'I think we could probably do more': an interview study to explore community pharmacists' experiences and perspectives of frailty and optimising medicines use in frail older adults.

BACKGROUND: Community pharmacists potentially have an important role to play in identification of frailty and delivery of interventions to optimise medicines use for frail older adults. However, little is known about their knowledge or views about this role. AIM: To explore community pharmacists' knowledge of frailty and assessment, experiences and contact with frail older adults, and perceptions of their role in optimising medicines use for this population. METHODS: Semi-structured interviews conducted between March and December 2020 with 15 community pharmacists in Northern Ireland. Interviews were transcribed verbatim and analysed thematically. RESULTS: Three broad themes were generated from the data. The first, 'awareness and understanding of frailty', highlighted gaps in community pharmacists' knowledge regarding presentation and identification of frailty and their reluctance to broach potentially challenging conversations with frail older patients. Within the second theme, 'problem-solving and supporting medication use', community pharmacists felt a large part of their role was to resolve medicines-related issues for frail older adults through collaboration with other primary healthcare professionals but feedback on the outcome was often not provided upon issue resolution. The third theme, 'seizing opportunities in primary care to enhance pharmaceutical care provision for frail older adults', identified areas for further development of the community pharmacist role. CONCLUSIONS: This study has provided an understanding of the views and experiences of community pharmacists about frailty. Community pharmacists' knowledge deficits about frailty must be addressed and their communication skills enhanced so they may confidently initiate conversations about frailty and medicines use with older adults.

Knowledge and practice of community pharmacists regarding the safety of drugs during pregnancy: a cross-sectional study from a developing country.

BACKGROUND: Drug use during pregnancy can cause unfavorable fetal and maternal outcomes. Information sharing is essential for pharmacists' role within intricate, modern healthcare systems. Community pharmacists (CPs) have demonstrated unsatisfactory knowledge across various pharmacological domains in most developing countries. This study aimed to explore the knowledge and practices of CPs regarding medications and herb safety during pregnancy. METHODS: A cross-sectional study was conducted in a developing country using a self-administered questionnaire. A sample of CPs working in the northern governorates of the West Bank was selected by convenience sampling. The questionnaire included questions on sociodemographic characteristics, practices and knowledge. Descriptive and inferential statistics were calculated using the Statistical Package for the Social Sciences (SPSS) to analyze the data. RESULTS: A total of 207 questionnaires were completed. Most respondents had only a bachelor's degree (89.9%) but did not participate in continuous professional development (CPD) (71.0%). Almost one-third of the CP workload involved dispensing drugs to pregnant women. The majority of the participants reported that they inquire about pregnancy status (59.9%), refer to scientific sources (82.6%), and contact a prescribing physician (51.2%) in cases of uncertainty. A higher knowledge score was associated with receiving a master's degree and CPD programs. Most CPs identified folic acid, paracetamol and amoxicillin as safe, while tetracycline, isotretinoin, enalapril, pseudoephedrine and ibuprofen were among the drugs mostly reported as unsafe. Castor oil, Senna, St. John's wort and ginseng were the most frequently reported herbs as unsafe. CONCLUSIONS: Despite the gaps in knowledge about herb pharmacology, CPs demonstrated acceptable knowledge and practice regarding drug safety during pregnancy. CPD is recommended for addressing gaps in knowledge and practice. Future research evaluating knowledge and practice may benefit from developing a specific, accurate, validated instrument.

Assessing pediatric antibiotic knowledge and practices among community pharmacists in Palestine: implications for antibiotic use and resistance.

BACKGROUND: Antibiotics are widely used in the pediatric population, and their inappropriate use contributes to antibiotic resistance, which is a growing concern in developing countries. Therefore, this national cross-sectional study aimed to assess community pharmacists' knowledge, attitudes and practices regarding appropriate antibiotic use and dosing in pediatric patients and to explore the barriers to such use in Palestine. METHODS: A questionnaire-based survey was conducted among community pharmacists on the West Bank, Palestine, from September 2022 to March 2023. The survey assessed the pharmacists' sociodemographic characteristics; knowledge, practices, and attitudes toward antibiotic use; and understanding of antibiotic dosing. The data were analyzed using descriptive statistics, and the factors affecting pharmacists' knowledge were evaluated. RESULTS: The study included 301 community pharmacists, with an average age of 30.06 years, who were primarily female (75.1%). The majority of the pharmacists (80.1%) correctly believed that antibiotics are effective against bacterial infections. However, 18.3% believed that antibiotics are effective against viruses. While 61.8% knew that antibiotics kill germs, 32.0% were unaware that not all antibiotics require refrigeration. Furthermore, 67.8% were aware that antibiotics do not speed up recovery from diarrhea. Over 99% of the participants recognized that antibiotic resistance developed due to various resistant mechanisms. The majority (78.7%) believed that each infection needed a different antibiotic. Pharmacists demonstrated reasonable knowledge of antibiotic dosing in case scenarios. Knowledge was positively correlated with years of experience (P = 0.001). CONCLUSIONS: This study revealed that community pharmacy professionals have a good understanding of antibiotic usage in pediatric patients. The findings suggest that professional expertise and quality training improve healthcare services. However, the results may not be universally applicable, as identifying knowledge gaps is necessary to help with the development of focused interventions. Therefore, ongoing educational initiatives, awareness campaigns and antibiotic stewardship programs are recommended.

Knowledge of community pharmacists on infantile haemangioma: Gaps and lack confidence to deliver propranolol still need to be filled.

AIM: To evaluate the knowledge, practices and self-confidence of community pharmacists, pharmacy technicians and pharmacy students about infantile haemangioma (IH) and propranolol treatment. METHODS: A national survey was conducted in France from May 2022 to October 2022. A 42-item online questionnaire was used to assess pharmacists' knowledge of the epidemiology, clinical features and management of IH and propranolol treatment. RESULTS: The survey included 255 participants. The mean age was 34.9 years (±9.0); 225 (88%) were women. In all, 193 (76%) practised in urban pharmacies. Altogether, 83 participants (33%) had delivered oral propranolol solution for IH in the last 6 months. Participants' median score for self-confidence regarding propranolol dispensing was five (interquartile range, 2.5-6) on a scale of 1 to 10. Overall, 96 (38%) had more than 50% correct answers on the questionnaire. Multinomial regression models showed high scores on the questionnaire associated with high self-confidence when delivering oral propranolol solution, low number of years since graduation and having already delivered propranolol treatment. CONCLUSION: This study highlights a lack of knowledge of IH and modalities of propranolol treatment by community pharmacists and slight self-confidence when delivering propranolol. Greater cooperation between healthcare professionals could improve the proper use of medicine.

Identifying training needs of practising community pharmacists in Jordan-a self-assessment study.

BACKGROUND: Being the professional membership body for pharmacists in Jordan, the Jordan Pharmacists Association (JPA) took the initiative to establish a training centre for practising pharmacists. This study aims to identify the self-assessed training priorities of community pharmacists in Jordan. METHODS: In the period between August and October 2022, an online self-administered questionnaire was distributed using a variety of participants' identification and recruitment approaches. The questionnaire targeted currently practising community pharmacists. Data were analysed descriptively and inferentially. RESULTS: In total, 470 community pharmacists participated in this study. Of 470 participants, 307 (65.3%) were employees, of which 206 were full-time employees. Results showed that only 97 (21%) had access to an in-house training programme or scheme. Self-assessment of training needs highlighted differences between the three competencies clusters. While administrative and managerial skills and competencies were more frequently prioritised on average than the other two clusters, interpersonal and communication skills were needed the least. Evidence showed a significant difference between female and male participants regarding the need for training addressing maternity and early childhood health training issues. Lastly, the role-based comparison showed that, compared to pharmacy owners, employees had a significantly higher need for training related to bookkeeping and taxation returns preparation and how to handle and manage records of narcotic and controlled medicines. CONCLUSIONS: If training and development programmes are tailored to address specific needs in administrative, clinical, and interpersonal competencies, community pharmacists have the potential to enhance public health, expand their role, provide patient-centred care, and support the national healthcare system.

The roles of French community pharmacists in palliative home care.

BACKGROUND: The World Health Organization identifies pharmacists as a key resource in palliative care. However, the roles of these professionals in end-of-life care at home remain poorly understood, and community pharmacists themselves sometimes struggle to recognize their true role in this care. The aim of our study was to analyze community pharmacists' representations of their roles in palliative care at home in France. METHODS: The methodology was qualitative and based on semi-structured interviews with community pharmacists (n = 26). The analysis of the interviews was carried out using a qualitative content approach with thematic and lexical analysis. RESULTS: Three main elements of the community pharmacist's role were identified: drug expertise, care management, and psychosocial support for patients and their families. CONCLUSIONS: This study highlights a wide variety of roles adopted by French community pharmacists in palliative care at home. Some of these roles, which are in line with WHO recommendations on palliative care, have been little described to date. These roles of community pharmacists in home-based palliative care could be better recognized, and the players better integrated into end-of-life care systems at home, in order to improve such care. TRIAL REGISTRATION: This work was carried out within the framework of a call for projects from the Fondation de France and has received the approval of the University Clermont Auvergne Research Ethics Committee (no. IRB00011540-2021-60).

Development and effectiveness of a BOPPPS teaching model-based workshop for community pharmacists training.

BACKGROUND/AIM: With the pharmaceutical innovation and clinical knowledge updating, the continuing education and on-the-job training are extremely important for improving community pharmacists' professional competence. Previous training often adopted traditional lecture-based teaching, and the efficacy was limited. The aim of this study is to develop a new strategy for community pharmacist training. METHODS: Based on the BOPPPS (Bridge-in, Objective, Pre-assessment, Participatory Learning, Post-assessment and Summary) teaching model and workshop method, a continuing on-the-job training program was constructed. Participates were randomly and evenly divided into two groups by random number table method. Twenty-four community pharmacists in total completed all training contents and evaluation components in this study. Twelve pharmacists in experimental group were trained via this new BOPPPS-based workshop, while others still adopted traditional didactic lecture-based approaches. RESULTS: After training, quantitative examination combined with clinical pharmacy practice tests were carried out to evaluate the effectiveness and outcomes of two training groups. For written exam, the total scores from the BOPPPS-based workshop group (82.67 ± 4.70) was higher than that of traditional lectured-base group (73.75 ± 6.15) (P < 0.001). Encouragingly, compared with the results of practical ability assessment from traditional training group (71.75 ± 4.75), the pharmacists receiving BOPPPS-based workshop training presented more excellent performance (78.25 ± 5.03), which displayed statistically significant differences (P < 0.01). In addition, an anonymous questionnaire was used to survey trainees' feelings after completing this continuing education program. The results revealed that the BOPPPS-based workshop can bring a better learning experience than traditional lecture-based training, and the percentages of positive response to each item were more than 91.7%. CONCLUSIONS: Through multi-dimensional evaluation, it was suggested that our BOPPPS-based workshop achieved desired training effects. Moreover, our research also demonstrated that this strategy had advantages of stimulating inspiration, autonomous learning, team-work spirit and pharmacy practice improvement. It may provide a reference of innovative training method for community pharmacists.

Exploring Community Pharmacists' Perception and Readiness Toward Telepharmacy Implementation in Jordan: A Cross-Sectional Study.

Objective: The present study was conducted to assess the perceptions and readiness of pharmacists toward implementing "Telepharmacy" in Jordan. Methods: This was a cross-sectional study that was conducted between April and May 2023. Any licensed community pharmacists practicing in Jordan were considered to be eligible to be included in this study. Pharmacists were approached at their pharmacy store using a convenience sampling method. Logistic regression analysis was utilized to identify predictors affecting pharmacists readiness to implement telepharmacy services. Results: Two hundred eighteen community pharmacists volunteered to participate in this study. Roughly around 42% of the pharmacists (n = 91) reported that they have previously used telepharmacy. More than 70% of the pharmacists believed that telepharmacy decreases the patient's visits to hospitals, private clinics, or pharmacies (n = 165, 75.7%). In addition, more than 65% of the pharmacists expressed their concerns that telepharmacy service may increase pharmacists' workload and commitment (n = 150, 68.8%), and it has a higher error rate for medication dispensing and filling (n = 147, 67.4%). Nearly 70% of the pharmacists (n = 153) expressed their readiness to implement telepharmacy. Regression analysis showed that pharmacists who had previous experience in using telepharmacy service and those who showed more positive perception toward telepharmacy showed significantly higher readiness to implement telepharmacy service (p < 0.001 for both). Conclusions: The utilization of telepharmacy by community pharmacists in Jordan is still limited. The adaption of telepharmacy faces many challenges, including a negative attitude from the pharmacist, financial reimbursement, training, regulations, and competency in and access to efficient technology.

Comparing knowledge, attitudes, and practices in cardiovascular disease prevention and health promotion between community and hospital pharmacists in Saudi Arabia: A cross-sectional study.

Purpose: Saudi Arabia is one of the leading nations in the world in terms of the high frequency of chronic diseases and their associated risk factors. Knowledge and awareness are crucial for pharmacists to play an active role in the prevention of cardiovascular diseases (CVD). The current study assessed the pharmacists' knowledge, attitude, and practice to determine the potential differences with respect to their respective practice settings toward CVD prevention and related health promotions. Methods: It is a cross-sectional study targeted the registered pharmacists in the Kingdom of Saudi Arabia. An online questionnaire was prepared, and the link was circulated through various social media platforms. Descriptive statistics, multivariate linear regression analysis and chi square test were used to analyze the data accordingly. Results: A total of 324 pharmacists were included in the study. Among these, 157 (48.4 %) were community pharmacists, and the remaining were hospital pharmacists (51.6 %). No significant differences in knowledge scores were observed between community and hospital pharmacists. The mean attitude score among community and hospital pharmacists was found to be 26.40 ± 5.125 and 25.09 ± 5.393 respectively, which was statistically significant (p = 0.026). Similarly, the total practice scores across the settings were statistically significant (p = 0.02). Gender plays a significant role in terms of knowledge scores among both community and hospital pharmacists (p = 0.016 & 0.029). Gender, professional practice experience, and number of prescriptions handled and prescriptions with CVD medications showed significant differences in the distribution of positive attitudes and good practice frequency between community and hospital pharmacists. Conclusion: It is evident that there is a deficiency in knowledge among hospital pharmacists compared to community pharmacists. Which indicates that there is a need for a rigorous continuous pharmacy education covering the fundamental aspects of CVD primary prevention and health promotion among pharmacists, given more focus on hospital pharmacists.

Do pharmacists counsel customers on the disposal of unused or expired household medications? A national survey among 1,596 pharmacists in Indonesia.

Introduction: Pharmacists play a vital role in counseling customers on proper medication disposal, yet their consistency in providing such information is often lacking. This study aimed to assess pharmacists' awareness of appropriate disposal practices for unused and expired household medications. Additional objectives included evaluating whether pharmacists offer disposal information during counseling, measuring their willingness to receive medication waste from the public, and identifying associated factors. Methods: A national cross-sectional online survey employing convenience sampling was conducted among pharmacists working in hospitals, pharmacies, clinics, or community health centers (CHCs) in Indonesia, using a validated questionnaire to assess awareness, information provision, and willingness to receive medications for disposal. Binary logistic regression, with 95% confidence intervals (CI) and odds ratios (OR), explored potential associations between factors and outcomes. Results: This study involved 1,596 pharmacists across 37 Indonesian provinces. Most pharmacists were women (80.4 %), aged 31-40 years (49.3 %), with a pharmacist professional background (93.8 %), working in CHCs (41.2 %), and practicing for 1-5 years (51.0 %). More than half were unaware of guidelines for returning medications to health facilities. While 69.9 % never counseled customers on disposal practices, 64.9 % expressed willingness to receive unused and expired medication from the public. Pharmacists practicing for at least six years were more likely to provide disposal information during counseling (OR: 2.54; 95 % CI: 1.44-4.47). Conversely, those in clinics (OR: 2.16; 95 % CI: 1.29-3.62), CHCs (OR: 2.07; 95 % CI: 1.45-2.95), or hospitals (OR: 2.00; 95 % CI: 1.27-3.14) were more likely to be unwilling to receive expired and unused household medication. Conclusions: The study reveals that most pharmacists, particularly those with limited practice duration, lacked awareness regarding the importance of proper medication disposal and did not provide counseling on appropriate medication disposal to patients. To address this issue, there is a pressing need for intensified education intensified education at the undergraduate level, continuous training for pharmacists, and a clear policy and practical guidelines, particularly targeting pharmacists in clinics, CHCs, and hospitals, to facilitate the acceptance of unused and expired household medications.

Impact of a Multicomponent Educational Intervention on Community Pharmacy-Based Naloxone Services Implementation: A Pragmatic Randomized Controlled Trial.

BACKGROUND: Despite US naloxone access laws, community pharmacists lack training and confidence in providing naloxone. OBJECTIVE: To assess the impact of the Empowering Community Pharmacists program on pharmacists' knowledge, perceived barriers, attitudes, confidence, and intentions regarding naloxone services implementation, as well as naloxone prescriptions dispensed. METHODS: A 3-month pragmatic randomized controlled trial was conducted from December 2018 to March 2019. Alabama community pharmacists were recruited by mail, email, phone, and fax and randomized to intervention (monthly resources/reminders + educational webinar) or control (monthly reminders only). Outcome measures were assessed via online surveys at baseline (T1), immediately post-intervention (T2), and 3 months post-intervention (T3), including naloxone knowledge (%correct); perceived barriers, attitudes, confidence, and intention regarding naloxone services implementation (7-point Likert-type scale; 1 = strongly disagree, 7 = strongly agree); and number of naloxone prescriptions dispensed. Mean differences between control and intervention from T1 to T3 were assessed using 2-way mixed analysis of variance and adjusted analyses were conducted using generalized estimating equations with negative binomial distribution to assess associations between variables. RESULTS: Of 55 participants (n = 27 intervention, n = 28 control), most were female (80.3%), white (80.6%), in independently owned pharmacies (39.1%). Increases in mean [SD] confidence (5.52 [1.03]-6.16 [0.74], P < 0.0005) and intention (5.35 [1.51]-6.10 [0.96], P = 0.023) occurred from pre- to post-program within the intervention group and were statistically significant compared with control (confidence P = 0.016, intention P = 0.014). Confidence (exp(ß) = 1.46, P = 0.031) and perceived barriers (exp(ß) = 0.75, P = 0.022) were associated with number of naloxone prescriptions dispensed. CONCLUSION AND RELEVANCE: The Empowering Community Pharmacists program improved community pharmacists' confidence and intention regarding naloxone services implementation. Other states can adapt program elements according to their laws. CLINICALTRIALS.GOV IDENTIFIER: NCT05093309.

The role of community pharmacists in primary and secondary prevention of skin cancer: an evaluation of a Flemish skin cancer prevention campaign.

BACKGROUND: Skin cancer is a leading form of cancer in Belgium. Prevention of skin cancer by community pharmacists can play a role in increasing awareness and promoting sun protection. However, which persons could be reached by community pharmacists for skin cancer awareness in Belgium and whether this increased awareness is associated with increased sun protection and early detection remains unclear. METHODS: Demographics of approached persons in Flemish community pharmacies during the months of May-June 2022 and the content of the skin cancer counseling were retrieved from the pharmacy database. Sunscreen purchases and dermatologist visits were evaluated up to 180 days after the skin cancer counseling. RESULTS: Community pharmacists provided skin cancer counseling to a broad population of visitors (n = 822, 69% females, median age of 59 years Q1-Q3: 44-71 years). During the campaign, 822 visitors received a leaflet with skin cancer prevalence and sunscreen importance. On top of that, 335 visitors (41%) received additional counseling: skin type sensitivity was checked for 198 visitors (24%), typical characteristics of melanoma were discussed with 100 visitors (12%) and 37 visitors (5%) were referred to a physician for further information or concerns regarding a skin spot. Overall, one out of three visitors purchased sunscreen on the day of the counseling (33%, increasing up to 38% after 180 days). Among people under 20 years, this was even higher (51%). Additional counseling increased the likelihood of a dermatologist visit within 180 days (OR = 1.80; 95%CI: 1.12-2.88). CONCLUSIONS: By providing skin cancer counseling in Belgian community pharmacies, a broad range of citizens was reached and triggered to purchase sunscreen, often on the same day as the counseling. Notably, young people were likely to purchase sunscreen. Citizens receiving additional counseling were more likely to visit a dermatologist within 180 days.

Predictors of community pharmacists' readiness to manage the effective and safe use of oral anticancer medicines in a developing setting.

BACKGROUND: There is a paucity of studies about the readiness of community pharmacists to manage the safe and effective use of oral anticancer medicines (OAMs) in developing settings. OBJECTIVES: Using the readiness component (knowledge and willingness) of the situational theory of leadership, the study assessed community pharmacists' readiness to manage the safe and effective use of OAMs in Qatar, and also identified its significant predictors. METHODS: A cross-sectional assessment of 252 community pharmacists was conducted with a pre-tested 48-item questionnaire. Readiness was assessed with a 5-point Likert-type scale and the maximum obtainable score was 70. The mean was used as the cut-off point to categorize willingness and knowledge as either high (≥ mean) or low (< mean). Independent t-test, one-way analysis of variance and multiple linear regression was used for data analyses. RESULTS: The mean SD score for the readiness of community pharmacists was 39.3 ± 11.2 (min = 11, max = 70). Only a minority of the respondents expressed an excellent understanding of the chemotherapy cycles (19.6%; 45/230), and familiarity with targeted anticancer therapy (14.3%; 33/230), side effects (22.2%; 51/230), and dosing of OAMs (14.4%; 33/230). Employment status, number of OAMs prescriptions dispensed per month and adequacy of the contents related to OAMs in undergraduate training were the significant predictors of readiness (R2 = 0.558, (F (11, 209) = 3.559, p = 0.0001). CONCLUSIONS: Community pharmacists' readiness appear inadequate especially regarding its dosing, side effects, handling, and disposal of OAMs. These inadequacies probably underline community pharmacists' low familiarity and comfortability with dispensing and educating patients on the effective and safe use of OAMs.

Assessment of practices and awareness regarding the disposal of unwanted pharmaceutical products among community pharmacies: a cross-sectional study in Palestine.

BACKGROUND: The improper disposal of pharmaceutical preparations substantially threatens human health and environmental safety. Pharmacists are responsible for properly disposing of unwanted medications and educating patients about how to do so themselves. This study aimed to assess community pharmacists' knowledge, determine their views on how to dispose of unwanted pharmaceuticals, and assess the extent to which they realize that it is their responsibility to guide patients toward the safe disposal of expired medications. METHODS: A descriptive cross-sectional study was conducted between December 2021 and April 2022 among 400 practicing pharmacists who were chosen to participate by random cluster sampling. Community pharmacists' practices, awareness, and beliefs about disposing of unused drugs were evaluated. The Statistical Package for Social Sciences (IBM-SPSS) version 21 was used for data entry and analysis. RESULTS: Of 400 pharmacists, 348 stated that they did not participate in courses on the safe disposal of unwanted medications. Disposal of drugs in the garbage, an unsafe method, was very frequently recommended by pharmacists to patients, especially regarding inhalers, antibiotics, hormonal drugs, and solid and semisolid drugs. However, many pharmacists advised patients to return their hormonal, category B, and category C drugs to the pharmacy. A total of 61.3% of pharmacists agreed and 26% strongly agreed that unsafe disposal of drugs negatively affects the environment. A total of 54.3% of the participants agreed that improper disposal of antibiotics might be a reason for increased antimicrobial resistance, and 54.5% of them agreed that improper disposal of hormonal drugs might contribute to the development of certain cancers. A total of 80.3% of the participants perceived that most unwanted drugs in pharmacies were those returned from patients. A total of 97.3% of the participants supported establishing a drug disposal system, with 77.5% choosing to have the district health board responsible for funding this system. A total of 48.5% of the participants indicated that a lack of education and awareness on the issue of getting rid of unused drugs constitutes a challenge to the safe disposal of medicines, and 66% of them said that a lack of law enforcement constitutes another challenge. A total of 95.5% of the participants agreed or strongly agreed that good training for health sector workers and organizing workshops to develop knowledge on this subject would improve practices. A total of 93.3% supported distributing educational brochures, and 92.8% supported placing special containers in every pharmacy to collect unwanted drugs. CONCLUSIONS: Most pharmacists in our study returned drugs to manufacturing companies and stores, and few followed the correct methods of incineration and return of drugs to the Ministry of Health. Current data emphasize the issue of improper disposal of medicine in Palestine and the need for improved education among healthcare workers.

Positioning of community pharmacists in interactions with general practitioners and patients regarding prescribing and using antibiotics.

Interprofessional collaboration between general practitioners (GPs) and community pharmacists (CPs) is important for ensuring antibiotics are used correctly and combating antibiotic resistance. The study's main objective was to investigate how CPs, GPs and patients, respectively, position CPs in their interactions with patients on antibiotic-related matters in Norwegian pharmacies. Seven focus-group interviews were performed. Data were analyzed using systematic text condensation. Positioning theory was used to identify positions assigned to CPs by themselves, by GPs and by patients. CPs position themselves as helpful, accessible drug specialists responsible for advising on antibiotic use, but also consider themselves dependent on GP-supplied information to do so. GPs position CPs as helpful, responsible businesspeople who, however, lack clinical experience and are overzealous gatekeepers. Patients position CPs as helpful people who supply information in "everyday language" and as the GP's extended arm. Patients utter they are best served when GPs and CPs collaborate. This discrepancy is a barrier to optimal service to patients in general, and to proper antibiotic use in particular.

Community Pharmacists' Role in Reducing the Incidence of Cardiometabolic Adverse Drug Events in Schizophrenia: Insights from Mental Health Professionals.

Background and Objectives: Schizophrenia, a debilitating mental illness, is often associated with significant physical health risks. Many second-generation antipsychotics increase the risk of metabolic syndrome and cardiovascular disease. Community pharmacists are highly accessible and could play a role in monitoring cardiometabolic adverse drug events in people with schizophrenia. However, it remains uncertain whether mental health professionals perceive this as valuable. This study aimed to explore the opinions of mental healthcare professionals regarding the role of community pharmacists in reducing the incidence of cardiometabolic adverse events in people with schizophrenia and their integration into a multidisciplinary mental health team. Materials and Methods: Qualitative semi-structured interviews were conducted with Australian psychiatrists, mental health nurses and mental health pharmacists. Transcription of the interviews underwent thematic analysis using an inductive approach. Results: Eleven mental healthcare professionals from metropolitan and regional areas across Australia were interviewed, leading to the identification of five overarching themes. These themes encompassed the following aspects: the benefits of community pharmacists' involvement in managing cardiometabolic adverse drug events in people with schizophrenia, improving communication pathways with community pharmacists, defining roles and responsibilities for monitoring cardiometabolic parameters and managing adverse cardiometabolic drug events, fostering collaboration between community pharmacists and mental health care professionals, and recognising the acceptance of community pharmacists' integration within a multidisciplinary team. Mental health professionals believed that community pharmacists could play a role in reducing the incidence of cardiometabolic adverse events in schizophrenia. However, they underscored the need for enhanced communication and collaboration pathways with other healthcare professionals, emphasised the importance of more comprehensive mental health first aid training, and identified potential barriers for community pharmacists such as remuneration, workload, and staff resources. Conclusions: Mental health professionals acknowledged the benefits of incorporating community pharmacists into multidisciplinary teams as a strategy to reduce the incidence of adverse events among individuals with schizophrenia. They recognise the competence of community pharmacists in monitoring cardiometabolic adverse events. However, these professionals have also highlighted specific perceived barriers to the complete integration of community pharmacists within these teams. Notably, there are concerns related to remuneration, staff resources, time constraints, acceptance by other healthcare professionals and patients, and the need for improved communication pathways. Addressing these barriers and providing targeted training could facilitate the valuable inclusion of community pharmacists in the comprehensive care of people with schizophrenia.

Knowledge, perceptions, and readiness of telepharmacy among community pharmacists.

Telepharmacy is a practical part of telemedicine that refers to providing pharmaceutical services within the scope of the pharmacist's obligations while maintaining a temporal and spatial distance between patients, users of health services, and healthcare professionals. The present study was a cross-sectional study conducted among community pharmacists in Saudi Arabia between March and May 2022 to assess their knowledge, perceptions, and readiness for telepharmacy. The survey was filled out by 404 respondents. The majority of respondents were male (59.90%) and the age of more than half of them was between 30 and 39 years old (54.46%). Most participants worked in urban areas (83.66%), and 42.57% had less than five years of experience in a pharmacy. Most participants agreed that telepharmacy is available in Saudi Arabia (82.67%). Approximately 70% of pharmacists felt that telepharmacy promotes patient medication adherence, and 77.72% agreed that telepharmacy increases patient access to pharmaceuticals in rural areas. More than 72% of pharmacists said they would work on telepharmacy initiatives in rural areas for free, and 74.26% said they would work outside of usual working hours if necessary. In the future, this research could aid in adopting full-fledged telepharmacy pharmaceutical care services in Saudi Arabia. It could also help academic initiatives by allowing telepharmacy practice models to be included as a topic course in the curriculum to prepare future pharmacists to deliver telepharmacy services.

Translating and piloting a cardiovascular risk assessment and management online tool using mobile technology.

Background: Cardiovascular disease (CVD) risk assessment and management (RAM) services face many challenges and barriers in the community. Mobile technology offers the opportunity to empower patients and improve access to health prevention strategies to overcome these barriers. However, there is limited information on the availability and use of CVDRAM-related mobile technology in the Arabic language. Objectives: To pilot test an Arabic version of a CVDRAM application among potential end-users accessing community pharmacy services in Qatar. Methodology: Translation of an established cardiovascular risk calculator (EPI·RxISK™) into the Arabic language was conducted. The English/Arabic version of the calculator was tested by potential end-users, consisting of a sample of community pharmacists (CRxs) and members of the public (MOP) accessing community pharmacy services. Semi-structured interviews were conducted based on the quality attributes of the Mobile Application Rating Scale (MARS). Data were analyzed using deductive content analysis. Results: A total of 10 CRxs and 5 MOP were interviewed. Five themes emerged to describe the EPI·RxISK™ calculator: Engagement, Functionality, Attractiveness, Education, and Responsiveness. For the most part, positive subthemes were associated with each of these themes. The functionality and educational themes had some negative subthemes. Conclusion: End-users of the EPI·RxISK™ calculator had mostly positive descriptors that were aligned with all five quality attributes of the web and mobile applications.

[Medication reconciliation and hospital-community transition securisation: Survey of community pharmacists]. / Conciliation médicamenteuse et sécurisation de la transition hôpital­ville : enquête auprès des pharmaciens d'officine.

OBJECTIVE: To collect the community pharmacists' perception on their role in the medication reconciliation's process. METHODS: We did an observational transverse study thanks to a survey of community pharmacists working in France, conducted in 2020. A digital questionnaire was submitted to Parisian community pharmacists before being shared on two Facebook groups. The responses were analysed with Microsoft Excel® software. We calculated percentages, used Chi2 or Fisher's exact tests and did qualitative analyses. RESULTS: We collected the perception of 135 community pharmacists, the majority was women (80%), relatively young (69.6% of 40 years old or less). They were 63.7% to claim knowing the medication reconciliation, but they could not define it properly. The subject's knowledge was statistically related to age (P-value<0.001) and previous contacts of the health care facilities (P-value<0.001). The majority of interviewed pharmacist considered the transmission of information to those health facilities as relevant and feasible and they expressed their willingness to get involved. However, they were limited by some obstacles such as the non-exhaustiveness of the medicinal record, the unsecured mail and the lack of feedbacks. CONCLUSIONS: Although the community pharmacists expressed interest for the medication reconciliation process and willingness to get involved, their role remained limited. Therefore, this process needs an improvement of its organisation and a generalisation of its practice to really benefit the hospital-community transition's safety.

Swallowing the pill of adverse effects: A qualitative study of patients' and pharmacists' experiences and decision-making regarding the adverse effects of chronic pain medications.

INTRODUCTION: Pharmacological treatments of chronic pain can lead to numerous and sometimes serious adverse effects. Drawing on a social science approach to chronic illness, this study aimed to understand the experiences of people living with chronic pain and community pharmacists regarding the definition, prevention and management of analgesic adverse effects. METHODS: This qualitative study proceeded through 12 online focus groups (FGs) with people living with chronic pain (n = 26) and community pharmacists (n = 19), conducted between July 2020 and February 2021 in the province of Quebec, Canada. The semistructured discussion guides covered participants' definitions of adverse effects and decision-making regarding their prevention and management. Discussions were audio-recorded, transcribed verbatim and analysed using grounded theory. RESULTS: Both people with chronic pain and pharmacists provided varying definitions of analgesic adverse effects depending on patients' social and clinical characteristics. Present quality of life and serious long-term risks related to treatment were described as key dimensions influencing adverse effect appraisal. Dilemmas and discrepancies occurred between patients and pharmacists when choosing to prioritize pain relief or adverse effect prevention. Some patients lacked information about their medications and wanted to be more involved in decisions, while many pharmacists were concerned by patients' self-management of adverse effects. Preventing opioid-related overdoses often led pharmacists to policing practices. Despite most pharmacists wishing they could have a key role in the management of pain and adverse effects face organizational and financial barriers. CONCLUSION: Defining, preventing and managing adverse effects in the treatment of chronic pain requires a person-centred approach and shared decision-making. Clinical training improvements and healthcare organization changes are needed to support pharmacists in providing patients with community-based follow-up and reliable information about the adverse effects of chronic pain treatments. PATIENT OR PUBLIC CONTRIBUTION: A person with lived experience of chronic pain was involved as a coinvestigator in the study. He contributed to shaping the study design and objectives, including major methodological decisions such as the choice of pharmacists as the most appropriate professionals to investigate. In addition, 26 individuals with chronic pain shared their experiences extensively during the FGs.