Australian Community Pharmacy Harm-Minimisation Services: Scope for Service Expansion to Improve Healthcare Access

Exploring the role of community pharmacies as a harm reduction environment for anabolic-androgenic steroid consumers: triangulating the perspectives of consumers and pharmacists

BACKGROUND

While community pharmacies have been successful in providing harm reduction support for illicit substance consumers, little research has explored their role in addressing the needs of anabolic-androgenic steroid (AAS) consumers.

OBJECTIVE

This study aimed to triangulate the attitudes and experiences of AAS consumers and community pharmacist's regarding AAS harm reduction.

METHODS

Semi-structured interviews were conducted with AAS consumers (n = 8) and community pharmacists (n = 15) between December 2022 and August 2023 in Australia. Interview data were analysed using reflexive thematic analysis.

RESULTS

While consumers emphasised easy access to pharmacies, particularly in urban areas, challenges were noted in rural regions. AAS consumers expressed a preference for community pharmacies, perceiving them as less confronting and a feasible avenue for accessing professional advice, highlighting the potential role of pharmacists in nurturing therapeutic alliances with AAS consumers. Similarly, pharmacists expressed receptivity to providing harm reduction information but acknowledged knowledge gaps, suggesting a need for tailored education programs to support AAS consumers effectively.

CONCLUSIONS

Community pharmacies can be an important environment for AAS harm reduction. Strategies include utilising private spaces for open discussions with AAS consumers and enhancing pharmacists' understanding of AAS to foster trust and support. Further research is needed to address knowledge gaps and training needs for pharmacy staff, with the aim of creating a safer environment for AAS consumers.

The Pharmacy of the Future: Pharmacy Professionals' Perceptions and Contributions Regarding New Services in Community Pharmacies

The use of information and communication technologies (ICTs) has revolutionized the provision of health services, often referred to as eHealth, benefiting community pharmacies that can offer new services in innovative formats, namely through telepharmacy. This study aimed to explore the perceptions of pharmacy professionals (i.e., pharmacists and pharmacy technicians) on the provision of new services. The study consisted of administering an online questionnaire to pharmacy professionals nationwide. The questionnaire was developed by the research team, based on focus group methodology, from which an inductive analysis led to the categories that made up the dimensions of the survey. Participants were 95 pharmacy professionals with a mean age of 33.69 years old (SD = 10.75). Almost 79% were women. The results show overall receptivity to the development of new services in community pharmacies. Suggestions for the development of the new services, conditions necessary for their implementation, potential obstacles, and strategies to promote adherence to the new services, among others, are identified. The knowledge thus acquired will help community pharmacies to develop innovative solutions in counselling, pharmacotherapy monitoring, and pharmacovigilance, for example, of herb/dietary supplement-drug adverse reactions and interactions. Based on this information, new services can become more accessible, namely through the use of ICTs.

Health worker perceptions of the impact of COVID-19 on harm reduction services for people who inject drugs

The COVID-19 pandemic has affected entire systems of health service provision globally, including health service closure, redeployment of staff and resources and implementation of infection prevention protocols. Harm reduction facilities face particular challenges responding to COVID-19, attempting to continue service provision to people who inject drugs with minimal service disruption whilst protecting their staff. This research assessed the impact of COVID-19 on staff working at harm reduction and alcohol and other drug (AOD) services in Australia in the first 9 months of the pandemic. The research employed mixed methods, using survey data to inform in-depth interviews. Surveys were completed by 207 participants working in the AOD sector and the harm reduction sector nationally. Interviews were conducted with 16 staff at three harm reduction sites in metropolitan Sydney and one regional NSW service. Staff felt able to respond to the trying circumstances of this pandemic, especially as practical messages around the COVID-19 response were similar to those already in place for clients in relation to blood-borne virus prevention. Staff felt that they were still able to provide core services to clients with some modifications in delivery. They were willing to take on additional responsibilities to ensure their own safety and that of clients, including conducting temperature checks and screening questions, whilst also adopting novel service provision strategies to reach clients during lockdowns such as postal services, outreach work and telehealth. NSP and AOD services were able to implement COVID-19 infection control strategies, whilst maintaining and expanding service access through remote and innovative strategies in a manner which supported both clients and service providers, during the first wave of the pandemic in 2020.

Management of Medicines Wastage, Returned Medicines and Safe Disposal in Malaysian Community Pharmacies: A Qualitative Study

Introduction

In supplying medicines to patients and consumers waste can occur in prescribing, dispensing, and leftover stages. Pharmacists in community pharmacies play a crucial role in dispensing and should share information on appropriate medicines disposal with consumers. This qualitative study explored how Malaysian community pharmacists manage medication wastage, returned medicines, and medicines disposal by eliciting their opinions on medicines wastage, the challenges faced, and feasibility of medicine return and safe medicine disposal in the setting of Malaysian community pharmacy.

Methods

Telephonic interviews were conducted using a pre-validated interview guide among community pharmacists. Purposive sampling was used to ensure heterogeneity of participants in terms of gender, age, and position in the pharmacy. The interview was conducted until a point where no new information was obtained. Interview data were thematically analyzed.

Results

The analysis identified nine themes organized into four domains. The results revealed that pharmacists have positive perceptions of the safe disposal of medicines. Pharmacists mentioned that medicine returns to service in community pharmacies are not common due to a lack of facilities in the management of unwanted, expired, and returned medicines. As such pharmacists have suggested a few ways to minimize medicinal wastage.

Conclusions

Respondents aimed to minimize medicines wastage (unused medicines) in order to minimize loss of revenue. Respondents did not usually accept returned medicines due to the operational costs of safe disposal. Disposal of unused medicines was undertaken by centralizing the stocks at an organization facility before being disposed of by outsourced waste management companies.