Screening for diabetic peripheral neuropathy at community pharmacies in Slovakia.

AIM: To identify diabetic patients with a potential risk of developing diabetic peripheral neuropathy (DPN) in community pharmacies in Slovakia using a modified Michigan Neuropathy Screening Instrument questionnaire (MNSIq-12). METHODS: This cross-sectional study enrolled 703 patients with type 1 and type 2 diabetes mellitus who had not been diagnosed with DPN. The study took place in selected community pharmacies across Slovakia in October 2019. The MNSIq-12 was administered by pharmacy students, and a Michigan score <1.5 was considered risky. The groups divided based on the Michigan score were compared in terms of duration of diabetes, age, body mass index (BMI), sex, weekly physical activity, level of education, and smoking. RESULTS: The risk of developing DPN was detected in 6.6% of respondents with type 1 diabetes and 13.4% with type 2 diabetes. Patients with both types of diabetes (38.2%; 67.0%) reported fatigue and heaviness in the legs as the most common clinical symptoms that may indicate the development of DPN. Those with a Michigan score <1.5 were older (P<0.0001), had a higher BMI (P<0.0001), a lower level of education (P=0.0020), and were less physically active (P<0.0001). Conclusion Approximately one-eighth of patients with diabetes who visited community pharmacies were potentially at risk for developing DPN. The modified MNSIq-12 was shown to be a simple, time-effective, and non-invasive indicative screening tool that can be applied in the environment of community pharmacies.

Facilitators and barriers to behavior change in overweight and obesity management using the COM-B model.

Introduction: Increasing overweight and obesity rates represent one of the global public health challenges. COM-B is a theoretical model used to identify areas to target to achieve behavior change. It identifies three factors that are needed for any behavior to occur: capability, opportunity, and motivation. We aimed to assess the potential facilitators and barriers to behavior change in weight management using the COM-B. Methods: The study included 139 people with overweight and obesity (mean age 48.81 ± 14.49 years; 64.5% female; body mass index 32.64 ± 6.51 kg/m2; waist-to-height ratio 0.62 ± 0.10) from primary care settings. All participants completed the Brief Measure of Behavior Change (COM-B), the General Self-Efficacy Scale (GSE), the Rosenberg Self-esteem Scale (RSE), and the Overall Evaluation of Health (OEH). Multiple linear regression was performed to analyse the data. Results: The associations between sociodemographic and clinical variables and COM-B domains attenuated or were no longer significant when psychological resources were added to the regression models. Self-efficacy was identified as a stronger facilitator of health behavior change (p < 0.001) when compared to self-esteem (p < 0.05). No associations between automatic motivation and psychological resources were identified, however. Automatic motivation was found to be associated with higher age, being in a relationship, and better health. Discussion: Behavioral interventions for weight management should specifically target different components of COM-B. Self-efficacy and self-esteem may play a significant role in individual capabilities, opportunities, and reflective motivation and should be included in tailored public health interventions. Health programs targeting younger and single people, and people with chronic conditions may help to promote sustainable behavior change.

Nutritional Treatment of Patients with Colorectal Cancer.

Colorectal cancer is one of the most common cancers in Europe and the world. Cancer treatments have side effects and cause significant deterioration of the patient's nutritional status. Patient malnutrition may worsen the health condition and prevent the deliberate effects of the therapy. The aim of this review was to describe the available data about clinical nutrition in colorectal cancer patients. A large proportion of colorectal cancer patients suffer from malnutrition, which negatively affects the survival prognosis, quality of life, and oncological therapy. Therefore, monitoring nutritional status during the treatment is essential and can be used to arrange proper nutritional therapy to enhance patient responses, prevent side effects, and shorten recovery time. The principles of nutrition during anticancer therapy should mainly consider light and low-fat foods, the exclusion of lactose and gluten-containing foods in certain cases, or the introduction of special dietary products such as oral nutrition supplements and it should be tailored to patients' individual needs.

Greek Translation and Cultural Adaptation of the Short Version of the Maastricht Utrecht Adherence in Hypertension Questionnaire.

BACKGROUND: The recently published short version of the Maastricht Utrecht Adherence in Hypertension (MUAH) questionnaire (MUAH-16) suggests that MUAH-16 better represents a patient's adherence to antihypertensive medication than the original MUAH questionnaire. OBJECTIVE: The aim of our study was the cultural adaptation and validation of the short MUAH-16 questionnaire in the Greek population. METHODS: 10 patients were involved in the process of translation and cultural adaptation of MUAH-16, providing feedback on the final version, which was then administered to 100 patients. All patients received at least one antihypertensive drug during the last three months and were followed in the Hypertension-24h ABPM ESH Center of Excellence, Outpatient Clinic for the Treatment of Hypertension in the 3rd Internal Medicine Department of Papageorgiou General Hospital of Thessaloniki. RESULTS: A factor analysis revealed a similar internal structure with four subscales that closely resembled the subscales in the original version of the questionnaire. Internal reliability indexes are equal or better than those of the original subscale structure. CONCLUSIONS: The Greek translation of the MUAH-16 is a good match for the original version with small, cultural differences. More research is needed in order to validate the proposed revised internal structure with a larger sample.

Assessment of patient counselling on the common cold treatment at Slovak community pharmacies using mystery shopping.

BACKGROUND: Up to now, there have been no data on patient counselling in the Slovak community pharmacies. The literature provides a wide range of activities for which mystery shopping methodology be used, including assessment of patient counselling. AIMS AND OBJECTIVES: To assess patient counselling on the common cold treatment with OTC medicine containing zinc provided by Slovak community pharmacists. To analyse this counselling considering the set scenarios, counsellors and their age. METHODS: 54 pharmacy students visited 270 different community pharmacies throughout Slovakia in 2 weeks in October 2016 to conduct mystery shopping with set scenarios. For assessment of patient counselling, we defined Counselling Performance. It was conceptualised as weighted mean percentage counselling successes rate of its three categories (Identification, Information and Communication) and their weights. Individual perception of counselling evaluated separately. Student t-test and Person's chi-squared test (p < 0.05) and Cohen delta were used for comparing outcomes and effect size of counselling. A simple linear regression was used to find relationships. RESULTS: The total Counselling Performance was 39.0 ±â€¯22.4%, Identification 30.6 ±â€¯28.7%, Information 39.8 ±â€¯25.1% and Communication 74.3 ±â€¯11.5%. 26.3% pharmacies achieved the average Counselling Performance (41-60%). Subjective Perception had a success rate of 73.4 ±â€¯21.2%, but it could be predicted by the Counselling Performance and the success rate of the three categories only in 1/5 pharmacies. Spontaneous counselling was provided more by pharmacy technicians (p = 0.0009). The duration of counselling was similar when comparing both scenarios, counsellors and their age. The product-requested scenario achieved a higher success rate in the Information category (p = 0.0304; d = 0.27). Pharmacists achieved a higher Counselling Performance (p < 0.0001; d = 0.48) and success rate in categories Identification (p = 0.0001, d = 0.46), Information (p = 0.0004, d = 0.37), and Perception (p = 0.0007; d = 0.54). The estimated age of counsellors did not have any impact on the counselling. CONCLUSION: Patient counselling on the common cold showed a suboptimal level, particularly considering its content. In the study, we found a significant relationship between the success of counselling and counsellors.

Soluble Cripto-1 Induces Accumulation of Supernumerary Centrosomes and Formation of Aberrant Mitoses in Human Embryonic Stem Cells.

Chromosomal instability evoked by abnormalities in centrosome numbers has been traditionally considered as a hallmark of aberrant, typically cancerous or senescent cells. We have reported previously that pristine human embryonic stem cells (hESC) suffer from high frequency of supernumerary centrosomes and hence may be prone to undergo abnormal mitotic divisions. We have also unraveled that this phenomenon of multicentrosomal mitoses vanishes with prolonged time in culture and with initiation of differentiation, and it is strongly affected by the culture substratum. In this study, we report for the first time that Cripto-1 protein (teratocarcinoma-derived growth factor 1, epidermal growth factor-Cripto/FRL-1/Cryptic) produced by hESC represents a factor capable of inducing formation of supernumerary centrosomes in cultured hESC. Elimination of Cripto-1 signaling on the other hand restores the normal number of centrosomes in hESC. Linking the secretory phenotype of hESC to the centrosomal metabolism may help to develop better strategies for propagation of stable and safe bioindustrial and clinical grade cultures of hESC. From a broader point of view, it may lead to unravelling Cripto-1 as a micro-environmental factor contributing to adverse cell behaviors in vivo.

Community pharmacy customer segmentation based on factors influencing their selection of pharmacy and over-the-counter medicines.

BACKGROUND: Within the competitive pharmacy market environment, community pharmacies are required to develop efficient marketing strategies based on contemporary information about consumer behavior in order to attract clients and develop customer loyalty. OBJECTIVES: This study aimed to investigate the consumers' preferences concerning the selection of pharmacy and over-the-counter (OTC) medicines, and to identify customer segments in relation to these preferences. METHODS: A cross-sectional study was conducted between February and March 2016 on a convenient quota sample of 300 participants recruited in the metropolitan area of Thessaloniki, Greece. The main instrument used for data collection was a structured questionnaire with close-ended, multiple choice questions. To identify customer segments, Two-Step cluster analysis was conducted. RESULTS: Three distinct pharmacy customer clusters emerged. Customers of the largest cluster (49%; 'convenience customers') were mostly younger consumers. They gave moderate to positive ratings to factors affecting the selection of pharmacy and OTCs; convenience, and previous experience and the pharmacist's opinion, received the highest ratings. Customers of the second cluster (35%; 'loyal customers') were mainly retired; most of them reported visiting a single pharmacy. They gave high ratings to all factors that influence pharmacy selection, especially the pharmacy's staff, and factors influencing the purchase of OTCs, particularly previous experience and the pharmacist's opinion. Customers of the smallest cluster (16%; 'convenience and price-sensitive customers') were mainly retired or unemployed with low to moderate education, and low personal income. They gave the lowest ratings to most of the examined factors; convenience among factors influencing pharmacy selection, whereas previous experience, the pharmacist's opinion and product price among those affecting the purchase of OTCs, received the highest ratings. CONCLUSIONS: The community pharmacy market comprised of distinct customer segments that varied in the consumer preferences concerning the selection of pharmacy and OTCs, the evaluation of pharmaceutical services and products, and demographic characteristics.

Level and Factors Influencing the Patient's Satisfaction with the Pharmaceutical Care in Slovakia.

The patients' satisfaction is an integral component of the provided pharmaceutical care and afactor affecting its quality. This study gives an assessment of the patients´ satisfaction with the pharmaceutical care provided by the community pharmacists in Slovakia and it identifies the factors influencing it. Atotal of 2,844 respondents from 33 community pharmacies in 23 different Slovak towns took part in the first Slovak nationwide survey during the period from October to December 2013. The survey used amodified and validated questionnaire containing 29 items from three dimensions of pharmaceutical care (Managing Therapy, Interpersonal Relationship, General Satisfaction). The results are presented in percentages and by the level of satisfaction within the following range level: positive evaluation (score 1.00 to 2.50), neutral evaluation (score 2.51 to 3.50) and negative evaluation (score 3.51 to 5.00) based on the calculated average scores from the Likert scale, which is used to express the satisfaction of respondents (1 ­ very satisfied, 2 ­ satisfied, 3 ­ neither satisfied, nor dissatisfied, 4 ­ dissatisfied, 5 ­ very dissatisfied). The survey showed high patients' satisfaction with the pharmaceutical care provided by community pharmacists in Slovakia. The evaluation of all three dimensions was positive (scores ranged from 1.85 to 2.24). The proportion of respondents with positive assessments was at the least 65.4% and at the most 86.7%. Interpersonal Relationship was the most positively assessed dimension (score 1.85 ± 0.598; 86.7% of respondents reached positive evaluation, 12.3% neutral and 1.0% negative evaluation) followed by General Satisfaction (score of 2.02 ± 0.643; 71.3% of respondents reached positive evaluation, 26.5% neutral and 2.2% negative evaluation). Managing Therapy was the least positively evaluated dimension (score 2.24 ± 0.704; 65.4% of respondents reached positive evaluation, 31.1% neutral and 3.5% negative evaluation). Age, level of education, number of patronized pharmacies, number of medicines, financial expenses in pharmacies and the region had astatistically significant impact on the evaluation of the patients' satisfaction in all three dimensions (p < 0.001). Gender had no statistically significant effect on satisfaction rating in either of the monitored dimensions (Managing Therapy p = 0,17; Interpersonal Relationship p = 0.002; General Satisfaction p = 0.022). Long-term use of medicines had no significant effect on satisfaction in Managing Therapy (p = 0.170), either. The evaluation of the patients' satisfaction requires further improvement and the analysis of the influence of identified factors which can determine it.

[Medical and entrepreneurial character of the community pharmacy]. / Zdravotnícky a podnikatelský charakter lekárne.

UNLABELLED: Community pharmacy provides citizens with pharmaceutical care and runs its health care business on the market with state regulatory interventions. These restrictions affect its stability and because of that it has to be constantly monitored. The convenient way of monitoring the financial health of a community pharmacy is the use of financial analysis and its outcomes that are profitability, liquidity, debt and productivity ratios. The aim of this paper was to determine the economic situation in the public pharmacy services in Slovakia. A representative set of community pharmacies was established that reflected the criteria of localization by regions in Slovakia, the size of the city or municipality and the legal form of the subject. The financial analysis for the years 2007-2012 showed a declining return on sales (in 2012 to 1.98 %), a decreasing current liquidity (in 2012 to 1.87 %), a declining quick ratio (in 2012 to 1.08 %), a decrease in the time receivables turnover (in 2012 to 53.8 days), a slight increase in the inventory turnover time - days sales in inventory (in 2012 to 36.5 days) and increased turnover time commitments - liabilities turnover (in 2012 to 86.3 days). KEYWORDS: community pharmacy financial health profitability liquidity productivity.

[Globalization and its impact on pharmacy services in the Slovak Republic]. / Globalizácia a jej dopady v lekárenstve SR.

Public pharmacies are excellent medical facilities having the largest number of contacts with patients. They are the facilities of the first and last contact with the health care system for the patient. Public pharmacies are unique and easily accessible places in the health care system with a high proficiency in the provision of pharmaceutical care and highly qualified medical staff. The aim of this paper was to determine geographical-demographic situation, the legal form of the ownership of public pharmacies, and the owner share of pharmacists on the capital of public pharmacies in Slovakia. The number on of providers of pharmaceutical care depends on the population at the level of regions, districts, towns and villages with differing tightness of binding. The most common legal form of the provider of pharmaceutical care in Slovakia in public pharmacies were limited companies with 73.6% share, a sole proprietor - pharmacist had 23.9%, and public limited companies had 1.3%. In the branches of public pharmacies the limited companies had 73.4% share, a sole proprietor - pharmacist had 26%, public limited companies had 1%. The owner share of the pharmacist on the capital in public pharmacies was 50.4%, and in the branches of public pharmacies it was 66%, owned by a sole proprietor or limited company.

[A view on providing care in the field of medicines in Slovakia - the pharmacist and the patient]. / Pohlad na poskytovanie starostlivosti v oblasti liekov na Slovensku - lekárnik a pacient.

The paper deals with the evaluation of care provided in a public pharmacy in terms of achieving patient / customer satisfaction. Expectations and opinions of patients are also confronted with the assumptions of pharmacists. Up to 82% of patients confirmed their satisfaction with the care given to them by the pharmacist. A key factor of patient satisfaction has proved particularly professional and human approach of pharmacist. 73.6% of patients in the survey accepted pharmacist as an expert on drugs. Pharmacist self-evaluation was more negative. Monitoring and evaluation of patient satisfaction with care delivered in the pharmacy is essential for the improvement of the quality of the health system and the implementation of pharmaceutical care focussed on the patient. The real application of pharmaceutical care in the practice currently lacks the necessary conditions and support.