Electronic health records and e-prescribing in Australia: An exploration of technological utilisation in Australian community pharmacies.

OBJECTIVE: This study aimed to assess the utilisation, benefits, and challenges associated with Electronic Health Records (EHR) and e-prescribing systems in Australian Community Pharmacies, focusing on their integration into daily practice and the impacts on operational efficiency, while also gathering qualitative insights from community pharmacists. METHODS: A mixed-methods online survey was carried out among community pharmacists throughout Australia to assess the utilisation of EHR and e-prescribing systems, including the benefits and challenges associated with their use. Data was analysed based on pharmacists' age, gender, and practice location (metropolitan vs. regional). The chi-square test was applied to examine the relationship between these demographic factors and the utilisation and operational challenges of EHR and e-prescribing systems. RESULTS: The survey engaged 120 Australian community pharmacists. Of the participants, 67 % reported usability and efficiency issues with EHR systems. Regarding e-prescribing, 58 % of pharmacists faced delays due to slow software performance, while 42 % encountered errors in data transmission. Despite these challenges, the benefits of e-prescribing were evident, with 79 % of respondents noting the elimination of illegible prescriptions and 40 % observing a reduction in their workload. Issues with prescription quantity discrepancies and the reprinting process were highlighted, indicating areas for improvement in workflow and system usability. The analysis revealed no significant statistical relationship between the utilisation and challenges of EHR and e-prescribing systems with the demographic variables of age, gender and location (p > 0.05), emphasising the necessity for healthcare solutions that address the needs of all pharmacists regardless of specific demographic segments. CONCLUSION: In Australian community pharmacies, EHR and e-prescribing may enhance patient care but come with challenges such as data completeness, technical issues, and usability concerns. Implementing successful integration relies on user-centric design, standardised practices, and robust infrastructure. While demanding for pharmacists, the digital transition improves efficiency and quality of care. Ensuring user-friendly tools is crucial for the smooth utilisation of digital health.

Barriers to Buprenorphine Dispensing by Medicaid-Participating Community Retail Pharmacies.

Importance: Controlled substances have regulatory requirements under the US Federal Controlled Substance Act that must be met before pharmacies can stock and dispense them. However, emerging evidence suggests there are pharmacy-level barriers in access to buprenorphine for treatment for opioid use disorder even among pharmacies that dispense other opioids. Objective: To estimate the proportion of Medicaid-participating community retail pharmacies that dispense buprenorphine, out of Medicaid-participating community retail pharmacies that dispense other opioids and assess if the proportion dispensing buprenorphine varies by Medicaid patient volume or rural-urban location. Design, Setting, and Participants: This serial cross-sectional study included Medicaid pharmacy claims (2016-2019) data from 6 states (Kentucky, Maine, North Carolina, Pennsylvania, Virginia, West Virginia) participating in the Medicaid Outcomes Distributed Research Network (MODRN). Community retail pharmacies serving Medicaid-enrolled patients were included, mail-order pharmacies were excluded. Analyses were conducted from September 2022 to August 2023. Main Outcomes and Measures: The proportion of pharmacies dispensing buprenorphine approved for opioid use disorder among pharmacies dispensing an opioid analgesic or buprenorphine prescription to at least 1 Medicaid enrollee in each state. Pharmacies were categorized by median Medicaid patient volume (by state and year) and rurality (urban vs rural location according to zip code). Results: In 2016, 72.0% (95% CI, 70.9%-73.0%) of the 7038 pharmacies that dispensed opioids also dispensed buprenorphine to Medicaid enrollees, increasing to 80.4% (95% CI, 79.5%-81.3%) of 7437 pharmacies in 2019. States varied in the percent of pharmacies dispensing buprenorphine in Medicaid (range, 73.8%-96.4%), with significant differences between several states found in 2019 (χ2 P < .05), when states were most similar in the percent of pharmacies dispensing buprenorphine. A lower percent of pharmacies with Medicaid patient volume below the median dispensed buprenorphine (69.1% vs 91.7% in 2019), compared with pharmacies with above-median patient volume (χ2 P < .001). Conclusions and Relevance: In this serial cross-sectional study of Medicaid-participating pharmacies, buprenorphine was not accessible in up to 20% of community retail pharmacies, presenting pharmacy-level barriers to patients with Medicaid seeking buprenorphine treatment. That some pharmacies dispensed opioid analgesics but not buprenorphine suggests that factors other than compliance with the Controlled Substance Act influence pharmacy dispensing decisions.

Pharmacist assessments and care to improve adult vaccination rates: A report from project IMPACT vaccine confidence.

BACKGROUND: Neglect of vaccination needs among adults results in a needless burden of hospitalization, suffering, and death. America's community pharmacists deliver a substantial portion of adult vaccinations, yet many Americans still have unmet vaccination needs. OBJECTIVES: This study evaluated rates of vaccine contraindications, acceptance, and willingness to be vaccinated among ambulatory adults. PRACTICE DESCRIPTION: This was a prospective, multisite, multistate, observational study conducted in three waves between October 2021 and August 2023. PRACTICE INNOVATION: Pharmacists conducted comprehensive vaccination need assessments. EVALUATION METHODS: The primary outcomes were numbers of vaccination needs per participant and vaccinations administered, scheduled, or declined. RESULTS: Pharmacists identified a mean of 1.8-2.2 unmet vaccination needs per adult assessed, more than in pilot studies. Participants had already received 61%-74% of vaccinations recommended for them hence 26%-39% of needs were unmet at baseline. The leading vaccination needs were COVID-19, influenza, zoster, tetanus-containing, and pneumococcal vaccines. From a baseline mean of 59.1% for these five vaccinations, pharmacists increased the mean percentage vaccinated to 73.2%. When an option for scheduling future vaccination was added to the process, declinations dropped from 46%-18%. CONCLUSION: This study provides insight into adult vaccine acceptance, willingness, and declination behaviors not described elsewhere. Offering options for future vaccination reduced declination rates. Pharmacists resolved substantial proportions of adult vaccination needs. The signal that apportioning adult vaccines needed, but not received on day of assessment, across several months could help resolve unmet vaccination needs warrants additional research, especially with the rising number of vaccines recommended for adults.

Determining the association between grocery nutrition scores and number of medications taken for metabolic syndrome: A pilot study.

BACKGROUND: Metabolic syndrome is a cluster of disease states that increases an individual's risk of developing diabetes or cardiovascular disease. When treating metabolic syndrome, lifestyle and diet are primary areas for interventions. A dietician-led grocery nutrition system scoring patients' purchases may correlate to better control of metabolic health. OBJECTIVE: To compare the number of medications taken for metabolic syndrome for patients with grocery nutrition scores at goal versus those below goal as pre-defined by the dietician team. PRACTICE DESCRIPTION: This exploratory, retrospective cohort pilot study took place in a single pharmacy within a large community pharmacy chain in Northwest Ohio. PRACTICE INNOVATION: This retrospective cohort study compared the number of medications taken for metabolic syndrome between two groups: patients with a grocery nutrition score at a dietician-set goal and patients not at goal. EVALUATION METHODS: Data were collected from May 2022 to March 2023, with patients completing a questionnaire collecting information on demographics. In addition, the questionnaire, grocery nutrition scores, and patient medication records were collected. Descriptive statistics were calculated for demographic items. A number of medications taken for metabolic syndrome by patients at dietician-set grocery nutrition score goal and not at goal were compared using a Mann-Whitney U test. RESULTS: A total of 40 patients were enrolled in this study. There was not a significant difference in a number of medications taken for metabolic syndrome between groups, with patients who had a grocery nutrition score at goal taking an average of 1.20 medications compared to 1.96 for those with grocery nutrition scores below goal. CONCLUSIONS: While no statistical difference in mean medication use was identified, grocery nutrition scores may help understand patients' dietary habits. Larger studies are required to test the relationship between grocery nutrition scores, patient-specific factors, and medications taken for metabolic syndrome.

Despair and hope: Is the retail community pharmacy workforce in danger of becoming a monopsony labor market?

OBJECTIVE: Mergers of big chain retail community pharmacies can affect the competitiveness of the pharmacy workforce to negotiate better wages and work conditions. However, it is unclear whether these types of mergers are generalizable to the U.S. pharmacy workforce. We should observe this effect when comparing annual wage trends between retail community pharmacy workers and nonretail community pharmacy workers. In the absence of this effect, annual wage trends would be similar. To examine this theory, annual wage trends for community pharmacy workers were compared with hospital pharmacy workers between 2012 and 2022. DESIGN, SETTING AND PARTICIPANTS: A serial cross-sectional study was performed to compare the annual wages between retail community pharmacy workers and hospital pharmacy workers between 2012 and 2022 using data from the U.S. Bureau of Labor and Statistics (BLS). Pharmacy workforce was categorized as pharmacists, pharmacy technicians, and pharmacy aides (clerks) and grouped into retail or hospital pharmacy settings based on the North American Industry Classification System. Pharmacy workers' annual wages were based on the U.S. BLS Quarterly Census of Employment and Wages data. OUTCOME MEASURES: Annual wages. RESULTS: Between 2012 and 2022, statistically significant annual wage reduction was greater among pharmacists in the retail than pharmacists in the hospital setting by -$1974 (95% CI -$2921 to -$1026) per year. However, these trends were not statistically significant among pharmacy technicians and pharmacy aides. Pharmacy technicians in the retail and hospital settings had a 3.4% and 7.0% increase in average annual wages, respectively. Pharmacy aides in the retail and hospital settings had a 16.8% and 21.6% increase in average annual wages, respectively. CONCLUSION: Although pharmacists' annual wages decreased, it is unclear whether this was caused by the monopsony labor market. These findings suggest that there may be inefficiencies in the retail community pharmacy labor market, which may stimulate policies to improve pharmacy workforce conditions and patient safety.

Spatial accessibility and travel to pharmacy by type in the Detroit region.

BACKGROUND: Community pharmacies are a critical part of the health care provision system. Yet less is understood about the spatial accessibility to pharmacies and how people travel to reach these services. OBJECTIVES: This study compared spatial accessibility and actual travel to different types of pharmacies among selected neighborhoods in the Detroit region. METHODS: Three types of neighborhoods were selected and compared, including two lower income Black urban neighborhoods of high-density and four upper income White suburbs (two of low density and two of high density). Spatial accessibility was computed by pharmacy type and compared among neighborhoods using ANOVA. Pharmacy trips reported in a travel survey were geocoded and linked with community pharmacies in a list generated from ReferenceUSA business data. Destination choices were mapped and the relationship between spatial accessibility and actual distance traveled was examined using ordinary least squares regressions. RESULTS: On average, urban residents in Detroit had higher access to local independent pharmacies (0.74 miles to the nearest one) but relatively lower access to national chains (1.35 miles to the nearest one), which most residents relied on. Urban residents also tended to shop around more for services even among national chains. In fact, they bypassed nearby local independent pharmacies and traveled long distances to use farther pharmacies, primarily national chains. The average trip distance to pharmacy was 2.1 miles for urban residents, but only 1.1 miles and 1.5 miles for residents in high-density suburbs and low-density suburbs, respectively. CONCLUSION: Supposedly good spatial access considering all pharmacies together may mask excessive burden in reaching the pharmacy services needed in low-income minority urban communities, as shown in the case of Detroit. Thus, when mapping pharmacy deserts, it is important to distinguish spatial accessibility among different pharmacy types.

Assessment of without prescription antibiotic dispensing at community pharmacies in Hazara Division, Pakistan: A simulated client's study.

Antibiotics dispensing without a prescription is an irrational practice and can increase the risk of antibiotic resistance, which is a significant public health concern around the globe. This study was aimed to determine the extent to which antibiotics are supplied without prescription in the community pharmacies (CPs) at Hazara Division from November 2020 to February 2021. The simulated client method (SCM) was used, and the data were gathered, recorded, and analyzed through different statistical methods with descriptive and inferential techniques. The antibiotic dispensing was observed in CPs (90.5%), the most dispensed antibiotics were azithromycin (29.4%) and ciprofloxacin (46.5%) respectively. Furthermore, visited medical stores/ drug outlets, 9.5% of the visited stores denied dispensing of antibiotics because they preferred a referral to visit physicians (23. 9%) and (12.8%) did not had the antibiotics at the time of visits. Antibiotics were more obtainable in retail medical stores (AOR = 8.6, 95 percent Cl: 3.0-24.7; p = 0.001) than in pharmacies. In rural areas antibiotics dispensing was more (p = 0.004) as compared to urban areas. Staff members also had asked about patient's (17.7%) symptoms and drug allergies (12.3% and 3.9%), and (1.5%) they consoled them about their medications. The findings of this study indicate that nonprescription antibiotic sales are very common, despite national rules prohibiting this activity. When the simulated Client requested for any medication to relieve his or her discomfort, many antibiotics were given out without a prescription. Pharmacies/medical stores in Hazara Division selling antibiotics without a prescription are worrying and need immediate action by regulators.

Perceptions of Pharmacy students about their competences for professional practice in community pharmacy

Abstract Pharmaceutical education should enable the development of competences for community pharmacy practice, which is an important field for the pharmacist workforce. The aim of this study was to evaluate the competences perceived by pharmacy interns from a Brazilian pharmacy school for community pharmacy practice. This study adopted a combined quantitative and qualitative approach. The study cohort included undergraduate students who undertook internships in community pharmacy in the final year of the pharmacy course. Students responded to an 11-item structured questionnaire according to a five-point Likert scale that included perceptions of their competences for community pharmacy practice. Among the 693 possible answers, 605 (87.3%) agreed that the course promoted the development of competences for professional practice in community pharmacy. Less than 70% of students perceived themselves as prepared to respond to symptoms and provide non-prescription medicines. Qualitative analysis of the comments revealed three themes: the need to improve patient information skills, improve practice as a member of a health care team, and improve dispensing according to legal requirements. These findings may support improvements in undergraduate pharmacy programs, such as the inclusion of experiential learning, active learning methods, interprofessional education, and development of clinical skills.

Mapping community pharmacy services in Brazil: a scoping review

Abstract The delivery of clinical pharmacy services has been growing in Brazilian community pharmacies, and it is necessary to have a comprehensive understanding of the topic. This scoping review aimed to provide an overview of Brazilian studies about clinical pharmacy services in community pharmacies. Original research articles, with no restriction of time, study design, or patient's health condition, were included. Searches were conducted in PubMed, Scopus, Web of Science, Scielo, and Lilacs. Two reviewers conducted the screening, full-text reading, and data extraction independently. ROB and ROBINS-I were used for the assessment of quality. Charts and tables were built to summarise the data. Seventy-two articles were included. A diversity of study designs, number of participants, terms used, and outcomes was found. São Paulo and Sergipe States had the highest number of studies (n=10). Pharmacists' interventions were not fully reported in 65% of studies, and most studies presented an unclear risk of bias. Studies were very diverse, impairing the comparisons between the results and hindering their reproducibility. This review suggests using guidelines and checklists for better structuration of pharmacists' interventions as well as reporting results and measuring fidelity in future research.

Challenges for Polish Community Pharmacists in Provision of Services to Immigrants and Non-Polish-Speakers in 2018.

BACKGROUND International patient services in community pharmacies are becoming increasingly common. The growing number of immigrants, as well as the developing trend of medical tourism, make it necessary to provide these people with access to healthcare services, including pharmaceutical services in generally accessible pharmacies. Serving non-Polish-speaking patients, however, requires both fluent specialist knowledge of a foreign language and interpersonal skills. These skills can greatly influence the proper use of medications by patients. This study aimed to investigate the reported challenges for Polish community pharmacists in the provision of services to immigrants and non-Polish-speakers in 2018. MATERIAL AND METHODS The study included 98 pharmacists and pharmaceutical technicians from community pharmacies in Poland. The research tool was a questionnaire sent to pharmacy staff in cooperation with pharmacy councils in 2018. RESULTS Analysis of the data gathered using a 5-point Likert scale showed that the participants rated the preparedness for international patient services in pharmacies as medium (mean 2.76±1.33). The mean foreign language knowledge score was 2.99±1.29. The participants indicated a low possibility of acquiring these language skills (mean 2.53±0.91), and emphasized that patients from abroad rarely asked about the use of the medications (mean=2.20±1.06). CONCLUSIONS This study showed that in 2018, pharmacy staff in Poland did not feel adequately prepared to provide comprehensive pharmacy services for immigrants and non-Polish-speakers, with concerns of non-compliance with medications due to poor communication.

Roles and reimbursement of pharmacists as South Africa transitions towards Universal Health Coverage (UHC): An online survey-based study.

BACKGROUND: The implementation of Universal Health Coverage in SA has sought to focus on promoting affordable health care services that are accessible to all citizens. In this regard, pharmacists are expected to play a pivotal function in the revitalization of primary health care (PHC) during this transition by the expansion of their practice roles. OBJECTIVES: To assess the readiness and perceptions of pharmacists to expand their roles in an integrated health care system. To determine the availability and pricing of primary health care services currently provided within a community pharmacy environment and to evaluate suitable reimbursement for the provision of such services by a community pharmacist. METHODS: Community pharmacists' across SA were invited to participate in an online survey-based study. The survey consisted of both open- and closed-ended questions. Descriptive statistics for closed-ended questions were generated and analysed using Microsoft Excel® and Survey Monkey®. Responses for the open-ended questions were transcribed, analysed, and reported as emerging themes. RESULTS: Six hundred and sixty-four pharmacists' responded to the online survey. Seventy-five percent of pharmacists' reported that with appropriate training, a transition into a more patient-centered role might be beneficial in the re-engineering of the PHC system. However, in order to adopt these new roles, appropriate reimbursement structures are required. The current fee levied by pharmacists in community pharmacies that offered these PHC services was found to be lower to that recommended by the South African Pharmacy Council; this disparity is primarily due to a lack of information and policy standardisation. Therefore, in order to ensure that fees levied are fair, comprehensive service package guidelines are required. CONCLUSIONS: This study provides baseline data for policy makers on pharmacists' readiness to transition into expanded roles. Furthermore, it can be used as a foundation to establish appropriate reimbursement frameworks for pharmacists providing PHC services.

Management of common minor ailments in Qatar: Community pharmacists' self-perceived competency and its predictors.

Studies focused on comprehensive assessment of self-perceived competency of community pharmacists to manage minor ailments are scanty despite that self-perceived competency is a valid determinant of task performance. The objectives of the study were to assess community pharmacists' self-perceived competency to manage fourteen common minor ailments in Qatar, and identify its significant predictors. A cross-sectional assessment of 307 community pharmacists was conducted with a pre-tested 20-item questionnaire. Self-perceived competency was assessed with nine elements on a scale of 1-10 (Maximum obtainable score: Each minor ailment = 90; each element = 140). Mann-Whitney U and bivariate logistic regression were used for data analyses. The response rate was 91.9% (282/307). The majority of the respondents were males (68.1%; 192/282), within the age range of 31-40 years (55.3%; 156/282). The minor ailments with the highest median competency score were constipation (76), and cold/catarrh (75) while travel sickness (69), and ringworm (69) had the lowest. The two condition-specific competency elements with the highest median score were recommendation of over-the-counter (OTC) medicines (115), and provision of instructions to guide its use (115). Ability to differentiate minor ailments from other medical conditions had the lowest median competency score (109). The significant predictors self-perceived competency were female gender (OR = 2.39, 95%CI: 1.34-4.25, p = 0.003), and working for chain pharmacies (OR = 2.54, 95%CI: 1.30-4.96, p = 0.006). Overall, Community pharmacists' self-perceived competency was adequate for majority of the common minor ailments, and it was highest for constipation and cold/catarrh, and specifically for the recommendation of OTC medicines and provision of instructions to guide its use. However, diagnostic ability to differentiate minor ailments from other medical conditions with similar features had the lowest median competency score. Female gender and working in chain pharmacies were the significant predictors of self-perceived competency to manage minor ailments.

Pharmacists' perceptions of the use of internet-based medication information by patients: A cross-sectional survey.

PURPOSE: The credibility and the reliability of Internet webpages to seek medication-related information is questionable. The main objective of the current study was to evaluate perception and experience of pharmacists with the use of Internet-based medication information by their patients. METHODS: This is a cross-sectional descriptive study that was conducted to evaluate perception and experience of pharmacists with the use of Internet-based medication information by their patients. During the study period, 200 pharmacists were approached to participate in the study using a paper-based survey to assess their perceptions and current experience with the use of Internet-based medication information by their patients. Data were analyzed using descriptive statistics (mean/standard deviation for continuous variables, and frequency/percentages for qualitative variables). Also, simple linear regression was utilized to screen factors affecting pharmacists' perception scores of the use of Internet-based medication information. RESULTS: Among 161 recruited pharmacists, the majority (n = 129, 80.1%) reported receiving inquiries from patients about Internet-based medication information within the last year. Among them, only 22.6% (n = 29) of pharmacists believed that Internet-based medication information is somewhat or very accurate. Unfortunately, only 24.2% (n = 31) of them stated that they always had enough time for their patient to discuss their Internet-based medication information. Regarding pharmacists' perception of the use of Internet-based medication information by their patients, more than half of the pharmacists (>50%) believe that Internet-based medication information could increase the patient's role in taking responsibility. On the other hand, 54.7% (n = 88) of the pharmacists believed that Internet-based medication information would contribute to rising the healthcare cost by obtaining unnecessary medications by patients. Finally, pharmacists' educational level was found to significantly affect their perception scores toward patient use of Internet-based medication information where those with higher educational level showed lower perception score (r = -0.200, P-value = 0.011). CONCLUSION: Although pharmacists felt that usage of Internet-based data by patients is beneficial, they also have believed that it has a negative impact in terms of rising the healthcare cost, and it promotes unnecessary fear or concern about medications. We suggest that pharmacists be trained on principles of critical appraisal to become professional in retrieval information on the Internet that might improve their delivery of healthcare information and their recommendations to patients.

E-prescribing and access to prescription medicines during lockdown: experience of patients in Aotearoa/New Zealand.

BACKGROUND: Health services internationally have been compelled to change their methods of service delivery in response to the global COVID-19 pandemic, to mitigate the spread of infection amongst health professionals and patients. In Aotearoa/New Zealand, widespread electronic delivery of prescriptions (e-prescribing) was enabled. The aim of the research was to explore patients' experiences of how lockdown, changes to prescribing and the interface between general practices and community pharmacy affected access to prescription medications. METHOD: The research employed a mixed-method approach. This included an online survey (n = 1,010) and in-depth interviews with a subset of survey respondents (n = 38) during the first COVID-19 lockdown (March-May 2020). Respondents were recruited through a snowballing approach, starting with social media and email list contacts of the research team. In keeping with the approach, descriptive statistics of survey data and thematic analysis of qualitative interview and open-ended questions in survey data were combined. RESULTS: For most respondents who received a prescription during lockdown, this was sent directly to the pharmacy. Most people picked up their medication from the pharmacy; home delivery of medication was rare (4%). Survey and interview respondents wanted e-prescribing to continue post-lockdown and described where things worked well and where they encountered delays in the process of acquiring prescription medication. CONCLUSIONS: E-prescribing has the potential to improve access to prescription medication and is convenient for patients. The increase in e-prescribing during lockdown highlighted how the system could be improved, through better feedback about errors, more consistency across practices and pharmacies, more proactive communication with patients, and equitable prescribing costs.

Knowledge, attitude and practices of community pharmacists regarding COVID-19: A paper-based survey in Vietnam.

OBJECTIVE: To survey the knowledge, attitude, and practices of Vietnamese pharmacists regarding the COVID-19 pandemic. METHOD: This cross-sectional, paper-based study was conducted from June to August 2020. A validated questionnaire (Cronbach's alpha = 0.84) was used to interview 1,023 pharmacists in nine provinces of Vietnam. Analysis of covariance was employed to identify factors associated with the knowledge of pharmacists. The best model was chosen by using the Bayesian Model Averaging method in R software version 4.0.4. RESULTS: The mean knowledge score was 12.02 ± 1.64 (range: 6-15), which indicated that 93.4% of pharmacists had good knowledge of COVID-19. There was no difference in the average score between males and females (p > 0.05). The multivariate linear regression model revealed that the knowledge was significantly associated with pharmacists' age, education level, and residence (p < 0.001). About attitude and practices, pharmacists daily sought and updated information on the COVID-19 pandemic through mass media and the internet (social network and online newspapers). Nearly 48% of them conceded that they communicated with customers when at least one person did not wear a face mask at the time of the COVID-19 outbreak. At medicine outlets, many measures were applied to protect pharmacists and customers, such as equipping pharmacists with face masks and hand sanitizers (95.0%), using glass shields (83.0%), and maintaining at least one-meter distance between two people (85.2%). CONCLUSION: The pharmacists' knowledge of COVID-19 transmission, symptoms, and prevention was good. Many useful measures against the spread of this perilous virus were applied in medicine outlets. However, pharmacists should restrict forgetting to wear face masks in communication with medicine purchasers. The government and health agencies should have practical remedies to reduce the significant differences in the COVID-19 knowledge of pharmacists among provinces and education-level groups.

Hydroxychloroquine availability during COVID-19 crisis and its effect on patient anxiety.

OBJECTIVE: To report the results of a survey exploring the experience of patients with SLE facing hydroxychloroquine (HCQ) shortage that occurred during the early phases of the COVID-19 pandemic. METHODS: A survey was designed by Lupus Europe's patient advisory network and distributed through its social media, newsflash and members' network. People with lupus were asked about their last HCQ purchases and their level of anxiety (on a 0-10 scale) with regard to not being able to have access to HCQ, once in April 2020 (first wave) and after 11 August (second wave). The results were compared. RESULTS: 2075 patients responded during the first wave; 1001 (48.2%) could get HCQ from the first place they asked, 230 (11.1%) could get the drug by going to more than one pharmacy, 498 (24.0%) obtained HCQ later from their usual pharmacy and 126 (6.1%) from other sources. 188 (9.1%) could not get any; 32 (1.5%) did not respond to this question. All countries showed significant improvement in HCQ availability during the second wave. 562 (27.4%) patients reported an extremely high level of anxiety in wave 1 and 162 (10.3%) patients in wave 2; 589 (28.7%) and 268 (17.1%) patients reported a high level of anxiety in wave 1 and wave 2, respectively. CONCLUSIONS: The HCQ shortage had a significant impact on patients with SLE and has been responsible for psychological consequences including anxiety. Indeed, despite an objective improvement in drug availability, the event is leaving significant traces in patients' mind and behaviours.

Naturaleza de las dispensaciones durante el servicio de guardia de fin de semana de las farmacias en la ciudad de Teruel / Nature of dispensations during the weekend guardservice of pharmacies in the city of Teruel

INTRODUCCIÓN: el trabajo que los farmacéuticos y otros profesionales sanitarios realizan durante el servicio de guardia tiene una importancia esencial, ya que asegura la accesibilidad al medicamento, ofreciendo consejo sanitario, seguimiento farmacoterapéutico y apoyo profesional a los pacientes fuera del horario habitual. OBJETIVO: conocer la naturaleza de las dispensaciones en el servicio de guardia de las farmacias de la ciudad de Teruel durante el fin de semana. METODOLOGÍA: estudio observacional descriptivo transversal realizado en tres farmacias comunitarias de la ciudad de Teruel. El primer período analizado comprende desde abril hasta junio de 2019 y el segundo en marzo de 2020, durante los cuatro fines de semana que las farmacias estudiadas estaban de guardia. RESULTADOS: de las 4.245 dispensaciones de los fines de semana analizadas en 2019, 1.059 (26,4 %) fueron medicamentos con prescripción realizada por servicios médicos de urgencia; 965 (21,8 %) de fármacos con prescripción crónica; 655 (15,2 %) no tenían prescripción médica de ningún tipo, pero se consideraron necesarios; 1.067 (25,8 %) no tenían prescripción médica y no se consideraron necesarios, y 499 (10,8 %) fueron dispensaciones no ortodoxas. CONCLUSIONES: el patrón de las dispensaciones durante las guardias de las farmacias es constante, independientemente de que el fin de semana sea ordinario, situación especial (Semana Santa) o situación de alarma ("COVID"). El servicio de urgencias farmacéutico no está siendo bien utilizado por la población, ya que el porcentaje de actuaciones farmacéuticas que tiene su origen en una urgencia médica es muy bajo

INTRODUCTION: The work that pharmacists and other healthcare professionals during the on-call service shades an importance that ensures accessibility to the drug, health advice, pharmacotherapeutic monitoring and profesional support to patients; out of regular hours. OBJECTIVES: Know the nature of the population in the guardservice of the pharmacies in the city of Teruel during the weekends. METHODOLOGY: Cross-sectional observational study conducted in three community pharmacies in the city of Teruel. The first period analyzed ranges from April to June 2019 and the second in March 2020, during the four weekends that the pharmacies studies were on call. RESULTS: Of the 4245 weekend dispensations analyzed in 2019: 1059 (26.4%)were prescription drugs performed by emergency medical services, 965 (21.8%) of chronically prescribed drugs, 655 (15.2%) did not have a prescription of any kind but were considered necessary, 1067 (25.8%) had no prescription and were not considered necessary and 499 (10,80%) were non-orthodox dispensations. CONCLUSIONS: The pattern of dispensing during pharmacy guards is constant, independently of whether the weekend is ordinary, special situation (Easter) or an Alarm Situation ("COVID"). The pharmaceutical emergency service is not being used well by the population, the percentage of pharmaceutical actions that originate from a medical emergency is very low

Self-medication consultations in community pharmacy: an exploratory study on teams' performance, client-reported outcomes and satisfaction

BACKGROUND: Community pharmacy teams (CPTs) have an established role in assisting self-medication, contributing to the safe and effective use of non-prescription medicines. OBJECTIVE: The study aimed to describe CPTs' performance in self-medication consultation, client-reported outcomes, and satisfaction. A secondary purpose was to develop an explanatory model for better understanding clients' satisfaction with this service. METHODS: Descriptive, cross-sectional exploratory study. Data were collected in a purposive sample of pharmacy clients recruited in six community pharmacies in Portugal. CPTs adopted a structured approach to self-medication consultations, encompassing 11 quality criteria (five for case evaluation and six for counselling). An evaluation score, a counselling score and an overall quality score were estimated. Client-reported outcomes and satisfaction were ascertained via a follow-up telephone interview. Besides descriptive statistics, the association with several independent variables on the clients' overall satisfaction was explored, using linear regression. RESULTS: Product-based dispensing was more frequent for lower educated clients. Reported compliance with the criteria by CPTs was overall high (93.95% of maximum compliance), mostly missing the 'other medication' questioning. Most clients (93%) reported improvement after the consultation. Clients' satisfaction score was 4.70 out of 5. The variables that seem to better explain clients' overall satisfaction are pharmacy loyalty, the evaluation score, and the female gender. CONCLUSIONS: Clients' reported outcomes were favourable, as well as satisfaction with the service. Clients' satisfaction appears to be determined by consultation quality (evaluation score), suggesting the advancement of the pharmacists' clinical role. A larger study is warranted to confirm these findings

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Dispensing errors in Lebanese community pharmacies: incidence, types, underlying causes, and associated factors

OBJECTIVES: To assess the incidence, types, the causes of as well as the factors associated with dispensing errors in community pharmacies in Lebanon. METHODS: An observational cross-sectional study was conducted in 286 pharmacies located all over Lebanon. Data were collected by senior pharmacy students during their experiential learning placement. Collected data included information on the types of dispensing errors, the underlying causes of errors, handling approaches, and used strategies for dispensing error prevention. Data were analyzed using multiple logistic regression to determine factors that were associated with dispensing errors. RESULTS: In the twelve thousand eight hundred sixty dispensed medications, there were 376 dispensing errors, yielding an error rate of 2.92%. Of these errors, 67.1% (252) corresponded to dispensing near-miss errors. The most common types of dispensing errors were giving incomplete/incorrect use instructions (40.9% (154)), followed by the omission of warning(s) (23.6% (89)). Work overloads/time pressures, illegible handwriting, distractions/interruptions, and similar drug naming/packaging were reported as the underlying causes in 55% (206), 23.13% (87), 15.15 % (57), and 7% (26) of the errors respectively. Besides, high prescription turnover volume, having one pharmacist working at a time, and extended working hours, were found to be independent factors that were significantly associated with dispensing errors occurrence (p < 0.05). CONCLUSIONS: This study sheds light on the need to establish national strategies for preventing dispensing errors in community pharmacies to maintain drug therapy safety, considering identified underlying causes and associated factors

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Assessment of job satisfaction among community pharmacists in Baghdad, Iraq: a cross-sectional study

BACKGROUND: Pharmacists have the unique position of providing safe and effective care. Hence, addressing their feelings about their working life is crucial to provide good pharmacy services. OBJECTIVE: this study aimed to assess job satisfaction among Iraqi community pharmacists and determine the effect of pharmacist characteristics on job satisfaction. METHODS: A cross-sectional study was conducted among community pharmacists in Baghdad, the capital of Iraq. A simple random sample technique was adopted to select community pharmacists. A survey questionnaire using Warr-Cook-Wall satisfaction scale (ranging from extremely dissatisfied to extremely satisfied) was used to assess job satisfaction. RESULTS: Community pharmacists experienced moderate satisfaction with their jobs. The mean satisfaction score for all pharmacists was 20.4 (SD 3.7). The lowest mean scores occurred for recognition (1.4; SD 0.7), public respect (1.8; SD 0.9), and pharmacy regulations (1.9; SD 0.9). Job satisfaction was significantly affected by pharmacist characteristics, including gender (p < 0.001), age (p < 0.001), degree level (p = 0.003), years in practice (p < 0.001), working patterns (p< 0.001), and working hours (p < 0.001). Regression analysis indicated pharmacist gender and age had the highest effect on job satisfaction, while, years in practice, working hours, and working pattern had the lowest effect. CONCLUSIONS: Community pharmacists expressed moderate satisfaction with their jobs with satisfaction levels being affected by gender, age, years in practice, working patterns, and working hours. New strategies will require support for Iraqi pharmacists by the Ministry of Health and Syndicate of Iraqi Pharmacists before being included in extended pharmacy services

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