1
|
El-Dahiyat F, Jairoun AA, Al-Hemyari SS, Shahwan M, Jairoun M, Zyoud SH, Jaber AAS, Faisal Alkhanani M, Alhasani RH, Ashour AM, Alshehri FS, Alorfi NM. Community pharmacists' skills and practice regarding dispensing fiscalized substances: a cross-sectional survey. Front Pharmacol 2023; 14:1237306. [PMID: 37719848 PMCID: PMC10500833 DOI: 10.3389/fphar.2023.1237306] [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: 06/12/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Background: The use of drugs containing fiscalized substances is essential in different medical areas, including pain management, obstetric emergencies, and the treatment of mental disorders. However, due to their potential for abuse and negative health effects, the dispensing of these substances demands pharmacists with the requisite skills and practice. Objective: This study assesses the skills and practices of pharmacy personnel in the United Arab Emirates (UAE) regarding the dispensing of tramadol, a medication containing fiscalized substances, in community pharmacies. Methodology: A cross-sectional study was conducted. Community Pharmacies were chosen via random sampling, and seven well-trained final year pharmacy students visited them and conducted face-to-face interviews. The survey tool covered items highlighting the demographic data of the subjects, and items on the practice and skills regarding dispensing the fiscalized substances. The content validity ratio values of all tool questions were more than 0.78, suggesting acceptable validity and the Cronbach's α of 0.75 showed as acceptable internal reliability. The primary outcome measures of interest were the skills and practice regarding dispensing Fiscalized substances. Results: A total of 612 pharmacists were recruited in the study. The average practice score was 80%. There was a statistically significant association (p < 0.05) between practices about dispensing fiscalized substances and gender, age group, pharmacy type, work experience, university of graduation, and receiving training on epilepsy and antiepileptic drugs. Conclusion: The results implied that competency and experience are vital factors for the dispensing of tramadol. Contextually, the majority of the pharmacists evidently have the requisite competencies to provide high-quality and proper medical care, with regards to dispensing tramadol, which will minimize drug abuse and medication errors, and assist outpatients to manage their drugs containing fiscalized substances.
Collapse
Affiliation(s)
- Faris El-Dahiyat
- Clinical Pharmacy Program, College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dubai, United Arab Emirates
| | - Ammar Abdulrahman Jairoun
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- Health and Safety Department, Dubai, United Arab Emirates
| | - Sabaa Saleh Al-Hemyari
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- Pharmacy Department, Emirates Health Services, Dubai, United Arab Emirates
| | - Moyad Shahwan
- College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Maimona Jairoun
- College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Sa’ed H. Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- Clinical Research Centre, An-Najah National University Hospital, Nablus, Palestine
| | - Ammar Ali Saleh Jaber
- Department of Clinical Pharmacy and Pharmacotherapeutics, Dubai Pharmacy College for Girls, Al MizharDubai, United Arab Emirates
| | - Mustfa Faisal Alkhanani
- Biology Department, College of Sciences, University of Hafr Al Batin, Hafr Al Batin, Saudi Arabia
| | | | - Ahmed M. Ashour
- Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Fahad S Alshehri
- Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Nasser M. Alorfi
- Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| |
Collapse
|
2
|
Mauricio C, Andrea SO, Daniel SH, Pedro A. Effectiveness of a continuing education program of drugs with fiscalized substance to improve pharmacy staff competencies: A multicenter, cluster-randomized controlled trial. Pharm Pract (Granada) 2022; 20:2632. [PMID: 36733513 PMCID: PMC9851815 DOI: 10.18549/pharmpract.2022.3.2632] [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: 01/20/2022] [Accepted: 08/06/2022] [Indexed: 02/05/2023] Open
Abstract
Background Drugs with fiscalized substances without a correct prescription may lead to undesirable side effects. Pharmacy staff needs to improve their competencies (knowledge, skills, and attitudes) to contribute to providing ambulatory pharmacy services and minimizing medication errors. Continuing education programs (CEP) could favor access to relevant and quality information on health promotion, disease prevention, and the rational use of drugs. Objective To evaluate the effectiveness of a continuing education program to improve pharmacy staff competencies to enhance the use of drugs with fiscalized substances. Methods A multicenter, prospective, parallel-group, cluster-randomized, controlled clinical trial was conducted in drugstores and pharmacies in Colombia (ambulatory retail establishments). The intervention group (IG) received a CEP: a web-based social networking site, a virtual course, a dispensing information system, and face-to-face training. The control group (CG) received general written material on the correct use of drugs. We measured pharmacy staff's skills, attitudes, and knowledge self-reported scores, and the simulated patient technique was used to assess the participant skills and attitudes in real practice. We used a questionnaire designed for this study, which was evaluated by a group of experts and piloted and showed a Cronbach's alpha of 0.96. Results Three hundred five drugstores and pharmacies were enrolled in two groups: IG (n = 153) and CG (n = 152). Out of the 750 potential participants, 88% (n=659) agreed to participate. The pharmacy staff's skills, attitudes, and knowledge self-reported scores post-intervention were higher than baseline in both groups; however, the IG had statistically significantly higher scores than the CG. Post-intervention, the self-efficacy skills and attitudes in the IG improved by 88% (22 of 25) and in six of the seven assessed knowledge components (p<0.001). However, the dispensing criteria evaluated with simulated patient methodology showed no statistically significant differences between groups in the pharmacy staff's skills and attitudes in real practice. Conclusions Providing a continuing education program using different educational strategies improved the pharmacy staff's competencies (assessed knowledge and self-reported skills and attitudes) to enhance the use of drugs with fiscalized substances. However, there were no improvements in skills and attitudes in real practice. These findings could show that pharmacy staff needs additional and continuous training/sustainability.
Collapse
Affiliation(s)
- Ceballos Mauricio
- Research Group on Pharmaceutical Promotion and Prevention, Research Group on Pharmacy Regency Technology. University of Antioquia, Medellin, Colombia.
| | - Salazar-Ospina Andrea
- Research Group on Pharmaceutical Promotion and Prevention, Research Group on Pharmacy Regency Technology. University of Antioquia, Medellin, Colombia.
| | | | - Amariles Pedro
- Research Group on Pharmaceutical Promotion and Prevention. University of Antioquia, Medellin, Colombia; Pharmaceutical Care Research Group, Faculty of Pharmacy, University of Granada, Granada, Spain.
| |
Collapse
|
3
|
Ceballos M, Llano Y, Salazar-Ospina A, Madrigal-Cadavid J, Pino-Marín D, Amariles P. Skills and practices of pharmacy staff for dispensing of drugs with fiscalized substances in drugstores and pharmacies. Rev Saude Publica 2021; 55:44. [PMID: 34231824 PMCID: PMC8244815 DOI: 10.11606/s1518-8787.2021055003103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/11/2020] [Indexed: 11/13/2022] Open
Abstract
OBJETIVE To evaluate the skills and practices of pharmacy staff during the dispensing of tramadol (drug with fiscalized substance) in drugstores and pharmacies in Medellin, Colombia. METHODS A cross-sectional study was performed. The simulated patient technique was used. The main outcomes included the information provided on the dispensed drug (tramadol), the use of tools to provide information, and the information provided on drug precautions and use recommendations. RESULTS We visited 305 drugstores and pharmacies. The average dispensing time was 2.3 min (SD 1.1 min). In nine drugstores and pharmacies (3.0%), tramadol was not dispensed because it was not in stock. In 17 drugstores and pharmacies (5.7%), the simulated patients were actively informed by the dispensing pharmacy staff; of these, 16 provided oral information and one provided oral and written information. Eight patients (2.7%) received information regarding tramadol use. However, 99% of patients were not informed about tramadol side effects such as dependence, sedation, or hypnosis, and none of the simulated female patients were informed on the precautions related to tramadol use during pregnancy or lactation. CONCLUSIONS Communication skills and appropriate practices of pharmacy staff are critical to patient self-care. However, this study shows their difficulty in counseling about precautions and use recommendations of drugs with fiscalized substances. These outcomes could inform future studies focusing on the rational use of these drugs in drugstores and pharmacies. It is necessary to improve the pharmacy staff competencies through continuing education programs, to facilitate access to information and training.
Collapse
Affiliation(s)
- Mauricio Ceballos
- Universidad de Antioquia. Facultad de Ciencias Farmacéuticas y Alimentarias. Departamento de Farmacia. Medellín, Antioquia, Colombia
| | - Yaqueline Llano
- Universidad de Antioquia. Facultad de Ciencias Farmacéuticas y Alimentarias. Departamento de Farmacia. Medellín, Antioquia, Colombia
| | - Andrea Salazar-Ospina
- Universidad de Antioquia. Facultad de Ciencias Farmacéuticas y Alimentarias. Departamento de Farmacia. Medellín, Antioquia, Colombia
| | - Juliana Madrigal-Cadavid
- Universidad de Antioquia. Facultad de Ciencias Farmacéuticas y Alimentarias. Departamento de Farmacia. Medellín, Antioquia, Colombia
| | - Daniel Pino-Marín
- Universidad de Antioquia. Facultad de Ciencias Farmacéuticas y Alimentarias. Departamento de Farmacia. Medellín, Antioquia, Colombia
| | - Pedro Amariles
- Universidad de Antioquia. Facultad de Ciencias Farmacéuticas y Alimentarias. Departamento de Farmacia. Medellín, Antioquia, Colombia
| |
Collapse
|
4
|
Amariles P, Ceballos M, González-Giraldo C. Primary health care policy and vision for community pharmacy and pharmacists in Colombia. Pharm Pract (Granada) 2020; 18:2159. [PMID: 33294064 PMCID: PMC7699829 DOI: 10.18549/pharmpract.2020.4.2159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Colombia is a decentralized republic with a population of 50 million, constituted by 32 departments (territorial units) and 1,204 municipalities. The health system provides universal coverage and equal access to health care services to 95% of the population. Primary health care is seen as a practical approach that guarantees the health and well-being of whole-of-society. The National Pharmaceutical Policy (NPP, 2012) goal is “to develop strategies that enable the Colombian population equitable access to effective medicines, through quality pharmaceutical services (PS)”. There are 4,351 providers certified to deliver PS: 3,699 (85%) ambulatory and 652 (15%) hospital care. The goals for PS are: a) promoting healthy lifestyles; b) preventing risk factors arising from medication errors; c) promoting rational use of medicines; and d) implementing Pharmaceutical Care. There are a number of ways that ambulatory patients access medications: through intermediary private companies, public and private hospitals pharmacies, and retail establishments (drugstores and pharmacies). Intermediary private companies are similar to Pharmaceutical Benefits Management in the U.S. health system, and act as intermediaries between health insurers, pharmaceutical laboratories, and patients. Pharmacists are being employed by these companies and in health insurance companies managing, auditing and delivering rational use of medicines programs. In 2014 there were approximately 20,000 pharmacies and drugstores, (private establishments) where a significant number of prescription-only medicines are sold without medical prescription. Colombian laws allow personal without pharmacy education to be a “director” in these establishments, so the training and education of persons working in drugstores and pharmacies is an important challenge. There about 8,000 registered pharmaceutical chemists with 25% to 30% working in patient care. Since the 90´s, there are more favorable conditions for pharmacist’s participation and contribution to health system and patient’s health outcome. These environmental facilitators include: a) laws and regulations regarding pharmaceutical services (2005-2007), b) establishment of a NPP (2012), and c) opportunities associated with the consolidation of private health management companies providing health services with an interest in pharmaceutical services (since 1995). Finally, telepharmacy, comprehensive care routes for pharmaceutical services, and further strengthen of postgraduate training in pharmacy practice are future strategies to improve the pharmacy profession in Colombia. They provide an opportunity to influence the recognition and value of the pharmacist as the health care professional.
Collapse
Affiliation(s)
- Pedro Amariles
- PhD, MPharm, BPharm. Professor. University of Antioquia. Medellín (Colombia).
| | - Mauricio Ceballos
- MSc, BPharm. Professor. University of Antioquia. Medellín (Colombia).
| | | |
Collapse
|