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1.
Rev Saude Publica ; 53: 94, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644724

RESUMO

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.


Assuntos
Anti-Hipertensivos/uso terapêutico , Comércio/tendências , Serviços Comunitários de Farmácia/tendências , Medicamentos Genéricos/uso terapêutico , Hipoglicemiantes/uso terapêutico , Programas Nacionais de Saúde/tendências , Brasil , Comércio/estatística & dados numéricos , Serviços Comunitários de Farmácia/estatística & dados numéricos , Diabetes Mellitus/tratamento farmacológico , Política de Saúde , Humanos , Hipertensão/tratamento farmacológico , Análise de Séries Temporais Interrompida , Estudos Longitudinais , Programas Nacionais de Saúde/estatística & dados numéricos , Farmácias/estatística & dados numéricos , Farmácias/tendências , Avaliação de Programas e Projetos de Saúde , Valores de Referência , Estudos Retrospectivos , Fatores de Tempo
2.
BMC Health Serv Res ; 19(1): 571, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412944

RESUMO

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.


Assuntos
Serviços Comunitários de Farmácia , Diazepam , Prescrições de Medicamentos/estatística & dados numéricos , Hipnóticos e Sedativos , Farmacêuticos , Serviços Comunitários de Farmácia/legislação & jurisprudência , Serviços Comunitários de Farmácia/estatística & dados numéricos , Estudos Transversais , Diazepam/provisão & distribução , Humanos , Hipnóticos e Sedativos/provisão & distribução , Farmacêuticos/legislação & jurisprudência , Farmacêuticos/estatística & dados numéricos , Tanzânia
3.
J Manag Care Spec Pharm ; 25(9): 989-994, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31456496

RESUMO

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.


Assuntos
Serviços Comunitários de Farmácia/estatística & dados numéricos , Imunização/estatística & dados numéricos , Telefone/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Feminino , Vacina contra Herpes Zoster/imunologia , Humanos , Vacinas contra Influenza/imunologia , Masculino , Pessoa de Meia-Idade , Farmacêuticos/estatística & dados numéricos , Vacinas Pneumocócicas/imunologia , Sistema de Registros , Inquéritos e Questionários
4.
Am J Health Syst Pharm ; 76(6): 360-365, 2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-31361840

RESUMO

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.


Assuntos
Atitude do Pessoal de Saúde , Call Centers/organização & administração , Serviços Comunitários de Farmácia/organização & administração , Segurança do Paciente , Gestão da Segurança , Centros Médicos Acadêmicos/organização & administração , Centros Médicos Acadêmicos/estatística & dados numéricos , Serviços Comunitários de Farmácia/estatística & dados numéricos , Aconselhamento/organização & administração , Implementação de Plano de Saúde , Humanos , Erros de Medicação/prevenção & controle , Farmacêuticos/psicologia , Farmacêuticos/estatística & dados numéricos , Técnicos em Farmácia/psicologia , Técnicos em Farmácia/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários/estatística & dados numéricos , Estados Unidos , United States Agency for Healthcare Research and Quality , Carga de Trabalho/psicologia , Carga de Trabalho/estatística & dados numéricos
5.
Am J Health Syst Pharm ; 76(6): 353-359, 2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-31361842

RESUMO

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.


Assuntos
Call Centers/organização & administração , Serviços Comunitários de Farmácia/organização & administração , Erros de Medicação/prevenção & controle , Segurança do Paciente , Centros Médicos Acadêmicos/organização & administração , Centros Médicos Acadêmicos/estatística & dados numéricos , Serviços Comunitários de Farmácia/estatística & dados numéricos , Prescrições de Medicamentos/estatística & dados numéricos , Eficiência Organizacional/estatística & dados numéricos , Implementação de Plano de Saúde , Humanos , Auditoria Administrativa/estatística & dados numéricos , Comportamento Multitarefa , Farmacêuticos/organização & administração , Farmacêuticos/psicologia , Farmacêuticos/estatística & dados numéricos , Técnicos em Farmácia/organização & administração , Técnicos em Farmácia/psicologia , Técnicos em Farmácia/estatística & dados numéricos , Papel Profissional/psicologia , Avaliação de Programas e Projetos de Saúde , Gestão da Segurança/organização & administração , Inquéritos e Questionários/estatística & dados numéricos , Telefone , Estados Unidos , United States Agency for Healthcare Research and Quality , Carga de Trabalho/psicologia , Carga de Trabalho/estatística & dados numéricos
6.
Pharm. pract. (Granada, Internet) ; 17(2): 0-0, abr.-jun. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184678

RESUMO

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


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Farmacêuticos/estatística & dados numéricos , Disponibilidade de Medicamentos Via Internet/estatística & dados numéricos , Serviços Comunitários de Farmácia/estatística & dados numéricos , Educação de Pacientes como Assunto/estatística & dados numéricos , Líbano/epidemiologia , Continuidade da Assistência ao Paciente/estatística & dados numéricos , Atitude Frente aos Computadores , Estudos Transversais , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos
7.
Int J Clin Pharm ; 41(4): 1110-1117, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31073974

RESUMO

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.


Assuntos
Serviços Comunitários de Farmácia/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Reconciliação de Medicamentos , Alta do Paciente , Participação do Paciente/psicologia , Idoso , Estudos Transversais , Inglaterra , Feminino , Humanos , Masculino , Educação de Pacientes como Assunto , Telefone , País de Gales
8.
BMC Health Serv Res ; 19(1): 285, 2019 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-31053122

RESUMO

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.


Assuntos
Serviços Comunitários de Farmácia , Oftalmopatias/diagnóstico , Otorrinolaringopatias/diagnóstico , Satisfação do Paciente/estatística & dados numéricos , Farmacêuticos/normas , Serviços Comunitários de Farmácia/normas , Serviços Comunitários de Farmácia/estatística & dados numéricos , Oftalmopatias/terapia , Humanos , Otorrinolaringopatias/terapia , Encaminhamento e Consulta , Inquéritos e Questionários
9.
Int J Clin Pharm ; 41(4): 872-879, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31140160

RESUMO

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.


Assuntos
Serviços Comunitários de Farmácia/estatística & dados numéricos , Farmacêuticos , Papel Profissional , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Países Baixos , Amostragem , Autorrelato , Smartphone , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
10.
BMC Health Serv Res ; 19(1): 304, 2019 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-31088459

RESUMO

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.


Assuntos
Atitude do Pessoal de Saúde , Serviços Comunitários de Farmácia/estatística & dados numéricos , Farmacêuticos/psicologia , Farmacêuticos/estatística & dados numéricos , Saúde Pública , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos e Questionários , Iêmen
11.
J Int Med Res ; 47(5): 2018-2025, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30885078

RESUMO

OBJECTIVE: To investigate the level of counselling regarding the effects of sedating antihistamines on driving skills provided by private community pharmacies in Madinah, Saudi Arabia. METHODS: This study randomly selected private community pharmacies. Mystery shoppers following a similar scenario individually visited these pharmacies. These clients asked for a commonly used brand of sedating antihistamine and noted the counselling offered by the pharmacist. If spontaneous counselling was not offered, necessary information regarding the medication's use was requested. Finally, the content of counselling was documented. RESULTS: Of the 100 pharmacies selected, 12 were excluded for various reasons and 88 pharmacies were included in the study. Only 23 pharmacies offered spontaneous counselling. Although 73.9% of pharmacists (65 of 88), spontaneously or upon request, mentioned sedation as a side-effect, only one pharmacist warned the client against driving after taking the medication, and three other pharmacists warned against dealing with hazardous machinery. Other side-effects were almost ignored. CONCLUSION: A life-threatening insufficiency in the quality of counselling at Saudi Arabian private community pharmacies exists. Traffic accidents, secondary to the side-effects of sedating antihistamines, may be avoided if proper counselling is offered. Saudi Arabian authorities should take appropriate actions to ensure optimal practice in community pharmacies.


Assuntos
Serviços Comunitários de Farmácia/normas , Aconselhamento , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , Antagonistas dos Receptores Histamínicos H1/administração & dosagem , Educação de Pacientes como Assunto/métodos , Farmacêuticos/normas , Serviços Comunitários de Farmácia/estatística & dados numéricos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Humanos , Farmacêuticos/psicologia , Farmacêuticos/estatística & dados numéricos , Qualidade de Vida , Arábia Saudita/epidemiologia , Inquéritos e Questionários
12.
BMC Health Serv Res ; 19(1): 186, 2019 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-30898124

RESUMO

BACKGROUND: Worldwide community pharmacies are shifting their role in the healthcare system from simple medication dispensers to health care providers. High levels of satisfaction with pharmacy services were found in previous studies. This study has two main goals. The primary goal is to describe the levels of satisfaction and knowledge regarding pharmacy services in Portugal. The secondary goal is to explore the perceptions and the utilisation of pharmacy services by the Portuguese. This statement includes exploring the impact of a set of variables on both perceptions and uses of pharmacies in regard to services that are currently offered as well as to new services that may be provided in the future. METHODS: A face-to-face survey of closed-ended questions was applied to a nationwide representative sample of the Portuguese population in September 2015. The sample was weighted based on population distribution across regions, habitat, age and gender. Data analysis comprises descriptive statistics and Multiple Correspondence Analysis to explore different typologies of respondent's orientation toward community pharmacy. RESULTS: A total of 1114 interviews comprised the study. Of the respondents, 36% used the pharmacy as a first resource when seeking to treat a minor ailment, and 54% reported that they use the pharmacy as a first resource when seeking answers about medicines. Of those who visited their pharmacy at least once in the previous year, 94% were either globally satisfied or very satisfied. The level of acknowledgement of pharmacy services' was also high among the Portuguese. Of the participants, 29% considered there could be more services available in pharmacies that are currently provided by other health care facilities. The construction of a typology of orientations towards community pharmacy practice resulted in three outcome groups: "Motivated" (63%), those with a connection to a pharmacy; "Settled" (23%), mainly those who had a pharmacy nearby; and "Demobilised" (14%), those who are weakly tied to a pharmacy. CONCLUSIONS: The vast majority of the Portuguese population has a strong positive attitude towards their community pharmacy, as expressed by the high levels of satisfaction with, and positive evaluation of, the pharmacy's services.


Assuntos
Serviços Comunitários de Farmácia/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Serviços Comunitários de Farmácia/estatística & dados numéricos , Assistência à Saúde/estatística & dados numéricos , Utilização de Instalações e Serviços , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Percepção , Farmácias/normas , Farmácias/estatística & dados numéricos , Portugal , Opinião Pública , Inquéritos e Questionários , Adulto Jovem
13.
J Manag Care Spec Pharm ; 25(3): 332-340, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30816817

RESUMO

BACKGROUND: Adherence to oral antihyperglycemic agents (AHAs) is important for managing blood glucose levels and avoiding hospitalizations or diabetes complications. Previous studies have found that use of mail-order pharmacy dispensing channels results in greater adherence than use of community pharmacies, but the link between use of mail-order pharmacies and improved clinical outcomes has not been established. OBJECTIVE: To compare the effect of mail-order and community pharmacy use on adherence to oral AHAs, hemoglobin A1c (A1c) level, and glycemic control, as well as emergency department (ED) and inpatient hospital use. METHODS: This retrospective cohort study of administrative claims data from January 1, 2008, to December 31, 2016, included patients with Medicare Advantage Prescription Drug plan coverage with ≥ 2 claims for the same oral AHA and a diagnosis of type 2 diabetes mellitus (T2DM). Patients were indexed to the start of the most advanced oral AHA identified to begin study observations at the start of a new treatment and assigned to mail-order or community pharmacy cohorts based on which channel dispensed ≥ 80% of their oral AHA claims; all others were excluded. Mail-order and community pharmacy patients were 1:1 propensity score matched. Matched cohorts were compared on proportion of days covered (PDC), adherence (PDC ≥ 0.8), A1c level, glycemic control, and ED and inpatient use for measurement periods of 12, 24, 36, and 48 months post-index. RESULTS: 19,307 mail-order and 19,307 community pharmacy users were matched. PDC was higher for mail-order pharmacy users at 12 months (0.93 vs. 0.82, P < 0.001) and sustainable through 48 months (0.87 vs. 0.77, P < 0.001). Adherence was also greater for mail-order pharmacy patients through 12 months (86% vs. 68%, P < 0.001) and sustainable through 48 months (78% vs. 62%, P < 0.001). Glycemic control as A1c < 7% was not significantly different, but control as A1c < 8% was greater for mail-order pharmacy users at 12 months (91% vs. 89%, P = 0.006) and was greater through 36 months (93% vs. 89%, P = 0.043). Effects on A1c level were not evident. Mail-order pharmacy users were less likely to have an ED visit within 12 months (26% vs. 28%, P < 0.0001), and the difference was observed through 36 months (50% vs. 54%, P < 0.0001). Similarly, fewer mail-order pharmacy users had an inpatient hospitalization within 12 months (17% vs. 19%, P < 0.0001), and the difference was observed through 48 months (43% vs. 47%, P = 0.009). CONCLUSIONS: The results of the study demonstrate a benefit to patients who use mail-order pharmacies for chronic medications to treat T2DM. The study identified greater glycemic control, lower ED use, and lower hospitalization among individuals using mail-order pharmacies. These positive outcomes were evident in the near term and sustained over time. DISCLOSURES: This study received no outside funding but was sponsored by Humana through regular employment activities by Schwab, Racsa, and Worley, who are employed by Humana Healthcare Research (formerly Comprehensive Health Insights). This study found benefits related to using mail-order versus community pharmacies for dispensing antihyperglycemic agents in the treatment of type 2 diabetes. Humana owns mail-order pharmacies under the Humana Pharmacy subsidiary. Mourer and Meah are paid employees of Humana Pharmacy Solutions. Rascati is employed by the University of Texas College of Pharmacy at Austin.


Assuntos
Serviços Comunitários de Farmácia/estatística & dados numéricos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/administração & dosagem , Adesão à Medicação , Serviços Postais/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Glicemia/efeitos dos fármacos , Estudos de Coortes , Bases de Dados Factuais , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Hemoglobina A Glicada/metabolismo , Hospitalização , Humanos , Estudos Longitudinais , Masculino , Medicare Part C , Pessoa de Meia-Idade , Estudos Retrospectivos , Estados Unidos
14.
Int J Pharm Pract ; 27(1): 17-24, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29687513

RESUMO

OBJECTIVES: To analyse attitudes towards sales and use of over-the-counter (OTC) drugs in the Swedish adult population. METHODS: Data were collected through the web-based Citizen Panel comprising 21 000 Swedes. A stratified sample of 4058 participants was emailed a survey invitation. Questions concerned use of OTC drugs, and attitudes towards sales and use of OTC drugs. Correlations between the attitudinal statements were assessed using Spearman's rank correlation. Associations between attitudes and participant characteristics were analysed using multinomial logistic regression. KEY FINDINGS: Participation rate was 64%. Altogether 87% reported use of OTC drugs in the last 6 months. Approximately 10% of participants stated that they used OTC drugs at the first sign of illness, and 9% stated that they used more OTC drugs compared with previously, due to increased availability. The statement on use of OTC drugs at first sign of illness correlated with the statement about using more OTC drugs with increased availability. Socio-demographic factors (age, sex and education) and frequent use of OTC drugs were associated with attitudes to sales and use of OTC drugs. CONCLUSIONS: Increased use due to greater availability, in combination with OTC drug use at first sign of illness illustrates the need for continuous education of the population about self-care with OTC drugs. Increased awareness of the incautious views on OTC drugs in part of the population is important. Swedish policy-makers may use such knowledge in their continuous evaluation of the 2009 pharmacy reform to review the impact of sales of OTC drugs in retail outlets on patient safety and public health. Pharmacy and healthcare staff could be more proactive in asking customers and patients about their use of OTC drugs and offering them advice.


Assuntos
Comércio/estatística & dados numéricos , Serviços Comunitários de Farmácia/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Medicamentos sem Prescrição/economia , Farmácias/estatística & dados numéricos , Adulto , Comércio/legislação & jurisprudência , Serviços Comunitários de Farmácia/economia , Serviços Comunitários de Farmácia/legislação & jurisprudência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Farmácias/economia , Farmácias/legislação & jurisprudência , Automedicação/economia , Automedicação/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Suécia , Adulto Jovem
15.
Int J Pharm Pract ; 27(1): 55-62, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29732640

RESUMO

OBJECTIVE: To explore the knowledge, attitudes and practice of final-year student pharmacists about public health. METHODS: Knowledge, attitudes and practice of all final-year student pharmacists (N = 158) in Namibia, Zambia and Zimbabwe were assessed through a quantitative 12-item survey. The survey assessed personal interest and attitude towards public health activities, self-assessed ability to perform basic public health activities, perspectives towards current pharmacist practices within public health activities in their country, and student involvement in public health activities during pharmacy school. KEY FINDINGS: Eighty-two per cent of students responded to the survey (n = 129). The majority (95%) of all final-year student pharmacists are interested in contributing to public health activities in both health promotion and disease prevention and feel, as pharmacists, they have the responsibility to do so. Additionally, the majority of students would like more education during pharmacy school on health promotion (93%) and disease prevention (89%). Despite their interest, low numbers of student pharmacists feel that pharmacists are currently utilised in disease prevention (35%) and health promotion (42%). CONCLUSION: Final-year student pharmacists in Namibia, Zambia and Zimbabwe express strong interest in public health education and involvement in public health activities. This interest and enthusiasm can serve as evidence for advancing public health education in the pharmacy curricula and for developing pharmacist opportunities in public health efforts that match the needs of the country.


Assuntos
Competência Clínica/estatística & dados numéricos , Educação em Farmácia/estatística & dados numéricos , Farmacêuticos/estatística & dados numéricos , Estudantes de Farmácia/estatística & dados numéricos , Adulto , Serviços Comunitários de Farmácia/estatística & dados numéricos , Currículo , Feminino , Educação em Saúde/estatística & dados numéricos , Promoção da Saúde/estatística & dados numéricos , Humanos , Masculino , Namíbia , Educação de Pacientes como Assunto , Inquéritos e Questionários , Adulto Jovem , Zâmbia , Zimbábue
16.
Int J Pharm Pract ; 27(1): 88-95, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29732649

RESUMO

OBJECTIVES: Investigating public perceptions of community pharmacists (CP) in public health and their use of social media (SM) and mobile health applications (MH apps) in that regard. METHODS: Two surveys were created. One sought public perceptions of SM and the other of MH apps for health advice. Both included a section on perceptions of the role of CPs in public health. A convenience sampling strategy, based on proximity, was used.The study population was the public (n = 8 500 000) living in Greater London. The general public were recruited face-to-face in public spaces. A minimum sample (95% confidence interval/5% margin of error) of 385 was needed. Ethical approval was obtained from the university ethics committee. Responses were analysed in SPSS. KEY FINDINGS: About 820/1800 (45.6%) completed one/both surveys. Respondents seek health advice primarily from GPs, followed by digital mediums and then CPs. Under 35s use digital mediums more frequently (P = 0.039). Those who had used SM (41.7%) or MH apps (61.8%) for health information did not confirm its accuracy with a healthcare professional (HCP). Of those that did (MH apps = 39.2%; SM = 58.3%), the HCP disagreed with the information on MH apps and SM on 19.6% and 36.7% of occasions, respectively. Nevertheless, 64.5% stated that if a SM page was maintained by an HCP they would use it. CONCLUSIONS: The public are using digital mediums for health advice instead of speaking to an HCP. If CPs want to have an impact on public health they must start imbedding digital mediums into their services.


Assuntos
Serviços Comunitários de Farmácia/organização & administração , Comunicação em Saúde , Comportamento de Busca de Informação , Farmacêuticos/psicologia , Relações Profissional-Paciente , Adulto , Idoso , Serviços Comunitários de Farmácia/estatística & dados numéricos , Feminino , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis/estatística & dados numéricos , Papel Profissional , Mídias Sociais/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , Reino Unido , Adulto Jovem
17.
Int J Pharm Pract ; 27(3): 241-248, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30480354

RESUMO

OBJECTIVES: The main objective of this study was to assess the ability of community pharmacists practicing in Beirut to identify red flag respiratory symptoms, and therefore to adequately refer clients to a general physician when warranted. Secondary objectives included determining whether demographic factors affect the odds of referral, and to qualify degree of agreement of community pharmacists with a panel of expert physicians. METHODS: In this cross-sectional study, pharmacies were randomly selected and invited to complete a self-administered survey, each containing 10 clinical vignettes that combined different characteristics (age group, gender, presenting symptom, duration of symptoms). Bivariate and multivariate logistic regressions were used to inspect predictors of referral, correct referral and under-referral. KEY FINDINGS: A total of 214 pharmacies were visited and 141 (65.9%) responded. Pharmacists were more likely to refer female patients (P = 0.035) and patients who presented with a longer duration of symptoms (P < 0.001). Correct referral was higher in pharmacies that were more than 20 min away from the nearest hospital (P = 0.013) and with clients who presented with haemoptysis (P < 0.001), dyspnoea (P < 0.001) or wheezing (P < 0.027), while it was lower with female patients (P < 0.001). Under-referral was higher in pharmacies that served more than 500 clients weekly (P = 0.048) and in patients presenting for dry cough (P < 0.001) or productive cough (P < 0.001). CONCLUSION: This study has shown that there is a need for further investigation into the practices of community pharmacists of Beirut. An action plan may be advised to alleviate the burden of patients who might currently be under-referred and experience morbidity as a result.


Assuntos
Atitude do Pessoal de Saúde , Serviços Comunitários de Farmácia/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Doenças Respiratórias/diagnóstico , Adulto , Fatores Etários , Serviços Comunitários de Farmácia/organização & administração , Estudos Transversais , Feminino , Clínicos Gerais/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Líbano , Masculino , Pessoa de Meia-Idade , Farmacêuticos/organização & administração , Farmacêuticos/estatística & dados numéricos , Papel Profissional , Fatores Sexuais , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
18.
Vaccine ; 37(1): 152-159, 2019 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-30446177

RESUMO

BACKGROUND: The prevalence of vaccine-preventable diseases in adults remains a significant public health issue in the United States. The objectives of this demonstration project were to increase the number of influenza, pneumococcal, pertussis, and herpes zoster immunizations administered to adults by community pharmacists, evaluate the percentage of immunizations documented in the state immunization information system (IIS), and design and pilot a value-based payment model. METHODS: A one-year prospective, observational demonstration project was conducted in 70 community pharmacies in western Washington State from September 1, 2016 to August 31, 2017. An immunization interface was integrated into workflow at each pharmacy to enable "forecasting" of and proactive recommendation to patients about their vaccine needs and documentation of vaccines administered in the state IIS. Categorical value-based payment models were developed and implemented in a subgroup of 12 community pharmacies from March 1 to November 30, 2017. The change in the number of immunizations administered in comparison to the baseline period and the percentage of immunizations documented in the state IIS during the demonstration period were analyzed using descriptive statistics. RESULTS: There was a 15% total increase in the collective number of influenza, pneumococcal, pertussis, and herpes zoster vaccines administered in the demonstration year in the 70 pharmacies, due to increases in influenza and pertussis vaccinations. Eighty-three percent of the vaccines administered were documented in the state IIS. Pneumococcal, pertussis, and herpes zoster performance appeared to be unaffected by the value-based payment models while influenza performance improved across the 12 pilot pharmacies. CONCLUSIONS: This work demonstrated that community pharmacists contribute to improving adult immunizations through vaccine "forecasting" and proactive recommendation. Meaningful quality measures with both positive and negative incentives could further drive adoption of best immunization practices. Further implementation and outcomes research is needed to fully examine the impact and scalability of these strategies.


Assuntos
Serviços Comunitários de Farmácia/economia , Vacinação/estatística & dados numéricos , Seguro de Saúde Baseado em Valor , Adulto , Serviços Comunitários de Farmácia/estatística & dados numéricos , Previsões , Humanos , Estudo de Prova de Conceito , Estudos Prospectivos , Saúde Pública , Estados Unidos , Vacinação/economia , Vacinas/economia , Washington
19.
Vaccine ; 37(1): 56-60, 2019 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-30471954

RESUMO

Over the course of this project, we utilized pharmacists at 159 community pharmacies in Nebraska and Iowa to administer vaccinations to adults 19 years of age or older with the objective of improving immunization rates in both states. We implemented a pharmacy-based technology platform and partnered with public health via the state immunization registries of both states to ensure that immunizations provided at the pharmacy were transmitted to the statewide registry, for which reporting is currently voluntary for health care providers. After using the technology platform for one year, an increase of immunization rates for influenza, herpes zoster, and pertussis vaccination rates by 37%, 12%, and 74%, respectively, was recorded in comparison to the prior year numbers. However, there was about 16% decrease in vaccination rates for pneumococcal vaccine. For the first time, the project's participating pharmacies in Nebraska reported immunization counts to their state's immunization registries. This project leveraged community pharmacies as healthcare destinations to achieve further gains in increasing immunization rates, improving the health of adults, and creating a community-wide network for prevention.


Assuntos
Sistemas de Informação em Farmácia Clínica , Serviços Comunitários de Farmácia/estatística & dados numéricos , Programas de Imunização , Cobertura Vacinal/métodos , Adulto , Serviços Comunitários de Farmácia/legislação & jurisprudência , Herpes Zoster/prevenção & controle , Vacina contra Herpes Zoster/administração & dosagem , Humanos , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Iowa , Nebraska , Farmácias , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/administração & dosagem , Saúde Pública , Cobertura Vacinal/legislação & jurisprudência , Adulto Jovem
20.
Res Social Adm Pharm ; 15(5): 584-590, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30093309

RESUMO

BACKGROUND: Dispensing antibiotics without a prescription, although forbidden by Sri Lankan law since 1986, is a common practice throughout the country. This study attempted to quantify this practice for the first time. OBJECTIVES: To evaluate the response of community pharmacy staff to an antibiotic product request without a prescription and to explore possible factors influencing such practice. METHODS: A cross-sectional simulated client study was conducted from Jan to Sept 2017. A total of 242 community pharmacies were visited by trained simulated clients (SCs) and they requested for one of four antibiotics (erythromycin tablets, amoxicillin syrup, metronidazole tablets, or ciprofloxacin tablets) without a prescription. Data on the interaction between the pharmacy staff and SC was recorded using a data collection sheet immediately after each visit. RESULTS: Nearly 50% of pharmacies had a pharmacist on duty during the visit. Attending pharmacy staff asked for a prescription for the requested antibiotic in 47% of the instances. Only 16 (7%) pharmacy staff recommended the SC to see a doctor. Overall, 61% of pharmacies dispensed antibiotics without a prescription. The highest dispensed antibiotic was ciprofloxacin (44/63 requests; 70%) and the least was amoxicillin (32/62; 52%). Patient history was obtained in only a few instances and none of the pharmacies dispensed alternative over the counter medicines. The availability of a pharmacist reduced the risk of dispensing an antibiotic without a prescription (Adj. OR = 0.54, 95% CI: 0.30-0.95; P = 0.033), however, it did not have any impact on patient history taking. CONCLUSIONS: Dispensing antibiotics without a prescription is a common practice in Sri Lankan community pharmacies. In most instances, pharmacy staff neither inquired about patient history nor requested the patient to obtain the advice of a doctor. Presence of a pharmacist may reduce dispensing antibiotics without prescription, but may not have an effect on interactions with clients requesting antibiotics.


Assuntos
Antibacterianos , Serviços Comunitários de Farmácia/estatística & dados numéricos , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Humanos , Masculino , Farmácias , Sri Lanka
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