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Thet MM, Khaing MNT, Zin SS, Oo S, Aung YK, Thein ST. Role of small private drug shops in malaria and tuberculosis programs in Myanmar: a cross-sectional study. J Pharm Policy Pract 2021; 14:89. [PMID: 34784970 PMCID: PMC8594090 DOI: 10.1186/s40545-021-00335-6] [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] [Received: 03/15/2021] [Accepted: 06/07/2021] [Indexed: 12/04/2022] Open
Abstract
Background The role of community drug shops in providing primary care has been recognized as important in Myanmar as in other countries. The contribution by private community drug shops to National Tuberculosis case notifications and National Malaria testing and positive cases is significant. Population Services International Myanmar (PSI/Myanmar) has been successfully training and engaging community drug shops to screen presumptive Tuberculosis to make referrals to public health clinics and perform malaria rapid diagnostic tests (mRDT) to malaria fever cases and provide management accordingly. Objectives The study aims to identify barriers to service provision of the trained providers at the drug shops that are currently engaged in PSI/Myanmar Tuberculosis and malaria programs. Exploring their needs enabled us to identify and address barriers, to provide evidence for better linkage with the primary care system. Method A mixed method study was conducted with the service providers at the drug shops. A quantitative follow up survey was done with 177 trained Tuberculosis service providers and 65 trained malaria service providers. A total of 32 qualitative in-depth interviews were completed. Seventeen Tuberculosis trained providers and 15 malaria trained providers participated in individual interviews. Content analysis approach was used to generate themes for the data analysis. Results From the survey, the majority of drug shops reported that they performed appropriate first steps, particularly referring symptomatic Tuberculosis cases and offering mRDT testing to fever cases. Nevertheless, in-depth interviews with them revealed they did not adhere to the national guidelines for every client. There was a need to emphasize the importance of following the national guidelines for referring patients with prolonged cough and fever cases management. For those who were trained in Tuberculosis case referral, support from program staff was needed to make smooth referrals. Those who were trained in malaria often considered differential diagnosis of fever other than malaria and did not test with malaria rapid diagnostic test due to declining numbers of malaria cases. Conclusion The study findings highlighted that the drug shops trained in Tuberculosis referral seemed to have the potential to fully engage into the primary care health system if provided with suitable support and supervision. On the other hand, those trained in malaria case management might be less motivated to engage in the era of declining malaria endemicity. Supplementary Information The online version contains supplementary material available at 10.1186/s40545-021-00335-6.
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Affiliation(s)
- May Me Thet
- Strategic Information Division, Population Services International Myanmar, No. 16, West Shwe Gone Dine 4th Street, Bahan Township, 11201, Yangon, Myanmar.
| | - Myat Noe Thiri Khaing
- Strategic Information Division, Population Services International Myanmar, No. 16, West Shwe Gone Dine 4th Street, Bahan Township, 11201, Yangon, Myanmar
| | - Su Su Zin
- Strategic Information Division, Population Services International Myanmar, No. 16, West Shwe Gone Dine 4th Street, Bahan Township, 11201, Yangon, Myanmar
| | - Sandar Oo
- Strategic Information Division, Population Services International Myanmar, No. 16, West Shwe Gone Dine 4th Street, Bahan Township, 11201, Yangon, Myanmar
| | - Ye Kyaw Aung
- Strategic Information Division, Population Services International Myanmar, No. 16, West Shwe Gone Dine 4th Street, Bahan Township, 11201, Yangon, Myanmar
| | - Si Thu Thein
- Strategic Information Division, Population Services International Myanmar, No. 16, West Shwe Gone Dine 4th Street, Bahan Township, 11201, Yangon, Myanmar
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Abubakar M, Atif M. Impact of Pharmacist-Led Interventions on Diabetes Management at a Community Pharmacy in Pakistan: A Randomized Controlled Trial. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2021; 58:469580211036283. [PMID: 34463538 PMCID: PMC8411651 DOI: 10.1177/00469580211036283] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Purpose The study aimed to determine the impact of pharmacist-led interventions on
diabetes management at a community pharmacy in Pakistan. Methods A one-month follow-up, randomized controlled trial (RCT) was carried out
between December 1, 2016 and June 30, 2017. Sampling population consisted of
patients diagnosed with type 2 diabetes mellitus (T2DM). The study
population was randomized to a control group or an intervention group to
determine the impact of a community pharmacist intervention on glycemic
control fasting blood glucose (FBG) and random blood glucose (RBG),
medication adherence (MMAS), and health-related quality of life (HRQoL)
(EQ-5D-3L). Both non-pharmacological and pharmacological interventional
tools were used that consist of array of charts and verbal communication by
pharmacist. Outcomes for continuous variables were analyzed using paired
sample t-test for time effect and one sample t-test to evaluate the study
group effect. Independent sample t-test was used to compare each independent
variable with dependent variable. A P-value of <.05 was
considered statistically significant. Results The control and intervention groups showed significant improvement
(P-value < .05) in glycemic control, medication
adherence, and HRQoL. However, the difference between the control and
intervention groups was not statistically significant in terms of blood
glucose levels and HRQoL (time trade off, TTO). There was a clinically
significant association between pharmacist intervention and predefined
glycemic control among the study participants (FBG: P-value
< .001 and RBG: P-value = .04). A clinically significant
association was also found between pharmacist intervention and medication
adherence at the end of the trial compared with baseline values
(P-value < .001). Similarly, a clinically
significant association was found between pharmacist intervention and
predefined HRQoL [TTO: P-value = .002 and EQ-VAS:
P-value = .001]. Conclusion A significant proportion of T2DM patients in the intervention group achieved
predefined glycemic control, medication adherence, and health related
quality of life.
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Affiliation(s)
- Muhammad Abubakar
- Department of Pharmacy Practice, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan.,Department of Pharmacy Practice, Faculty of Pharmacy and Health Sciences, University of Balochistan, Quetta, Pakistan
| | - Muhammad Atif
- Department of Pharmacy Practice, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
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Anosike C, Chu-Madu CN, Igboeli NU, Adibe MO, Ukwe CV. The participation of community pharmacists in the case management of malaria in Enugu metropolis, Nigeria: a cross-sectional survey. Malawi Med J 2021; 32:218-225. [PMID: 34457207 PMCID: PMC8364789 DOI: 10.4314/mmj.v32i4.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Nigeria accounts for approximately 25% of the global malaria burden. Malaria is a major cause of morbidity and mortality, especially in children and pregnant women. Pharmacists play vital roles in the fight against malaria. However, in Nigeria, the role of the community pharmacist in managing cases of malaria has received very little research attention. This study aimed to evaluate the level of participation of community pharmacists in the management of malaria cases in Enugu metropolis and to explore factors associated with such participation. Methods A cross-sectional survey was conducted among community pharmacists in Enugu metropolis using a modified and re-validated 16-item self-administered questionnaire. The questionnaire was distributed to participants in selected pharmacies for completion. Descriptive statistics and the chi-square test were used for statistical analysis. Results Out of the 103 participants, more than half (55.3%) were male. More than half of the pharmacists satisfactorily provided preventive (57.3%), pharmaceutical (62.1%), and curative (51.1%) services for patients with malaria. Overall, 57% of the pharmacists satisfactorily participated in the management of malaria cases. The number of years of practice was significantly associated with the pharmacists level of involvement in preventive (P=0.003) and curative (P=0.018) services. However, the provision of pharmaceutical care services for malaria patients was significantly associated with the sex of the respondents (P=0.023). Conclusions Our results suggest that more than half of the community pharmacists in Enugu metropolis were satisfactorily involved in the management of malaria cases. However, the number of years of practice and sex were factors associated with the extent of pharmacist involvement in the management of malaria cases.
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Affiliation(s)
- Chibueze Anosike
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, 410001, Enugu State, Nigeria
| | - Cordelia Ngozi Chu-Madu
- Department of Pharmacy, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - Nneka Uchenna Igboeli
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, 410001, Enugu State, Nigeria
| | - Maxwell Ogochukwu Adibe
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, 410001, Enugu State, Nigeria
| | - Chinwe Victoria Ukwe
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, 410001, Enugu State, Nigeria
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Batista AD, A. Rodrigues D, Figueiras A, Zapata-Cachafeiro M, Roque F, Herdeiro MT. Antibiotic Dispensation without a Prescription Worldwide: A Systematic Review. Antibiotics (Basel) 2020; 9:E786. [PMID: 33171743 PMCID: PMC7694985 DOI: 10.3390/antibiotics9110786] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/31/2020] [Accepted: 11/06/2020] [Indexed: 01/10/2023] Open
Abstract
Antibiotic resistance still remains a major global public health problem and the dispensing of antibiotics without a prescription at community pharmacies is an important driver of this. MEDLINE, Pubmed and EMBASE databases were used to search and identify studies reporting the dispensing of non-prescribed antibiotics in community pharmacies or drugstores that sell drugs for human use, by applying pharmacy interviews/questionnaires methods and/or simulated patient methods. Of the 4683 studies retrieved, 85 were included, of which 59 (69.4%) were published in low-and middle-income countries. Most of the papers (83.3%) presented a percentage of antibiotic dispensing without a prescription above 60.0%. Sixty-one studies evaluated the active substance and the most sold antibiotics without a prescription were amoxicillin (86.9%), azithromycin (39.3%), ciprofloxacin (39.3%), and amoxicillin-clavulanic acid (39.3%). Among the 65 articles referencing the diseases/symptoms, this practice was shown to be mostly associated with respiratory system problems (100.0%), diarrhea (40.0%), and Urinary Tract Infections (30.8%). In sum, antibiotics are frequently dispensed without a prescription in many countries and can thus have an important impact on the development of resistance at a global level. Our results indicate the high need to implement educational and/or regulatory/administrative strategies in most countries, aiming to reduce this practice.
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Affiliation(s)
- Ana Daniela Batista
- Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Daniela A. Rodrigues
- Research Unit for Inland Development, Polytechnic Institute of Guarda (UDI/IPG), 6300-559 Guarda, Portugal; (D.A.R.); (F.R.)
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15702 Santiago de Compostela, Spain; (A.F.); (M.Z.-C.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), 28001 Madrid, Spain
- Health Research Institute of Santiago de Compostela (IDIS), 15702 Santiago de Compostela, Spain
| | - Maruxa Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15702 Santiago de Compostela, Spain; (A.F.); (M.Z.-C.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), 28001 Madrid, Spain
| | - Fátima Roque
- Research Unit for Inland Development, Polytechnic Institute of Guarda (UDI/IPG), 6300-559 Guarda, Portugal; (D.A.R.); (F.R.)
- Health Sciences Research Centre, University of Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal
| | - Maria Teresa Herdeiro
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
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Björnsdottir I, Granas AG, Bradley A, Norris P. A systematic review of the use of simulated patient methodology in pharmacy practice research from 2006 to 2016. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2019; 28:13-25. [PMID: 31397533 DOI: 10.1111/ijpp.12570] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 07/09/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Simulated patient (SP) methodology (mystery shopping) is used increasingly to assess quality of pharmacy services, and evaluate impact of interventions. Our objective was to review papers reporting on the use of SP methodology in pharmacy practice research 2006-2016 in community pharmacies worldwide. METHODS We searched EMBASE and MEDLINE for papers reporting on the use of mystery shopping in pharmacy settings, using a wide range of terms for SPs, based on previous review. We removed irrelevant papers, duplicates, papers not written in English, and review papers and reviewed remaining papers. Two reviewers carried out data abstraction, using the same tool as the previous review and inserting data into Excel, focusing on how the SP methodology is used. KEY FINDINGS A total of 148 papers from 52 countries from all regions of the world were included in the review. A wide range of terms described the method, and simulated patient was the most common (49 papers). Most studies were cross-sectional (124), and most investigated only community pharmacies (115). The most common aim was to evaluate some aspect of pharmacists' or other staff's advice and counselling (94). Number of visits is 2-7785. Many papers did not cover details, such as number of visits planned, and carried out, scenario used, training and background of SPs, and ethical approval for the study. CONCLUSIONS The use of SP methodology has increased substantially in the field of pharmacy over the past decade. This is a useful method in a wide range of countries and settings. Greater detail is required in reporting.
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Affiliation(s)
| | | | - Amanda Bradley
- Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Pauline Norris
- School of Pharmacy, University of Otago, Dunedin, New Zealand
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Auta A, Hadi MA, Oga E, Adewuyi EO, Abdu-Aguye SN, Adeloye D, Strickland-Hodge B, Morgan DJ. Global access to antibiotics without prescription in community pharmacies: A systematic review and meta-analysis. J Infect 2019; 78:8-18. [DOI: 10.1016/j.jinf.2018.07.001] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 06/28/2018] [Accepted: 07/01/2018] [Indexed: 10/28/2022]
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Sinopoulou V, Gordon M, Rutter P. A systematic review of community pharmacies' staff diagnostic assessment and performance in patient consultations. Res Social Adm Pharm 2018; 15:1068-1079. [PMID: 30342907 DOI: 10.1016/j.sapharm.2018.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 10/02/2018] [Accepted: 10/09/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND Increases in patients seeking advice at pharmacies has led to pharmacy staff engaging in diagnostic behaviours. Approaches to diagnosis include using mnemonics and clinical reasoning. OBJECTIVES The primary aim of this review was to assess the degree to which the criteria researchers use to evaluate diagnostic performance in pharmacy consultations, in studies that have simulated patients or vignettes, conform with a clinical reasoning and a mnemonic framework. A secondary aim of the review was to characterize staff performance in the studies, based on the authors' comments of their results. METHODS MEDLINE, EMBASE and Web of Science were searched between October 2016 and April 2017. Only peer-reviewed studies assessing pharmacy staff's diagnostic performance using simulated patients or vignettes were eligible for inclusion. Data were extracted about how each study's criteria conformed with clinical reasoning and mnemonic frameworks. A scoring system between 0 and 4 was devised to determine the degree to which studies aligned to these two approaches. Risk of bias was assessed using the NHI Study Quality Assessment Tools. The review was registered in PROSPERO with identification number CRD42017054827. RESULTS Sixty-eight studies (55 cross-sectional, 11 educational interventions and 2 RCTs) with sample sizes between 10 and 2700 were included in the review. Most studies were of poor or fair quality. Performance of pharmacy staff was overwhelmingly reported as poor by study authors. This was the case regardless of geography, scenario used, or assessment framework adopted. Scrutiny on how authors arrived at these conclusions revealed that mnemonic criteria were employed to assess pharmacy staff's diagnostic performance rather than a clinical reasoning approach. CONCLUSIONS Potentially important aspects of the decision-making process, such as clinical reasoning, were left unexplored. The number and geographic distribution of the included studies is a strength of this review; however, a validated tool was not employed.
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Affiliation(s)
- Vassiliki Sinopoulou
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, United Kingdom.
| | - Morris Gordon
- School of Medicine, University of Central Lancashire, United Kingdom
| | - Paul Rutter
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, United Kingdom
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Abstract
In 2013, the Guinean health authority had to reorganise and run a national response against malaria as a priority. The review of the National Strategic Plan to fight malaria in Guinea was carried out and one of its critical components was the prevention and rapid management of fever (RMF) attributable to malaria in children. The study reports on the demographic and health determinants of this rapid management in children under 5. The participants were 4786 children from 2874 representative households. RMF was defined in terms of recourse to primary care. The recourse was defined by child's reference for the treatment of fever which led or not to treatment of malaria. We found that 1491 children (31.2%) had a bout of fever within the 2 weeks that preceded the survey. The prevalence of malaria was 45.4% among those children who have a bout of fever. The recourse to traditional healers was estimated at 9.6% and the use of health facilities was estimated at 71.5%. Overall, 74.9% of children with fever received treatment within the recommended timeliness (24 h), with regional disparity in this rapid response. The high proportion of recourse to traditional healers is still a matter of concern. New control and prevention strategies should be extended to traditional healers for their training and involvement in directing febrile children to health facilities.
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