Willingness and readiness to test for COVID-19; A qualitative exploration of community pharmacists

Assessing Community Pharmacists' Perception on Readiness to Initiate Point-of-Care Testing for SARS-CoV-2 in New York State During the Pandemic

Introduction: Pursuant to the COVID-19 pandemic, an executive order issued by the New York State (NYS) governor allowed pharmacists to act as laboratory directors for a limited-service laboratory (LSL) to order and perform Food and Drug Administration (FDA) and Emergency Use Authorization (EUA) Clinical Laboratory Improvement Amendment (CLIA)-waived COVID-19 point-of-care testing (POCT). Objectives: To (i) assess the status of NYS community pharmacists with POCT in the early stages of the COVID-19 pandemic, (ii) assess the readiness and willingness of community pharmacists to incorporate COVID-19 POCT into their workflow during a pandemic, and (iii) assess community pharmacists' perception of the barrier to initiating COVID-19 POCT. Methods: This is a prospective cross-sectional study conducted from February 4 to February 21, 2021. An electronic survey consisting of 66 Likert-type questions, select all that apply, and fill-in-style questions were emailed to 250 Community Pharmacy Enhanced Service Network (CPESN) NY pharmacies, with a follow-up email sent halfway into the data collection period. The data were analyzed using descriptive statistics. Results: The result indicated that most participants (median = 5) demonstrated readiness and willingness to offer COVID-19 testing. Barriers to COVID-19 POCT were identified: impact on pharmacy workflow (59%), lack of payment mechanism (55%) and lack of sufficient training (21%). Most participants expressed interest in continuing POCT beyond the pandemic (86.1%). Conclusion: Community pharmacists in NYS reported willingness to initiate COVID-19 POCT. Addressing the identified barriers, such as workflow disruption and reimbursement challenges, will enable pharmacies to be better prepared to provide patient care, including POCT.

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

Introduction

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

Objectives

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

Methods

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

Results

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

Conclusion

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

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

OBJECTIVES

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

DESIGN, SETTING AND PARTICIPANTS

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

RESULTS

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

CONCLUSIONS

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

The response to COVID-19 among drug retail outlets in Indonesia: A cross-sectional survey of knowledge, attitudes, and practices

Background

Pharmacists have been at the frontline of the COVID-19 response in Indonesia, providing medicines, advice, and referral services often in areas with limited healthcare access. This study aimed to explore their knowledge, attitudes, and practices during the pandemic, so that we can be better prepared for future emergencies.

Methods

A cross-sectional online survey of community pharmacists and pharmacy technicians in Indonesia was conducted between July and August 2020. The dataset was analysed descriptively, and logistic regression was used to explore willingness to participate in COVID-19 interventions.

Findings

4716 respondents participated in the survey. Two-thirds (66·7%) reported knowing only “a little” about COVID-19 and around a quarter (26·6%) said they had not received any COVID-19 guidelines. Almost all were concerned about being infected (97·2%) and regularly took steps to protect themselves and their clients (87·2%). Stock-outs of Personal Protective Equipment (PPE) and other products (32·3%) was the main reason for not taking any precautions. Around a third (37·7%) mentioned having dispensed antibiotics to clients suspected of having COVID-19. To support COVID-19 response efforts, most respondents were willing to provide verbal advice to clients (97·8%), distribute leaflets to clients (97·7%), and participate in surveillance activities (88·8%). Older respondents, those identifying as male, and those working in smaller outlets were more willing to provide information leaflets. Those working in smaller outlets were also more willing to engage in outbreak surveillance.

Interpretation

Drug retail outlets continue to operate at the frontline of disease outbreaks and pandemics around the world. These providers have an important role to play by helping to reduce the burden on facilities and providing advice and treatment. To fulfil this role, drug retail outlets require regular access to accurate guidelines and steady supplies of PPE. Calls for drug retail outlet staff to plat in response efforts including the provision of information to clients and surveillance could ease escalating pressures on the health system during future outbreaks.

Funding

This study was funded by a grant from the Department of Foreign Affairs and Trade, Australia, under the Stronger Health Systems for Health Security Scheme.

Coronavirus disease patients' views and experiences of pharmaceutical care services in Lebanon

OBJECTIVES

This study aimed to explore the experiences and views of domiciliary coronavirus disease (COVID-19) patients towards pharmaceutical care services provided during their infection.

METHODS

This was a single-centred observational study conducted among home-treated COVID-19 patients (n = 500), who were tested positive for COVID-19 in a medical centre in Lebanon.

KEY FINDINGS

Out of the 500 home-treated COVID-19 patients invited to participate in the study, 279 patients completed the questionnaire. Although the participants had a good view of pharmacists caring for COVID-19 patients (mean view score: 17.79/25), their treatment experiences were unsatisfactory (mean experience score: 1.51/4).

CONCLUSIONS

COVID-19 patients reported minimal involvement of pharmacists in their treatment. Therefore, in response to the COVID-19 pandemic, healthcare authorities should intervene in restructuring, guiding and reviewing unrealized new pharmaceutical services to COVID-19 outpatients.

A qualitative study on the working experiences of clinical pharmacists in fighting against COVID-19

BACKGROUND

The spread of coronavirus disease 2019 (COVID-19) has overwhelmed healthcare systems across the world. Along with the medical team, clinical pharmacists played a significant role during the public health emergency of COVID-19. This study aimed to explore the working experience of clinical pharmacists and provide reference for first-line clinical pharmacists to prepare for fighting against COVID-19.

METHODS

A qualitative study based on descriptive phenomenology was employed with face-to-face and audio-recorded interviews to study the working experience of 13 clinical pharmacists (including two clinical nutritional pharmacists). All interviews were transcribed verbatim, and the interview data were analyzed thematically using NVivo software.

RESULTS

Four themes emerged from interview data, including roles of clinical pharmacists, working experiences of clinical pharmacists, psychological feelings of clinical pharmacists, and career expectations of clinical pharmacists.

CONCLUSIONS

The results contributed to a deeper understanding of the clinical pharmacists' work experiences in COVID-19 and offered guidance to better prepare clinical pharmacists in participating in a public health crisis.

Pharmacists' awareness of COVID-19 and perceptions of their roles, barriers, and roles of policymakers: Exploring the Middle East and North Africa (MENA)

BACKGROUND

The coronavirus disease (COVID-19) was declared in January 2020 as a public health emergency of international concern. The Middle East and North Africa (MENA) suffered from several pandemics previously. Pharmacists have vital roles to play to prevent the spread of this virus.

OBJECTIVES

To assess the COVID-19 awareness amongst pharmacists from Arabic-speaking countries located in the MENA region, and to assess their perspectives of their role, barriers, and roles of the educational institutions/pharmaceutical associations.

METHODS

An online survey was conducted to run a descriptive cross-sectional study in Jordan from 12th to 22nd April 2020. The questionnaire was validated (face validity) and put on Facebook and directed for pharmacists only (clarified in the introduction of the questionnaire). Assessment of pharmacists' awareness (20 questions) about pandemics and COVID-19, their perceived roles and barriers, and roles of the educational institutions (eg, universities) and pharmaceutical associations (eg, Pharmacists Syndicate) was performed. Data were analysed using Statistical Package for the Social Science (SPSS).

RESULTS

Study participants (n = 2589) had a mean age of 29.3 (8.2) years and 1329 (51.5%) were females. Most of the participants were from Egypt (n = 819, 40.8%), followed by Jordan, Algeria, and Syria. Regarding the sources of information about coronavirus management, 60.8% of participants got their information from social media. Fear of contracting the coronavirus while performing their duties was reported by the majority of pharmacists as the main barrier to delivering their roles (82.3%). The majority of pharmacists identified positive roles for the pharmaceutical institutions (74.8%) and pharmaceutical associations (63.6%).

CONCLUSION

Pharmacists from the MENA countries believe they got enough education previously about pandemics, and the majority follow the latest coronavirus updates from social media. Fear was reported as the major barrier that requires resolution by the policymakers. Certain gaps in the awareness about COVID-19 were identified.

Pharmacists' perspectives on providing the COVID-19 vaccine in community pharmacies

Objectives

The objective of this study was to explore community pharmacists’ perspectives on administering COVID-19 vaccine in community pharmacies in Jordan.

Methods

Purposeful sampling was used to identify a list of 100 community pharmacies which were approached to participate in the study. Twenty-three interviews were needed to reach data saturation. In-depth interviews were conducted, recorded, transcribed and analysed using NVivo 11 software. Interviews followed a previously prepared and validated 12-item interview guide. The interview guide discussed pharmacists’ perspectives on providing the COVID-19 vaccine in community pharmacies.

Key findings

The three overarching themes which described the participating pharmacists’ views towards administrating the COVID-19 vaccine in community pharmacies were advantage, support and barriers. The reported advantages included expediting the COVID-19 vaccination process, convince people to take the vaccine, increased patient accessibility to vaccines and aiding the healthcare system in the vaccination process. Respondents indicated that they would be more willing to administer the COVID-19 vaccine if they received the needed support from the Ministry of Health and the Pharmacists Association. Furthermore, from the respondents’ perspectives, the main barriers to this practice were having no confidence in the vaccine, risk of adverse effects and lack of training and expertise.

Conclusions

Respondents reported a positive attitude towards administering the COVID-19 vaccine in community pharmacies. Respondents highlighted that they could help fighting the pandemic through administering the vaccine and expedite the vaccination process.

Providing pharmaceutical care during the COVID-19 pandemic: attitudes and experiences of home-treated patients in Jordan

Objectives

This study aims to explore home-treated COVID-19 patients’ experiences and perceptions of pharmaceutical care services offered during their sickness.

Methods

This is a cross-sectional online questionnaire study, where a 30-item questionnaire was texted via a link to COVID-19 patients who were tested positive previously. A list of anonymised numbers was obtained from different COVID-19 testing centres. The study received ethical approval from the Institutional Review Board at the King Abdulla University Hospital/Jordan University of Science and Technology.

Key findings

A total of 268 patients who were previously diagnosed with COVID-19 agreed to participate in this study. Only 22.9% of patients reported taking medications regularly. Almost one-third of respondents (28.7%) indicated that pharmacists were involved in prescribing medicine to patients. Almost half the respondents (49.6%) stated that they or their caregivers obtained information and advice about their medicine from the pharmacists. Only 54.9% of the respondents agreed/strongly agreed that pharmacists have enough scientific information to provide the necessary medical assistance to COVID-19 patients. Patients who work in the medical field, and who always get their medication from the same pharmacy, showed better perception towards pharmaceutical care services that might be provided to COVID-19 patients (P < 0.01).

Conclusions

Pharmacists had an unsatisfactory contribution to the management of the disease in outpatient settings. Moreover, there was a poor perception of the pharmacists’ role including their knowledge, communication skills and counselling skills. Thus, it is essential to improve pharmacists’ knowledge and practices about infectious diseases.

Considerations for diagnostic COVID-19 tests

During the early phase of the coronavirus disease 2019 (COVID-19) pandemic, design, development, validation, verification and implementation of diagnostic tests were actively addressed by a large number of diagnostic test manufacturers. Hundreds of molecular tests and immunoassays were rapidly developed, albeit many still await clinical validation and formal approval. In this Review, we summarize the crucial role of diagnostic tests during the first global wave of COVID-19. We explore the technical and implementation problems encountered during this early phase in the pandemic, and try to define future directions for the progressive and better use of (syndromic) diagnostics during a possible resurgence of COVID-19 in future global waves or regional outbreaks. Continuous global improvement in diagnostic test preparedness is essential for more rapid detection of patients, possibly at the point of care, and for optimized prevention and treatment, in both industrialized countries and low-resource settings.

Social Work during the COVID-19 Crisis: Responding to Urgent Social Needs

Social work during the COVID-19 crisis has faced one of the most challenging times to cover urgent social needs in an uncertain scenario. This study analyzes the immediate responses in social work to vulnerable groups in the first 15 days of the pandemic in Barcelona, one of the most affected areas worldwide by COVID-19. The sample for this qualitative study includes 23 semi-structured interviews with social workers from different fields of intervention, from general approaches (primary care) to specific ones (health, ageing, homeless, and justice). The data analysis followed the communicative methodology, including transformative and exclusionary dimensions, and the analytical categories focused on the impact of the COVID-19 pandemic on social services users, the organizational responses of social workers, and the impact of the interventions to cover urgent social needs of attendees. The interventions have been accompanied by an improvement in communication channels with vulnerable groups, ensuring an understanding of the situation of families and individuals, and covering the most urgent social needs. The study shows the key role of social workers from diverse social attention tools and their contribution to the sustainability of social services with a long-term impact.

Pharmacists' perception of their role during COVID-19: a qualitative content analysis of posts on Facebook pharmacy groups in Jordan

OBJECTIVE

This study aimed to evaluate the content available on Facebook pharmacy groups in Jordan regarding the perception of the pharmacists' role during the coronavirus pandemic in Jordan.

METHODS

Researchers identified Facebook pharmacy groups through the search engine on the Facebook website. The main search keywords were pharmacy, pharmacist, pharmacists, and Jordan using both Arabic and English. Two researchers analyzed the posts and discussion threads on local pharmacy Facebook groups in a period between March 20th and April 3rd. A total of 184 posts and threads were identified for the purpose of the study.

RESULTS

Identified threads and responses resulted in three overarching themes: pharmacists having a positive role during the pandemic, taking additional responsibilities and services, and having passive or negative roles. A positive role was seen in pharmacists acting as first-line healthcare providers, creating public's awareness regarding COVID-19, and being responsible for chronic medication refill during the pandemic. Taking additional responsibilities was summarized in home deliveries and involvement in industrial and corporate efforts to deal with the pandemic. A passive/negative role was seen mostly among hospital pharmacists not being proactive during the pandemic and by pharmacists trying to maximize profits during pandemic time.

CONCLUSIONS

Pharmacists perceived their role as a positive role during the coronavirus pandemic. Not only they took responsibilities for their daily services during the crises, but they took additional responsibilities to assure patient safety and satisfaction.