Evaluation of community pharmacists' knowledge, practice and barriers towards diabetes management in Asir region, Saudi Arabia.

RATIONALE, AIMS AND OBJECTIVES: Diabetes mellitus is a global serious health problem that has a clear negative impact on economy. The high prevalence of diabetes worldwide urges for prevention and educational programs. Engagement of community pharmacists in offering various diabetes care services enables delivery of quality of care for patients and could play key role in diabetes management. The current study was designed to assess the knowledge towards diabetes among community pharmacists and to investigate their role in diabetes management through identifying different diabetes care services they provide in Asir region, Saudi Arabia. In addition, possible barriers for providing these services were evaluated. METHOD: A cross-sectional study was performed using an online self-administered anonymous survey that consisted of 4 domains: demographics, knowledge, practice and barriers related to diabetes management. RESULTS: A total of 258 pharmacists completed the survey, and one-third of respondents (34.5%) demonstrated good knowledge while 42.2% showed moderate knowledge towards diabetes. Respondents of the age group (30-39) years, males, those with bachelor's degree and those with 5 years or less of experience had higher mean knowledge. Nearly half of the participants had positive practice. The most prominent (75%) services offered by the community pharmacists were counselling on the appropriate administration, handling and storage of insulin and the appropriate time to administer oral antidiabetic drugs. Pharmacists who received training had higher mean practice scores. Lack of time, lack of diabetic patients visiting the pharmacy and low patient expectations regarding pharmacists' role in diabetes care were identified as the most important barriers they encountered. CONCLUSION: Community pharmacists of Asir region exhibited moderate knowledge and practices regarding diabetes management. Our results support the need for national advanced diabetes training programs targeting community pharmacists for providing quality of care services for diabetic patients Moreover, strategies to overcome the reported barriers are indispensable.

Dispensing Errors and Self-medication Practices-Pharmacists' Experience in Tabuk: A Cross-sectional Study.

Background: Community pharmacists are engaged in various professional activities starting from drug dispensing to promoting the well-being of patients. They dispense medications as stated in the prescription and are also licensed to prescribe over-the-counter (OTC) medications. Self-medication is widely practiced in various countries, which may lead to irrational drug use. The objectives of this study were to identify the factors associated with dispensing errors, to find ways to minimize dispensing errors, to identify patients' reasons for self-medication, and to find the drugs commonly utilized by patients as OTC medications and the sources of their drug information. Methods: A cross-sectional survey of a convenience sample of 286 registered community pharmacists all over Tabuk was conducted using a self-administered questionnaire. Results: Physician's unclear handwriting in the prescription was the major factor for dispensing error (2.6 out of 3) and writing the prescription clearly by the physician or using a printed form of prescription was an important factor in minimizing dispensing errors (2.91 out of 3). Previous similar complaints in the past were the main reason for self-medication (2.45 out of 3) with analgesics and antipyretics being the commonly dispensed drug groups dispensed as OTC medications (2.95 out of 3). Conclusion: Self-medication practices and dispensing errors are widespread in Tabuk. Antibiotics were dispensed as OTC medication, which may lead to more chance of irrational drug use. Writing the prescription clearly and legibly would reduce dispensing errors. It is the community pharmacists' responsibility to increase awareness regarding the appropriate use of drugs to the public.

Jordanian community pharmacists' perceptions and experiences with continuing professional development - A comprehensive analysis.

Continuing professional development (CPD) is a process by which healthcare professionals, including pharmacists, can be engaged in life-long learning and development. In 2018, the Jordanian government issued Regulation No. 46, which addresses the CPD and relicensing cycle requirements. This study aims to investigate Jordanian community pharmacists' experiences and perceptions toward CPDs. The study also discussed factors influencing pharmacists' engagement in CPD activities. An online self-administered questionnaire was distributed between August and October of 2022 using a range of participant identification and recruitment strategies. The questionnaire was designed for community pharmacists who are currently in practice. Descriptive data analysis was carried out. Of the 425 participating community pharmacists, 270 (63.5%) had a positive attitude toward CPD in terms of considering CPD to be a professional responsibility for all practising pharmacists. Almost 50% of recruited community pharmacists had no preference between theoretical and practical activities. Moreover, carrying out research projects and participating in research groups were the least preferred CPD activities. Evidence indicates that the most influencing factors were feasibility and capacity-related issues such as time, cost, work burden and requirements and the logistics related to CPD activities. Regulators, professional associations, and legislators are responsible for planning and implementing actions that reduce obstacles and increase facilitators. CPD activities should also be made available through various delivery methods and strategies to guarantee relevance, prevent duplication, and promote pharmacists' involvement.

Implementation strategies and outcomes in the delivery of HIV test services (HTS) in community pharmacies in Nigeria.

BACKGROUND: Studies have shown that training interventions fail when proper strategies are not in place for their implementation. The study described the implementation strategies used in the delivery of the HIV test services (HTS) and measured implementation outcomes in the delivery of the services. METHODS: The study was conducted between August and November 2019 among 50 selected community pharmacies in Oyo State, Nigeria using a mixed-method quantitative and qualitative data survey design. The implementation strategies and activities used in the delivery of HTS in the pharmacies and during outreaches were described while both observational and survey methods were used to collect data. Implementation outcomes were measured and analysed in terms of penetration, adoption, acceptability, feasibility, fidelity, and appropriateness of the intervention. RESULTS: Penetration among respondents was 90%. Acceptability of the HTS was high (77.3%) among clients 20-49 years of age with 919 clients participating in the HIV screening. While 919 HIV tests were conducted, only 19 (2.1%) were positive. Adherence to the protocol of delivery of HTS (fidelity) indicated that all the respondents conducted rapid HIV testing, pre-testing counselling (43, 95.6%), post-testing counselling (40, 88.9%), and provision of confidential test results (39, 86.7%). Respondents' responsiveness indicated that 23 (51.1%%) of the respondents could use up to 80% and above of the test strips given within the period. Researchers' observations showed respondents' ability to perform the tests as intended with little challenges. Participants felt that rendering the services was an interesting experience, and fulfilling, and allowed them to improve on their professional deliverables and practice. It also showcased the relevance of pharmacists in rendering HTS, creating awareness of the menace of HIV/AIDS, and helping people to stop the spread. CONCLUSION: The study showed that HTS is acceptable, appropriate, feasible, and easy to adopt in community pharmacies and penetration was high. For sustainability, community pharmacists should be well remunerated, and need for an established policy to include this scope in community pharmacy practice.

Pharmaceutical Activities, Services, Medicines, and Products at Community Pharmacies in the Qassim Region of Saudi Arabia: Findings and Implications for the Future.

Introduction  Community pharmacies are highly accessible and provide access to several services to patients and community members. Recently, several developments have been made in Saudi Arabia to enhance the roles and contributions of community pharmacists to the healthcare system, including expanding their scope of practice. This study aims to evaluate the current pharmaceutical activities, medicines, products, and services offered by community pharmacies.  Methods This was a cross-sectional questionnaire-based descriptive study. The questionnaire consisted of three sections. The first section comprised the demographic characteristics of the participants. The second section explored the types of pharmaceuticals and products sold by community pharmacies, while the third section explored the current professional services and activities offered by pharmacies. This study was conducted among community pharmacists in the Qassim region of Saudi Arabia. Results  Overall, 109/115 community pharmacies participated in the study, yielding a response rate of 94.78%. Most participants (97.25%) were men, and 42.20% were 31-40 years old. All pharmacies (100%) dispensed prescriptions and provided over-the-counter medicines, self-care therapeutics, vitamins, minerals, and dietary supplements. However, only a few pharmacies had controlled and narcotic medicine services (5.50%) and supplied vaccines (3.67%). Almost all pharmacies provided access to herbal products (97.25%), self-diagnostic test/home-test kits (97.25%), first-aid kits (95.41%), and medical equipment and devices and their accessories (89.91%). All pharmacies (100%) sold health-related products, including oral, skin, and hair care products. All pharmacists (100%) provided medication counseling. However, e-prescription services (Wasfaty) were provided in only 55.96% of the pharmacies. Most pharmacists provided health education and promotion (95.41%), management of minor ailments (88.99%), and patient training on the use of medical devices (92.66%). Other pharmaceutical activities included travel health advice (52.29%) and smoking cessation (31.19%). However, patient care services, including vaccination services (0.92%), patient assessment and monitoring services (0.92%), and point-of-care (POC) testing (0.92%), were limited. Additional services included online shopping (66.97%), home delivery of medicines (54.13%), and instant/live chat communication with pharmacies (70.64%). Conclusion  Community pharmacies play a crucial role in Saudi Arabia's healthcare system. These include providing access to medicines, medical equipment, and various products related to health and wellness. Community pharmacies provide public health services. However, their clinical services are limited. Consequently, a holistic strategy involving all stakeholders is required to further enhance the role of community pharmacists and better utilize their skills and training to provide preventive healthcare services and optimize medication therapy in primary care settings.

A Preliminary Scoping Review of the Impact of e-Prescribing on Pharmacists in Community Pharmacies.

OBJECTIVE: This scoping review aims to map the available literature and provide an overview of the published articles discussing the impact of electronic prescribing on medication errors and pharmacy workflow. METHODS: The literature search was conducted using PubMed®, Web of Science®, and the Cochrane Database of Systematic Reviews®, as well as grey literature reports, using the search terms and related components of "pharmacists", "electronic prescribing", "medication errors", and "efficiency". The search included all articles that were published from January 2011 to September 2023. Twenty-two relevant articles were identified and fully reviewed, ten of which were included in this review. RESULTS: Electronic prescribing (e-prescribing) provides a solution for some of the challenges that are associated with handwritten and paper prescriptions. However, the implementation of e-prescribing systems has been recognized as a source of new unforeseen medication errors in all the reviewed articles. Productivity in community pharmacies has been affected with receiving electronic prescriptions (e-prescriptions) and having to deal with the issues that arise from them. The pharmacists' interventions were not eliminated with e-prescriptions compared to other prescription formats. The most frequently reported reason for intervention was related to incomplete instructions in the field of directions of use. Other common challenges with e-prescriptions were related to missing information, quantity, inappropriate dose, dosage form, and drug. DISCUSSION: This review demonstrates the scarcity of research about the impact of electronic prescribing on medication error and efficiency in community pharmacies. In the literature, most of the studies had mainly focused on hospital pharmacies. The literature search demonstrated that there are still some barriers to overcome with e-prescribing systems and that medication errors were not fully eliminated with e-prescriptions. New errors have been identified with e-prescriptions, all of which caused delays in processing, which affected the productivity of the pharmacy staff, and could have negatively impacted patients' safety if not properly resolved. CONCLUSION: e-Prescribing solved some of the challenges associated with illegibility of handwritten prescriptions. However, more time is required to allow e-prescribing systems to mature. Further training for prescribers and pharmacists is also recommended before and after the implementation.

Insight into Current Practices of Community Pharmacists in Topical Corticosteroid Prescribing and Counseling: Cross-Sectional Survey Study from Saudi Arabia.

BACKGROUND: Topical corticosteroids are commonly used to treat several skin conditions, most notably atopic dermatitis. Many studies have found that patients lack knowledge about the safety, potency, and appropriate use of topical corticosteroids. This can be due to ineffective education by pharmacists and other healthcare providers. This study aims to evaluate the appropriateness of dispensing and counseling practices of community pharmacists towards topical corticosteroids in Saudi Arabia. METHODS: A cross-sectional survey study was conducted in Saudi Arabia among 418 community pharmacists from different regions of Saudi Arabia. Data were collected using a validated questionnaire that covered community pharmacists' sociodemographic information, their perceptions of patient knowledge about topical corticosteroid use, and their dispensing and their counseling practices, in addition to their perceived barriers to counseling. RESULTS: The majority of the participating community pharmacists were Saudi (57.4%), female (66.7%), holding a bachelor's degree (63.4%), and full-time workers (91.1%). Most of the time, community pharmacists counseled patients on the frequency of application per day and the duration of treatment (75.8% and 74.8%, respectively). The median counseling practice score was 17, with an IQR of 14-21. The main barrier to counseling was lack of time (33.7%). Only 15% of community pharmacists accurately identified all scenarios that necessitate medical referrals. Dry skin, itchiness, and irritation were the most common side effects reported by community pharmacists for patients to complain about (69.4%). Most pharmacists agreed that misuse is the most likely cause of topical corticosteroid adverse drug events (53.7%), followed by medication overuse, such as patient self-treatment (48%). CONCLUSION: Community pharmacists counseling practices to their patients about the use of topical corticosteroids require improvement. Continuing education and hands-on training are needed for community pharmacists regarding counseling about topical corticosteroids use.

Identifying strategies to improve adverse drug reporting through key informant interviews among community pharmacists in a developing country.

Reporting adverse drug reactions (ADRs) is fundamental in improving medication safety. Community pharmacists (CPs) being the first point of contact for individuals seeking healthcare in a community, play a significant role in ADR reporting. However, this has been poorly implemented in many countries including Nigeria. This paper aims to explore stakeholders' perspectives on current reporting practices and suggest ways to enhance ADR reporting among CPs in Nigeria. This qualitative study employed a purposive sampling approach to identify key informants. Key informant interviews (KIIs) were conducted with 25 carefully selected pharmacists, using a semi-structured interview guide between July 2023 and August 2023. The interview transcripts were analyzed using a thematic content approach. While a low ADR reporting trend was observed among all participating pharmacists, it was notably higher among those with less than five years of experience. The main barriers to ADR reporting, as identified by the interviewed community pharmacists were lack of awareness and knowledge, absence of motivation, and insufficient feedback from National Agency for Food Drug Administration and Control (NAFDAC). Training and awareness campaigns were the most frequently suggested methods for improving ADR reporting. Other proposed strategies included providing motivation, regular feedback, establishing mandatory reporting, and simplifying the reporting process. The study has highlighted the suboptimal ADR reporting practices among CPs in Anambra state. It underscores the significance of training, sensitization, advocacy, and other related interventions as pivotal means to enhance ADR reporting in this group. Furthermore, there is a pressing need for intervention-based studies to delve into and implement these approaches effectively.

Assessing pharmacists' awareness of financial indicators in community pharmacy management: A cross-sectional study.

Background: Community pharmacists play a vital role in the healthcare system, serving as accessible healthcare providers and entrepreneurs. To effectively manage community pharmacies, pharmacists must possess financial literacy and utilize appropriate financial indicators. However, studies addressing community pharmacists' awareness of financial indicator concepts are scarce. This study assesses the awareness of community pharmacists in Jordan regarding financial indicators. Methods: Employing a cross-sectional study design, we utilized a structured and validated questionnaire to collect data from 353 community pharmacy owners across Jordan. The questionnaire assessed pharmacists' awareness and utilization of financial indicators in pharmacy management. Descriptive statistics summarized demographic data, while analytical statistics examined associations between demographic factors and financial indicator awareness. Results: The study revealed varying levels of awareness among pharmacists regarding financial indicators, with younger pharmacists exhibiting higher awareness levels. Factors such as educational background and years of experience were found to influence awareness. Furthermore, pharmacists predominantly utilize profitability indicators to assess financial performance. Conclusion: The findings underscore the importance of enhancing pharmacists' financial literacy and integrating financial management principles into pharmacy education. Continuous professional development programs are essential to improve financial competence among pharmacists. This study provides valuable insights into the awareness of financial indicators among community pharmacists in Jordan, emphasizing the need for collaborative efforts from policymakers, pharmacy faculties, and associations to enhance financial education and promote research in this critical area.

Attitudes of community pharmacists towards extending their professional roles in Oman.

Background: Over the last few decades, the pharmacy profession has witnessed a substantial evolution accompanied by the developing role of community pharmacists (CPs). Evidence indicates that extending the role of CPs contributes to fostering public health outcomes. However, in many countries, their role is still underused. To extend the role of CPs in Oman, it is crucial to understand their perception and determine the influences. Aim: This study determines the willingness of CPs in Oman to extend their role and assess their perception towards barriers. Method: A cross-sectional study was conducted across Oman using an online self-administered survey targeting CPs working in the private sector. Result: Generally, respondents welcomed broadening their professional role. However, among the top perceived barriers were shortage of staff, insufficient training, lack of interconnection between CPs and physicians, and regulation constraints. Different socio-demographic characteristics of respondents showed a noticeable impact on their responses. Conclusion: CPs welcomed extending their role. However, several obstacles were raised that need to be tackled to enable CPs to advance their role.

Perceptions and experiences of community pharmacists with off-label prescribing in the pediatric population.

OBJECTIVES: This study aimed to investigate and provide insight into the prevalence and patterns of off-label drug use in the pediatric population from the perspective of community pharmacists, addressing the existing data gap in a developing setting. METHODS: A questionnaire-based cross-sectional study was conducted on Albanian community pharmacists in June 2021. The online administered survey explored the participants' demographic details, perceptions, and experiences with off-label prescriptions in pediatric patients. The statistical analysis conducted on the survey data comprised the construction of frequency tables and the application of the chi-square test for independence. KEY FINDINGS: Three hundred and thirty-six community pharmacists nationwide completed the survey, out of which 186 (55.3%) were practiced in Tirana, the capital of Albania. Over 80% of surveyed pharmacists (n = 275) had encountered off-label drug prescriptions in pediatric patients, yet only 40% of participants reported dispensing medicines for off-label use. Community pharmacists reported that general pediatricians tended to prescribe off-label medications more frequently than pediatric subspecialists or general practitioners. It was found that off-label prescriptions were more frequently observed among children aged between 2 and 11 years. Antibiotics were the most reported medicines for off-label use in this study mentioned in almost all off-label categories. CONCLUSIONS: Prescribing medicines for unapproved uses for the treatment of pediatric patients is present in community settings in Albania. This indicates the need for further data collection and analysis to understand off-label practices in our country's pediatric population comprehensively.

The role of community pharmacists and their perception towards antimicrobial stewardship in Baghdad, Iraq.

Background: This study aimed to assess the role of community pharmacists and their perception toward antimicrobial stewardship, in addition to identifying factors influencing their perception and practices in community pharmacy. Methods: A cross-sectional study was carried out among community pharmacists regarding antimicrobial stewardship. Convenience sampling was used to obtain the required sample from a community pharmacy in Baghdad. In total, 381 participants have completed the survey. Results: The majority of the participants (85.6%) strongly agreed/agreed that "antimicrobial stewardship programs reduce the problems of antibiotic resistance"; and 85.5% of them strongly agreed/agreed that community pharmacists required adequate training on antibiotics use. In addition, high percent of community pharmacists (88.4%) strongly agreed/agreed that pharmacists have a responsibility to take a prominent role in antimicrobial stewardship programs and infection-control programs in the health system. The total score of perception was significantly influenced by older age groups, postgraduate degrees, and experience of 6-10 years (p < 0.001). This study also showed that 65.4% of pharmacists always/often advise patients to continue the full course of antimicrobials, and 64.9% of them reported always/often considering clinical and safety parameters before dispensing antibiotics. The role of pharmacists was significantly influenced by the younger age group, females, higher degree in pharmacy, experience of 3-5 years, and medical complex pharmacy (p < 0.001). Conclusion: Community pharmacists have a good perception toward antimicrobial stewardship programs, but their role is still limited. More efforts are needed to design better strategies for antimicrobial stewardship in community pharmacy.

Exploration of herbal medicine practices, perceptions and knowledge among Spanish community pharmacists: A cross-sectional survey study.

INTRODUCTION: Herbal medicine has seen remarkable growth in consumption over the past few years. Community pharmacists are health care professionals who have an important role in the dispensing and counselling of these products. The aim of this study was to evaluate perceptions, professional practices and knowledge about herbal medicine among community pharmacists in Tenerife (Canary Islands, Spain). METHOD: A descriptive cross-sectional study was conducted in community pharmacies in Tenerife using a questionnaire that included demographic data, perceptions, professional practices and knowledge of herbal medicine. Data from 610 community pharmacists was analyzed using SPSS 26.0 software program. RESULTS: Most of the responders had a positive attitude towards herbal medicine, considering its products useful (80.9%), safe (64.2%) and those sold in pharmacies of high quality and standardized (84.6%). They thought that these products should only be sold in pharmacies (78.0%) and that it was their responsibility to provide information about them (95.5%). However, only 32.1% believed they are well prepared to provide herbal pharmaceutical care services and 36.1% that there are reliable and easily accessible sources of information. Moreover, 60.7% considered lack of training a barrier to recommending herbal medicinal products, being interested in updating their knowledge on it (96.9%). CONCLUSION: This study showed that community pharmacists have a positive perception of herbal medicines, considering them beneficial and safe. However, participants requested reliable sources of information, easy access, and more training to dispense, counsel, and safely label these products. Education and training programs in herbal medicine are needed to enhance their ability to provide herbal pharmaceutical care.

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 role of community pharmacists as oral health advisors in the management of oral effects of asthma medications: an exploratory survey.

OBJECTIVES: To investigate community pharmacists' attitudes, confidence, practice, knowledge, and barriers towards the management of oral side effects of asthma medications. METHODS: A paper-based questionnaire was developed from previous research, trialled, and validated. Convenience sampling through web search was used to identify pharmacy practices across Cairns, Queensland, Australia. Practices were contacted by email and phone before hand-delivering and collecting questionnaires. KEY FINDINGS: Thirty eight community pharmacist responses were descriptively analysed. Community pharmacists surveyed within the Cairns region feel that it is within their role to help manage the side effects of asthma medications. Many feel this is best conveyed during inhaler dispensing and instruction. Current advice is more prompted rather than preventative. Pharmacists routinely advise patients of mouth-rinsing following inhaler use, however the link to preventing side effects is not clearly communicated. Pharmacists are confident in recognizing and managing common side effects such as oral thrush and dry mouth, but fewer are aware of dental decay and gingivitis. Many identify a lack of guidelines as the largest barrier to providing preventive oral health advice. CONCLUSIONS: Cairns community pharmacists already self-perceive their role in the management of oral side effects of asthma medications. Advice given to patients is practical but does not clearly convey the causative associations between asthma medications and their potential oral side effects. Patient education is prompted more by enquiry rather than a preventative approach. The development of standardized practice protocols and integration within undergraduate degrees or continuing education may benefit the community-pharmacist delivered care.

Evaluating Greek pharmacists' attitudes and barriers regarding medicines adherence.

Adherence constitutes an integral aspect of achieving consistently good clinical results. Understanding pharmacists' perceptions and attitudes, along with existing barriers is essential on the roadmap of enhancing patient adherence. This constitutes the goal of this study. Methodology: A validated questionnaire was sent to a sample of 280 community pharmacists. Pharmacists were notified both by email and telephone. A response rate of 55% was achieved. Results: Most pharmacists agree that the identification of patients' suboptimal adherence falls under their professional responsibility and they engage in activities to promote it. There is evidence to support that the most popular interventions were self-management and indirect methods. Specific tools were used to a lesser degree. Finally, the current study illustrated that the most commonly identified barriers were the preference of patients for physicians regarding adherence, lack of information from patients and lack of time. Conclusion: Although the important role of pharmacists in adherence is ascertained, significant discrepancies in the tools used to control and promote adherence among pharmacists were identified, and also in obstacles faced by themselves and their patients. The interventions should be more consistent and the notion of cooperation among health care professionals should be nurtured.

Peer support as a potential tool to promote pharmacists' wellbeing.

Discussion regarding burnout in health professionals, including community pharmacists, has grown substantially since the arrival of the COVID-19 pandemic. Rapid legislative and societal behavioural changes led to significant global disruption of physical and emotional wellbeing during the pandemic as pharmacists continued to provide care while under unprecedented levels of stress. Community pharmacists have had an essential role in maintaining face-to-face care as the number of COVID-19 diagnoses and deaths rose. Communications emerged from the World Health Organisation which implored long-term changes to healthcare workplaces, including increased access to psychosocial support for employees. Peer support is a unique initiative in that it is low-cost and accessible across many platforms. Its main purpose is to bring people together with shared experiences and can often include people in the same career field or workplace. The feasibility and efficacy of peer support programs have been studied in other professional groups such as nurses and physicians, and also in undergraduate medical students. The conclusions drawn from these studies suggest that involvement in peer support reduced the risk of burnout and increased workplace engagement. In contrast to many other healthcare professionals, community pharmacists often work in relative isolation. Research has shown that younger pharmacists, and those in the earlier stages of their careers, reported feeling stressed, undervalued and supported. They also mentioned a desire for access to a mentoring or coaching program. Following the success of peer support in other cohorts, research is needed to verify if this intervention will similarly benefit early career community pharmacists.

'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.

Actual practices of community pharmacists in the management of diabetes: a comparison of simulated patient-based study with perceived role of involvement.

Objectives: This study evaluated the level of community pharmacy professionals' (CPPs) actual practices and contrasted it with their self-reported perceived involvement in diabetes management. Methods: A self-reported cross-sectional and simulated patient (SP)-based study were employed at community drug retail outlets (CDROs) in Northwest Ethiopia. SP-case scenarios were used to examine the actual practices of CPPs in diabetes management and were compared with self-reported perceived involvement. The data were managed and analysed using SPSS version 26. Results: About 184 participants in the self-reported and 100 CPPs' actual practices using three SP visits were included. The overall actual practice (17.8%) was found to be significantly different compared with the perceived level of involvement (73.5%) (p-value <0.05). About 94.3% of CPPs dispensed requested medications to the SP without a prescription. Despite most participants being perceived to be involved, more than 76% of CPPs did not counsel the SP for lifestyle modifications, avoiding risky behaviours, adherence to treatment, routine blood glucose checkups, diabetic foot care techniques, or consultation with physicians for further management. Conclusion: A significant discrepancy between actual practices and perceived CPPs' involvement in the management of diabetes was observed. The findings may suggest that exploring possible gaps may be crucial.