Is there a need for standardization of medication counseling in community pharmacies?

Medication counseling is one of the most important duties in community pharmacies aiming to ensure rational pharmacotherapy and medication safety. However, based on research evidence, the quality of medication counseling in pharmacies is often low and shown to vary between different patient groups. This Commentary raises a question whether there is a need to standardize medication counseling in community pharmacies to ensure quality of care for every customer? The law obligates to counsel about medications when dispensing medicines in many countries, however, on a very general level. It seems clear that the general level in which medication counseling is required in law is not enough to ensure the quality of medication counseling, and thus, some standards are needed. However, these standards should take into account the multidisciplinary nature of the pharmacotherapy process as well as the different patient groups and situations that patients face. Most importantly, such standards should not inhibit interaction between the patient and the pharmacist, and they should encourage tailored medication counseling that is based on the individual needs of the patient.

Understanding medication-related burden from patient perspectives: a qualitative study testing the applicability of the conceptual model among chronically ill outpatients in Finland.

OBJECTIVES: Disease self-management and medication therapy can cause burden to patients that can influence adherence. The conceptual model 'patients' lived experience with medicine' (PLEM) brings new insights into medication-related burden (MRB) from patient perspective. This study aimed to test the applicability of the PLEM model by interviewing chronically ill patients in Finland and to investigate the MRB experienced by the Finnish patients. DESIGN: Focus group discussion study conducted online via Zoom. Directed qualitative content analysis guided by the PLEM model. SETTING: Outpatient primary care in Finland. PARTICIPANTS: Chronically ill outpatients (n=14) divided into five focus groups according to their chronic condition: asthma (n=3), heart disease (n=3), diabetes (n=6), intestinal disease (n=2). RESULTS: Our findings were mainly in line with the PLEM model although some new contributing factors to MRB emerged. In general, the participants were satisfied with their medication, and that it enabled them to live normal lives. The most common causes of MRB were medication routines and the healthcare system. The participants introduced two new aspects contributing to MRB: medication-related environmental anxiety associated with the waste resulting from medicine use, and the effect of medication use on their working life. Our findings are consistent with previous findings that a higher level of MRB may lead to independently modifying the medication regimen or not taking the medicine. CONCLUSIONS: Our findings provide further evidence that the PLEM model is an applicable tool also in the Finnish context for gaining better understanding of MRB in chronically ill patients self-managing their long-term medications. The model provides a promising tool to understand the connection between MRB and the rationale for not always taking medicines as prescribed. Further research is needed to explore the potential of the model in extending patient perspectives in chronic disease management.

Laboratory pre-assays for soil remediation by electro synthesis of oxidants and their electrokinetic distribution.

The feasibility of an innovative electrokinetic soil remediation technique for an in situ application against fuel-contaminated soil has been studied in this work. This technique combines the anodic production of oxidizing agents on boron-doped diamond (BDD) electrode surfaces with their electrokinetic distribution in soil. In this study, the production of oxidizing agents, i.e., hydroxyl radicals (OH degrees ) and peroxodisulfate (S(2)O(8)(2 -)), from a 0.85 M sodium sulfate electrolyte with mechanically implanted BDD anodes at room temperature has been investigated. It was found that about 12 mmol/L of oxidants could be produced after 10 Ah/L with a current density of 200 mA/cm(2). For investigating the transport velocity of peroxodisulfate in soil a vertical column system has been created. Experimental results show linear velocity behaviour for the oxidants' migration in 100% sand soil reaching up to 2 cm/h at an electrical gradient of 4 V/cm. As for different soil textures which have been tested, the assays stated that the highest velocity can be achieved in a 100% silt soil with 3.3 cm/h.