A qualitative study on female executive pharmacists with convergent roles.

BACKGROUND: Although women's participation is relatively high in the pharmacist workforce, women remain underrepresented in executive positions. The rate of executive female pharmacists in diversified pharmaceutical areas, from education and research to politics, is recognized as being disproportionately low. OBJECTIVES: In this study, we aimed to explore female executive pharmacists' roles and identify reasons for their being underrepresented in such executive positions in Turkey. METHODS: Semistructured in-depth interviews were conducted from a feminist standpoint with female executive delegates working in the Grand National Assembly of Turkey, pharmacy chambers, and public pharmacy faculties. A thematic data analysis of transcriptions was conducted using MAXQDA 2020 software and was reported according to Consolidated Criteria for Reporting Qualitative Research. RESULTS: The researchers interviewed 19 participants. Three primary themes emerged: gender roles, being an executive, and being a pharmacist. Eight roles came to the surface: mother, child, wife, pharmacist, manager, homemaker, cook, and planner. Taking the responsibility for an executive position involves a continued and simultaneous performance of all other roles as well. CONCLUSION: In this context, female pharmacists' views on gender roles in relation to motherhood, inequalities, and their dedication to their profession came to the fore. This study can be considered as a starting point for studying the underlying causes of the limited representation of female pharmacists in executive positions.

Oral Care and Maintenance Habits Among Pharmacy Students.

Objective. This study aimed to identify and evaluate oral care habits, awareness, and knowledge of oral dental health among a group of pharmacy students.Methods. An e-questionnaire on oral care habits, awareness, and knowledge was completed by students in a university pharmacy.Results. A total of 484 students with a mean (SD) age of 21.4 (1.6) years participated. Of all participants, 9.3% were not regularly brushing their teeth. The percentage of regular fluoridated toothpaste usage was 44.8%. Three in 5 (64.5%) participants had visited a dentist for a complaint. When answering questions on the possible effects of dental plaque accumulation on teeth, the causative factors for dental decay and signs of periodontal disease, the percentages of students who indicated they "did not know" were 16.3%, 4.8%, and 43.2%, respectively. Among participants, 38.7% were unaware of the cariogenic or erosive effects of pediatric syrups or suspensions. Of all the pharmacy students, 32% stated they have been consulted about some issue related to oral health.Conclusion. The oral care habits, awareness, and oral health knowledge of pharmacy students in one program needs to be improved. Improvement of these measures is a multi-layered issue, not limited only to the quality of life but also to increased awareness associated with public health-related issues related to dental care.

Websites as a Gate of Pharmacy Schools to the World: Does National Accreditation Cause a Difference?

Objectives: Websites have become the main information source, being a crucial element of our daily life and a global network. In this context, the importance of the websites of pharmacy schools is considered not only for their educational mission, but also for their gates to the world. In this study, we evaluated the websites of pharmacy schools based on criteria issued in the literature. Materials and Methods: Websites of all pharmacy schools in Türkiye were evaluated by scoring the availability of predetermined items, where t-tests and paired t-test were used to compare the groups. Results: As a result, we found that there is no statistical difference between private and public and accredited or non-accredited schools (p>0.05). Also, we observed no statistical difference between the scores in 2012 and 2021 (p>0.05). Conclusion: Most pharmacy schools in this study were public, and the accreditation status still seems challenging. Of these 39 schools, only 14 schools are accredited. Total scores of public schools were found to be higher than the private ones and notably, accredited schools have higher scores. Yet, there is no statistically difference between accredited and non-accredited schools or public and private schools. Importance of websites as a communication tool for higher education institutions (HEIs) is indisputable. In conclusion, pharmacy schools should keep up to date with their official websites, considering the virtual world we fell into with the web technologies' developments. Also, further studies should be conducted on the websites of pharmacy schools regarding user demands. Besides we suggest that pharmacy schools' website' quality should be improved and keeping them up to date should be ensured.

COVID-19 Vaccination Scenarios: A Cost-Effectiveness Analysis for Turkey.

As of March 2021, COVID-19 has claimed the lives of more than 2.7 million people worldwide. Vaccination has started in most countries around the world. In this study, we estimated the cost-effectiveness of strategies for COVID-19 vaccination for Turkey compared to a baseline in the absence of vaccination and imposed measures by using an enhanced SIRD (Susceptible, Infectious, Recovered, Death) model and various scenarios for the first year after vaccination. The results showed that vaccination is cost-effective from a health care perspective, with an incremental cost-effectiveness ratio (ICER) of 511 USD/QALY and 1045 USD/QALY if vaccine effectiveness on transmission is equal or reduced to only 50% of effectiveness on disease, respectively, at the 90% baseline effectiveness of the vaccine. From a societal perspective, cost savings were estimated for both scenarios. Other results further showed that the minimum required vaccine uptake to be cost-effective would be at least 30%. Sensitivity and scenario analyses, as well as the iso-ICER curves, showed that the results were quite robust and that major changes in cost-effectiveness outcomes cannot be expected. We can conclude that COVID-19 vaccination in Turkey is highly cost-effective or even cost-saving.

Assessing Medical Prescription Forms as a Communication Tool in Trans-European Health Care.

OBJECTIVE: The objective of the study was to compare the medical prescription forms in European Union (EU) countries, evaluating their convergence toward the implementation of cross-border care, as proposed by the existing EU health-care directives. It also aims to assess how the existing EU prescription models fulfill higher standards of medication prescribing quality and patient safety. METHODS: Prescription forms from all EU countries were purposively collected. The prescription fields and other content elements were qualitatively and quantitatively analyzed. Forms were statistically compared with each other and a theoretical EU cross-border prescription form, using hierarchical cluster analysis and nonparametric testing. FINDINGS: None of the EU countries' prescriptions include all the elements required by the cross-border legislation (CBL), with most countries having seven or less mandatory elements. Cluster analysis revealed that countries with similar prescription forms are geographically nearer. Important elements from the EU directive to assure patient safety are also absent such as the International Classification of Diseases, the patient's ID according to the European Health Insurance Card, and the patient's contact. However, Western and Nordic countries showed higher standardization when compared to the CBL and model. CONCLUSION: Political action is still needed to harmonize medical prescription forms between countries, serving the common goal of trans-European health care and to increase EU patients' safety using medications and other prescribed treatments.

Self-medication and non-prescription drug counseling: Illustrating profession uncertainty within Turkish pharmacy practice.

BACKGROUND: Recommending effective minor ailment treatments and using non-prescription or over-the-counter (OTC) medicines is a pharmacist's duty. Although common in most European countries, self-medication counseling practices may differ from country to country. OBJECTIVES: This study explored Turkish community pharmacists' attitudes concerning the present self-medication market, professional responsibilities toward patients' self-care, and the usefulness of e-learning for patients' counseling education. METHODS: The study was comprised of three phases: initially, a document content analysis searched for relevant OTC regulatory and/or practice frameworks; secondly, qualitative individual interviews on self-medication with purposively selected Turkish community pharmacists were performed; finally, a focus group with practitioners and continuing education experts was conducted to deepen previous results. A thematic data analysis, based on the attitudinal theory, was conducted, supported by MAXQDA v12 software. RESULTS: Sixteen documental sources allowed the extraction of three initial main themes: self-medication, classification of medicines and pharmacists' role. Individual interviews outlined four themes that informed the focus group discussion, which produced four new themes. Themes and their codes reflected dissimilar practitioners' cognitions towards OTCs, OTC usage and self-medication, particularly if compared to other European conceptualizations. Contradictory feelings towards the value of OTCs for professional development, e.g., patient counseling influenced by profit-based expectations, were identified. CONCLUSION: Turkish community pharmacists and their minor ailments treatment competences have yet to thrive as a relevant professional intervention. There are risks of missing the best pharmacy practice standards, thus losing their contribution to rational self-care. Besides weakening the societal recognition of the profession to help individuals' everyday health decisions and well-being, there might be a reduced active role in public health.

Potential Cost-Effectiveness of RSV Vaccination of Infants and Pregnant Women in Turkey: An Illustration Based on Bursa Data.

BACKGROUND: Worldwide, respiratory syncytial virus (RSV) is considered to be the most important viral cause of respiratory morbidity and mortality among infants and young children. Although no active vaccine is available on the market yet, there are several active vaccine development programs in various stages. To assess whether one of these vaccines might be a future asset for national immunization programs, modeling the costs and benefits of various vaccination strategies is needed. OBJECTIVES: To evaluate the potential cost-effectiveness of RSV vaccination of infants and/or pregnant women in Turkey. METHODS: A multi-cohort static Markov model with cycles of one month was used to compare the cost-effectiveness of vaccinated cohorts versus non-vaccinated cohorts. The 2014 Turkish birth cohort was divided by twelve to construct twelve monthly birth cohorts of equal size (111,459 new-borns). Model input was based on clinical data from a multicenter prospective study from Bursa, Turkey, combined with figures from the (inter)national literature and publicly available data from the Turkish Statistical Institute (TÜÏK). Incremental cost-effectiveness ratios (ICERs) were expressed in Turkish Lira (TL) per quality-adjusted life year (QALY) gained. RESULTS: Vaccinating infants at 2 and 4 months of age would prevent 145,802 GP visits, 8,201 hospitalizations and 48 deaths during the first year of life, corresponding to a total gain of 1650 QALYs. The discounted ICER was estimated at 51,969 TL (26,220 US $ in 2013) per QALY gained. Vaccinating both pregnant women and infants would prevent more cases, but was less attractive from a pure economic point of view with a discounted ICER of 61,653 TL (31,106 US $ in 2013) per QALY. Vaccinating only during pregnancy would result in fewer cases prevented than infant vaccination and a less favorable ICER. CONCLUSION: RSV vaccination of infants and/or pregnant women has the potential to be cost-effective in Turkey. Although using relatively conservative assumptions, all evaluated strategies remained slightly below the threshold of 3 times the GDP per capita.

Economic evaluations of hepatitis A vaccination in middle-income countries.

Economic evaluations of hepatitis A vaccination are important to assist national and international policy makers in different jurisdictions on making effective decisions. Up to now, a comprehensive review of the potential health and economic benefits on hepatitis A vaccination in middle-income countries (MICs) has not been performed yet. In this study, we reviewed the literature on the cost-effectiveness of hepatitis A vaccination in MICs. Most of the studies confirmed that hepatitis A vaccination was cost effective or even cost saving under certain conditions. We found that vaccine price, medical costs, incidence and discount rate were the most influential parameters on the sensitivity analyses. Vaccine price has been shown as a barrier for MICs in implementing universal vaccination of hepatitis A. Given their relatively limited financial resources, implementation of single-dose vaccination could be considered. Despite our findings, we argue that further economic evaluations in MICs are still required in the near future.

Is there an improvement on the Web sites of the national and international pharmaceutical companies in Turkey? A follow-up study.

OBJECTIVE: In this follow-up study, we aimed to assess national and international pharmaceutical companies' Web sites using guidelines of The Association of Research-Based Pharmaceutical Companies (AIFD) and Pharmaceutical Manufacturers Association of Turkey (IEIS) to define whether there has been progress since 2004. MATERIALS AND METHODS: We used two national guidelines in order to evaluate the Web sites of pharmaceutical companies in our study. The first guideline was from IEIS, and the second was from AIFD, which was issued recently. We collected our data between February 1 and April 30, 2011. Data analyses were performed using SPSS version 15.0. Chi squared test was done for comparing the two assessments in different years (2004 and 2011). RESULTS: In general, the progress that we were expecting was not satisfactory for both the international and national companies. The percentage of unmet criteria increased for "links" (from 48.0% to 52.0%) and for "mentioning the responsible person/firm for the Web site design" (from 40.6% to 59.4%) among national companies. We observed statistically significant progress only for the "information for the public" criterion (from 52.9% to 100%) among international companies. On the other hand, there was progress and a statistically significant difference in terms of not displaying any "drug ads" on the Web sites of national firms (from 55.9% to 87.5%), availability of "mail address" (from 88.2% to 100%), "telephone number" (from 88.2% to 100%), "indication of the target group" (from 23.5% to 52.1%), and "disclaimer stating the given information cannot replace a physician or pharmacist" (from 29.4% to 53.1%). CONCLUSIONS: Our major recommendation to pharmaceutical companies is to update their Web sites with evidence-based scientific information about themselves and their products using international and national standards. From the companies' perspective, this should be a priority responsibility based on the ethical aspect of individual and community health.

Turkish community pharmacists' self-report of their pharmacies' physical atmosphere.

OBJECTIVE: There is a great recognition that store interiors and exteriors can be designed to create feelings in potential customers which can have an important reinforcing effect on purchase. In this study it is mainly aimed to explore the behaviors of the community pharmacists related to their store's physical environment. Also we aimed to determine whether any difference exist between behaviors of pharmacists serving in high and low socio-economic regions. METHODS: A total of 200 pharmacists that work socio-economically different regions were randomly selected from 1424 pharmacists registered in Ankara Chamber of Pharmacists. A uniform questionnaire was applied to the pharmacists by using a face-to-face interview technique. FINDINGS: There are differences in terms of behavior between the pharmacists serving in high and low socio-economic regions within the context of putting importance to their stores' atmosphere. More pharmacists attach importance to the physical sight of their pharmacy serving in high socio-economic regions (90%) vs. pharmacists in low socio-economic regions (70%). Also pharmacists in high socio-economic regions indicated higher importance level of selection of the decoration equipments (84%) than pharmacists serving in high socio-economic regions (60%). CONCLUSION: Our study suggests that some pharmacists pay more attention to interior atmospheric elements and others do not. There is a difference in terms of attaching importance to some store atmospheric elements (i.e. physical site, decoration equipment, it's color, wall color, etc.) serving in high versus low socio-economic regions in this context.

Community pharmacists' burnout levels and related factors: an example from Turkey.

OBJECTIVE: To determine community pharmacists' burnout levels and prevalences as well as factors associated with burnout. SETTING: Study was conducted in Ankara, the capital of Turkey. METHOD: In this cross-sectional study, 251 pharmacists were randomly selected from 1,504 community pharmacists registered in Ankara Chamber of Pharmacists. A questionnaire including questions related to pharmacists' individual and professional characteristics and Maslach Burnout Inventory was administered. The data was collected between February 27 and May 25, 2007. MAIN OUTCOME MEASURE: Three Maslach Burnout Inventory subscales (emotional exhaustion-EE, depersonalization-D, and personal accomplishment-PA) scores. RESULTS: Pharmacists' mean emotional exhaustion score was found to be 16.84 (SD: 6.25), depersonalization score was 4 (Range: 0-14), and personal accomplishment score was 22 (Range: 9-32). Of the pharmacists, 1.2% had high level of EE, .8% had high level of D, and 71.3% had high level of inefficacy. Age, marital status, work experience, work contentment, workload, time pressure, stress, and satisfaction with customers were found to be related with pharmacists' burnout levels. CONCLUSION: It can be useful to monitor pharmacists' burnout levels and prevalences periodically. Interventions on individual and organizational basis were needed to cope with burnout, respond to job demands, minimize the level of chronic stress, and increase work contentment and satisfaction.

Vancomycin vs teicoplanin in the treatment of Gram-positive infections: a pharmacoeconomic analysis in a Turkish University Hospital.

OBJECTIVE: The aim of this study was to estimate and compare the costs of vancomycin and teicoplanin in the treatment of Gram-positive hospital infections in Turkey using a cost minimisation analysis. SETTING: Hacettepe University Hospital, Ankara, Turkey. METHOD: The health-care provider's perspective was considered within formal pharmacoeconomic assessment methodology. The records of 76 patients who had been hospitalised and treated for Gram-positive infections at Hacettepe University Hospital between 16 July 2003 and 22 November 2003 were retrospectively evaluated to obtain individual data on resources and associated costs. MAIN OUTCOME MEASURE: From a cost minimisation perspective, hospital directors may consider teicoplanin to be a relevant option in addition to vancomycin. RESULT: The estimated mean treatment cost per patient was 1,780 TRY (1,101 EUR) for teicoplanin and 1,429 TRY (884 EUR) for vancomycin, with statistical analysis failing to reveal any significant difference between the two drugs in terms of these total costs (p = 0.33). This cost minimisation analysis shows that the average costs of vancomycin and teicoplanin per patient observed did not differ significantly. CONCLUSION: Other potential advantages of one drug over the other, as reported by other authors, such as differing safety profiles or advantages in administration, may ultimately decide which is preferred.

An evaluation of the quality of Turkish community pharmacy web sites concerning HON principles.

The objective of this study was to find all the existing Web sites of Turkish community pharmacies and evaluate their "quality" in terms of Health on the Net (HON) Code of conduct principles. Multiple Internet search engines were used (google.com, yahoo.com, altavista.com, msn.com). While searching on the Internet, "eczane (pharmacy)" and "eczanesi (pharmacy of)" key words were used. The Internet search lasted for 2 months starting from March 1, 2007 until May 1, 2007. SPSS ver. 11.5 statistical program (SPSS, Inc., Chicago, IL) was used for data entry and analysis. At the end of the Internet search via all the indicated search engines, a total of 203 (all different from each other) community pharmacy Web sites were determined; of these, 14 were under construction and 6 were not accessible. As a result, 183 community pharmacy Web sites were included in the study. All of the Web sites could be accessed (100%). However, the availability of some characteristics of the pharmacies were quite poor. None of the pharmacies met all of the HON principles. Only 11 Web sites were appropriate in terms of complementarity (6.0%). Confidentiality criteria was met by only 14 pharmacies (7.7%). Nine pharmacies (4.9%) completed the "attribution" criteria. Among 183 pharmacy Web sites, the most met HON principle was the "transparency of authorship" (69 pharmacy Web sites; 37.7%). Because of the results of our study, the Turkish Pharmacists Association can take a pioneer role to apply some principles such as HON code of conduct in order to increase the quality of Turkish community pharmacists' Web sites.

What is behind smoking among pharmacy students: a quantitative and qualitative study from Turkey.

This study, performed in two phases, compared the smoking status of first- and last-year pharmacy students and identified underlying factors of smoking using both "quantitative" and "qualitative" research techniques. The quantitative phase was a cross-sectional study with 207 students (of these, 102 were first-year and 105 were last-year students). The mean age at which first-year students tried tobacco/tobacco products was 14.1 +/- 3.2 and for last-year students, 16.0 +/- 2.4. The students completed an 18-item questionnaire at the end of the spring semester in May 2004. Chi-square and t-test analyses were used for statistical comparisons. Furthermore, focus group discussion techniques were used to find out the underlying factors of smoking in the second phase.

What is missing on their web sites? An evaluation of national and international pharmaceutical companies in Turkey.

The Turkish Pharmaceutical Manufacturers Association-Ilaç Endüstrisi Isverenler Sendikasi (IEIS) set guidelines for pharmaceutical companies when designing their websites in 2003. The objective of this study is to evaluate whether pharmaceutical company websites comply with these guidelines. The list of all the national and international pharmaceutical companies active in Turkey is obtained from Farmalist Vademecum. We evaluated each site in terms of availability of drug advertisement, mail address, e-mail address, telephone number, fax number, update information, indication of target group, links, references, information, appropriate content for the intended target group, disclaimer stating the given information is only for health care professionals, disclaimer stating the given information cannot replace a health care professional, responsible body for the website design. The search was done throughout February 2005. We used x(2) test and Fisher's exact x(2) tests for statistical analysis. Of the 82 pharmaceutical companies active in Turkey, 51 had a website eligible for evaluation. Of the 51 companies, 34 (66.7%) were national and 17 (33.3%) were international. Eighteen companies had drug advertisement on the home page of their websites (64.7%). Of the total companies majority had mail address (89.2%); telephone number (89.2%); fax number (84.3%); links (66.7%); and appropriate content for the health care professionals (62.7%). The frequency of having update information and a separate pharmacist/physician information part was higher among international pharmaceutical company websites compared to the national ones. These differences were statistically significant (p < 0.05). As a result of the evaluation, the majority of the pharmaceutical companies failed to comply wholly with the guidelines set by IEIS when designing their website on the Internet.