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1.
Rev Bras Epidemiol ; 23: e200028, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32401921

RESUMEN

OBJECTIVE: The prevalence of hypertension in Brazil and worldwide has been increasing in recent decades, and drug therapy is one of the strategies used to control this condition. The objective of this study was to estimate the prevalence of use and identify the sources for obtaining antihypertensive drugs in Brazil, according to sociodemographic variables, comparing three periods: 2011, 2014 and 2017. METHODS: Data from individuals aged ≥20 years who reported a medical diagnosis of hypertension, interviewed by Vigitel in 2011, 2014 and 2017 were used. Frequency and prevalence of drug use in addition to the sources for obtaining medication were estimated by sociodemographic variables, with 95% confidence intervals. The differences between proportions were verified by Pearson's chi-square test (Rao-Scott), with a significance level of 5%. RESULTS: The prevalence of antihypertensive drug use remained stable (80%). Regarding the sources for obtaining these medicines, there was variation in the period, indicating a decrease in usage through the Brazilian Unified Health System (SUS) (44.2% in 2011; 30.5% in 2017). This decrease was accompanied with increase in PFPB (16.1% in 2011; 29.9% in 2017). The prevalence of other sources for obtaining medicine (private pharmacies/drugstores) showed stability in the period. CONCLUSIONS: The prevalence of medication use remained high and there was a change in the pattern of use according to sources, demonstrating migration between SUS pharmacies to the PFPB, and suggesting a reduction in the availability of medicines from public pharmacies universally, and for free.


Asunto(s)
Antihipertensivos/provisión & distribución , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Hipertensión/tratamiento farmacológico , Hipertensión/epidemiología , Adulto , Distribución por Edad , Antihipertensivos/uso terapéutico , Brasil/epidemiología , Servicios Comunitarios de Farmacia/estadística & datos numéricos , Servicios Comunitarios de Farmacia/provisión & distribución , Estudios Transversales , Femenino , Programas de Gobierno/estadística & datos numéricos , Encuestas Epidemiológicas , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Programas Nacionales de Salud , Prevalencia , Distribución por Sexo , Factores Socioeconómicos , Teléfono , Adulto Joven
2.
Artículo en Inglés | MEDLINE | ID: mdl-31855570

RESUMEN

Background Pharmacists are known as health care professionals who are responsible for the safety and efficacy of medicine to achieve optimal therapeutic results. Community pharmacists have an opportunity to provide direct services including giving an active medication information service in women during pregnancy and breastfeeding. This study aimed to determine the factors associated with the practice of community pharmacists for actively giving the drug information service for women with chronic diseases during pregnancy and breastfeeding based on the Health Belief Model. Methods About 300 community pharmacists were randomly chosen to participate in the study. All participants were asked to complete questionnaires that were designed based on the theory of the Health Belief Models. The questionnaires measured the community pharmacists' knowledge, beliefs, cues to action, and practice for actively giving medication information services. Results About 267 pharmacists in the community agreed to participate in this study. Nearly 80% of the participants were female pharmacists (n = 213). The results show that pharmacists' knowledge had significant influences towards perceived threat (p = 0.009), perceived benefit (p = 0.011), and pharmacists' self-efficacy (p < 0.001). The self-efficacy factor was the most influential factor in the practice of pharmacists to give medication information service actively (p < 0.001). Conclusions The findings of the study indicate that self-efficacy is the most important factor for pharmacist to be able to provide the medication information services successfully particularly in women during pregnancy and breastfeeding. Providing continuous learning programs through seminars and training related to medication use during pregnancy and breastfeeding to pharmacists is needed to optimise the confidence and the ability of pharmacists in providing the services.


Asunto(s)
Servicios Comunitarios de Farmacia/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Farmacéuticos/psicología , Adulto , Lactancia Materna , Enfermedad Crónica , Estudios Transversales , Femenino , Humanos , Masculino , Educación del Paciente como Asunto , Embarazo , Encuestas y Cuestionarios
3.
BMC Health Serv Res ; 19(1): 816, 2019 Nov 08.
Artículo en Inglés | MEDLINE | ID: mdl-31703672

RESUMEN

BACKGROUND: Pharmaceutical compounding is an essential component in pharmacy practice allowing pharmacists to provide dosage forms or strengths that are commercially unavailable. Medications compounded for patient-specific needs contribute to personalized medicine. Extemporaneous compounding provided by pharmacies overcomes the market shortage of these therapeutic products. The aim of this study is to investigate and characterize the prevalence, characteristics, and determinants of extemporaneous compounding in Jordanian pharmacies. METHODS: This study was based on a cross-sectional questionnaire and included 431 randomly selected pharmacies in the twelve governorates of the country. Data were collected via face to face interviews of pharmacists who voluntarily and verbally responded to the questions. RESULTS: Results revealed that 223 (51.7%) of the surveyed pharmacies practiced extemporaneous compounding. The main reason for not providing extemporaneous compounding services was lack of prescription orders for compounded preparations (53.8%). The second reason was lack of the equipment and supplies necessary for compounding (24.4%). Extemporaneous compounding prescriptions were mainly issued by dermatologists (98.2%); dermatological indication was the most common of all extemporaneous compounded prescriptions. The main reason for requesting compounded medications was the lack of a commercially available product (87.9%). The vast majority of the compounded dosage forms were creams (99.6) and ointments (91.5), followed by solutions (23.3%). Only 5 (2.2%) of the studied compounding pharmacies prepared sterile products. The major sources for compounding protocols were the physician order (94.2%), and 'in-house' protocols (44.8%). However, the main resource for estimating compounded medications expiration date was information based on pharmacist's experience (57.8%) and the physician's order (53.4%). CONCLUSIONS: Extemporaneous compounding is a common element of pharmaceutical care. Topical preparations are the most commonly compounded products. Finding from this study suggest that there is a need for standardizing the compounded product formularies, product quality testing, and improving the consistency in estimation of an expiration date of compounded products.


Asunto(s)
Composición de Medicamentos/estadística & datos numéricos , Farmacias/estadística & datos numéricos , Adulto , Anciano , Servicios Comunitarios de Farmacia/estadística & datos numéricos , Estudios Transversales , Femenino , Humanos , Jordania , Masculino , Persona de Mediana Edad , Farmacéuticos/estadística & datos numéricos , Servicio de Farmacia en Hospital/estadística & datos numéricos , Médicos/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto Joven
4.
Rev Saude Publica ; 53: 94, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31644724

RESUMEN

OBJECTIVE: To evaluate trends in the use of generic and non-generic medicines to treat hypertension and diabetes under the Farmácia Popular Program (FP) and its impact on generic medicines sales volume and market share in the Brazilian pharmaceutical market. METHODS: This longitudinal, retrospective study used interrupted time series design to analyze changes in monthly sales volume and proportion of medicines sales (market share) for oral antidiabetic and antihypertensive medicines for generic versus non-generic products. Analyses were conducted in a combined dataset that aggregate monthly sales volumes from the Farmácia Popular program and from the QuintilesIMS™ (IQVIA) national market sales data from January 2007 to December 2012. The Farmácia Popular program phases analyzed included: a) 2009 reductions in medicines reference prices (AFP-II) and b) 2011 implementation of free medicines program for hypertension and diabetes, the Saúde não tem preço (SNTP - Health has no price). RESULTS: Patterns of use for FP-covered antidiabetic and antihypertensive medicines were similar to their use in the market in general. After one year of the decreases in government subsidies in April 2010, market share of antidiabetic and antihypertensive medicines experienced relative declines of -54.5% and -59.9%, respectively. However, when FP-covered medicines were made free to patients, overall market volume for antidiabetic and antihypertensive generics increased dramatically, with 242.6% and 277.0% relative increases by February 2012, as well as non-generics with relative increase of 209.7% and 279% for antidiabetic and antihypertensive medicines, respectively. CONCLUSIONS: Ministry of Health policies on the amount of patient cost sharing and on the choice of medicines on coverage lists have substantial impacts on overall generic sales volume in retail pharmacies.


Asunto(s)
Antihipertensivos/uso terapéutico , Comercio/tendencias , Servicios Comunitarios de Farmacia/tendencias , Medicamentos Genéricos/uso terapéutico , Hipoglucemiantes/uso terapéutico , Programas Nacionales de Salud/tendencias , Brasil , Comercio/estadística & datos numéricos , Servicios Comunitarios de Farmacia/estadística & datos numéricos , Diabetes Mellitus/tratamiento farmacológico , Política de Salud , Humanos , Hipertensión/tratamiento farmacológico , Análisis de Series de Tiempo Interrumpido , Estudios Longitudinales , Programas Nacionales de Salud/estadística & datos numéricos , Farmacias/estadística & datos numéricos , Farmacias/tendencias , Evaluación de Programas y Proyectos de Salud , Valores de Referencia , Estudios Retrospectivos , Factores de Tiempo
5.
Int J Clin Pharm ; 41(6): 1499-1506, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31564041

RESUMEN

Background Oral emergency contraceptives containing levonorgestrel or ulipristal acetate are available without prescription and only in pharmacies in Germany since March 2015. Due to this change community pharmacists are responsible for evaluating whether the product is appropriate and to educate women on proper use. Objective To measure the utilization of emergency contraceptives without a prescription and describe potential concerns and safety issues identified by community pharmacists in Germany. Setting The Drug Commission of German Pharmacists' nationwide network of reference pharmacies which includes 860 community pharmacies. Methods Reference community pharmacies were asked to participate in the eleven-questions online survey. Respondents were asked to recall their experiences with oral emergency contraceptives in the past 3 months. Data were collected between January 8 and February 19, 2018. Main outcome measure The survey focused on the utilization of emergency contraceptives without a prescription in Germany, and on the pharmacists' experiences with (potential) problems and concerns regarding safe use. Results In total, 555 community pharmacies (64.5%) participated. Overall 38.2% of community pharmacists stated they dispensed six to ten courses of emergency contraceptives within the past 3 months. In addition, 54.3% of the pharmacists estimated they dispensed emergency contraceptives exclusively without prescription and 35.9% dispensed more than 30% of emergency contraceptives during night-time and emergency services. Moreover, 82.8% of pharmacists stated that emergency contraceptives were requested not by the women concerned but a third person and 44.3% identified uncertainties in woman's self-diagnosis. Three out of four pharmacists had concerns about the effective and safe use of emergency contraceptives. In situations suggesting sexually transmitted diseases, or suspicion for use of force, 59.5% and 55.8% of the pharmacists, respectively, dispensed emergency contraceptives. In cases of acute health impairment or chronic disease, or (potentially) relevant drug/drug interaction, the vast majority (91.0% and 90.5%) did not. Here, most pharmacists referred to gynecologists. Conclusion Pharmacists had safety concerns when dispensing emergency contraceptives. Professional expertise in evaluating the need for oral emergency contraceptives and the proper use is needed.


Asunto(s)
Servicios Comunitarios de Farmacia/estadística & datos numéricos , Anticonceptivos Orales/provisión & distribución , Anticonceptivos Poscoito/provisión & distribución , Farmacéuticos/estadística & datos numéricos , Servicios Comunitarios de Farmacia/organización & administración , Femenino , Alemania , Encuestas de Atención de la Salud , Humanos , Levonorgestrel/administración & dosificación , Norpregnadienos/administración & dosificación , Farmacéuticos/organización & administración , Rol Profesional , Derivación y Consulta/estadística & datos numéricos
6.
PLoS One ; 14(9): e0222132, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31498831

RESUMEN

BACKGROUND: Suicide prevention is a global priority. Despite the focus on primary care in suicide prevention, little is known about the contributory role of community pharmacists and nothing about the role of the wider community pharmacy team in this area. We aimed to explore the current and potential role of community pharmacy teams in self-harm and suicide prevention. METHODS: We conducted one-to-one semi-structured qualitative interviews with community pharmacy staff (pharmacists, pre-registration pharmacists, pharmacy technicians, dispensing/pharmacy assistants, delivery drivers) in the North West of England, UK. We identified themes from the interview transcripts through an iterative process of inductive thematic analysis. RESULTS: We conducted twenty-five interviews with community pharmacy staff. Many described examples of helping those who were contemplating suicide or self-harm. No participants had received suicide prevention training. We identified six themes. The first two themes (i) Relationship with Patient and (ii) Pharmacy environment were seen as facilitators, which, if supported by (iii) Training, could underpin the final three themes: (iv) Opportunities for contact, (v) Facilitated referral pathway and (v) Restricting access to means. The distinct lack of training should be overcome with evidence-informed training. Referral pathways should be clear and enable direct and accessible referral by community pharmacy teams. There are opportunities for existing pharmacy services and schemes to be adapted to maximise suicide and self-harm prevention activities. Pharmacy teams did not identify themselves to have a clear role in restricting access to medication. CONCLUSIONS: Pharmacy teams already support patients in relation to self-harm and suicide, often relying on their personal experience in the absence of formal training. With the implementation of evidence-informed training and clear referral pathways, this could be done in a more effectively.


Asunto(s)
Servicios Comunitarios de Farmacia/estadística & datos numéricos , Conducta Autodestructiva/prevención & control , Suicidio/prevención & control , Adolescente , Adulto , Anciano , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Adulto Joven
7.
J Clin Pharm Ther ; 44(6): 895-903, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31479521

RESUMEN

WHAT IS KNOWN AND OBJECTIVE: Evidence from clinical trials should form the foundation of healthcare advice. Comparatively little has been investigated about the implementation of evidence in over-the-counter (OTC) counselling in community pharmacies. The objective of this study was to explore the current impact of clinical trials on OTC counselling from the perspective of pharmaceutical staff. METHODS: Pharmaceutical staff in German community pharmacies were invited to participate in a nationwide cross-sectional survey using SoSci Survey. Within the questionnaire, the following items were queried: (i) attitudes towards influencing factors on OTC drug recommendation, (ii) practical procedure of OTC drug recommendations, (iii) experiences and challenges in handling clinical trials, and (iv) current and desired continuing education on self-medication. Multiple logistic regression was employed to identify predictors for OTC recommendations based on clinical trials in routine. RESULTS AND DISCUSSION: In total, 1068 participants completed the survey. (i) Clinical trial data were rated as 'very important' for drug recommendations by 33% and as 'rather important' by 50%. (ii) 8% reported that they base their recommendations on clinical trial data 'in almost all consultations', 40% 'in most consultations'. (iii) 69% faced difficulties in including clinical trial data into their counselling. (iv) 7% read original clinical trials at least once a month. Predictors for routine OTC recommendations based on clinical trials were as follows: male gender, university degree, clinical trials considered to be important for recommendations, inclusion of clinical trials in counselling assessed as easy, higher frequency of reading specialized literature per year, increasing number of working pharmacists in the pharmacy, and more casual than regular customers in the pharmacy. WHAT IS NEW AND CONCLUSION: Most of the pharmaceutical staff recognize the importance of clinical studies for self-medication advice. Based on self-report, however, clinical trial data are not taken routinely into account in practice. Only a minor proportion of staff routinely deal with studies. Therefore, appropriate instruments are required to make knowledge from clinical trials available in community pharmacies.


Asunto(s)
Servicios Comunitarios de Farmacia/estadística & datos numéricos , Consejo/estadística & datos numéricos , Medicamentos sin Prescripción/uso terapéutico , Farmacias/estadística & datos numéricos , Derivación y Consulta/estadística & datos numéricos , Adulto , Estudios Transversales , Femenino , Alemania , Humanos , Masculino , Persona de Mediana Edad , Farmacéuticos/estadística & datos numéricos , Rol Profesional , Automedicación/estadística & datos numéricos , Encuestas y Cuestionarios
8.
Pharm. pract. (Granada, Internet) ; 17(3): 0-0, jul.-sept. 2019. tab
Artículo en Inglés | IBECS | ID: ibc-188119

RESUMEN

Background: The introduction of universal healthcare coverage in 2014 has affected the practice of community pharmacies in Indonesia. Studies regarding the practice of pharmacist in the chain community pharmacy setting in Indonesia are very limited. The chain community pharmacies in Indonesia are operated and controlled by the same management. The chain community pharmacies usually show better services compared to independent community pharmacies in Indonesia. Objective: The study aimed to assess the knowledge, attitude and practice (KAP) of pharmacist working in chain community pharmacy towards their current function and performance in delivering pharmacy services. Methods: A cross-sectional study using questionnaires was conducted between January and March 2017 in KF, one of the largest chain community pharmacies in Indonesia. The total sampling method was used in the recruitment process. The data were analyzed using descriptive statistics, independent t-Test and one-way ANOVA. The KAP scores were assessed and categorized as "poor", "moderate" and "good" based on the standardized scoring system. Results: A total of 949 KF's pharmacists (100% response rate) were participated in the study. The majority of pharmacists showed a good score in terms of knowledge and attitude, which is in contrast to practice as majority only obtained a moderate score. Working experience, age and the availability of standard operating procedures (SOP) for both dispensing and self-medication services were found to be statistically significant (p<0.005) aspects to KAP of pharmacists in delivering pharmacy services. Conclusions: This study identified several important aspects that could affect the KAP of pharmacists working in chain community pharmacies in Indonesia. Specific policies should be conceived to improve the competencies of pharmacist and to ensure the compliance with the SOP and standardization system within pharmacy sector


No disponible


Asunto(s)
Humanos , Competencia Profesional/estadística & datos numéricos , Servicios Comunitarios de Farmacia/estadística & datos numéricos , Farmacéuticos/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Indonesia , Estudios Transversales , Automedicación/estadística & datos numéricos , Prescripciones de Medicamentos/estadística & datos numéricos , Factores de Edad
9.
Pharm. pract. (Granada, Internet) ; 17(3): 0-0, jul.-sept. 2019.
Artículo en Inglés | IBECS | ID: ibc-188122

RESUMEN

Background: Kosovo is a new state and has a high consumption of antibiotics in relation to other European countries. Existing quantitative studies have shown that practices exist that is not optimal when it comes to antibiotic use in Kosovo, this includes citizens' use of antibiotics, pharmacy practices of selling antibiotics without prescriptions and physicians' prescribing behaviours. To address these problems, there is a need for a deeper understanding of why antibiotics are handled in a suboptimal way. Objective: The objective was to explore antibiotic users', community pharmacists' and prescribers' attitudes towards, experiences of, and knowledge about antibiotics in Kosovo. Methods: Semi-structured interviews were conducted with patients who recently received an antibiotic prescription for an upper respiratory tract infection (URTI), patients who recently received antibiotics for a URTI without a prescription, community pharmacists, and physicians. Interviews were recorded, translated into English, and analysed using deductive content analysis. Results: In total, 16 interviews were conducted in the period from 2015-2016. Five themes were identified: Obtaining antibiotics, Choice of antibiotics, Patient information, Patients' knowledge and views on when to use antibiotics, and Professionals' knowledge and attitudes towards antimicrobial resistance. Antibiotics were sometimes obtained without a prescription, also by patients who currently had received one. The specific antibiotic could be chosen by a physician, a pharmacist or the patient him/herself. Former experience was one reason given by patients for their choice. Patients' knowledge on antibiotics was mixed, however health professionals were knowledgeable about e.g. antimicrobial resistance. Conclusions: There is currently a culture of antibiotic use in Kosovo, including attitudes and behaviours, and hence also experiences, which is possibly underlying the high consumption of antibiotics in the country. The culture is reproduced by patients, pharmacists and physicians. There is, however, an awareness of the current problematic situation among practitioners and policy makers; and as Kosovo is a new country, opportunities to effectively tackle antimicrobial resistance exist


No disponible


Asunto(s)
Humanos , Antibacterianos/uso terapéutico , Enfermedades Transmisibles/tratamiento farmacológico , Servicios Comunitarios de Farmacia/estadística & datos numéricos , Prescripciones de Medicamentos/estadística & datos numéricos , Prescripción Inadecuada/estadística & datos numéricos , Kosovo/epidemiología , Factores Culturales , Encuestas de Atención de la Salud/estadística & datos numéricos , Médicos/estadística & datos numéricos , Pacientes/estadística & datos numéricos , Farmacorresistencia Bacteriana , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Actitud del Personal de Salud
10.
Pharm. pract. (Granada, Internet) ; 17(3): 0-0, jul.-sept. 2019. tab
Artículo en Inglés | IBECS | ID: ibc-188127

RESUMEN

Background: In Germany over-the-counter medications (OTC) - which since 2004 are no longer subject to binding prices - can only be purchased in pharmacies. Pharmacy owners and their staff therefore have a special responsibility when dispensing, advising on and setting the prices of medications. Objective: The aim of this study was to assess medication dispensing, additional therapeutic recommendations and pricing practices for acute diarrhoea in adults and to evaluate the role of the patient's approach (symptom-based versus medication-based request) in determining the outcome of these aspects. Methods: A cross-sectional study was conducted from 1 May to 31 July 2017 in all 21 community pharmacies in a medium-sized German city. Symptom-based and medication-based scenarios related to self-medication of acute diarrhoea were developed and used by five simulated patients (SPs) in all of the pharmacies (a total of 84 visits). Differentiating between the different test scenarios in terms of the commercial and active ingredient names and also the prices of the medications dispensed, the SPs recorded on collection forms whether the scenario involved generic products or original preparations as well as whether recommendations were made during the test purchases regarding an additional intake of fluids. Results: In each of the 84 test purchases one preparation was dispensed. However, a preparation for oral rehydration was not sold in a single test purchase. On the other hand, in 74/84 (88%) of test purchases, medications with the active ingredient loperamide were dispensed. In only 35/84 (42%) of test purchases, the patient was also recommended to ensure an 'adequate intake of fluids' in addition to being dispensed a medication. In symptom-based scenarios significantly more expensive medications were dispensed compared to the medication-based scenarios (Wilcoxon signed rank test: z = -4.784, p < 0.001, r = 0.738). Also within the different scenarios there were enormous price differences identified - for example, in the medication-based scenarios, even for comparable loperamide generics the cheapest preparation cost EUR 1.99 and the most expensive preparation cost EUR 4.53. Conclusions: Oral rehydration was not dispensed and only occasionally was an adequate intake of fluids recommended. There were also enormous price differences both between and within the scenarios investigated


No disponible


Asunto(s)
Humanos , Servicios Farmacéuticos/organización & administración , Dispensarios de Medicamentos , Medicamentos con Supervisión Farmacéutica/provisión & distribución , Diarrea/tratamiento farmacológico , Alemania/epidemiología , Buenas Prácticas de Dispensación , Loperamida/uso terapéutico , Antidiarreicos/uso terapéutico , Servicios Comunitarios de Farmacia/estadística & datos numéricos , Precio de Medicamento , Automedicación/estadística & datos numéricos , Prescripciones de Medicamentos/estadística & datos numéricos , Estudios Transversales
11.
BMC Health Serv Res ; 19(1): 571, 2019 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-31412944

RESUMEN

BACKGROUND: The use of psychotropic substances is controlled in most parts of the world due to their potential of abuse and addiction. Diazepam is one of the psychotropic substances which can be dispensed in community pharmacies in Tanzania. As per good dispensing practices and pharmacy laws, diazepam in the community pharmacies should strictly be stored in a controlled box and dispensed only by prescription. However, to our understanding little had been reported on availability and dispensing practices of diazepam in Tanzania. METHODS: A descriptive cross-sectional study which involved 178 randomly selected registered community pharmacies in Kinondoni district was conducted from January to March 2018. Simulated client approach was used to assess the availability and dispensers practice about dispensing of diazepam. Location of pharmacies was categorized as being at the centre or periphery of the Kinondoni district. Chi-squared test was used for the analysis of categorical data using SPSS version 23. The p-value of < 0.05 was considered significant. RESULT: The total of 178 community pharmacies were visited, the majority of the dispensers (89.1%) encountered were female. Most (69.1%) of the studied pharmacies were located at the centre of Kinondoni district. Diazepam was available in 91% of community pharmacies and 70% of dispensers issued diazepam without prescription. CONCLUSION: Diazepam was available in most of the community pharmacies in Kinondoni district, and the majority of the dispensers dispensed diazepam without prescription. This calls for the regulatory authorities to be more vigilant on the availability of diazepam and enhance the provision of ethical pharmacy practice in the community pharmacies.


Asunto(s)
Servicios Comunitarios de Farmacia , Diazepam , Prescripciones de Medicamentos/estadística & datos numéricos , Hipnóticos y Sedantes , Farmacéuticos , Servicios Comunitarios de Farmacia/legislación & jurisprudencia , Servicios Comunitarios de Farmacia/estadística & datos numéricos , Estudios Transversales , Diazepam/provisión & distribución , Humanos , Hipnóticos y Sedantes/provisión & distribución , Farmacéuticos/legislación & jurisprudencia , Farmacéuticos/estadística & datos numéricos , Tanzanía
12.
J Manag Care Spec Pharm ; 25(9): 989-994, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31456496

RESUMEN

BACKGROUND: Pharmacies have a unique opportunity to address suboptimal adult vaccination rates, but few solutions have proven effective. Such strategies are challenged by the lack of access that many pharmacies have to a patient's complete immunization history; consequently, they are unable to identify which of their patients actually require vaccination. A pharmacy-based strategy that leverages such information could enhance efforts to increase rates of guideline-based vaccination. OBJECTIVE: To determine the effect on vaccination rates of an automated telephonic intervention for adults in need of either pneumococcal vaccination or herpes zoster vaccination, or both. METHODS: Over a 1-year period, patients with identified vaccine gaps at 246 pharmacies of 3 pharmacy chains were randomly assigned to receive either usual care or an automated telephonic prompt for pneumococcal and/or herpes zoster vaccines based on patient records contained in state immunization registries and pharmacy data. The primary outcome was the proportion with administration of at least one of the vaccines offered between March 2016 and January 2017 based on intention-to-treat principles. Subgroup analyses included vaccination rates by age and sex. An as-treated analysis was also performed. RESULTS: 21,971 patients were included in the study, 57% of whom were female, with a mean age of 63 years. Vaccine administration proportions were 0.0214 (236/11,009) in the intervention group, and 0.0205 (225/10,962) in the control group (OR = 1.05, 95% CI = 0.87-1.26). Results did not differ in subgroup analyses based on patient age, sex, or individual pharmacy chain. Among intervention patients, 3,666 (0.333) completed the call by listening to the entire prompt. In an as-treated analysis comparing individuals who completed calls versus control, the intervention increased the odds of vaccination by 26% (OR = 1.26, 95% CI = 1.00-1.61). CONCLUSIONS: The automated prompt did not significantly increase vaccination rates. Potential barriers included intervention technical flaws, low rates of connecting with patients, insufficient follow-up by the pharmacy, and patients placing a relatively low priority on being vaccinated. DISCLOSURES: This project was funded by Pfizer and Merck through a grant from the Pharmacy Quality Alliance. Stolpe was an employee of the Pharmacy Quality Alliance at the onset of this project and an employee of Scientific Technologies Corporation during the data collection phase of the project. Stolpe has also served on the advisory board for Merck. Choudhry has no conflicts of interest to declare.


Asunto(s)
Servicios Comunitarios de Farmacia/estadística & datos numéricos , Inmunización/estadística & datos numéricos , Teléfono/estadística & datos numéricos , Vacunación/estadística & datos numéricos , Femenino , Vacuna contra el Herpes Zóster/inmunología , Humanos , Vacunas contra la Influenza/inmunología , Masculino , Persona de Mediana Edad , Farmacéuticos/estadística & datos numéricos , Vacunas Neumococicas/inmunología , Sistema de Registros , Encuestas y Cuestionarios
13.
Am J Health Syst Pharm ; 76(6): 360-365, 2019 Feb 21.
Artículo en Inglés | MEDLINE | ID: mdl-31361840

RESUMEN

PURPOSE: This study evaluated employee perceptions of safety culture in 9 health-system-owned community pharmacies using a safety culture survey before and after implementation of a Pharmacy Services Call Center (PSCC) designed to reduce distractions through reduction of phone volume related to refills and prescription readiness. METHODS: The Agency for Healthcare Research and Quality (AHRQ) Community Pharmacy Survey on Patient Safety Culture (CPSPSC) was used to collect employee safety culture perceptions pre-post PSCC implementation. A percent positive score (PPS) was calculated for each of 11 CPSPSC composite questions and for 1 overall rating of patient safety question based on AHRQ-suggested analytic procedures. Pre-post PSCC implementation, PPSs were compared using a chi-square test. RESULTS: Overall, the lowest composite PPS (Staffing, Work Pressure, and Pace) and the highest composite PPS (Patient Counseling) ranked the same in both survey periods. Of the nine PSCC pharmacies, statistically significant (p < 0.05) PPS improvements occurred in 4 composites including Teamwork (11.9%), Communication About Mistakes (18%), Staff Training and Skills (20.6%), and Staffing, Work Pressure, and Pace (11.8%). PSCC pharmacies also reported a 9.3% (NS) improvement in overall rating of pharmacy patient safety post PSCC implementation. Separate analysis of pharmacist responses was consistent with pharmacy level results, but technician results differed slightly in overall rating of safety perceptions. CONCLUSION: Presence of the PSCC appeared to increase pharmacy employees' perceptions of safety culture in the community pharmacies, an integral part of overall patient safety.


Asunto(s)
Actitud del Personal de Salud , Centrales de Llamados/organización & administración , Servicios Comunitarios de Farmacia/organización & administración , Seguridad del Paciente , Administración de la Seguridad , Centros Médicos Académicos/organización & administración , Centros Médicos Académicos/estadística & datos numéricos , Servicios Comunitarios de Farmacia/estadística & datos numéricos , Consejo/organización & administración , Implementación de Plan de Salud , Humanos , Errores de Medicación/prevención & control , Farmacéuticos/psicología , Farmacéuticos/estadística & datos numéricos , Técnicos de Farmacia/psicología , Técnicos de Farmacia/estadística & datos numéricos , Evaluación de Programas y Proyectos de Salud , Encuestas y Cuestionarios/estadística & datos numéricos , Estados Unidos , United States Agency for Healthcare Research and Quality , Carga de Trabajo/psicología , Carga de Trabajo/estadística & datos numéricos
14.
Am J Health Syst Pharm ; 76(6): 353-359, 2019 Feb 21.
Artículo en Inglés | MEDLINE | ID: mdl-31361842

RESUMEN

PURPOSE: The process and methods used in an impact assessment of a centralized pharmacy call center on community pharmacy employee patient safety climate perceptions, telephone distractions/interruptions, and prescription filling efficiency are described. SUMMARY: A broad-based team designed a multi-faceted, pre-post call center implementation analysis that included multiple change assessment measures. First, yearly administration of the Agency for Healthcare Research and Quality Community Pharmacy Survey on Patient Safety Culture was used to assess patient safety climate based on employee perceptions of a safe working environment and potential for errors due to interruptions and distractions. Evaluative measures of staff workload that assessed telephone interference with prescription filling activities pre and 3 months post implementation included (1) the NASA Task Load Index, (2) multi-tasking observations through shadowing of pharmacists and technicians to count number of interruptions/distractions per prescription "touched," and (3) self-reported work sampling to assess proportional time estimates of clinical, professional, and technical activities. Finally, pharmacy efficiency and prescription filling capacity were assessed using operational measures (prescriptions filled, patients served, phone call volume changes, prescription rework counting). Data analysis included summary statistics, Student's t-test, and chi-square analysis, as appropriate, in addition to assessing convergence and agreement among measures. Every evaluative method showed a positive outcome from call center implementation, although individual pharmacies may have accrued greater benefit from call reduction than others. CONCLUSION: Multiple analysis methods can be used to evaluate the impact of workflow changes.


Asunto(s)
Centrales de Llamados/organización & administración , Servicios Comunitarios de Farmacia/organización & administración , Errores de Medicación/prevención & control , Seguridad del Paciente , Centros Médicos Académicos/organización & administración , Centros Médicos Académicos/estadística & datos numéricos , Servicios Comunitarios de Farmacia/estadística & datos numéricos , Prescripciones de Medicamentos/estadística & datos numéricos , Eficiencia Organizacional/estadística & datos numéricos , Implementación de Plan de Salud , Humanos , Auditoría Administrativa/estadística & datos numéricos , Comportamiento Multifuncional , Farmacéuticos/organización & administración , Farmacéuticos/psicología , Farmacéuticos/estadística & datos numéricos , Técnicos de Farmacia/organización & administración , Técnicos de Farmacia/psicología , Técnicos de Farmacia/estadística & datos numéricos , Rol Profesional/psicología , Evaluación de Programas y Proyectos de Salud , Administración de la Seguridad/organización & administración , Encuestas y Cuestionarios/estadística & datos numéricos , Teléfono , Estados Unidos , United States Agency for Healthcare Research and Quality , Carga de Trabajo/psicología , Carga de Trabajo/estadística & datos numéricos
15.
Pharm. pract. (Granada, Internet) ; 17(2): 0-0, abr.-jun. 2019. tab
Artículo en Inglés | IBECS | ID: ibc-184678

RESUMEN

Background: Continuing education (CE) is an internationally recommended approach as a lifelong learning model for pharmacists, enabling them to maintain the necessary knowledge, skills and ethical attitudes so as to remain current and competent in their practice. Objectives: The objective of this study is to 1) describe factors associated with taking different types of CE courses among pharmacists in Lebanon, and 2) assess the correlation between types of CE activity and the attitude of Lebanese pharmacists (motivation and value) and their computer literacy. Methods: This is a cross-sectional observational study conducted between February and May 2017, using a random sample of Lebanese pharmacists from all districts of Lebanon. All pharmacists were eligible to participate; the sample consisted of those who agreed to complete the questionnaire. The questionnaire includes questions about computer literacy, motivation and value about CE, in addition to sociodemographic characteristics of pharmacists. Results: Out of the 750 questionnaires distributed, 628 (83.73%) were filled out and returned to be analyzed. The mean age of the participants was 39.04 (SD 10.57) years, 66.9% of them were females, and 41.1% of them had a bachelor degree in pharmacy and worked in Mount Lebanon. Among the 628 respondents, 567 (90.3%) have earned at least one CE credit. Of those, 5.4% took mainly online courses, 15.4% took mainly live courses and the remaining took both types of CE. Higher motivation (aOR=1.05; CI 0.994-1.109) and higher value (aOR=1.076; CI 0.968-1.197) were associated with higher odds of taking live CE courses. Higher motivation (aOR=1.07; 95%CI 0.994-1.152) was associated with higher odds of taking online CE courses. Higher motivation (aOR=1.059; 95%CI 1.006-1.114) and higher general confidence with computer use (aOR=1.058; 95%CI 1.012-1.106) were significantly associated with higher odds of taking both types of CE courses. Conclusions: A high percentage of Lebanese pharmacists enrolled in the CE system, mainly driven by motivation and value of CE, in addition to a higher general confidence in computer use. Further efforts should be exerted by the Lebanese Order of Pharmacists to motivate pharmacists and help them improve their computer literacy, which is expected to improve not only enrollment in CE activities, but also the completion of their CE requirements


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Farmacéuticos/estadística & datos numéricos , Disponibilidad de Medicamentos Vía Internet/estadística & datos numéricos , Servicios Comunitarios de Farmacia/estadística & datos numéricos , Educación del Paciente como Asunto/estadística & datos numéricos , Líbano/epidemiología , Continuidad de la Atención al Paciente/estadística & datos numéricos , Actitud hacia los Computadores , Estudios Transversales , Encuestas de Atención de la Salud/estadística & datos numéricos
16.
Int J Clin Pharm ; 41(4): 872-879, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31140160

RESUMEN

Background Community pharmacy is undergoing a transition, shifting focus from traditional roles to the provision of cognitive pharmaceutical services. However, traditional activities performed by community pharmacists reduce the amount of available time for implementing and providing such services. Therefore, hampering the community pharmacist in the transition. Objective The aim of this study was to identify characteristics of community pharmacists that spend a higher proportion of their time on cognitive pharmacy services and to identify activities that compete with time spent on such activities by community pharmacists. Setting Daily community pharmacy practice. Method Self-reporting work sampling using smartphone technology was used to register the activities of community pharmacists. Participating pharmacists recorded their current activity five times per working day for 6 weeks and also completed an online survey about baseline characteristics. Main outcome measure Time utilization. Results Ninety-one Dutch community pharmacists provided work-sampling data. The results showed that Dutch community pharmacists are predominantly spending less time on managerial activities when spending more time on cognitive services (from 25.7% to 14.5%, p = 0.016). Pharmacists who are spending more time on such services, want to spend even more time on direct patient contact compared to pharmacists who spend less time on it (p = 0.030). Conclusion This study shows that community pharmacists that spend more time on cognitive pharmacy services are devoting less time on managerial activities, logistics and other activities. Pharmacists spending more time on cognitive pharmaceutical services are mostly locum pharmacists or work at a pharmacy located in a residential area with largely older inhabitants.


Asunto(s)
Servicios Comunitarios de Farmacia/estadística & datos numéricos , Farmacéuticos , Rol Profesional , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Países Bajos , Muestreo , Autoinforme , Teléfono Inteligente , Encuestas y Cuestionarios , Factores de Tiempo , Adulto Joven
17.
Obstet Gynecol ; 133(6): 1231-1237, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31135739

RESUMEN

OBJECTIVE: To describe early utilization of pharmacist prescription of contraception in Oregon's Medicaid program. METHODS: Using Oregon Medicaid claims data, we conducted a retrospective analysis and quantified overall and monthly trends in pharmacist-prescribed contraceptives from January 1, 2016, to December 31, 2017. Our population was restricted to patients obtaining a new prescription for oral and transdermal methods and who had continuous Medicaid coverage during the study period. We summarized demographic and utilization characteristics, including whether patients were continuing or switching methods or initiating contraception. New prescriptions were those written to patients who did not have one for hormonal contraception in the prior 30 days. To assess program safety, we examined rates of prescriptions to patients with medical contraindications to contraceptive use. RESULTS: Among the 3,614 patients receiving a new prescription for oral or transdermal contraceptives in the Oregon Medicaid program from all health care providers, 367 (10%) received their prescription from a pharmacist. Five months after implementation, pharmacists filled an average of 61 prescriptions per month as the prescriber. Most claims originated from retail chain pharmacies (94%) in urban locations (71%). The majority of patients who were prescribed contraception by pharmacists (73.8%) had no history of contraceptive prescriptions in the preceding 30 days (n=252). Ages ranged from 13 to 49 years, fewer patients lived in a rural location (35.7%), most received a combined hormonal pill (90.5%), and the average day's supply dispensed was 65 (range of 21-364 days). Fewer than 5% (12) of patients had a diagnostic code indicating a possible contraindicating comorbidity. CONCLUSION: Among Medicaid enrollees, we found that 10% of all new oral and transdermal contraceptive prescriptions were written by pharmacists.


Asunto(s)
Servicios Comunitarios de Farmacia/estadística & datos numéricos , Anticoncepción/estadística & datos numéricos , Prescripciones de Medicamentos/estadística & datos numéricos , Medicaid , Farmacéuticos/estadística & datos numéricos , Adolescente , Adulto , Actitud del Personal de Salud , Anticonceptivos Hormonales Orales/administración & dosificación , Femenino , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Oregon , Rol Profesional , Encuestas y Cuestionarios , Estados Unidos , Adulto Joven
18.
BMC Health Serv Res ; 19(1): 285, 2019 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-31053122

RESUMEN

BACKGROUND: Community pharmacy Common Ailments Services can ease the considerable workload pressures on primary and secondary care services. However, evidence is needed to determine whether there are benefits of extending such services beyond their typically limited scope. This study therefore aimed to evaluate a new community pharmacy model of a service for patients with ear, nose and throat (ENT) and eye conditions who would otherwise have had to seek primary care appointments or emergency care. METHODS: People with specified ENT or eye conditions registered with General Practitioners in Staffordshire or Shropshire who presented at participating community pharmacies were offered a consultation with a pharmacist trained to provide the service. The service included provision of relevant self-care advice and, where clinically appropriate, supply of non-prescription medicines or specified prescription-only medicines (POMs), including antibiotics, under Patient Group Directions. Patients received a follow up telephone call from the pharmacist five days later. Data were collected on the characteristics of patients accessing the service, the proportion of those who were treated by the pharmacist without subsequently seeing another health professional about the same condition, and patient reported satisfaction from a questionnaire survey. RESULTS: A total of 408 patients accessed the service, of whom 61% received a POM, 15% received advice and medicine supplied under the common ailments service, 9% received advice and purchased a medicine, 10% received advice only and 5% were referred onwards. Sore throat accounted for 45% of diagnoses where a POM was supplied, 32% were diagnosed with acute otitis media and 15% were diagnosed with acute bacterial conjunctivitis. The number of patients successfully followed up was 309 (76%), of whom 264 (85%) had not seen another health professional for the same symptoms, whilst 45 (15%) had seen another health professional, usually their GP. The questionnaire was completed by 259 patients (response rate 63%) of whom 96% reported being very satisfied or satisfied with the service. CONCLUSIONS: The study demonstrates that pharmacists can effectively diagnose and treat these conditions, with a high degree of patient satisfaction. Wider adoption of such service models could substantially benefit primary care and emergency care services.


Asunto(s)
Servicios Comunitarios de Farmacia , Oftalmopatías/diagnóstico , Enfermedades Otorrinolaringológicas/diagnóstico , Satisfacción del Paciente/estadística & datos numéricos , Farmacéuticos/normas , Servicios Comunitarios de Farmacia/normas , Servicios Comunitarios de Farmacia/estadística & datos numéricos , Oftalmopatías/terapia , Humanos , Enfermedades Otorrinolaringológicas/terapia , Derivación y Consulta , Encuestas y Cuestionarios
19.
BMC Health Serv Res ; 19(1): 304, 2019 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-31088459

RESUMEN

BACKGROUND: Patients in Yemen commonly visit community pharmacies to obtain consultation or treatment for common ailments. Community pharmacists have an opportunity to optimize medication use and improve patient outcomes. This study aimed to evaluate the attitudes and practices of community pharmacists regarding their participation in public health activities and barriers to their participation in these activities. METHODS: This cross-sectional study was carried out among community pharmacists working in pharmacies located in urban areas of the Aden governorate of Yemen from March to June 2017 using a self-administered questionnaire. We selected pharmacies from a line list using proportional sampling according to the number of pharmacies in the urban areas of each district. The questionnaire contained four sections: demographic characteristics, attitudes, practices, and barriers encountered. Data were analyzed descriptively, and the Chi-square test was used for analyzing the association of variables (alpha = 0.05). RESULTS: The questionnaire was distributed to 200 community pharmacists working in community pharmacies. Of the 200 respondents, 62% (n = 124) were male. Overall, the mean age (sd) was 30.0 years (8.6) with the number of years of work experience between 2 and 9.9 years (n = 158, 79%). On average, 62.3% of the pharmacists had a positive attitude toward participation in public health activities. Providing education to stop tobacco chewing, smoking, alcohol drinking and improve oral hygiene was an important activity of the community pharmacists. Blood pressure measurements (86%, n = 172) and glucose tests (45%, n = 90) were commonly conducted for clients. Lack of time (71%, n = 142) and lack of teamwork (70%, n = 140) were mentioned as common barriers to participation in public health activities. CONCLUSIONS: Community pharmacists had a positive attitude toward public health activities. Health education and routine health tests were important practices of the community pharmacists. Barriers need to be overcome to enable more active participation by community pharmacists in public health activities by consulting with all stakeholders, assessing the situation, considering alternatives and taking action.


Asunto(s)
Actitud del Personal de Salud , Servicios Comunitarios de Farmacia/estadística & datos numéricos , Farmacéuticos/psicología , Farmacéuticos/estadística & datos numéricos , Salud Pública , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Yemen
20.
Int J Clin Pharm ; 41(4): 1110-1117, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31073974

RESUMEN

Background The post-discharge Medicines-Use-Review (dMUR) is a commissioned service in England and Wales whereby community pharmacists facilitate patients' understanding of their medicines and resolve any medicine-related problems. This service is poorly utilised. Objective To explore the impact of raising hospital patients' awareness of dMURs on their uptake. Setting Hospital in South East England. Method Patients on medical wards with at least one change (medicine, or dose regimen) to their admission medicines were provided with standardized written and verbal information about the service. Participants were responsible for their own medicines and anticipated that they would be discharged home. Structured telephone interviews conducted 4 weeks after discharge explored any medicine-related issues experienced, and reasons for engaging, or not, with the dMUR service. Responses to closed questions were analysed using descriptive statistics. Responses to open questions were analysed thematically. Ethics approval was obtained. Main outcome measure Proportion of patients who received a dMUR and their motivations or barriers to accessing the service. Results Hundred patients were recruited and 84 interviewed. Their mean (SD) age was 73 (11) years. They were taking a median (range) of 9 (2-19) medicines. 67% (56/84) remembered receiving information about dMURs. Nine (11%) had attempted to make an appointment although four had not received the service because the pharmacist was unavailable. Most (88%) were not planning to access the service. The most common reason given was poor morbidity or mobility (13/31, 42%). Conclusion The use of written and verbal information to encourage patients to use the dMUR service had minimal impact.


Asunto(s)
Servicios Comunitarios de Farmacia/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Conciliación de Medicamentos , Alta del Paciente , Participación del Paciente/psicología , Anciano , Estudios Transversales , Inglaterra , Femenino , Humanos , Masculino , Educación del Paciente como Asunto , Teléfono , Gales
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