Patient Satisfaction with Private Community Pharmacies versus Pharmacies in Primary Health Care Centers in Saudi Arabia

Introduction

Saudi Arabia has begun reforming its government-run health care system to increase efficiency and reduce costs. One effort is the adoption of an electronic prescribing system (Wasfaty) and outsourcing pharmaceutical services from government-run clinics to community pharmacies (CP). This study aims to compare satisfaction with pharmaceutical services offered in the two systems.

Materials and methods

This cross-sectional observational study used existing survey data collected from patients (≥15 years of age) visiting government primary health care centers from January 2022 to June 2022. Satisfaction with three pharmaceutical services (availability of medications, pharmacist's explanation of the prescription, and waiting time to get medications) were the main outcomes.

Results

The study comprised 91,317 participants, 74.06 % of them were CP/Wasfaty users. CP/Wasfaty patients had lower odds of satisfaction with the three pharmaceutical services: availability of medications (OR = 0.49, 95 % CI = 0.47-0.51), pharmacists' explanation of prescription (OR = 0.55, 95 % CI = 0.53-0.58), and waiting time to get medications (OR = 0.81, 95 % CI = 0.75-0.88). Additional findings showed variations in satisfaction levels based on demographic factors and clinic types.

Conclusions

The significant differences observed in satisfaction levels based on demographic characteristics and type of clinics visited emphasize the importance of tailoring pharmaceutical services to meet the specific needs and expectations of different patient populations.

Drivers of vulnerability to medicine smuggling and combat strategies: a qualitative study based on online news media analysis in Iran

BACKGROUND

Medicine smuggling poses a serious public health threat, limiting patients' safe and timely access to this essential resource. Thus, this study aims to identify the factors contributing to the vulnerability to medicine smuggling and propose effective strategies to combat this issue in Iran.

METHODS

An analysis of news media was conducted using qualitative content analysis. News text items related to medicine smuggling were retrieved from various online news sources between March 21, 2017, and May 21, 2023. To select health-oriented and general online news stations, news agencies, and newspapers, the purposeful sampling method with a maximum variation strategy was used. The selected sources included Mehr News Agency, Khabar Online, Islamic Consultative Assembly News Agency (ICANA), Islamic Republic News Agency (IRNA), Iranian Students News Agency (ISNA), Hamshahri, Donya-e-Eqtesad newspapers, Webda, Sepid Online, and Iran's Food and Drug Administration News Agency (IFDANA). All data coding was manually done using Microsoft Excel software version 2016.

RESULTS

A total of 277 news articles were found to meet the established criteria for inclusion. The analysis revealed four main themes, each with several sub-themes, that shed light on the factors that drive vulnerability and the strategies to combat medicine smuggling. These themes are the economic environment, government and stewardship, information technology systems, and socio-cultural factors. The economic environment emerged as the most significant theme, encompassing medicine selection, reimbursement, and procurement, all of which affect the smuggling of pharmaceuticals in Iran.

CONCLUSION

To combat medicine smuggling, it is important to adjust policies based on the identified vulnerabilities. Effective strategies to reverse pharmaceutical smuggling include capacity building of pharmaceutical manufacturing companies, implementing regulated and enhanced supervisory and rulemaking policies, strengthening health insurance, improving e-infrastructure, and increasing public awareness through collaborative approaches involving various stakeholders within and outside the health system.

An overview and visual analysis of research on government regulation in healthcare

Objective

During the period of COVID-19, government regulation (GR) played an important role in healthcare. This study examines the current research situation of GR in healthcare, discusses the research hotspots, the most productive authors and countries, and the most common journals, and analyzes the changes in GR in healthcare before and after the outbreak of COVID-19.

Methods

This study followed PRISMA guidelines to collect literature on GR in healthcare. And the VOSviewer software was used to perform a quantitative analysis of these documents to obtain a visual map, including year, country, institution, journal, author, and research topic.

Results

A total of 1,830 papers that involved 976 academic journals, 3,178 institutions, and 133 countries were identified from 1985 to 2023. The United States was the country with the highest production (n = 613), followed by the United Kingdom (n = 289). The institution with the largest number of publications was the University of London in the UK (n = 103); In the author collaboration network, the biggest cluster is Bomhoff M, Bouwman R, Friele R, et al. The top five journals in terms of the number of articles were BMC Health Services Research (n = 70), Plos One (n = 35), Health Policy (n = 33), Social Science & Medicine (n = 29), Health Policy and Planning (n = 29), and Frontiers in Public Health (n = 27). The existing literature mainly focused on "health policy," "public health," "China," "mental health," "India," "qualitative research," "legislation," and "governance," et al. Since 2020, research on "COVID-19" has also become a priority in the domain of healthcare.

Conclusion

This study reveals the overall performance of the literature on GR published in healthcare. Healthcare needs GR, especially in response to the COVID-19 epidemic, which has played an irreplaceable role. The outbreak of COVID-19 not only tested the health systems of various countries, but also changed GR in healthcare. With the end of COVID-19, whether these changes will end remains to be further studied.

Government regulation and organizational effectiveness in the health-care supply chain

Purpose

In the context of the debate on ensuring health-care efficiency, this study aims to identify and prioritize factors and subfactors that influence organizational effectiveness (OE) in the health-care supply chain.

Design/methodology/approach

For the purpose of this qualitative study, triangulation was applied to identify, explore and systematically analyze the OE-related practices used by diverse stakeholders along the health-care supply chain. Sixty-two OE practices were thus identified. Subsequently, these were grouped in six different nodes before the analytical hierarchical process (AHP) was used to identify the weightings of specific practices (and related factors) and their impact on OE.

Findings

The findings suggest that external factors associated with government regulation, including government directives and branding, are the most critical factors that influence OE-related practices, while cost-related factors are the least important.

Originality/value

The originality of this study derives from the introduction of system theory supported by a modified supplier-input-process-output-customer (SIPOC) framework. Two important factors – government regulation and branding – have been introduced to the existing SIPOC chart as a valuable process structure for the health-care chain.

Antihypertensive prescribing pattern, prescriber adherence to ISH 2020 guidelines, and implication of outpatient drug price on blood pressure control at selected hospitals in Southern Ethiopia

PURPOSE

To determine the impact of drug prescribing pattern, outpatient drug price of medicines, and level of adherence to evidence-based international guidelines on blood pressure (BP) control at selected hospitals in Southern Ethiopia.

METHODS

Hospital-based cross-sectional study was conducted. The data entry and analysis were done by using SPSS version 21.0.

RESULTS

A mean age of participants was 55.87 ± 11.02 years. The rate of BP control was 17.5% based on International Society of Hypertension (ISH) guidelines 2020. In about two-thirds of patients, 270 (66.5%) were taking combination therapy. Mean annual cost of drugs for hypertension was 11.39 ± 3.98 US dollar (USD). Treatment was affordable for only 91 (22.4%) of patients. There was considerable variation on prescriber's adherence to evidence-based guidelines. Body mass index (BMI) of 18-24.9 kg/m², adjusted odds ratio (AOR) = 3.63 (95% confidence interval (C.I), 1.169-11.251, p = 0.026), physically activity, AOR = 12.69 (95% C.I, 1.424-113.17, p = 0.023), presence of no comorbidity, AOR = 12.82 (95% C.I, 4.128-39.816, p = 0.000), and taking affordable antihypertensive regimen, AOR = 3.493 (95% C.I, 1.4242-9.826, p = 0.018), were positively associated BP control.

CONCLUSION

The level of BP control, affordability of drugs for the management of hypertension and related comorbidities, and the prescriber's adherence to evidence-based guidelines were inadequate. Therefore, addressing factors associated with good BP control including affordability and clinician adherence to evidence-based guidelines by responsible stakeholders could improve BP control and reduce associated complications.