Pharmacists in dispensing drugs (PharmDisp): protocol for a clinical trial to test the effectiveness of distance education in training pharmacists for dispensing drugs

ABSTRACT Dispensing drug is a moment in which the pharmacist is able to analyze pharmacotherapy and contribute to its rational use. However, research has shown that some pharmacists lack adequate knowledge to perform this service. This study aims to describe a research protocol for a clinical trial to test the effectiveness of a distance learning program to train pharmacists in dispensing drugs. This is a protocol for an open diagnostic, non-randomized, single group clinical trial. A 12-week duration distance learning course was structured on the Moodle platform for training community pharmacists who are registered in the Regional Board of Pharmacy and work as employees or owners in Brazilian community pharmacies. The course curricula involves concepts and practice of dispensing drugs applied to the treatment of hypertension, diabetes mellitus, dyslipidemia and asthma. Pharmacists are divided randomly into groups, to which previously selected tutors give directions to the discussion and clarify questions. A validated questionnaire is being used before and after the course to measure participants' knowledge. Participant satisfaction with the course is also being measured. Pharmacists who work in the study headquarters municipality receive two visits from a mystery shopper, before and after the course, to evaluate their performance in dispensing drugs. The virtual platform and the content of the course material were evaluated by judges. The study has been approved by the Research Ethics Committee of the School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo. The sample size was estimated to provide desired power for testing the significance of the difference between baseline-to-endpoint change scores. Information about the course is being released through channels such as social networks. The results will be submitted for publication in scientific journals, but information enabling the identification of the study subjects will be kept confidential. The trial has been registered in The Brazilian Clinical Trials Registry with number RBR7mbrp3 on January 15th, 2015.

Evaluation of community pharmacists' knowledge, attitude and practice towards good pharmacy practice in Iran

The principles of pharmaceutical care are embedded in the concept of Good Pharmacy Practice [GPP]. GPP is poorly applied in community pharmacies not only in Asian countries, but even in United States and Europe. The present study was undertaken to evaluate the knowledge, attitude and practice of the community pharmacists in Iran, regarding GPP. A total of 794 pharmacists were evaluated with a reliable and validated KAP [Knowledge, Attitude, and Practice] questionnaire regarding GPP in September 2008. The most important finding in the present study was the pharmacists' low knowledge [Mean= 13.42] and practice [Mean= 29.85] level about GPP, while their attitude towards this subject was at a high level [Mean= 74.83]. Increase in their knowledge of good pharmacy practice aligned with an increase in their attitudes towards this issue. Also increase in our pharmacists' knowledge and attitude aligned with an increase in quality of their practice. The current practice of Iranian community pharmacists needs further improvement. National pharmaceutical organizations should organize educational programs for the community pharmacists to equip them for their main role in community practice: promoting rational drug use.

Perfil da Assistência Farmacêutica na Coordenadoria Regional de Saúde Sul do município de São Paulo

A qualidade do uso de medicamentos está diretamente relacionada à qualidade do serviço de saúde. Neste contexto, a padronização e a distribuição de fármacos tornam-se fatores primordiais para a boa avaliação destes serviços, visto que a farmácia é o elo final entre o serviço prestado pelo SUS e o usuário. A credibilidade de todo o sistema depende, entre outras coisas, do bom trabalho da farmácia. A distribuição dos serviços de farmácia, de forma regionalizada visa aproximar o usuário da satisfação de suas necessidades, colocando a sua disposição uma série de equipamentos especializados, que enriquecem a atenção básica em saúde

Perfil da assistência farmacêutica na coordenadoria regional de saúde sul do município de São Paulo / Profile of the pharmaceutical care

A qualidade do uso de medicamentos está diretamente relacionada à qualidade do serviço de saúde. Neste contexto, a padronização e a distribuição de fármacos tornam-se fatores primordiais para a boa avaliação destes serviços, visto que a farmácia é o elo final entre o serviço prestado pelo SUS e o usuário. A credibilidade de todo o sistema depende, entre outras coisas, do bom trabalho da farmácia. A distribuição dos serviços de farmácia, de forma regionalizada visa aproximar o usuário da satisfação de suas necessidades, colocando a sua disposição uma série de equipamentos especializados, que enriquecem a atenção básica em saúde.

Imagen profesional de farmacias comunitarias: causas y estrategias de mejora aplicando técnicas de investigación cualitativa / Community pharmacies' professional image: causes and improvement strategies by applying qualitative research techniques

Objetivo Conocer las opiniones de los farmacéuticos con relación a los factores que explican la falta de visibilidad de la farmacia comunitaria como establecimiento sanitario y proponer estrategias de desarrollo profesional a fin de lograr mejorar la accesibilidad a los servicios profesionales mediante técnicas de investigación cualitativa. Material y métodos Se utilizó una Técnica de Grupo Nominal (TGN) en 2 rondas sucesivas, respondiendo a 2 consignas guía sobre factores y estrategias. Posteriormente se realizó un Framework analysis. Resultados Se aportaron 34 ideas referidas a factores y 32 a estrategias. Las estrategias fueron agrupadas en 14 temas, destacándose las vinculadas a la priorización de los servicios profesionales orientados a los pacientes, al cumplimiento de la ética y a la formación continua del farmacéutico. Discusión Las técnicas utilizadas permitieron evidenciar situaciones percibidas por los farmacéuticos que no están formalmente descriptas en la literatura. Aumentar la visibilidad de los servicios profesionales en las farmacias comunitarias implica acordar y abordar estrategias que deben sustentarse en la participación conjunta de los propios farmacéuticos, las asociaciones profesionales y las universidades.

Objective Ascertaining pharmacists' views related to factors explaining the lack of visibility of community pharmacies as being health facilities and proposing strategies for improving community pharmacy professional service accessibility using qualitative research techniques. Methods The nominal group technique (NGT) was used in two successive rounds using separate guidelines for factors and strategies. Framework analysis was then carried out. Results Thirty-four ideas related to "factors" and 32 related to "strategies" were obtained. Strategies were grouped into 14 topics, emphasising those prioritising patient-orientated professional services, ethical aspects and pharmacists' ongoing education. Discussion The techniques used led to identifying situations perceived by pharmacists which are not formally described in the literature. Raising awareness of professional services in community pharmacies implies agreeing on and developing strategies which should be based on joint participation by the pharmacists themselves, professional associations and universities.

La farmacoeconomía en la toma de decisiones: una perspectiva de superación profesional en Santiago de Cuba / Pharmacoeconomics in decision-making: a perspective of occupational training in Santiago de Cuba

Este estudio responde al proyecto ramal: Estrategia para el desarrollo de la Farmacoeconomía en Santiago de Cuba, del cual solo se analizó la línea de investigación denominada: Superación profesional, con la finalidad de contribuir al adecuado uso de las herramientas que brinda la fusión de ambas especialidades para la toma de decisiones en las diferentes instituciones sanitarias de la provincia, mediante acciones a realizar a corto y largo plazos en pro del perfeccionamiento y la actualización de la labor de los profesionales vinculados con esa esfera de la salud.

This study responds to the branch project: Strategy for developing the Pharmacoeconomics in Santiago de Cuba, of which the line of investigation termed Occupational training was only analyzed, with the purpose of contributing to the appropriate use of tools that the combination of both specialties offers for decision-making in different health institutions of the province, by taking the short-and long-term actions for improving and updating the work of professionals linked to that health sphere.

Leucopenias por medicamentos / Leukopenia by drugs

Em estudo retrospectivo realizado no Centro de Hematologia de Säo Paulo, envolvendo a análise de 10.000 casos no período de 5 anos, avaliou-se a frequência de reaçöes adversas a medicamentos que provocassem leucopenia, agranulocitose e aplasia medular e sua classificaçäo de acordo com os critérios estabelecidos pelo "Registry of Tissue Reactions to Drugs". Constatou-se que leucopenias, agranulocitose e aplasia medular como reaçäo adversa a medicamentos säo relativamente raras, incidindo no total, em um centro especializado, na proporçäo de 2 em 1000 casos. A concomitância em alguns caos de produtos ditos "naturais" faz os autores discutirem a necessidade de controle e normalizaçäo no uso de tais produtos )