A Qualitative Approach to Exploring Workflow and Cost Factors of Dispensing Services in Community Pharmacies in Taiwan.

Purpose: This study aimed to thoroughly document the process and cost factors involved in dispensing services within a community pharmacy. Methods: Using a cross-sectional design, this study incorporated a pragmatic and descriptive qualitative approach to outline pharmacists' viewpoints on providing dispensing services in community settings. A purposive sampling was employed to recruit pharmacists from geographically different community pharmacies, spanning from March to July 2022. Semi-structured interviews with direct content analysis were conducted through face-to-face interactions to gather firsthand insights into pharmacists' professional dispensing services. The data underwent analysis through descriptive and in vivo coding techniques to categorize, define, and label themes, thereby identifying key steps and cost components in the prescription dispensing process. The qualitative data management software, MAXQDA 2020, was utilized for data management and maintenance. Results: Ten community pharmacists participated in the study, cooperatively completing the interview process. Of these, 7 were male and 3 were female, with age ranging from 29 to 62 years. The average length of pharmacy practice experience was 11.4 years. The study revealed six integral steps in the dispensing process: (1) receiving and clarifying legality and completeness of prescriptions, (2) profiling and verifying patient prescriptions, (3) preparing prescription labels and containers, (4) dispensing right medications with right quantity, (5) inspecting dispensing accuracy, (6) handing over medications and providing counseling. Along with these processes, pharmacists emphasized that pharmacy manpower, representing a substantial portion of the associated costs, determines the success and quality of the dispensing service. Additionally, rental, utilities, consumables, and physical equipment were identified as other important cost factors associated with carrying out pharmacy dispensing services. Conclusion: The study offers a comprehensive understanding of the dispensing service workflow within community pharmacies. The findings may inform key stakeholders and policymakers about required resources for enhancing and sustaining quality dispensing services for the public in Taiwan.

Effects of a blended multimedia teaching approach on self-efficacy and skills in over-the-counter medication counselling versus a lecture-based approach: protocol for a prospective cohort study of undergraduate students from a pharmacy school in Taiwan.

INTRODUCTION: Addressing communication skills in pharmacy curricula is one of the effective tactics to equip future pharmacists with better skillsets for medication counselling. To achieve this, blended teaching of PowerPoint slides and videos holds great potential for undergraduate pharmacy education majors by integrating multimedia and performance feedback into instruction. This study will develop a blended teaching programme featuring didactic lectures with video-based materials to improve students' self-efficacy and skills in medication counselling. METHODS AND ANALYSIS: This study applies critical principles and effects outlined in multimedia learning by Richard Mayer et al to develop teaching materials and perform skill evaluation for two undergraduate cohorts (class of 2025 and 2026) enrolled in Introduction to Community Pharmacy separately in 2022 and 2023. Students will receive different teaching approaches to medication counselling. In the control cohort (ie, class of 2025), students will receive a 4-week PowerPoint slides-based instruction in communication skills. We will develop six videos illustrating common scenarios of over-the-counter (OTC) medication counselling in community pharmacies. In the intervention cohort (ie, class of 2026), students will receive a 3-week PowerPoint slides-based instruction and a week-long video-based instruction in communication skills. A pre-and-post survey will be administered to evaluate students' self-efficacy in OTC counselling. In addition, each student will be evaluated through one-on-one role-playing with standardised patients in the final to demonstrate their skills in OTC counselling. A structured checklist will be used to assess students' counselling skills. T-tests will be applied to examine differences in self-efficacy of OTC counselling. Multivariate regression analyses will determine which teaching approach better facilitates the development of self-efficacy and performance in OTC counselling. ETHICS AND DISSEMINATION: The Research Ethics Committee of the National Taiwan University Hospital approved this study. The findings will be shared with pharmacy educators and contribute to existing instructional methods to facilitate the competence of pharmacy students in OTC counselling.

Engaging consumers in wise use of over-the-counter medications in Taiwan: Development and evaluation of a structured medication counseling approach.

OBJECTIVE: To evaluate the impact of a tailored Symptom Allergy Indication Direction Self-care (SAIDS) counseling by pharmacists on consumers' correct understanding of over-the-counter (OTC) medication use. METHODS: This study used a time-based sampling of two independent cohorts at a single community pharmacy in Taiwan for two years beginning in December 2018. In the control cohort, participants received conventional counseling for the OTCs they selected. In the intervention cohort, participants received SAIDS counseling along with pointing out OTC package label instructions. A paper-and-pencil survey was administered face-to-face to evaluate participants' understanding for the correct use of OTCs. Descriptive statistics and chi-square tests were used to evaluate the effect of the SAIDS approach on cohorts' understanding of OTC use. RESULTS: Compared with conventional OTC counseling, participants reported better understanding regarding potential side effects of OTCs that they acquired (p < 0.001) and were more aware of strategies to cope with the associated side effects (p < 0.001). CONCLUSIONS AND PRACTICE IMPLICATIONS: Despite the time constraints that pharmacists often can offer to each customer, the SAIDS counseling approach may refine the structure and effectiveness of pharmacists' OTC counseling skills and thereby improve consumers' understanding of their ailments and self-care medications in Taiwan.

A family-oriented treatment program for youths with ketamine abuse and their caregivers: a pilot study in Taiwan.

OBJECTIVE: The abuse of ketamine by youths has grown into a serious public health issue. However, a reliable and efficient treatment has still not been found for youths who abuse ketamine. This pilot study investigated the effects of a family-oriented treatment program for ketamine-using youths and their caregivers. METHODS: To carry out this study, 42 youths with ketamine use (mean age 16.6±1.1 years) who were referred to take part in a 10-week treatment program based on motivational enhancement principles were selected, as were their principal caregivers (mean age 46.4±7.1 years), who were similarly referred to take part in a 10-week training program for parenting skills. The study had the youths complete the Chinese Craving Beliefs Questionnaire, the Adolescents' Behavior problem Scale, and the Family APGAR both immediately before and after the program. Likewise, the youths' caregivers completed the Family APGAR, the 12-item version of the Chinese Health Questionnaire, and the Parenting Stress Index. RESULTS: Of the 42 youth-caregiver pairs that took part in this study, 37 (88%) completed the 10-week program and both sets of assessments. After the treatment, the participating youths' substance cravings declined (t=3.88, P<0.001), while family function, as perceived by the participating caregivers, significantly increased (t=2.22, P=0.033). The improvement in caregivers' perceptions of family function were positively related to the improvement of the caregivers' health status (r=-0.36, P=0.022). CONCLUSION: According to its results, this pilot study submits that family-oriented treatment programs may be considered a potentially effective treatment option for youths who abuse ketamine. Additional studies with larger sample sizes, as well as longer follow-up periods, are necessary to verify whether this type of treatment also prevents youths using ketamine from relapsing.

TM-1-1DP exerts protective effect against myocardial ischemia reperfusion injury via AKT-eNOS pathway.

Coronary heart disease remains a leading cause of death in the world. The demand on targeting therapy to reduce myocardial ischemia/reperfusion (I/R) injury is still urgent. The pathogenesis of I/R-induced myocardial injury is complicated. Reactive oxygen species (ROS) generation and inflammatory response activation participate in the development of I/R injury. Cell death occurs and finally leads to myocardial infarction. A newly phenolic aporphine alkaloid derivative, TM-1-1DP, was synthesized in our team. We aimed to investigate the effect of novel compound on myocardial I/R injury. Rats were subjected to 1-h coronary artery occlusion and followed by 2-h reperfusion. Adult rat cardimoycyte was isolated for the cell study, and H2O2 was added into culture medium to induce ROS stress. As compared to the sham group, TM-1-1DP-treated rats had better cardiac performance in association with less infarct size and cardiac injury markers after myocardial I/R. The protective effect is associated with the inhibition of inflammatory response, cell death-related pathway (caspase-3 and TNF-α), and the activation of AKT-eNOS pathway. The finding was further coincided with the cell study. TM-1-1DP treatment significantly alleviated ROS production and improved cell viability in cardiomyocyte after H2O2 exposure. The action of TM-1-1DP is via a nitric oxide (NO)-dependent manner, since NOS inhibitor, L-NAME, abolished the protective effect. We provide a new insight into this therapeutic potential for phenolic aporphine alkaloid in myocardial I/R.