ABSTRACT
Background: Self care is an important concept, which is increasingly being applied by policy makers on a large scale. It is associated with improved health literacy and technological advances. Community pharmacy practitioners are easily accessible for self care counselling, purchase of non-prescription products and for referrals to other healthcare providers. Objective: To describe self care policies and strategies in Swedish healthcare authorities, pharmaceutical organizations and community pharmacy. Methods: A search was conducted to retrieve self care policy documents and strategies in Swedish healthcare authorities, pharmaceutical organizations and community pharmacy on respective websites, as well as personal contacts with key persons in pharmaceutical organizations and community pharmacy practice. Results: A new law on self care was adopted by the Swedish Parliament becoming effective in 2023. The law defines self care as a healthcare measure that has been assessed by a treating licenced healthcare practitioner to be possible to be performed by the patient him/herself. The law includes a wide range of measures. According to a Government Commission that followed Sweden's the National Pharmaceutical Strategy's Action Plan in 2018, the Medical Products Agency (MPA) was assigned to establish requirements of qualifications in self care counselling. In its report in late 2022, the MPA stated that self care counselling by community pharmacy practitioners plays an important role in society. The new requirements are expected to become effective in mid-2023. None of the four community pharmacy chains operating 97% of Sweden's community pharmacies have developed any specific self care policies, although self care counselling and sales of non-prescription products, as well as provision of some primary healthcare services, constitute important components of their operations. Furthermore, all Swedish pharmacies offer several digital self care solutions, supporting people to manage their own health. Neither the Swedish Pharmacy Association, representing most pharmacies, nor the Swedish Pharmacists Association, the trade union, have developed any self care policies. However, the Swedish Association of the Pharmaceutical Industry is promulgating Swedish self care reform using a systematic review of self care and which medicines should be over-the-counter. Conclusions: Self care is not currently established as a core pillar of a Swedish national health strategy. There are further opportunities to enable pharmacists to fulfil their potential in supporting individual wellbeing and promoting self care interventions. A new system needs to be created which fully integrates the promotion of everyday wellbeing, self care for self-treatable conditions and the management of long-term conditions.
ABSTRACT
Digital transformation impacts health care through technology. Telepharmacy is set to become one of the most important aspects of Telemedicine in the years to come with its ability to provide patients with increased and more timely access to pharmaceutical care, reduced costs for individuals and health systems, improved patient satisfaction, experience and convenience, and better health outcomes. Telepharmacy has gained increasing importance in the delivery of pharmaceutical care, largely due to the COVID-19 pandemic which has placed enormous pressures on healthcare systems globally. There is a significant amount of published literature from different countries around the world that provide examples of Telepharmacy. There are some innovative models of Telepharmacy services aimed at optimizing and improving access to pharmaceutical care, resulting in improved patient safety and outcomes. The benefits of Telepharmacy include increased value for pharmacies and pharmacists and adapting to patients´ needs, enhanced interprofessional care and increased efficiency of health systems and increased provision of patient- centred services, among others. However, despite these benefits, major barriers for implementation of Telepharmacy remain such as patient confidentiality and privacy of health information. These barriers to the implementation of Telepharmacy have been identified and can be divided into four different environments: technological, organizational, human and economic. Delivering pharmaceutical care and services through digital media is identified as a key priority for the International Pharmaceutical Federation. Digital health is one of the 21 Development Goals launched by International Pharmaceutical Federation in 2020. The International Pharmaceutical Federation Digital Health in Pharmacy Education report in 2021, describes the readiness, adaptability and responsiveness of pharmacy education and knowledge and skill needs of pharmaceutical workforce on digital health. Amongst other digital health tools, telehealth/Telepharmacy has been reported as one of the most preferred tools to teach and learn about by respondents.
La tecnología surgida de la transformación digital ha traído consigo cambios en la asistencia sanitaria. En los próximos años, la Telefarmacia previsiblemente se convertirá en uno de los aspectos más importantes de la Telemedicina, ya que ofrece a los pacientes un acceso más inmediato a la atención farmacéutica, supone una reducción de costes tanto para los pacientes como para los sistemas sanitarios, y deriva en una mayor satisfacción, experiencia y comodidad de los pacientes, mejorando así los resultados clínicos. Debido en gran medida a la pandemia de COVID19, la Telefarmacia ha adquirido gran importancia en el ámbito de la atención farmacéutica, ya que esta crisis ha provocado una enorme presión sobre los sistemas sanitarios de todo el mundo. Se pueden encontrar multitud de experiencias publicadas en la literatura científica sobre modelos de Telefarmacia en diferentes países del mundo. Existen algunos modelos innovadores de servicios de Telefarmacia orientados a optimizar y mejorar el acceso a la atención farmacéutica, lo que se traduce en una mejora de la seguridad y los resultados de los pacientes. Entre las ventajas de la Telefarmacia se incluye el aumento del valor para las farmacias y los farmacéuticos y la adaptación a las necesidades de los pacientes, la mejora de la atención interprofesional, el aumento de la eficiencia de los sistemas sanitarios y la mayor prestación de servicios centrados en el paciente, entre otras. Sin embargo, a pesar de presentar múltiples ventajas, siguen existiendo importantes barreras para la implantación de la Telefarmacia, como la confidencialidad del paciente y la privacidad de la información clínica. Estas barreras para la implantación de la Telefarmacia pueden dividirse en cuatro ámbitos: tecnológico, organizativo, humano y económico. La prestación de atención y servicios farmacéuticos a través de medios digitales es una prioridad clave de la Federación Internacional Farmacéutica. La salud digital es uno de los 21 Objetivos de Desarrollo lanzados por la Federación Internacional Farmacéutica en 2020. El informe de la Federación Internacional Farmacéutica sobre salud digital en la formación farmacéutica en 2021 describe la preparación, adaptabilidad y capacidad de respuesta de la formación farmacéutica y las necesidades de conocimientos y habilidades de los farmacéuticos sobre la salud digital. Entre otras herramientas de salud digital, la Telemedicina/Telefarmacia ha sido señalada como una de las herramientas preferidas por los encuestados para formar y aprender.
Subject(s)
COVID-19 , Pharmaceutical Services , Telemedicine , Humans , Pandemics , Pharmaceutical Preparations , Internet , Patient SatisfactionABSTRACT
La tecnología surgida de la transformación digital ha traído consigo cambios en la asistencia sanitaria. En los próximos años, la Telefarmaciaprevisiblemente se convertirá en uno de los aspectos más importantes dela Telemedicina, ya que ofrece a los pacientes un acceso más inmediato ala atención farmacéutica, supone una reducción de costes tanto para lospacientes como para los sistemas sanitarios, y deriva en una mayor satisfacción, experiencia y comodidad de los pacientes, mejorando así losresultados clínicos. Debido en gran medida a la pandemia de COVID-19,la Telefarmacia ha adquirido gran importancia en el ámbito de la atención farmacéutica, ya que esta crisis ha provocado una enorme presiónsobre los sistemas sanitarios de todo el mundo. Se pueden encontrar multitud de experiencias publicadas en la literatura científica sobre modelos deTelefarmacia en diferentes países del mundo. Existen algunos modelosinnovadores de servicios de Telefarmacia orientados a optimizar y mejorar el acceso a la atención farmacéutica, lo que se traduce en una mejorade la seguridad y los resultados de los pacientes. Entre las ventajas dela Telefarmacia se incluye el aumento del valor para las farmacias y losfarmacéuticos y la adaptación a las necesidades de los pacientes, lamejora de la atención interprofesional, el aumento de la eficiencia de los sistemas sanitarios y la mayor prestación de servicios centrados enel paciente, entre otras. Sin embargo, a pesar de presentar múltiplesventajas, siguen existiendo importantes barreras para la implantación dela Telefarmacia, como la confidencialidad del paciente y la privacidadde la información clínica. Estas barreras para la implantación de la Telefarmacia pueden dividirse en cuatro ámbitos: tecnológico, organizativo,humano y económico. La prestación de atención y servicios farmacéuticosa través de medios digitales es una prioridad clave de la FederaciónInternacional Farmacéutica. (AU)
Digital transformation impacts health care through technology. Telepharmacy is set to become one of the most important aspects of Telemedicinein the years to come with its ability to provide patients with increased andmore timely access to pharmaceutical care, reduced costs for individualsand health systems, improved patient satisfaction, experience and convenience, and better health outcomes. Telepharmacy has gained increasingimportance in the delivery of pharmaceutical care, largely due to theCOVID-19 pandemic which has placed enormous pressures on healthcaresystems globally. There is a significant amount of published literature fromdifferent countries around the world that provide examples of Telepharmacy. There are some innovative models of Telepharmacy services aimedat optimizing and improving access to pharmaceutical care, resulting inimproved patient safety and outcomes. The benefits of Telepharmacyinclude increased value for pharmacies and pharmacists and adaptingto patients´ needs, enhanced interprofessional care and increased efficiency of health systems and increased provision of patient-centred services, among others. However, despite these benefits, major barriers forimplementation of Telepharmacy remain such as patient confidentialityand privacy of health information. These barriers to the implementation of Telepharmacy have been identified and can be divided into four differentenvironments: technological, organizational, human and economic. Delivering pharmaceutical care and services through digital media is identified as a key priority for the International Pharmaceutical Federation. (AU)
Subject(s)
Humans , Pharmacy , Patient Safety , Severe acute respiratory syndrome-related coronavirus , Telemedicine , Patient Satisfaction , TechnologyABSTRACT
Background: Allergic rhinitis (AR) management requires a coordinated effort from healthcare providers and patients. Pharmacists are key members of these integrated care pathways resolving medication-related problems, optimizing regimens, improving adherence and recommending therapies while establishing liaisons between patients and physicians. Methods: Allergic Rhinitis and its Impact on Asthma (ARIA) first published a reference document on the pharmacist's role in allergic rhinitis management in 2004. Several guidelines were developed over the past 20 years improving the care of allergic rhinitis patients through an evidence-based, integrated care approach. Results: This ARIA/EAACI/FIP Position Paper is based on the latest ARIA in the Pharmacy guidelines and provides: (a) a structured approach to pharmacists identifying people with AR and/or allergic conjunctivitis as well as those at risk of poor disease control; (b) an evidence-based clinical decision support tool for optimising the management of allergic rhinitis in the community pharmacy; and (c) a framework of referral to the physician. Conclusion: This document is not intended to be a mandatory standard of care but is provided as a basis for pharmacists and their staff to develop relevant local standards of care for their patients, within their local practice environment. Pharmacy care varies between countries, and the guide should be adapted to the local situation.
ABSTRACT
The nptA gene of Vibrio cholerae has significant protein sequence homology with type II sodium-dependent phosphate (P(i)) cotransporters found in animals but not previously identified in prokaryotes. The phylogeny of known type II cotransporter sequences indicates that nptA may be either an ancestral gene or a gene acquired from a higher eukaryotic source. The gene was cloned into an expression vector under the control of an inducible promoter and expressed in Escherichia coli. The results demonstrate that nptA encodes a functional protein with activity similar to that of the animal enzyme, catalyzing high-affinity, sodium-dependent P(i) uptake with comparable affinities for both sodium and phosphate ions. Furthermore, the activity of NptA is influenced by pH, again in a manner similar to that of the NaPi-2a subtype of the animal enzyme, although it lacks the corresponding REK motif thought to be responsible for this phenomenon. P(i) uptake activity, a component of which appeared to be sodium dependent, was increased in V. cholerae by phosphate starvation. However, it appears from the use of a reporter gene expressed from the nptA promoter that none of this activity is attributable to the induction of expression from nptA. It is thus proposed that the physiological function of NptA protein may be the rapid uptake of P(i) in preparation for rapid growth in nutrient-rich environments and that it may therefore play a role in establishing infection.