Toward inclusive health care: Pharmacists' perceptions on academic preparedness and health care provision for the LGBTQIA+ community.

BACKGROUND: The community of lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other identities (LGBTQIA+), comprising sexual and gender minorities, frequently encounters violence, discrimination, and numerous obstacles in accessing health care services. Pharmacists have the potential to significantly contribute to the health care provision for this community. OBJECTIVE: To assess pharmacists' perceptions regarding academic preparedness and health care provision for the LGBTQIA+ community in Brazil. METHODS: An online cross-sectional survey was conducted from August 2022 to February 2023, focusing on the academic training of pharmacists and the provision of health care to the LGBTQIA+ community in Brazil. Data collection was achieved through a 28-question online questionnaire, comprising both closed-ended questions, and Likert-type items. The study variables were subjected to an exploratory descriptive analysis. RESULTS: We received 261 complete and valid responses. A majority of pharmacists indicated that they provided health care to the LGBTQIA+ community (n = 161, 61.7%); however, they lacked formal education on LGBTQIA+ health care during their pharmacy program (n = 256, 98.1%). Most participants strongly agreed that pharmacists play a crucial role in promoting health care for this community (n = 213, 81.6%). However, only a small percentage felt confident in addressing issues related to the effectiveness and safety of hormone use for transgender patients (n = 38, 14.6%). Furthermore, less than a third believed that the health care provided by pharmacists should be differentiated for patients within and outside of the LGBTQIA+ community (n = 76, 29.1%). CONCLUSION: The results of this study underscore the necessity and significance of incorporating this topic both in pharmacy training and continuing education. This approach is crucial to enhance and bolster the clinical practice of pharmacists.

Physicochemical Evaluation of Compounded Oral Preparations for Respiratory Illnesses, also known as Mezclitas.

OBJECTIVE: Compounded oral solutions for respiratory illnesses such as the common cold and cough are commonly prepared and dispensed by licensed pharmacists in the United States and Puerto Rico (PR). Standard protocols for their preparation and quality assessment and for patient counseling are available for most of the prescribed compounded solutions. However, in PR there is a common prescription approach colloquially referred to as "mezclitas": mixtures of antitussives, expectorants, decongestants, and other active ingredients available in commercial solutions for which there are no science-driven compounding guidelines for local pharmacists. METHODS: This study evaluated the physicochemical stability of a commonly dispensed compounded preparation (containing guaifenesin, dextromethorphan, and dexamethasone) that is used for the treatment of respiratory illnesses in PR. The stability indicators tested included clarity, odor, pH, and viscosity. Changes in stability indicators were evaluated for different storage conditions (ambient temperature and refrigerated) over a period of 6 months. RESULTS: The samples exhibited small changes in color, odor, and viscosity. Although the observed changes were small, they may be indicative of chemical and/or physical transformations that occurred over time. A survey of local pharmacists also evidenced the absence of standardized protocols for the preparation and dispensation of the mezclitas in PR. CONCLUSION: In spite of the absence of protocols for compounding oral solutions for respiratory illnesses, our study suggests that the stability of such solutions is not heavily compromised. However further chemical and physical testing is needed and the findings of such testing used to develop standardized protocols for the compounding of oral solutions for respiratory illnesses.

Biomonitoring of pharmacists and nurses at occupational risk from handling antineoplastic agents.

OBJECTIVE: The objective of this study was to evaluate the frequency of genetic lesions in pharmacists and nurses who prepare and/or handle antineoplastic agents and to evaluate whether there are traces of contaminants in the urine of these professionals. METHODS: A total of 59 professionals participated in the study, of which 10 were non-exposed professionals (controls), 25 were pharmacists, and 24 were nurses. KEY FINDINGS: There was a significant increase in genetic damage in lymphocytes and cells of the oral mucosa in both pharmacists and nurses. The levels of cyclophosphamide and ifosfamide were also increased in the urine samples from those individuals. CONCLUSIONS: These results demonstrate the growing need for genetic biomonitoring and biomonitoring of trace antineoplastic agents in the urine of health professionals who prepare and/or handle antineoplastic agents.

Availability of pharmacist prescription of contraception in rural areas of Oregon and New Mexico.

OBJECTIVE: To determine the availability of pharmacist prescribing of hormonal contraception in rural areas of two states. STUDY DESIGN: Cross-sectional survey. RESULTS: Overall, 42% of pharmacies prescribed contraception (Oregon: 46% and New Mexico 19%). A similar proportion of rural pharmacies reported offering pharmacist prescription of 37 contraception as urban locations (39% vs 46%, p = 0.26). Nearly 53% of rural and 45% of urban pharmacies report billing women, rather than insurance, directly for the cost of the pharmacist consultation. Over 80% of pharmacists in both rural and urban locations did not know if Medicaid covered the cost. CONCLUSION: Pharmacists in rural areas are as willing as their urban counterparts to prescribe hormonal contraception. Financial barriers remain a concern.

A Distance-Learning Course to Improve Drug-Dispensing Behaviors Among Brazilian Community Pharmacists.

Objective. To evaluate the effectiveness of a distance-learning course in the training of pharmacists in drug dispensing. Methods. This interventional study was carried out with community pharmacists throughout Brazil. A 12-week distance-learning course was conducted. Pharmacists' knowledge and performance during drug dispensing were evaluated before and after completion of the course. Results. Community pharmacists' knowledge of drug dispensing was greater after completing the distance-learning course than before (mean=5.7, SD=2.8 points vs mean=3.8, SD=1.9 points, respectively). However, no improvement was observed in pharmacists' drug-dispensing practice. Almost all participants (96.5%) considered that they were more qualified to perform the drug dispensing after the course. There were 1492 pharmacists enrolled in the course, of which 1061 were included in the study, and 472 completed the surveys. Only pharmacists from Ribeirão Preto, Brazil, were invited to take the mytery shopper evaluation (n=26). However, 10 pharmacists completed the mystery shopper encounter. Conclusion. A distance-learning course was effective in improving community pharmacists' knowledge. However, the course did not seem to improve overall drug-dispensing performance. Additional educational strategies should be adopted in future studies to address this gap.

Importância do farmacêutico na Atenção Primária / The importance of pharmacists in Primary Care

Objetivo: Verificar a presença do farmacêutico nas Unidades Básicas de Saúde, identificando as classes terapêuticas mais dispensadas e suas condições de armazenamento. Métodos: Estudo de campo, com caráter descritivo e abordagem qualiquantitativa, utilizando Graphpad Prism®, versão 5.03, e o Microsoft Excel 2010. Resultados: O farmacêutico estava ausente nas 96 Unidades Básicas de Saúde estudadas. Por meio de checklist aplicado em 18 Unidades Básicas de Saúde, 8 tinham algum tipo de fonte de calor; 4, umidade; 14 não controlavam temperatura para produtos termolábeis; 8 tinham medicamentos próximos do piso, da parede e do teto; 1 tinha medicamentos sujeitos a controle especial fora de um armário com chave. Todas as Unidades Básicas de Saúde apresentaram descarte correto das medicações vencidas. As classes medicamentosas mais dispensadas foram anti-inflamatórios não esteroides, anti-hipertensivos, antidiabéticos, anticoncepcionais, anti-helmínticos, antibióticos, antifúngicos, inibidores da bomba de prótons e psicotrópicos. Conclusão: A ausência do farmacêutico nas Unidades Básicas de Saúde estudadas possivelmente foi responsável pelas inconformidades nas condições de armazenamento dos medicamentos, regulamentada inclusive por Resolução da Diretoria Colegiada. As classes terapêuticas dispensadas estavam de acordo com o padrão da Atenção Primária, porém a não participação do farmacêutico pode gerar riscos aos pacientes. As autoridades devem se conscientizar da importância da participação desse profissional no ciclo primário de saúde. (AU)

Objective: To verify the availability of pharmacists in the Basic Health Units, and to identify the most dispensed types of drugs, and their storage conditions. Methods: This is a descriptive field study with a qualitative/quantitative approach, using GraphpadPrism ® version 5.03 and Microsoft Excel 2010. Results: The pharmacist was absent in 96 Basic Health Units studied. A checklist applied to the 18 Basic Health Units showed that 8 of them had heat sources; 4, humidity; 14 lacked control of temperature for thermolabile products; 8 kept drugs near the floor, wall, and ceiling; 1 kept prescription drugs out of lockable cabinets; all of them presented correct disposal of expired medications. The most dispensed drug types were: non-steroidal anti-inflammatory drugs (NSAIDs), antihypertensives, antidiabetic drugs, contraceptives, anthelmintics, antibiotics, antifungals, proton pump inhibitors, and psychotropics. Conclusion: The absence of pharmacists in the Basic Health Units studied was possibly responsible for nonconformities in the drugs maintenance conditions, which are regulated by an ANVISA's Board Resolution. The dispensed therapeutic classes are in accordance with the Primary Care standard, but the absence of a pharmacist can lead to risks to the patients. The authorities shall be aware of the importance of the participation of this professional in the primary health cycle. (AU)

Pharmacist perceptions of the New Mexico pharmacist-performed tuberculosis testing program.

OBJECTIVE: This study evaluated pharmacists' perceptions of the New Mexico pharmacist-performed tuberculosis skin testing (PPTST) program. METHODS: This cross-sectional study was conducted using a telephone survey. New Mexico pharmacists who completed the tuberculin skin test (TST) training from March 2011 to June 2016 were eligible for inclusion. Data collected included demographics, years since licensure, pharmacy setting and location, reasons for obtaining certification, training time, training quality, self-perceived competency after training, whether the participant was performing TSTs, number of tests performed, time required to administer or interpret the test, and reasons for not testing. RESULTS: We attempted to contact all 209 pharmacists who completed the TST training during the evaluation period. Ninety-four of the 99 pharmacists contacted consented to participate (overall study response rate of 45%). The chain community pharmacy was the most common practice setting of respondents. After training completion, greater than 95% agreed or strongly agreed they felt confident in administering the TST. The percent of respondents working in New Mexico who were actively testing was 50.6%, with 42% of those pharmacists providing TSTs in small cities. Eleven pharmacists reported that they were performing TSTs in locations where testing would not otherwise have been available. An initial TST visit was approximately 6-15 minutes, and follow-up visits were typically 5 minutes or less. The most common reason reported for not testing was lack of employer support (61%). The strongest association with testing was training requirement by employer (odds ratio [OR], 20.4; 95% CI 4.2-99.2), followed by strong confidence in their ability to perform the TST (OR, 14.2; 95% CI 2.8-71.2). CONCLUSION: PPTST is positively perceived by New Mexico pharmacists and provides testing in non-urban areas where access may be low. Survey respondents were confident in their ability to perform the TST and report that testing typically takes less than 15 minutes. The main hindrance to implementing PPTST was lack of employer support.

Pharmacists in dispensing drugs (PharmDisp): protocol for a clinical trial to test the effectiveness of distance education in training pharmacists for dispensing drugs

ABSTRACT Dispensing drug is a moment in which the pharmacist is able to analyze pharmacotherapy and contribute to its rational use. However, research has shown that some pharmacists lack adequate knowledge to perform this service. This study aims to describe a research protocol for a clinical trial to test the effectiveness of a distance learning program to train pharmacists in dispensing drugs. This is a protocol for an open diagnostic, non-randomized, single group clinical trial. A 12-week duration distance learning course was structured on the Moodle platform for training community pharmacists who are registered in the Regional Board of Pharmacy and work as employees or owners in Brazilian community pharmacies. The course curricula involves concepts and practice of dispensing drugs applied to the treatment of hypertension, diabetes mellitus, dyslipidemia and asthma. Pharmacists are divided randomly into groups, to which previously selected tutors give directions to the discussion and clarify questions. A validated questionnaire is being used before and after the course to measure participants' knowledge. Participant satisfaction with the course is also being measured. Pharmacists who work in the study headquarters municipality receive two visits from a mystery shopper, before and after the course, to evaluate their performance in dispensing drugs. The virtual platform and the content of the course material were evaluated by judges. The study has been approved by the Research Ethics Committee of the School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo. The sample size was estimated to provide desired power for testing the significance of the difference between baseline-to-endpoint change scores. Information about the course is being released through channels such as social networks. The results will be submitted for publication in scientific journals, but information enabling the identification of the study subjects will be kept confidential. The trial has been registered in The Brazilian Clinical Trials Registry with number RBR7mbrp3 on January 15th, 2015.

Evaluation of community pharmacists' involvement in public health activities in Nigeria

The aims of the study were to identify the types, determine the extent of community pharmacists' involvement, and evaluate the factors influencing their participation in public health activities in Nigeria. The study was a cross-sectional survey of randomly selected 130 registered community pharmacies. Pretested questionnaire was the instrument for data collection. Descriptive and inferential statistics were used to analyse data. Response rate was 94.9%. The study identified 31 types of public health activities which community pharmacists participated in. Their extent of involvement was highest in patient counseling (4.93 ± 0.25), personal hygiene (4.90 ± 0.37), maintenance of normal blood pressure (4.88 ± 0.32), and techniques for using vagina pessaries (4.85 ± 0.38). Lowest areas of involvement were elimination of smokeless tobacco use (2.27 ± 1.56), use of seat belts when driving (2.03 ± 1.46), and the need to live in a safe neighborhood (1.42 ± 0.53). Inadequate training (96%), lack of pharmacists' time (94.6%), inadequate personnel (92.3%), lack of patients' time (88.5%), lack of profit (85.4%), inadequate space in the pharmacy (82.3%) and inadequate patients' information (69.9%) significantly influenced their participation. The study concluded that community pharmacists would participate more in public health activities if the identified barriers are reduced.

Perceptions and utilization of generic medicines in Guatemala: a mixed-methods study with physicians and pharmacy staff.

BACKGROUND: Access to low-cost essential generic medicines is a critical health policy goal in low-and-middle income countries (LMICs). Guatemala is an LMIC where there is both limited availability and affordability of these medications. However, attitudes of physicians and pharmacy staff regarding low-cost generics, especially generics for non-communicable diseases (NCDs), have not been fully explored in Guatemala. METHODS: Semi-structured interviews with 30 pharmacy staff and 12 physicians in several highland towns in Guatemala were conducted. Interview questions related to perceptions of low-cost generic medicines, prescription and dispensing practices of generics in the treatment of two NCDs, diabetes and hypertension, and opinions about the roles of pharmacy staff and physicians in selecting medicines for patients. Pharmacy staff were recruited from a random sample of pharmacies and physicians were recruited from a convenience sample. Interview data were analyzed using a thematic approach for qualitative data as well as basic quantitative statistics. RESULTS: Pharmacy staff and physicians expressed doubt as to the safety and efficacy of low-cost generic medicines in Guatemala. The low cost of generic medicines was often perceived as proof of their inferior quality. In the case of diabetes and hypertension, the decision to utilize a generic medicine was based on multiple factors including the patient's financial situation, consumer preference, and, to a large extent, physician recommendations. CONCLUSIONS: Interventions to improve generic medication utilization in Guatemala must address the negative perceptions of physicians and pharmacy staff toward low-cost generics. Strengthening state capacity and transparency in the regulation and monitoring of the drug supply is a key goal of access-to-medicines advocacy in Guatemala.

Pharmacists' perceptions of professionalism on social networking sites.

BACKGROUND: Social networking sites (SNS) are a new venue for communication, and health care professionals, like the general population, are using them extensively. However, their behavior on SNS may influence public perceptions about their professionalism. OBJECTIVE: This study explored how pharmacists separate professional and personal information and activities on SNS, their perceptions of professional behavior on SNS, and opinions on guidelines in this area. METHODS: In-depth, semi-structured interviews were conducted with international practising pharmacists (n = 31) recruited from a range of countries (n = 9). Initially, pharmacists known to the research team were invited, and thereafter, participants were recruited using a snowballing technique. The interviews lasted from 30 to 120 min. All interviews were recorded, transcribed verbatim, and thematically analyzed. RESULTS: A majority of participants mixed professional and personal information and activities on SNS, and about one third adopted a separation strategy where professional information and activities were clearly separated from personal ones (e.g. two different SNS accounts, or one particular SNS for professional use and another platform for personal purposes). Most participants expressed concern over how pharmacists present themselves and behave in SNS when they reported (un)professional behaviors of peers they had observed. Examples of perceived unprofessional behaviors included revealing details of personal life and activities; open complaints about the pharmacy sector, co-workers, physicians, and patients; inappropriate description of pharmacists' roles and activities; and breaches of patient confidentiality. Positive professional behaviors, such as expression of compassion for patients, examples of effective patient management, promotion of pharmacists' role, and correction of misleading health information being spread online were also observed. There was no consensus on having professional social media guidelines. Some preferred SNS to be unregulated while most believed certain guidance was needed to maintain high professional standards in the online environment. CONCLUSIONS: A definitive strategy to separate professional and personal information and activities on SNS was not adopted by most pharmacists. E-professionalism issues could negatively impact on the standing of individual practitioners and the profession. Most agreed that education about SNS use would be beneficial; however, support for guidelines or regulations for pharmacists' use of SNS was not unanimous.

Purchase of prescription and OTC medicines in Slovakia: factors influencing patients' expectations and satisfaction

ABSTRACT Slovakia is a country where the purchase of OTC (over the counter) medicines outside the pharmacy is not allowed by the government. This study aimed at evaluating patients' satisfaction and acceptance of community pharmacists. Customer's behaviour and expectations influencing the purchase of prescription and OTC medicines were analyzed. A structured questionnaire having 15 multiple-choice questions was used to analyze the descriptive parameters. Data collection lasted from January to February 2014. The sample size consisted of 357 high-school educated individuals under 40 years of age. The survey showed that the prescription and OTC medicines were bought equally. The participants reported a 96.0%, 96.3% and 90.2% satisfaction rate with willingness and approach of the community pharmacist, pharmacy services and provision of drug information respectively. As for the OTC medicines, 89.5% people considered the pharmacist an expert: 88.2% purchased medicines with pharmacist's recommendation, 97.8% needed a professional counselling and 97.2% required a pharmacist's guidance. As for the prescription drugs, only 72.1% considered the pharmacist an expert: 96.3% suggested that physician's prescription was significant and 88.3% considered pharmacist's guidance in the process of selection of prescription medicines nonessential. A comprehensible and respectable conversation was highly expected in regards to both the OTC and prescription medicines.

Cohort study for evaluation of dose omission without justification in a teaching general hospital in Bahia, Brazil.

OBJECTIVE: To evaluate the incidence of medication errors due to dose omissions and the reasons for non-administration of medications. DESIGN: A cohort study blinded to the nursing staff was conducted for 5 consecutive days to evaluate administration of prescribed medications to selected inpatients. SETTING: A major academic teaching hospital in Brazil. PARTICIPANTS: Dispensed doses to patients in medical and surgical wards. MAIN OUTCOME MEASURES: Doses returned to pharmacy were evaluated to identify the rate of dose omission without a justification for omission. RESULTS: Information was collected from 117 patients in 11 wards and 1119 doses of prescribed medications were monitored. Overall, 238/1119 (21%) dispensed doses were not administered to the patients. Among these 238 doses, 138 (58%) had no justification for not being administered. Failure in the administration of at least 1 dose occurred for 58/117 (49.6%) patients. Surgical wards had significantly more missed doses than that in medical wards (P = 0.048). The daily presence of a pharmacist in the wards was significantly correlated with lower frequency of omission errors (P = 0.019). Nervous system medications were missed more significantly than other medications (P < 0.001). No difference was noted in the omission doses in terms of route of administration. CONCLUSIONS: High incidence of omission errors occurs in our institution. Factors such as the deficit of nursing staff and clinical pharmacists and a weak medication dispensing system, probably contributed to incidence detected. Blinding nursing staff was essential to improve the sensibility of the method for detecting omission errors.

Pharmacist recommendations in an intensive care unit: three-year clinical activities.

OBJECTIVE: To analyze the clinical activities performed and the accepted pharmacist recommendations made by a pharmacist as a part of his/her daily routine in an adult clinical intensive care unit over a period of three years. METHODS: A cross-sectional, descriptive, and exploratory study was conducted at a tertiary university hospital from June 2010 to May 2013, in which pharmacist recommendations were categorized and analyzed. RESULTS: A total of 834 pharmacist recommendations (278 per year, on average) were analyzed and distributed across 21 categories. The recommendations were mainly made to physicians (n = 699; 83.8%) and concerned management of dilutions (n = 120; 14.4%), dose adjustment (n = 100; 12.0%), and adverse drug reactions (n = 91; 10.9%). A comparison per period demonstrated an increase in pharmacist recommendations with larger clinical content and a reduction of recommendations related to logistic aspects, such as drug supply, over time. The recommendations concerned 948 medications, particularly including systemic anti-infectious agents. CONCLUSION: The role that the pharmacist played in the intensive care unit of the institution where the study was performed evolved, shifting from reactive actions related to logistic aspects to effective clinical participation with the multi-professional staff (proactive actions).

Recomendações farmacêuticas em unidade de terapia intensiva: três anos de atividades clínicas / Pharmacist recommendations in an intensive care unit: three-year clinical activities

RESUMO Objetivo: Analisar 3 anos de atividades clínicas e recomendações farmacêuticas aceitas durante a rotina diária do farmacêutico na unidade de terapia intensiva clínica adulta. Métodos: Estudo exploratório, descritivo, transversal, realizado no período de junho de 2010 a maio de 2013, em um hospital universitário, terciário, durante o qual foram categorizadas e analisadas as recomendações farmacêuticas. Resultados: Foram analisadas 834 recomendações farmacêuticas (média anual de 278), sendo estas classificadas em 21 categorias. As recomendações farmacêuticas foram dirigidas principalmente a médicos (n = 699; 83,8%), sendo as mais frequentes: manejo de diluição (n = 120; 14,4%), ajuste de dose (n = 100; 12,0%) e manejo de evento adverso a medicamento (n = 91; 10,9%). Comparando-se os períodos, verificou-se crescimento, ao longo dos anos, das recomendações farmacêuticas com maior componente clínico e diminuição daquelas referentes a aspectos logísticos, como a provisão de medicamentos. As recomendações envolveram 948 medicamentos, tendo destaque para os anti-infecciosos de uso sistêmico. Conclusão: A atuação do farmacêutico no cuidado intensivo evoluiu na instituição onde o estudo foi realizado, caminhando das ações reativas associadas à logística para a participação clínica efetiva junto à equipe multiprofissional (ações proativas). .

ABSTRACT Objective: To analyze the clinical activities performed and the accepted pharmacist recommendations made by a pharmacist as a part of his/her daily routine in an adult clinical intensive care unit over a period of three years. Methods: A cross-sectional, descriptive, and exploratory study was conducted at a tertiary university hospital from June 2010 to May 2013, in which pharmacist recommendations were categorized and analyzed. Results: A total of 834 pharmacist recommendations (278 per year, on average) were analyzed and distributed across 21 categories. The recommendations were mainly made to physicians (n = 699; 83.8%) and concerned management of dilutions (n = 120; 14.4%), dose adjustment (n = 100; 12.0%), and adverse drug reactions (n = 91; 10.9%). A comparison per period demonstrated an increase in pharmacist recommendations with larger clinical content and a reduction of recommendations related to logistic aspects, such as drug supply, over time. The recommendations concerned 948 medications, particularly including systemic anti-infectious agents. Conclusion: The role that the pharmacist played in the intensive care unit of the institution where the study was performed evolved, shifting from reactive actions related to logistic aspects to effective clinical participation with the multi-professional staff (proactive actions). .

Needs-based human resources for health planning in Jamaica: using simulation modelling to inform policy options for pharmacists in the public sector.

BACKGROUND: Planning for human resources for health (HRH) is central to health systems strengthening around the world, including in the Caribbean and Jamaica. In an effort to align Jamaica's health workforce with the changing health needs of its people, a partnership was established between Jamaican and Canadian partners. The purpose of the work described in this paper is to describe the development and application of a needs-based HRH simulation model for pharmacists in Jamaica's largest health region. METHODS: Guided by a Steering Committee of Jamaican stakeholders, a simulation modelling approach originally developed in Canada was adapted for the Jamaican context. The purpose of this approach is to promote understanding of how various factors affect the supply of and/or requirements for HRH in different scenarios, and to identify policy levers for influencing each of these under different future scenarios. This is done by integrating knowledge of different components of the health care system into a single tool that shows how changes to different parameters affect HRH supply or requirements. Data to populate the model were obtained from multiple administrative databases and key informants. Findings were validated with the Steering Committee. RESULTS: The model estimated an initial shortage of 110 full-time equivalent (FTE) pharmacists in the South East Region that, without intervention, would increase to a shortage of about 150 FTEs over a 15-year period. In contrast to the relatively small impact of a large enrollment increase in Jamaica's pharmacy training programme, interventions to increase recruitment of pharmacists to the public sector, or improve productivity - through, for example, the use of support staff and/or new technologies - may have much greater impact on reducing this shortage. CONCLUSIONS: The model represents an improvement on the HRH planning tools previously used in Jamaica in that it supports the estimation of HRH requirements based directly on measures of population health need. Both the profession (pharmacists) and country (Jamaica) considered here are under-studied. Further investments by Jamaica's MoH in continuing to build capacity to use such models, in combination with their efforts to enhance health information systems, will support better informed HRH planning in Jamaica.

Over-the-counter but out of reach: a pharmacy-based survey of OTC syringe sales in Tijuana, Mexico.

Sterile syringe access is critical to HIV prevention efforts targeting injection drug users (IDUs) but some pharmacies do not sell syringes over-the-counter (OTC) even where such sales are legal. We conducted a pharmacy survey in Tijuana, Mexico (where OTC sales are legal) to characterize attitudes toward syringe sales and to explore support for expanding pharmacy-based HIV prevention efforts. Of 203 respondents, 28% supported OTC syringe sales to IDUs and 74% said their pharmacy required a prescription for at least some syringe sales. Support for OTC syringe sales was independently associated with selling OTC syringes, understanding the role of sterile syringes in HIV prevention, and recognizing pharmacies as an important health resource for IDUs. Most respondents supported an expanded role for pharmacies in HIV prevention, exclusive of OTC syringe sales. Our study provides information for developing interventions to promote OTC syringe sales and expanding pharmacy-based distribution of HIV-related information and resources.

Pharmaceutical services and health promotion: how far have we gone and how are we faring? Scientific output in pharmaceutical studies

The objective of this study was to investigate the scientific output on health promotion within the pharmaceutical field and its relation with the development of pharmaceutical services within health systems. A comprehensive review of published scientific articles from the Medline and Lilacs databases was carried out. The review comprised articles published until December 2011, and used combinations of the terms 'health promotion' or 'health education' and 'pharmacy', 'pharmacist' or 'pharmaceutical'. The articles were selected according to inclusion and exclusion criteria. A total of 170 full texts and 87 indexed abstracts were analyzed, evidencing that most described actions of health promotion in community pharmacies and other services. Following the Ottawa Charter, most of the studies dealt with new guidance of the service and the supply of pharmaceutical information and services. It was concluded that there is a lack of theoretical background on health promotion in the pharmaceutical field to sustain the professional education and practice required by the health system and the population.

O objetivo do estudo foi investigar a produção científica sobre o desenvolvimento teórico e prático da promoção da saúde na farmácia e sua relação com o desenvolvimento da área e dos serviços farmacêuticos. A revisão integrativa de artigos científicos foi realizada a partir das bases de dados Medline e Lilacs. Ela compreendeu os artigos publicados até dezembro de 2011, através da combinação dos termos 'promoção da saúde ou educação em saúde' e 'farmácia, farmacêutico ou farmacêutica'. Critérios de inclusão e exclusão definiram a seleção dos textos. Ao todo, 170 artigos e 87 resumos foram analisados, sendo a maioria identificada como trabalhos teóricos que relatam atividades descritas como de promoção da saúde em farmácias comunitárias ou outros serviços. Confrontando com o referencial da Carta de Ottawa, a maioria dos estudos revelou ter como campo de investigação principal alguma proposição de reorientação dos serviços de saúde e oferta de informações e práticas farmacêuticas. Conclui-se que há uma carência de embasamento teórico sobre promoção da saúde na área farmacêutica para sustentar a formação e prática profissional, conforme exigido pelo sistema de saúde e pela população.