team 2, INCIT, Team 2, Nantes, France
- Department of General Practice, Faculty of Medicine, Nantes Université, Nantes, France
| | - Jean-François Huon
- Nantes Université, CHU Nantes, Pharmacie, F-44000, France
- UMR INSERM 1246 SPHERE "methodS in Patient-centered Outcomes and HEalth ResEarch, Nantes Université, Université de Tours, Tours, France
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Sarasmita MA, Sudarma IW, Jaya MKA, Irham LM, Susanty S. Telepharmacy Implementation to Support Pharmaceutical Care Services during the COVID-19 Pandemic: A Scoping Review. Can J Hosp Pharm 2024; 77:e3430. [PMID: 38204502 PMCID: PMC10754407 DOI: 10.4212/cjhp.3430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 05/02/2023] [Indexed: 01/12/2024]
Abstract
Background Telepharmacy was effectively applied for remote pharmaceutical care during the COVID-19 pandemic. Objectives To determine the implementation of telepharmacy services to support pharmacists in providing pharmaceutical care during the pandemic. Data Sources Seven electronic databases were searched from inception to June 2021: PubMed, Ovid MEDLINE, Excerpta Medica database (Embase), Web of Science, Proquest, Scopus, and the Cochrane Database of Systematic Reviews. Study Selection and Data Extraction The review followed PRISMA guidelines and was registered with the PROSPERO registry of systematic reviews. Reports of original research investigating the implementation of telepharmacy during the COVID-19 pandemic were retrieved. Researchers screened the title and abstract of each article, and then evaluated the full text of eligible articles to identify studies that met the inclusion criteria. Pharmacists' responsibilities and actions were classified in relation to the International Pharmaceutical Federation guideline for managing the COVID-19 pandemic. Extracted data included study characteristics, pharmacists' interventions delivered through a telepharmacy system, and the benefits of telepharmacy implementation. Data Synthesis The database search yielded 1400 articles. After removal of duplicates and articles not meeting the specific inclusion criteria (n = 1381), a total of 19 relevant original research articles were reviewed. According to these studies, telepharmacy was used to perform remote medication review and optimization, assess medication adherence, dispense and deliver medications, educate and counsel patients, promote disease prevention, collaborate with health care providers, and monitor treatment outcomes. Conclusions This study highlighted the use of telepharmacy services to support pharmacists' activities during the COVID-19 pandemic. Randomized clinical trials are needed to investigate the long-term efficacy and cost-effectiveness of telepharmacy services.
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Affiliation(s)
- Made Ary Sarasmita
- , MClinPharm, is with the Pharmacy Study Program, Faculty of Mathematics and Science, Udayana University, Badung City, Bali Province, Indonesia, and the Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - I Wayan Sudarma
- , MD, is with the Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Sanglah General Hospital, Bali, Indonesia
| | - Made Krisna Adi Jaya
- , MClinPharm, is with the Pharmacy Study Program, Faculty of Mathematics and Science, Udayana University, Badung City, Bali Province, Indonesia
| | - Lalu Muhammad Irham
- , PhD, is with the Faculty of Pharmacy, University of Ahmad Dahlan, Yogyakarta, Indonesia, and the Research Center for Computing, Research Organization for Electronics and Informatics, National Research and Innovation Agency (BRIN), Republic of Indonesia, Cibinong Science Center, Cibinong, Indonesia
| | - Sri Susanty
- is with the Nursing Study Program, Faculty of Medicine, Halu Oleo University, Kendari, Southeast Sulawesi, Indonesia
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Messner K, Eickhoff C, Schulz M, Allemann SS, Arnet I. Knowledge and attitudes of German and Swiss community pharmacists towards biologicals and biosimilars - a prospective survey before and after the COVID-19 pandemic. BMC Health Serv Res 2023; 23:1432. [PMID: 38110932 PMCID: PMC10726545 DOI: 10.1186/s12913-023-10475-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 12/12/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Knowledge, attitudes and substitution laws of biosimilars are not consistent across countries. Biosimilar acceptance among patients and healthcare professionals may be suffering from gaps in knowledge and understanding about biosimilars and their regulatory approval process. Pharmacists' roles and responsibilities changed considerably during the COVID-19 pandemic. Thus, they might have gained new skills and self-confidence in counseling and substitution of biosimilars. AIMS To examine and compare the knowledge, perceptions and information needs of German and Swiss pharmacists regarding original biologicals and biosimilars in 2020 and 2022. METHODS We conducted an online survey among Swiss and German community pharmacies in February 2020 (before) and August 2022 (after the COVID-19 pandemic). Descriptive statistics were calculated and the Chi-Square test was used for comparisons among categorical variables. RESULTS A total of 764 pharmacists took part in the survey (390 in 2020 and 374 in 2022) with comparable demographics. The frequency of dispensing biologicals remained similar between German and Swiss pharmacists in 2020 and 2022, but the Swiss dispensation of biosimilars increased significantly in 2022 compared to 2020. Concerning the understanding of the term biosimilars, knowledge remained moderate in both countries in both years. Participants were equally familiar with the term and most felt sufficiently informed. In both countries, substitution with a biosimilar showed the least confidence of all attitudes. A third of the participants indicated correct substitution rules in their country. In both years, around 85% of the participants were highly interested in additional training on this topic. DISCUSSION/CONCLUSION The results indicate that similarities and differences between Germany and Switzerland regarding knowledge and attitudes towards biologicals and biosimilars remained unchanged before and after the COVID-19 pandemic. An influence of the pandemic is unlikely. There is still a clear lack of knowledge among community pharmacists on biosimilars, especially regarding the substitution rules. Due to a rising market with many benefits but also big challenges to overcome, the topic of biosimilars should receive more attention in the future. This requires additional training for pharmacists.
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Affiliation(s)
- Kirstin Messner
- Pharmaceutical Care Research Group, University of Basel, Basel, Switzerland.
| | - Christiane Eickhoff
- Department of Medicine, ABDA - Federal Union of German Associations of Pharmacists, Berlin, Germany
| | - Martin Schulz
- Department of Medicine, ABDA - Federal Union of German Associations of Pharmacists, Berlin, Germany
- Institute of Pharmacy, Freie Universität Berlin, Berlin, Germany
| | - Samuel S Allemann
- Pharmaceutical Care Research Group, University of Basel, Basel, Switzerland
| | - Isabelle Arnet
- Pharmaceutical Care Research Group, University of Basel, Basel, Switzerland
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Zhang S, Kwach B, Omollo V, Asewe M, Malen RC, Shah PD, Odoyo J, Mugo N, Ngure K, Bukusi EA, Ortblad KF. The Acceptability of Pharmacy-Based HPV Vaccination in Western Kenya among Pharmacy Clients and Providers. Vaccines (Basel) 2023; 11:1808. [PMID: 38140211 PMCID: PMC10747628 DOI: 10.3390/vaccines11121808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/21/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
Vaccine coverage for the human papillomavirus (HPV) remains low globally, and differentiated models of vaccine delivery are needed to expand access. Pharmacy-based models of the HPV vaccination may engage women who could benefit. We assessed the acceptability of such a model among pharmacy clients and providers at 20 private pharmacies in Kisumu County, Kenya. In questionnaires, participants (≥18 years) were asked the extent they agreed (5-point scale) with statements that assessed different acceptability component constructs outlined in the Theoretical Framework of Acceptability (TFA). From March to June 2022, 1500 pharmacy clients and 40 providers were enrolled and completed questionnaires. Most clients liked the intervention (TFA: affective attitude; 96%, 1435/1500) and did not think it would be hard to obtain (TFA: burden; 93%, 1399/1500). All providers agreed the intervention could reduce HPV infection (TFA: perceived effectiveness) and felt confident they could deliver it (TFA: self-efficacy). Among the clients who had received or were planning to receive the HPV vaccine in the future, half (50%, 178/358) preferred a pharmacy-based HPV vaccination. In this study, most Kenyan pharmacy clients and providers perceived a pharmacy-delivered HPV vaccination as highly acceptable; however, more research is needed to test the feasibility and effectiveness of this novel vaccine delivery model in Africa.
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Affiliation(s)
- Shengruo Zhang
- Department of Epidemiology, University of Washington, Seattle, WA 98195, USA
| | - Benn Kwach
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi 00200, Kenya; (B.K.); (V.O.); (M.A.); (J.O.)
| | - Victor Omollo
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi 00200, Kenya; (B.K.); (V.O.); (M.A.); (J.O.)
| | - Magdaline Asewe
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi 00200, Kenya; (B.K.); (V.O.); (M.A.); (J.O.)
| | - Rachel C. Malen
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA; (R.C.M.); (P.D.S.); (K.F.O.)
| | - Parth D. Shah
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA; (R.C.M.); (P.D.S.); (K.F.O.)
| | - Josephine Odoyo
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi 00200, Kenya; (B.K.); (V.O.); (M.A.); (J.O.)
| | - Nelly Mugo
- Center for Clinical Research, Kenya Medical Research Institute, Nairobi 00200, Kenya;
- Department of Global Health, University of Washington, Seattle, WA 98195, USA
| | - Kenneth Ngure
- School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi 00200, Kenya;
| | - Elizabeth A. Bukusi
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi 00200, Kenya; (B.K.); (V.O.); (M.A.); (J.O.)
- Department of Global Health, University of Washington, Seattle, WA 98195, USA
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA 98195, USA
| | - Katrina F. Ortblad
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA; (R.C.M.); (P.D.S.); (K.F.O.)
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Ljungberg Persson C, Nordén Hägg A, Södergård B. A survey of pharmacists' perception of the work environment and patient safety in community pharmacies during the COVID-19 pandemic. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100327. [PMID: 37780549 PMCID: PMC10534261 DOI: 10.1016/j.rcsop.2023.100327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/19/2023] [Accepted: 09/01/2023] [Indexed: 10/03/2023] Open
Abstract
Background Community pharmacies have changed during the COVID-19 pandemic, and new routines have been introduced to address the needs of customers and staff and to reduce the risk of spreading infection. Burnout has been described among staff possibly due to a changed working climate. However, little research has focused on the pandemic's effect on patient safety in community pharmacies. Objective To examine pharmacists' perceptions of the impact of the COVID-19 pandemic on workload, working environment, and patient safety in community pharmacies. Methods A survey was distributed to all Swedish community pharmacists, constituting a census study. Questions regarding the pharmacists' perception of the impact of the pandemic on workload, working environment, and patient safety were included. Respondents were asked to provide comments on their working situation. Quantitative results were analysed using descriptive statistics, and comments were analysed using qualitative content analysis. Results The response rate was 41% (2034 responses). Most pharmacists (62%) considered the workload to be increased during the pandemic while work environment deteriorated (physical work environment was considered worse by 47% of respondents while psychosocial work environment was considered worse by 59%). Despite this, many respondents (55%) believed that patient safety was not affected. Neither having had COVID-19 nor being afraid of contracting it, influenced these perceptions in any substantial way. Findings were consistent regardless of education, professional role, number of years in community pharmacies, or special assignments in the pharmacies. According to the respondents, the communication within pharmacy companies during the pandemic was inadequate. Conclusions The impact of the pandemic on working conditions is in line with previous findings but the effect on patient safety needs further studies. The respondents felt the management had a limited understanding of the conditions during the pandemic, which stresses the importance of good and clear communication during a crisis.
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Affiliation(s)
- C. Ljungberg Persson
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | | | - B. Södergård
- Pharmaceutical Sciences Laboratory, Faculty of Science and Engineering, Åbo Akademi University, Finland
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Warr H, Gandhi A, Hussain S, Greenwood D. Community pharmacy services during the COVID-19 pandemic: Insights from providers and policy makers. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100344. [PMID: 37860224 PMCID: PMC10582732 DOI: 10.1016/j.rcsop.2023.100344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/01/2023] [Accepted: 10/03/2023] [Indexed: 10/21/2023] Open
Abstract
Background Readily accessible to the public, community pharmacies (CPs) were placed under increased pressure during the COVID-19 pandemic. In England, dispensing volume increased by 25% between February and March 2020. This followed a decade of stagnant government funding, which has been attributed to CP closures. If another pandemic emerged, the reduced number of CPs may face increased pressures. Objective To explore CP service provision in England throughout the COVID-19 pandemic from the perspectives of providers and policy makers, including what can be learned in preparation for any future pandemic. Methods CP providers (n = 10) and policy makers (n = 6) were interviewed via telephone between June and September 2021. Interviews were transcribed and then analysed thematically using NVivo. Results Pandemic specific pressures were identified, as well as long-term issues which preceded the pandemic. Increased workload was recognised by both providers and policy makers due to changes in prescribing habits and was exacerbated by staff shortages. CP staff safety was a major concern, with limited personal protective equipment provided despite being open to the public. General Practitioner (GP) surgeries received more protective equipment than CP and still referred patients to pharmacy e.g., for a blood pressure check. Conclusions The pandemic re-confirmed CPs role of providing accessible healthcare, particularly medicines provision, but also highlighted the demand for in-person clinical services. Improved communication channels between CP and GP surgeries are required, as is pandemic prescribing guidance to ensure appropriate prescribing to safeguard the medicines supply chain. To ensure the health of all providers is fairly protected, activities which require in-person contact or can be undertaken remotely by CP, GP surgeries and other providers should be reviewed. For pandemic preparation, legislative changes are required which empower pharmacy to fully contribute to patient care. A review of pharmacy funding and staffing is also needed to ensure services are sustainable.
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Affiliation(s)
- Harriet Warr
- School of Medicine, Anglia Ruskin University, Chelmsford, CM1 1SQ, United Kingdom
| | - Ankesh Gandhi
- School of Medicine, Anglia Ruskin University, Chelmsford, CM1 1SQ, United Kingdom
| | - Syed Hussain
- School of Medicine, Anglia Ruskin University, Chelmsford, CM1 1SQ, United Kingdom
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Al Hail M, Abdulrouf P, Stewart D, Elkassem W, Singh R, Al Enany R, Mohammed Azad A, Tarannum A, Thomas B. Behaviour and associated determinants of COVID-19 vaccine acceptance and advocacy: a nationwide survey of pharmacy professionals in Qatar. J Pharm Policy Pract 2023; 16:160. [PMID: 38017533 PMCID: PMC10683145 DOI: 10.1186/s40545-023-00668-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/16/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Vaccine hesitancy poses a global challenge and is acknowledged to be a complex, multifactorial phenomenon. Of particular concern is hesitancy among health professionals, as this may also impact their advocacy roles. There is a lack of theory-based investigations of pharmacy professionals. AIM The study aims to determine the behaviour and associated determinants influencing pharmacy professionals' attitude towards vaccine acceptance and advocacy. METHODS A cross-sectional survey of 2400 pharmacists and pharmacy technicians at government, semi-government, and private community pharmacies in Qatar. Questionnaire items captured perspectives on COVID vaccine acceptance, advocacy and associated determinants based on the domains and constructs of the Theoretical Domains Framework (TDF). Data were analysed by descriptive and inferential statistics, with TDF items subjected to principal components analysis (PCA). FINDINGS The response rate was 38.6% (927/2400). Almost all (n = 825, 89.0%) were willing to receive the vaccine, which was higher for males (p < 0.001) and those in polyclinics (p < 0.05). PCA of acceptance items gave five components, with response to 'emotions' being most negative, associated with acceptance (p < 0.001) and more negative in females (p < 0.001). The majority (n = 799, 86.2%) agreed that it was their professional duty to advocate vaccines. PCA for advocacy items gave two components, with the most negative responses for 'professional role and identity', which were more negative for those working in hospitals (p < 0.05). CONCLUSION Respondents were least positive regarding emotion-related behavioral determinants for acceptance and professional role and identity for advocacy. Behavior change technique interventions that target these issues have the potential to influence the vaccine hesitancy of pharmacy professionals and other individuals.
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Affiliation(s)
- Moza Al Hail
- Pharmacy Executive Directors Office, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Wessam Elkassem
- Pharmacy Executive Directors Office, Hamad Medical Corporation, Doha, Qatar
| | - Rajvir Singh
- Pharmacy Executive Directors Office, Hamad Medical Corporation, Doha, Qatar
- Cardiology Research, Adult Cardiology Dept, Heart Hospital, Doha, Qatar
| | | | - Aftab Mohammed Azad
- Corporate Department of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Asma Tarannum
- St John of God, Midland Public and Private Hospitals, Perth, Australia
| | - Binny Thomas
- Pharmacy Executive Directors Office, Hamad Medical Corporation, Doha, Qatar.
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Piraux A, Angibaud M, Nizet P, Navas D, Sallenave-Namont C, Prot-Labarthe S, Huon JF. Factors influencing French community pharmacists' willingness to participate in research projects: a mixed method study. BMC PRIMARY CARE 2023; 24:229. [PMID: 37919662 PMCID: PMC10623853 DOI: 10.1186/s12875-023-02163-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/27/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND French community pharmacists are facing an increasing demand to provide a wider range of services to meet the needs of the population. These new missions must be evaluated by primary care research studies. This study aims to explore the factors that influence French community pharmacists' willingness to participate in research projects. METHODS A mixed-method design was adopted for this study, comprising an initial quantitative online survey followed by semi-directed interviews. The investigation was conducted at two French faculties of pharmacy, Angers and Nantes, involving students in their 6th and final year of pharmacy education, and their community pharmacist tutors. The survey items were based on a study by Saini et al. and participants responded using five-point Likert scales. The semi-directed interviews were conducted after the quantitative analysis, only with volunteer and already graduated community pharmacists. RESULTS A total of 131 people participated in the quantitative analysis, comprising 75 students and 56 pharmacists. Pharmacists and students agreed on the significance of two key aspects: the research must possess a clear and meaningful purpose, and researchers must keep the pharmacists informed about the study's results. Among the 27 proposed items, only three showed significantly different results between students and pharmacists. Moreover, 11 semi-structured interviews were conducted. Research in the community pharmacy domain is relatively new for many pharmacists. Despite limited training, their willingness to participate is contingent on being actively involved from the outset, receiving appropriate support and training. However, the research should be seamlessly integrated into their daily practice, without being too time-consuming and administratively burdensome. Time constraints emerged as the main obstacle, along with concerns about the availability of human resources. Pharmacists expressed strong motivation driven by the research topic's relevance, and its potential impact on patients or the profession. While financial compensation is desirable, it did not appear to be the main criterion for participation in a study. CONCLUSIONS French pharmacists are willing to participate in research projects to improve patient care and develop the profession. Research teams must guide and involve from the project's inception.
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Affiliation(s)
- Arthur Piraux
- Department of Pharmacy, Univ Angers, CHU Angers, Angers, F-49000, France.
| | - Morgane Angibaud
- Primary Care Federative Department, Faculty of Medicine, University of Nantes, Nantes, F-44000, France
| | - Pierre Nizet
- UMR INSERM 1246 SPHERE "methodS in Patient-centered Outcomes and HEalth ResEarch, Nantes Université, Université de Tours, Nantes, France
- Nantes Université, CHU Nantes, Pharmacie, Nantes, F-44000, France
| | - Dominique Navas
- Nantes Université, CHU Nantes, Pharmacie, Nantes, F-44000, France
| | - Claire Sallenave-Namont
- UR2160 ISOMer - UFR de Sciences Pharmaceutiques et biologiques, Université de Nantes, Nantes, F- 44035, France
| | - Sonia Prot-Labarthe
- Nantes Université, CHU Nantes, Université Paris Cité, Inserm, ECEVE, F- 75010, Pharmacie, Paris, France
| | - Jean-François Huon
- UMR INSERM 1246 SPHERE "methodS in Patient-centered Outcomes and HEalth ResEarch, Nantes Université, Université de Tours, Nantes, France
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Costa S, Guerreiro J, Teixeira I, Helling DK, Mateus C, Pereira J. Patient preferences and cost-benefit of hypertension and hyperlipidemia collaborative management model between pharmacies and primary care in Portugal: A discrete choice experiment alongside a trial (USFarmácia®). PLoS One 2023; 18:e0292308. [PMID: 37796918 PMCID: PMC10553278 DOI: 10.1371/journal.pone.0292308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 09/18/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Little is known about patient preferences and the value of pharmacy-collaborative disease management with primary care using technology-driven interprofessional communication under real-world conditions. Discrete Choice Experiments (DCEs) are useful for quantifying preferences for non-market services. OBJECTIVES 1) To explore variation in patient preferences and estimate willingness-to-accept annual cost to the National Health Service (NHS) for attributes of a collaborative intervention trial between pharmacies and primary care using a trial exit DCE interview; 2) to incorporate a DCE into an economic evaluation using cost-benefit analysis (CBA). METHODS We performed a DCE telephone interview with a sample of hypertension and hyperlipidemia trial patients 12 months after trial onset. We used five attributes (levels): waiting time to get urgent/not urgent medical appointment (7 days/45 days; 48 hrs./30 days; same day/15 days), model of pharmacy intervention (5-min. counter basic check; 15-min. office every 3 months for BP and medication review of selected medicines; 30-min. office every 6 months for comprehensive measurements and medication review of all medicines), integration with primary care (weak; partial; full), chance of having a stroke in 5 years (same; slightly lower; much lower), and annual cost to the NHS (0€; 30€; 51€; 76€). We used an experimental orthogonal fractional factorial design. Data were analyzed using conditional logit. We subtracted the estimated annual incremental trial costs from the mean WTA (Net Benefit) for CBA. RESULTS A total of 122 patients completed the survey. Waiting time to get medical appointment-on the same day (urgent) and within 15 days (non-urgent)-was the most important attribute, followed by 30-minute pharmacy intervention in private office every 6 months for point-of-care measurements and medication review of all medicines, and full integration with primary care. The cost attribute was not significant. Intervention patients were willing to accept the NHS annual cost of €877 for their preferred scenario. The annual net benefit per patient is €788.20 and represents the monetary value of patients' welfare surplus for this model. CONCLUSIONS This study is the first conducted in Portugal alongside a pharmacy collaborative trial, incorporating DCE into CBA. The findings can be used to guide the design of pharmacy collaborative interventions with primary care with the potential for reimbursement for uncontrolled or at-risk chronic disease patients informed by patient preferences. Future DCE studies conducted in community pharmacy may provide additional contributions. TRIAL REGISTRATION Current Controlled Trials (ISRCTN): ISRCTN13410498, retrospectively registered on 12 December 2018.
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Affiliation(s)
- Suzete Costa
- NOVA National School of Public Health (ENSP), Universidade NOVA de Lisboa, Lisboa, Portugal
- Institute for Evidence-Based Health (ISBE), Lisboa, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - José Guerreiro
- Centre for Health Evaluation & Research (CEFAR), Infosaúde, Associação Nacional das Farmácias, Lisboa, Portugal
| | - Inês Teixeira
- Centre for Health Evaluation & Research (CEFAR), Infosaúde, Associação Nacional das Farmácias, Lisboa, Portugal
| | - Dennis K. Helling
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Denver, Colorado, United States of America
| | - Céu Mateus
- Health Economics at Lancaster, Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - João Pereira
- NOVA National School of Public Health (ENSP), Universidade NOVA de Lisboa, Lisboa, Portugal
- Public Health Research Centre (PHRC/CISP), Comprehensive Health Research Centre (CHRC), Lisboa, Portugal
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Advinha AM, Santos MC, Duarte-Ramos F, Perdigão M, Santos P, Oliveira-Martins S. Experience and Learning from the COVID-19 Pandemic in Portugal: Perceptions of Community Pharmacy Professionals. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2023; 41:122-131. [PMID: 38021255 PMCID: PMC10664277 DOI: 10.1159/000531446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 05/29/2023] [Indexed: 12/01/2023] Open
Abstract
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.
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Affiliation(s)
- Ana Margarida Advinha
- CHRC – Comprehensive Health Research Centre, University of Évora, Evora, Portugal
- Department of Health and Medical Sciences, School of Health and Human Development, University of Évora, Evora, Portugal
- Pharmacovigilance Regional Unit of Central and North Alentejo, University of Évora, Evora, Portugal
| | - Margarida C. Santos
- Lisbon School of Health Technology, Polytechnic Institute of Lisbon, Lisboa, Portugal
- Research Center for Psychological Science, University of Lisbon, Alameda da Universidade, Lisboa, Portugal
| | - Filipa Duarte-Ramos
- Research Institute for Medicines (iMed.ULisboa), Lisboa, Portugal
- Faculty of Pharmacy, Universidade de Lisboa, Lisboa, Portugal
- EPIUnit – Public Health Institute, University of Porto, Porto, Portugal
| | - Margarida Perdigão
- Pharmacovigilance Regional Unit of Central and North Alentejo, University of Évora, Evora, Portugal
| | | | - Sofia Oliveira-Martins
- CHRC – Comprehensive Health Research Centre, University of Évora, Evora, Portugal
- Faculty of Pharmacy, Universidade de Lisboa, Lisboa, Portugal
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Hoste ME, Colman E, Wanat M, Hayward G, Tissier JL, Postma M, Goossens H, Anthierens S, Tonkin-Crine S. Stakeholders' views and experiences on implementing new diagnostics in primary care to support management of community-acquired acute respiratory tract infections: a qualitative study. Front Public Health 2023; 11:1216940. [PMID: 37583883 PMCID: PMC10425264 DOI: 10.3389/fpubh.2023.1216940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/06/2023] [Indexed: 08/17/2023] Open
Abstract
Background The majority of antibiotics are prescribed in primary care for respiratory tract infections. Point-of-care tests (POCTs) for the management of community-acquired acute respiratory tract infections (CA-ARTI) have been developed to help optimize antibiotic prescribing. While some countries in Europe have adopted these tests in primary care settings, most have not. Stakeholders, such as policy-makers, regulators, the diagnostic industry, and scientific associations, have roles in the implementation of new diagnostics in primary care. The aim of this study is to explore these stakeholders' views and experiences, and identify areas of unmet need relating to POCT implementation. Methods Stakeholders were recruited using purposive sampling and snowballing. Between March 2021 and May 2022, semi-structured interviews were conducted online with stakeholders in Belgium, the UK and from European Union (EU) -level organizations. Interviews were audio recorded and transcribed verbatim. Transcripts were analysed inductively and deductively using thematic analysis. Results Twenty-six stakeholders participated: eleven from EU-level organizations, seven from Belgium, and eight from the UK. Five themes were identified. Stakeholders felt a balance of top-down and bottom-up approaches were an optimal strategy to the implementation of POCTs. Stakeholders stressed the need to engage with clinicians to act as champions for tests to help raise awareness and generate new evidence on how tests are used. While acknowledging the potential of POCTs for improving patient outcomes and impacting antibiotic prescribing behavior, some raised concerns on how tests would be used in practice and wished to see national data on effectiveness. COVID-19 catalyzed the use of tests, but stakeholders were pessimistic that processes for approving diagnostics during the pandemic would be replicated in the future. Conclusion Stakeholders provided recommendations for research and practice. Robust reimbursement policies could alleviate financial burden from clinicians and patients, encouraging practices to adopt POCTs. Industry is likely to benefit from engaging as early on as possible with other stakeholders. Due to uncertainty among stakeholders on the impact of POCTs on antibiotic prescribing, further evidence is needed to understand how practices adopt POCTs and the implications for stewardship. Monitoring how POCTs are used can inform future guidelines on successful diagnostic implementation.
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Affiliation(s)
- Melanie Eugenie Hoste
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Elien Colman
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Marta Wanat
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Gail Hayward
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Maarten Postma
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Herman Goossens
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Sibyl Anthierens
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Sarah Tonkin-Crine
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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15
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Smith A, Kardos P, Pfaar O, Randerath W, Estrada Riolobos G, Braido F, Sadofsky L. The treatment of mild upper respiratory tract infections - a position paper with recommendations for best practice. Drugs Context 2023; 12:2023-4-2. [PMID: 37521107 PMCID: PMC10379023 DOI: 10.7573/dic.2023-4-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/31/2023] [Indexed: 08/01/2023] Open
Abstract
Following the waning severity of COVID-19 due to vaccination and the development of immunity, the current variants of SARS-CoV-2 often lead to mild upper respiratory tract infections (MURTIs), suggesting it is an appropriate time to review the pathogenesis and treatment of such illnesses. The present article reviews the diverse causes of MURTIs and the mechanisms leading to symptomatic illness. Different symptoms of MURTIs develop in a staggered manner and require targeted symptomatic treatment. A wide variety of remedies for home treatment is available, including over-the-counter drugs and plant-derived substances. Recent pharmacological research has increased the understanding of molecular effects, and clinical studies have shown the efficacy of certain herbal remedies. However, the use of subjective endpoints in these clinical studies may suggest limited validity of the results. In this position paper, the importance of patient-centric outcomes, including a subjective perception of improved well-being, is emphasized. A best practice approach for the management of MURTIs, in which pharmacists and physicians create an improved multi-professional healthcare setting and provide healthcare education to patients, is proposed. Pharmacists act as first-line consultants and provide patients with remedies, considering the individual patient's preferences towards chemical or plant-derived drugs and providing advice for self-monitoring. Physicians act as second-line consultants if symptoms worsen and subsequently initiate appropriate therapies. In conclusion, general awareness of MURTIs should be increased amongst medical professionals and patients, thus improving their management.
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Affiliation(s)
- Andrew Smith
- School of Psychology, Cardiff University, Cardiff, UK
| | - Peter Kardos
- Centre of Allergy, Respiratory and Sleep Medicine, Maingau Clinic of the Red Cross, Frankfurt am Main, Germany
| | - Oliver Pfaar
- Department of Otorhinolaryngology, University Hospital Marburg, Philipps University Marburg, Marburg, Germany
| | - Winfried Randerath
- Institute of Pneumology, University of Cologne, Cologne, Germany
- Bethanien Hospital, Clinic of Pneumology and Allergology, Centre for Sleep Medicine and Respiratory Care, Solingen, Germany
| | | | - Fulvio Braido
- Istituti di Ricovero e Cura a Carattere Scientifico, Ospedale Policlinico San Martino, Genova, Italy
- Università di Genova, (DIMI), Genova, Italy
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16
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Sharma R, Javid FA. The impact of COVID-19 on electronic repeat dispensing (eRD) in general practice. J Pharm Policy Pract 2023; 16:66. [PMID: 37198700 DOI: 10.1186/s40545-023-00566-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/28/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Electronic repeat dispensing (eRD) has been part of the community pharmacy contact since 2005 and a requirement in the General Medical Services contract since 2019. NHS England highlights benefits of eRD as increased efficiency in general practice of 2.7 million hours annually if 80% of all repeat prescriptions are issued as eRD. Despite clear benefits to patients, community pharmacies and general practices, the uptake of eRD remains low and variable across general practices in West Yorkshire, UK. OBJECTIVES To investigate the impact of COVID-19 on eRD in general practice and understand the key enablers to its uptake. METHODS A 19-item questionnaire was developed and piloted during cognitive interviews. A cross-sectional survey was conducted via emails to general practices in West Yorkshire, UK, between July 2020 and November 2020. RESULTS Sixty-seven complete responses were received (23 pharmacists, 21 practice managers, 11 general practitioners, seven pharmacy technicians, four advanced practitioners, one prescription clerk). 59% of respondents were aware of eRD uptake in their surgery (mean value 4.56% ± 0.229%). Higher uptake of eRD was demonstrated where the general practice integrated eRD into routine workflows during the repeat prescription reauthorisation process (P < 0.001) and where an eRD service lead is nominated (P = 0.04). CONCLUSION Utilising eRD in the respective practices should be considered due to potential efficiency gains and the increase in average eRD utilisation observed in the study participating general practices was from 7.2% average uptake in March 2020 to 10.4% November 2020, as the response to COVID-19. The stated benefits of eRD by NHS England of 2.7 million hours per annum predates the roll out of electronic transmission of prescriptions suggesting further research is needed to quantify the efficiency gains in present NHS general practice environments.
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Affiliation(s)
- Raman Sharma
- Parkside Medical Practice, Horton Park Health Centre, Bradford, BD7 3EG, UK.
| | - Farideh A Javid
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, HD1 3DH, UK
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Thomas D, Abdalla A, Hussein S, Joury J, Elshamy A, Khalifa S, Saleh Z. Pharmacists’ readiness and willingness to vaccinate the public in United Arab Emirates community pharmacies: A cross-sectional study. F1000Res 2023; 12:292. [DOI: 10.12688/f1000research.131153.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
Background: Pharmacist-administered vaccination is currently implemented in many countries worldwide. It has contributed to increased vaccine access and vaccine uptake. This observational cross-sectional study assessed community pharmacists’ willingness, and readiness to administer vaccines to the public in the United Arab Emirates (UAE) and relate it to national and international policies on vaccination. Methods: This research was an online survey of 24-questions that was made available to community pharmacists via social media and WhatsApp. The survey was open for six weeks (from April to June 2022). Descriptive and inferential analysis was performed. Results: The questionnaire was completed by 374 of 575 (65%) respondents. More than half (64.2%) of the respondents agreed or strongly agreed that pharmacists should be able to vaccinate and 68.4% responded that they were willing to administer vaccines if local regulations allowed them to vaccinate. Most (81.8%) expressed willingness to complete training required to be able to administer vaccines in their pharmacies. Logistic regression showed that pharmacists defined as having high readiness were significantly more willing to undergo all essential training to start a vaccination service in their pharmacies than were pharmacists with poor readiness (OR 2.647; 95% CI: 1.518–4.615; p=0.001). High readiness was also significantly associated with agreement on safety of pharmacy-based vaccination (p=0.027). Conclusions: The majority of community pharmacists surveyed showed readiness to commence pharmacy-based vaccination services. Those with high readiness characteristics are amenable to receiving essential training and consider that vaccination in the community pharmacy setting would be safe.
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Chang CT, Mohd Shariff SM, Abu Bakar NS, Ramzuzzaman NS, Lim CK, Lim EYJ, Ong PS, Lee JM, Tan AY, Kamis SF, Liew WM, Low YM, George D, Voo JYH, Tan HS, Rajan P, Lee SWH. Polypharmacy and potentially inappropriate medications among hospitalized older adults with COVID-19 in Malaysian tertiary hospitals. J Pharm Policy Pract 2023; 16:2. [PMID: 36635766 PMCID: PMC9836327 DOI: 10.1186/s40545-022-00504-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 12/11/2022] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Older adults are among the most vulnerable groups during the COVID-19 epidemic, contributing to a large proportion of COVID-19-related death. Medication review and reconciliation by pharmacist can help reduce the number of potentially inappropriate medications but these services were halted during COVID-19. AIM To assess the prevalence and factors associated with inappropriate medicine use among older populations with COVID-19. METHODS This was a cross-sectional, retrospective analysis of medications among hospitalized older adults with COVID-19. Potentially inappropriate medication use was categorized using the Beer's and STOPP criteria. RESULTS Combining both criteria, 181 (32.7%) of the 553 patients were identified to have used at least one or more potentially inappropriate medication. A marginally higher number of inappropriate medications was documented using the Beers 2019 criteria (151 PIM in 124 patients) compared to STOPP criteria (133 PIMS in 104 patients). The long-term use of proton pump inhibitors (n = 68; 12.3%) and drugs which increases the risk of postural hypotension were the most commonly reported PIM (n = 41; 7.4%). Potentially inappropriate medication use was associated with previous history of hospital admission in the past 12 months (Odds ratio [OR]: 2.27; 95% CI 1.29-3.99) and higher number of discharge medications. CONCLUSIONS Nearly, one in three older adults with COVID-19 had been prescribed a PIM, and the proportion of older adults with polypharmacy increased after discharge. This highlights the importance of having clinical pharmacist conducting medication reviews to identify PIMs and ensure medication appropriateness.
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Affiliation(s)
- Chee-Tao Chang
- Clinical Research Centre (CRC) HRPB Ipoh, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia ,grid.440425.30000 0004 1798 0746School of Pharmacy, Monash University Malaysia, Subang Jaya, Malaysia
| | | | - Nur Suriana Abu Bakar
- Pharmacy Department, Hospital Sungai Buloh, Ministry of Health Malaysia, Sungai Buloh, Malaysia
| | | | - Chun Kiat Lim
- Pharmacy Department, Hospital Sungai Buloh, Ministry of Health Malaysia, Sungai Buloh, Malaysia
| | - Eddy Yew Joe Lim
- Pharmacy Department, Hospital Sungai Buloh, Ministry of Health Malaysia, Sungai Buloh, Malaysia
| | - Peng Seng Ong
- grid.477137.10000 0004 0573 7693Pharmacy Department, Hospital Pulau Pinang, Ministry of Health Malaysia, George Town, Malaysia
| | - Jie Min Lee
- grid.477137.10000 0004 0573 7693Pharmacy Department, Hospital Pulau Pinang, Ministry of Health Malaysia, George Town, Malaysia
| | - Aie Yen Tan
- Pharmacy Department, Hospital Sultan Ismail, Ministry of Health Malaysia, Johor Bahru, Malaysia
| | - Siti Fatimah Kamis
- Pharmacy Department, Hospital Sultan Ismail, Ministry of Health Malaysia, Johor Bahru, Malaysia
| | - Wei Mun Liew
- Pharmacy Department, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia
| | - Yuet Man Low
- Pharmacy Department, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia
| | - Doris George
- Pharmacy Department, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia
| | - James Yau Hon Voo
- Pharmacy Department, Hospital Duchess of Kent, Ministry of Health Malaysia, Sandakan, Malaysia
| | - Hoo Seng Tan
- Pharmacy Department, Hospital Duchess of Kent, Ministry of Health Malaysia, Sandakan, Malaysia
| | - Philip Rajan
- Clinical Research Centre (CRC) HRPB Ipoh, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia ,grid.452879.50000 0004 0647 0003School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Malaysia
| | - Shaun Wen Huey Lee
- grid.440425.30000 0004 1798 0746School of Pharmacy, Monash University Malaysia, Subang Jaya, Malaysia
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Smith DJ, McGill L, Carranza D, Adeyemo A, Hakim AJ. Global engagement of pharmacists in test and treat initiatives: Bringing care from clinics to communities. J Am Pharm Assoc (2003) 2023; 63:419-423. [PMID: 36379864 PMCID: PMC9576199 DOI: 10.1016/j.japh.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 01/25/2023]
Abstract
The coronavirus disease 2019 pandemic has placed substantial strain on the global health care workforce, disrupting essential and nonessential services. Task sharing of test and treat services to nontraditional prescribers, such as pharmacists, can facilitate more resilient health care systems by expanding access to health services while simultaneously decreasing the pressure on traditional health care providers. Expansion of pharmacists' scope of work has historically been hindered by sociopolitical, resourcing, and competency considerations; addressing these challenges will be key to including pharmacists in testing and treatment of priority diseases. Sociopolitical considerations include migrating to flexible national legislation and scope of practices as well as engagement with other health care providers and the public to increase the acceptance of pharmacists participating in test and treat services. Resourcing issues include health care financing for test and treat services to parallel established systems or use voucher systems and service competition. In addition, pharmacists can use their training in supply chain management to ease and prevent medication stockouts in test to treat initiatives. Investments in technologies that support disease surveillance, basic reporting, and interoperability with health management information systems can integrate these initiatives into health care systems. Competency considerations comprise test and treat specific education for the pharmacy profession to equip them with the knowledge and confidence to execute successfully. Monitoring and evaluating the outcomes of these services can facilitate the scalability of test and treat initiatives. Pharmacists are uniquely positioned to bring testing and treatment from the clinic to the community.
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Affiliation(s)
- Dallas J. Smith
- Correspondence: Dallas J. Smith, PharmD, Epidemic Intelligence Service, Centers for Disease Control and Prevention, 1600 Clifton Rd., Mailstop: H24-10, Atlanta, GA 30329
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Patterson SM, Cadogan CA, Barry HE, Hughes CM. 'It stayed there, front and centre': perspectives on community pharmacy's contribution to front-line healthcare services during the COVID-19 pandemic in Northern Ireland. BMJ Open 2022; 12:e064549. [PMID: 36137632 PMCID: PMC9511011 DOI: 10.1136/bmjopen-2022-064549] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To explore community pharmacists and key stakeholders' perspectives and reflections on the community pharmacy workforce's preparedness for, and response to, COVID-19, including lessons for future public health crises. DESIGN, SETTING AND PARTICIPANTS Qualitative study using semistructured interviews (via telephone or online videoconferencing platform), with community pharmacists and a range of key stakeholders (representing other health professions, professional/governing organisations concerned with community pharmacy and patient advocacy groups) from across Northern Ireland. Data were analysed using thematic analysis and constant comparison. RESULTS Thirty interviews were conducted with community pharmacists (n=15) and key stakeholders (n=15). Four themes were identified: (1) adaptation and adjustment (reflecting how community responded quickly to the need to maintain services and adjusted and adapted services accordingly); (2) the primary point of contact (the continuing accessibility of community pharmacy when other services were not available and role as a communication hub, particularly in relation to information for patients and maintaining contact with other healthcare professionals); (3) lessons learnt (the flexibility of community pharmacy, the lack of infrastructure, especially in relation to information technology, and the need to build on the pandemic experience to develop practice); and (4) planning for the future (better infrastructure which reinforced concerns about poor technology, coordination of primary care services and preparing for the next public health crisis). There was a general view that community pharmacy needed to build on what had been learnt to advance the role of the profession. CONCLUSIONS The strengths of community pharmacy and its contribution to healthcare services in the COVID-19 pandemic were noted by community pharmacists and acknowledged by key stakeholders. The findings from this study should inform the policy debate on community pharmacy and its contribution to the public health agenda.
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Affiliation(s)
| | - Cathal A Cadogan
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
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21
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Patterson SM, Cadogan C, Barry HE, Bennett KE, Hughes C. 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. BMJ Open 2022; 12:e064545. [PMID: 36137621 PMCID: PMC9511007 DOI: 10.1136/bmjopen-2022-064545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
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.
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Affiliation(s)
| | - Cathal Cadogan
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | | | - Kathleen E Bennett
- Data Science Centre, School of Population Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Carmel Hughes
- School of Pharmacy, Queen's University Belfast, Belfast, UK
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22
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Rose O, Erzkamp S, Schöbel W, Grajeda M, Köberlein–Neu J. COVID-19 vaccinations in German pharmacies: A survey on patient and provider satisfaction. Vaccine 2022; 40:5207-5212. [PMID: 35918204 PMCID: PMC9329147 DOI: 10.1016/j.vaccine.2022.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 11/02/2022]
Abstract
Background Methods Results Conclusions
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