Attitudes, perceptions, and barriers of community pharmacists in Rwanda towards health promotion: a cross sectional study

Actual practices of community pharmacists in the management of diabetes: a comparison of simulated patient-based study with perceived role of involvement

Objectives

This study evaluated the level of community pharmacy professionals' (CPPs) actual practices and contrasted it with their self-reported perceived involvement in diabetes management.

Methods

A self-reported cross-sectional and simulated patient (SP)-based study were employed at community drug retail outlets (CDROs) in Northwest Ethiopia. SP-case scenarios were used to examine the actual practices of CPPs in diabetes management and were compared with self-reported perceived involvement. The data were managed and analysed using SPSS version 26.

Results

About 184 participants in the self-reported and 100 CPPs' actual practices using three SP visits were included. The overall actual practice (17.8%) was found to be significantly different compared with the perceived level of involvement (73.5%) (p-value <0.05). About 94.3% of CPPs dispensed requested medications to the SP without a prescription. Despite most participants being perceived to be involved, more than 76% of CPPs did not counsel the SP for lifestyle modifications, avoiding risky behaviours, adherence to treatment, routine blood glucose checkups, diabetic foot care techniques, or consultation with physicians for further management.

Conclusion

A significant discrepancy between actual practices and perceived CPPs' involvement in the management of diabetes was observed. The findings may suggest that exploring possible gaps may be crucial.

Workplace wellbeing in community pharmacy practice: A cross-sectional study in Can Tho, Vietnam

Background

Among pharmacy workers, low workplace wellbeing can lead to reduced effectiveness. However, to date, studies on this issue are limited within the community pharmacy setting in Vietnam.

Objectives

This study was conducted to identify the component aspects of workplace wellbeing and their associations with demographic characteristics.

Methods

The cross-sectional descriptive study was conducted in Can Tho, Vietnam. Self-administered questionnaires were hand-delivered to all pharmacy workers working at selected community pharmacies. The workplace wellbeing scale comprised 18 items.

Results

In total, 382 pharmacy workers participated in this study. Factor analysis revealed three fundamental aspects to workplace wellbeing: Factor 1 - perceived self-worth and job satisfaction, Factor 2 - positive emotions with work, and Factor 3 - negative emotions with work. Factor 1 showed a positive correlation with Factor 2, with a correlation coefficient (ρ) of 0.509, while both Factor 1 (ρ = -0.399) and Factor 2 (ρ = -0.416) demonstrated negative correlations with Factor 3. Higher income was associated with higher positive emotions with work (P = 0.008), higher perceived self-worth and job satisfaction (P = 0.013), and lower negative emotions with work (P < 0.001).

Conclusion

Workplace wellbeing of pharmacy workers in their professional environments was associated with financial aspects. These findings suggest that policies aimed at improving income for pharmacy workers could bring benefits to enhancing job satisfaction and workplace wellbeing.

Request for Antimalarial Medicines and Their Dispensing Without a Prescription in Community Pharmacies in Rwanda

Purpose

This study aimed to explore the request and dispensing of antimalarial medicines without a prescription in community pharmacies in Rwanda, as well as factors associated.

Methods

We employed an embedded mixed-methods design that involved a convenience sample of 235 licensed community pharmacists between February and April 2022. To simultaneously collect qualitative and quantitative data, we used a self-administered questionnaire containing a combination of close and open-ended questions. Bivariate and multivariate regression analyses were performed to examine the relationship between dispensing antimalarial medicines without a prescription and the selected independent variables. Statistical significance was set at p<0.05, and a 95% confidence interval was applied. The factors influencing the dispensing of antimalarial medicines without a prescription were analyzed using thematic content analysis as a qualitative analysis approach.

Results

Most respondents (88.5%) were asked to dispense antimalarial medicines by clients without a prescription. More than half of them (54%) agreed, but 34.5% refused; instead, they referred clients to malaria diagnostic testing facilities. Those who had rapid diagnostic tests for malaria in stock (OR=2.08, 95% CI:1.1-3.94), and thought that antimalarials were over-the-counter medicines (OR=7.03, 95% CI:2.01-24.5) were more likely to dispense antimalarial medicines without prescriptions. The primary reasons reported by community pharmacists for dispensing antimalarial medicines without prescriptions included their prior knowledge of malaria diagnosis, client pressure, and fear of losing clients. However, non-adherence to negative results obtained from formal health facilities and long queues at these institutions have also been cited as additional factors driving clients to seek antimalarial medicines without prescriptions.

Conclusion

Dispensing antimalarial medicines without prescriptions is a common practice in community pharmacies in Rwanda. The main factors contributing to this practice include lack of awareness regarding the classification of antimalarials as prescription medicines, the availability of malaria diagnostic tests, client pressure, and fear of losing clients.

Malaria rapid diagnostic tests in community pharmacies in Rwanda: availability, knowledge of community pharmacists, advantages, and disadvantages of licensing their use

BACKGROUND

Presumptive treatment of malaria is often practiced in community pharmacies across sub-Saharan Africa (SSA).To address this issue, the World Health Organization (WHO) recommends that malaria Rapid Diagnostic Tests (m-RDTs) be used in these settings, as they are used in the public sector. However, their use remains unlicensed in the community pharmacies in Rwanda. This can lessen their availability and foster presumptive treatment. Therefore, this study investigated the availability of m-RDTs, knowledge of community pharmacists on the use of m-RDTs, and explored Pharmacists' perceptions of the advantages and disadvantages of licensing the use of m-RDTs in community pharmacies.

METHODS

This was a cross-sectional study among 200 licensed community pharmacists who were purposefully sampled nationwide from 11th February to 12th April 2022. Data was collected using an online data collection instrument composed of open-ended and closed-ended questions. Statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 25.0. The chi-square test was used to evaluate the association between the availability of m-RDTs and independent variables of interest. Content analysis was used for qualitative data.

RESULTS

Although 59% were consulted by clients requesting to purchase m-RDTs, only 27% of the participants had m-RDTs in stock, 66.5% had no training on the use of m-RDTs, and 18.5% were not at all familiar with using the m-RDTs. Most of the participants (91.5%) agreed that licensing the use of m-RDTs in community pharmacies could promote the rational use of antimalarials. The chi-square test indicated that being requested to sell m-RDTs (x2 = 6.95, p = 0.008), being requested to perform m-RDTs (x2 = 5.39, p  = 0.02),familiarity using m-RDTs (x2 = 17.24, p = 0.002), availability of a nurse in the Pharmacy (x2 = 11.68, p < 0.001), and location of the pharmacy (x2 = 9.13, p = 0.048) were all significantly associated with the availability of m-RDTs in the pharmacy.

CONCLUSIONS

The availability of m-RDTs remains low in community pharmacies in Rwanda, and less training is provided to community pharmacists regarding the use of m-RDTs. Nevertheless, community pharmacists had positive perceptions of the advantages of licensing the use of m-RDTs. Thus, licensing the use of m-RDTs is believed to be the first step toward promoting the rational use of antimalarial medicines in Rwanda.

Determine the perceived level of involvement and factors affecting diabetes management by community pharmacy professionals at drug retails in northwestern amhara region, Ethiopia

Background

Pharmacists in community drug retail outlets (CDROs) have significant involvement in diabetes prevention and management by providing more direct interventions in medication education, preventive measures, and disease management. This study examined the perceived level of involvement of community pharmacy professionals (CPPs) in diabetes management at CDROs in Northwest Ethiopia.

Methods

A multicenter cross-sectional study was conducted among CPPs in Northwest Ethiopia between September 1 and 30, 2022. The Statistical Package for Social Science (SPSS) version 26 was used to analyzed the data, which had been gathered using a self-administered structured questionnaire. An independent sample t-test and one-way ANOVA were used to examine the mean perceived involvement score difference between CPPs. The association between CPPs' involvement and other sociodemographic variables was examined using linear regression analysis. At a 95% confidence interval (CI), a p-value <0.05 was considered statistically significant.

Results

The study included 184 (94.3%) of 195 CPPs approached. The overall mean perceived involvement score of CPPs in diabetes management was 3.80 ± 0.63 out of 5. CPPs with a bachelor's degree or higher [β = 3.065, 95% CI: 2.704, 3.641; p < 0.001], CPPs with a higher monthly income (≥5000 ETB) [β = 0.242, 95% CI: 0.112, 0.596; p = 0.034], and those who provided more than 8 hours of service per day [β = 0.163, 95% CI: 0.051, 0.332; p = 0.043] had higher perceived involvement in the management of diabetes compared with their counterparts.

Conclusions

This study found that most CPPs had a high level of perceived involvement in diabetes management. Higher educational backgrounds, a higher monthly salary, and working longer hours were associated with an increased level of perceived involvement. Promoting the educational background of CPPs may be crucial to enhance their active involvement in the management of diabetes.

Pharmacists' involvements and barriers in the provision of health promotion services towards noncommunicable diseases: Community-based cross-sectional study in Northwest Ethiopia

BACKGROUND

Community drug retail outlets (CDROs) are among the initial healthcare facilities where pharmacists play a crucial role in preventing and managing noncommunicable diseases (NCDs). Therefore, this study assessed pharmacists' level of involvement and barriers in the provision of health promotion for noncommunicable diseases at CDROs in Northwest Ethiopia.

METHODS

A community-based multicenter cross-sectional study was conducted among community pharmacists in Northwest Ethiopia from April to June 2022. Data was collected using a self-administered structured questionnaire, and analyzed using the Statistical Package for Social Science (SPSS) version 26. The level of involvement mean score difference among pharmacists was investigated using an independent samples t-test and a one-way ANOVA. Logistic regression analysis was used to examine the association between pharmacists' level of involvement and other variables. A p-value < 0.05 at a 95% confidence interval (CI) was considered statistically significant.

RESULTS

A total of 285 (94.4%) participants participated in the study out of 302 approached samples. Overall, more than half (58.9%) of the participants showed a high level of involvement in health promotion. Pharmacists who had a degree and/or above (AOR = 0.03, 95% CI: 0.01-0.63; p < 0.001) and served a lower number of clients per day (AOR = 0.19, 95% CI: 0.04-94; p = 0.042) were less likely to have low involvement in health promotion services. Pharmacists who worked fewer hours per day (AOR = 3.65, 95% CI: 1.79-7.48; p = 0.005) were more likely to have low involvement. Lack of an appropriate area in the CDROs (52.1%) and lack of coordination with other healthcare providers (43.6%) were the most reported barriers to the provision of health promotion.

CONCLUSION

Most pharmacists were found to have a high level of involvement in health promotion activities. A lack of an appropriate area in the CDROs and a lack of coordination with other healthcare providers were among the most reported barriers. Pharmacists might benefit from training to increase their educational backgrounds, and barriers could be addressed to enhance the pharmacist involvement.

Pharmacists' Medication Counseling Practices and Knowledge and Satisfaction of Patients With an Outpatient Hospital Pharmacy Service

The degree of communication between patients and pharmacists has a significant impact on the process of medication counseling. The purpose of this study was to evaluate pharmacists' practices of medication counseling and to assess patients' knowledge of medications and satisfaction with pharmacy services at Woldia Comprehensive Specialised Hospital (WCSH). A cross-sectional study involving 23 pharmacists and 339 patients was carried out between February and May 2022 at WCSH. A self-administered structured questionnaire was used to assess the medication counseling activities of pharmacists, whereas interview-based questionnaires were used to evaluate patients' knowledge of the drugs prescribed to them and their level of satisfaction with outpatient hospital pharmacy services. The Statistical Package for Social Sciences (SPSS) Version 25.0 was used to analyze the data. Around two-thirds of pharmacy professionals (73.9%) agreed that they were satisfied with their counseling activities. But a very low number of them always provided counseling regarding the purpose of medications (13%), major drug-drug interactions (26.1%), possible side effects (30.4%), the importance of compliance (30.4%), storage conditions (34.8%), and drug-food interactions (39.1%). Among the 339 patients involved in the study, less than half (46.3%) of them had sufficient knowledge of their dispensed medication at the exit interview. Only nearly half of the patients (54.3%) agreed that they were satisfied with the pharmacy service. Despite the fact that a significant proportion of the pharmacy professionals agreed that they were satisfied with their counseling practices, their level of involvement in major counseling activities was limited, which impacted the knowledge of patients about their medication and patients' satisfaction with pharmacy services. This might be because of potential barriers in terms of workload and lack of resources. The findings may indicate that pharmacy services need to improve through identifying potential gaps and tackling barriers.

Assessment of community pharmacy professionals' willingness, involvement, beliefs, and barriers to offer health promotion services: a cross-sectional study

INTRODUCTION

The role of community pharmacy professionals has been expanded to patient care and health promotion service globally. However, in Ethiopia, there is a scanty of data on the issue, although the country is dealing with a double burden of non-communicable and communicable diseases.

OBJECTIVES

This study aimed to assess community pharmacy professionals' willingness, involvement, beliefs, and barriers to offer extended services for health promotion in Injibara town, Amhara, Ethiopia.

METHODS

A cross-sectional study was conducted among licensed and registered community pharmacy professionals working in Injibara town from June 25 to July 10, 2022. A structured self-administered questionnaire was used to collect data. The data were presented using descriptive statistics. The data were analyzed using STATA version 16 software.

RESULTS

A total of 24 community pharmacy professionals were involved in the study, with a response rate of 92.3%. Approximately 91.7% of them were involved in health promotional services. Of them, 54.1% were willing and strongly believed that their involvement in health promotion services would have a positive impact on promoting health. A total of 60.9% of the community pharmacy professionals reported that they were very involved in family planning and alcohol consumption counseling. Different barriers to not providing health promotion services were also cited.

CONCLUSIONS

Majority of community pharmacy professionals in this study is involved in health promotional services but there are also barriers on their involvement. Therefore, governmental strategies to overcome the barriers that hamper their involvement should be designed.