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1.
PLoS One ; 15(8): e0237338, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32797093

RESUMO

OBJECTIVE: The study was aimed to explore patient safety culture of community pharmacists working in Dessie and Gondar towns, Northern Ethiopia. METHODS: A cross-sectional study was conducted from 1st to 31st March 2018. In this cross-sectional survey, the Pharmacy Survey on Patient Safety Culture (PSOPSC), developed by the Agency for Healthcare Research and Quality (AHRQ), was used to collect data. PSOPSC is a self-administered questionnaire. The questionnaire was distributed among staffs who work in community pharmacies of Dessie and Gondar towns. All staffs available on data collection period in the pharmacy were included. The Statistical Package for Social Science (SPSS) software version 25 was used to enter and analyze the data. RESULTS: A total of 120 participants were approached and completed the questionnaire. Results from the study showed that high positive response rate was demonstrated in the domains of "Teamwork" (90.2%) followed by physical space and environment (83.1%). On the other hand, the result also identified that there is an enormous problem related to mistake communication (44.8%) and work pressure (45%). In addition, significant difference of percent positive responses were obtained across towns and staff working hours. CONCLUSIONS: The patient safety culture of community pharmacists is appreciable especially with respect to their teamwork. Besides, urgent attention should be given to areas of weakness, mainly in the domain of "mistake communication" and "staffing and work pressure".


Assuntos
Serviços Comunitários de Farmácia/organização & administração , Segurança do Paciente , Farmacêuticos/organização & administração , Gestão da Segurança/estatística & dados numéricos , Adulto , Serviços Comunitários de Farmácia/estatística & dados numéricos , Estudos Transversais , Etiópia , Feminino , Humanos , Relações Interprofissionais , Masculino , Pessoa de Meia-Idade , Admissão e Escalonamento de Pessoal/organização & administração , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Farmacêuticos/psicologia , Farmacêuticos/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Carga de Trabalho/psicologia , Carga de Trabalho/estatística & dados numéricos , Adulto Jovem
2.
PLoS One ; 15(7): e0235205, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32658918

RESUMO

BACKGROUND: Generic medicines are similar to innovator medicine in terms of safety, quality, efficacy, dosage form, strength, and route of administration. They have the same therapeutic use to innovator medicines and available at a far lower price. However, health professionals' poor knowledge and attitude may limit its utilization. The present study aimed at assessing the knowledge, attitude, and practice of pharmacy professionals towards generic medicines in Harar city, Eastern Ethiopia. METHODS: A cross-sectional survey was conducted among community pharmacists in Harar city. A self-administered thirty-three item questionnaire on Knowledge, attitude, and practice of community pharmacists was utilized. Logistic regression analysis was performed to predict the determinants of knowledge and attitude of pharmacists. An odds ratio at 95% confidence interval along with a p-value < 0.05 was considered significant. RESULTS: Among 80 community pharmacists' approached, 74 completed the survey, providing a response rate of 92.5%. Sixty-seven percent of the respondents knew that generic drugs are bioequivalent to brand drugs and claimed generic medicines are cheaper (86.5%). Nearly half (48.6%) of participants believe that generic medicines are less effective and slower in the onset of action (58.1%). More than half (54.1%) of study participants revealed their lack of belief in generic medicine as a factor hindering the selection and dispensing of generic medicines. In multivariate logistic regression, experience in community pharmacy practice (Adjusted odds ratio (AOR = 2.18, 95%CI: 1.21-63.1) and Sex (AOR = 3.88, 95%CI: 2.12-39.62) were significantly associated with knowledge and attitude toward generic medicines, respectively. CONCLUSION: The current study revealed that there is a gap in the knowledge and attitude of community pharmacists towards generic and brand drugs. More than averages of the respondents have known the concept of generic medicine including their right to perform generic substitution and had a positive attitude toward generics. Female pharmacists were more likely to have a positive attitude and the overall knowledge was higher in those who have more than 5 years of work experience.


Assuntos
Serviços Comunitários de Farmácia/estatística & dados numéricos , Medicamentos Genéricos/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Farmacêuticos/psicologia , Competência Profissional/estatística & dados numéricos , Adulto , Estudos Transversais , Substituição de Medicamentos , Medicamentos Genéricos/farmacologia , Etiópia , Feminino , Humanos , Masculino , Farmacêuticos/estatística & dados numéricos , Fatores Sexuais , Inquéritos e Questionários/estatística & dados numéricos , Equivalência Terapêutica , Adulto Jovem
3.
PLoS One ; 15(7): e0236797, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32726366

RESUMO

Topical corticosteroids (TCs) are widely used to treat dermatological conditions such as eczema and psoriasis. It can be a safe and effective treatment when used appropriately. However, misguided information and corticosteroid phobia appear to contribute to inadequate adherence to therapy, leading to unsatisfactory treatment outcomes. Therefore, community pharmacists (CPs) are in a prime position to inform patients about the appropriate use of medicine. The aim of this study was to examine how the knowledge and perceptions of CPs, as well as other factors, associate CPs' patient counseling practice around the use of TCs. A structured, validated questionnaire was distributed to CPs in the Republic of Korea, and additional focus group discussions were implemented to obtain a deeper understanding of the survey findings. We analyzed the survey results by applying a modified knowledge-perception-practice model. In addition, we used path analysis to validate the model and assessed how knowledge level and perceptions of barriers affect CPs' counseling behavior. We ran a multiple regression to identify factors that associate CPs' practice levels. A total of 1018 surveys were analyzed. In general, respondents had sufficient knowledge to provide appropriate patient counseling on TC use. An increase in knowledge level positively associated the quality of practice, and more knowledge increased the perception of barriers that negatively associated patient counseling. Location in rural areas and pharmacists' perception of counseling barriers negatively associated the quality of practice. A higher level of knowledge, training in ADEs, higher proportion of OTC TC sales, and increased time for counseling positively associated the quality of practice. Therefore, minimizing barriers such as negative perceptions is very important in facilitating CPs' counseling practice around TC use.


Assuntos
Corticosteroides/administração & dosagem , Aconselhamento/estatística & dados numéricos , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Percepção , Farmacêuticos/estatística & dados numéricos , Inquéritos e Questionários , Administração Tópica , Adulto , Serviços Comunitários de Farmácia/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Segurança do Paciente , Farmacêuticos/psicologia , República da Coreia
4.
Rev Bras Epidemiol ; 23: e200028, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32401921

RESUMO

OBJECTIVE: The prevalence of hypertension in Brazil and worldwide has been increasing in recent decades, and drug therapy is one of the strategies used to control this condition. The objective of this study was to estimate the prevalence of use and identify the sources for obtaining antihypertensive drugs in Brazil, according to sociodemographic variables, comparing three periods: 2011, 2014 and 2017. METHODS: Data from individuals aged ≥20 years who reported a medical diagnosis of hypertension, interviewed by Vigitel in 2011, 2014 and 2017 were used. Frequency and prevalence of drug use in addition to the sources for obtaining medication were estimated by sociodemographic variables, with 95% confidence intervals. The differences between proportions were verified by Pearson's chi-square test (Rao-Scott), with a significance level of 5%. RESULTS: The prevalence of antihypertensive drug use remained stable (80%). Regarding the sources for obtaining these medicines, there was variation in the period, indicating a decrease in usage through the Brazilian Unified Health System (SUS) (44.2% in 2011; 30.5% in 2017). This decrease was accompanied with increase in PFPB (16.1% in 2011; 29.9% in 2017). The prevalence of other sources for obtaining medicine (private pharmacies/drugstores) showed stability in the period. CONCLUSIONS: The prevalence of medication use remained high and there was a change in the pattern of use according to sources, demonstrating migration between SUS pharmacies to the PFPB, and suggesting a reduction in the availability of medicines from public pharmacies universally, and for free.


Assuntos
Anti-Hipertensivos/provisão & distribução , Acesso aos Serviços de Saúde/estatística & dados numéricos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Adulto , Distribuição por Idade , Anti-Hipertensivos/uso terapêutico , Brasil/epidemiologia , Serviços Comunitários de Farmácia/estatística & dados numéricos , Serviços Comunitários de Farmácia/provisão & distribução , Estudos Transversais , Feminino , Programas Governamentais/estatística & dados numéricos , Inquéritos Epidemiológicos , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Prevalência , Distribuição por Sexo , Fatores Socioeconômicos , Telefone , Adulto Jovem
5.
PLoS One ; 15(4): e0230863, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32241021

RESUMO

BACKGROUND: The emergence of chronic diseases as major causes of disability and death has necessitated the introduction of new strategies to effectively address the ever-changing nature of public health problems. As a result, the role of community pharmacies in promoting public health is growing in recent years through the provision of extended pharmacy services. This study was conducted with the aim of assessing community's extent of use and approval of extended pharmacy services at community pharmacies in Bonga town, Southwest Ethiopia. MATERIALS AND METHODS: Community based cross-sectional study was conducted in Bonga town, Southwest Ethiopia, on households selected by systematic random sampling. Data was collected using semi-structured questionnaire. Data was collected by personally delivering questionnaires to respondents in selected households. Results of the study were described by frequency, mean and standard deviation (SD). Binary logistic analysis was performed to identify potential associations between dependent and independent variables. RESULTS: Out of 356 individuals included in the study, 58.4% recalled visiting community pharmacy premises during the previous six months. Out of these, 34.6% visited the community pharmacies to get extended pharmacy services. College educated participants were 19.4 times more likely to have used extended pharmacy services as compared to illiterate individuals whereas those who earn monthly income more than 5000 Ethiopian Birr were 3.6 times more likely than those with monthly income of 2000 Ethiopian Birr or less. Of the total participants, 91.3% approved the provision of extended pharmacy services in community pharmacies. CONCLUSION: The extent of community's use of extended pharmacy services at community pharmacies was found to be low. Nevertheless, majority of the study subjects approved the provision of extended pharmacy services at community pharmacies. Efforts to improve the practice of extended pharmacy service provision at community pharmacies should be made by all stake holders.


Assuntos
Serviços Comunitários de Farmácia/tendências , Farmácias/estatística & dados numéricos , Farmácias/tendências , Adulto , Serviços Comunitários de Farmácia/estatística & dados numéricos , Estudos Transversais , Etiópia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Farmacêuticos/estatística & dados numéricos , Papel Profissional , Saúde Pública , Inquéritos e Questionários
6.
PLoS One ; 15(4): e0231482, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32315319

RESUMO

OBJECTIVE: To evaluate the influence of pharmacists' dispensing workload (PDW) on pharmacy services as measured by prescription suggestion rate (PSR) and dispensing error rate (DER). METHOD: This was an observational study in northern and southern Taiwan's two largest medical centers, from 2012 to 2018. We calculated monthly PDW as number of prescriptions divided by number of pharmacist working days. We used monthly PSR and DER as outcome indicators for pharmacists' review and dispensing services, respectively. We used Poisson regression model with generalized estimation equation methods to evaluate the influence of PDW on PSR and DER. RESULTS: The monthly mean of 463,587 (SD 32,898) prescriptions yielded mean PDW, PSR and DER of 52 (SD 3) prescriptions per pharmacist working days, 30 (SD 7) and 8 (SD 2) per 10,000 prescriptions monthly, respectively. There was significant negative impact of PDW on PSR (adjusted rate ratio, aRR: 0.9786; 95%CI: 0.9744-0.9829) and DER (aRR: 0.9567; 95%CI: 0.9477-0.9658). Stratified analyses by time periods (2012-2015 and 2016-2018) revealed the impact of PDW on PSR to be similar in both periods; but with positive association between PDW and DER in the more recent one (aRR: 1.0086, 95%CI: 1.0003-1.0169). CONCLUSIONS: Reduced pharmacist workload was associated with re-allocation of pharmacy time to provide prescription suggestions and, more recently, decrease dispensing errors. Continuous efforts to maintain appropriate workload for pharmacists are recommended to ensure prescription quality.


Assuntos
Serviços Comunitários de Farmácia/estatística & dados numéricos , Farmacêuticos/estatística & dados numéricos , Carga de Trabalho/estatística & dados numéricos , Humanos , Farmácias/estatística & dados numéricos , Técnicos em Farmácia/estatística & dados numéricos , Prescrições/estatística & dados numéricos , Taiwan
7.
Public Health ; 181: 135-140, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32014641

RESUMO

OBJECTIVES: This study sought to describe patient experiences and perceptions of a public health initiative designed to improve tuberculosis (TB) testing access using the tuberculin skin test (TST) in a community pharmacy setting. STUDY DESIGN: This was a cross-sectional study. METHODS: A telephonic survey of patients who had received a TST at one of twelve participating community pharmacies between August 2014 and July 2016 was conducted. The 26-question survey was developed by two pharmacists with expertise in TB management and one pharmacy student. Before administration the survey was peer-reviewed for clarity. Potential study patients were identified through TST records at the study pharmacies. English-speaking patients older than 18 years were eligible for study inclusion. Statistical differences in responses based on location were identified using chi-squared test for frequency comparisons with a P-value of <0.05 to determine statistical significance. RESULTS: A total of 1709 patients received a TST during the study period, of whom 431 were contacted and 325 participated, meeting the predetermined representative sample needed of 314 patients. The majority of study patients were female (67.1%) and white (81%). The mean age was 36 years (standard deviation = 14.1). A majority (68.3%) lived <5 miles from the TST pharmacy, while 45.2% of those with a primary care provider (PCP) (61.6% of respondents) lived within 5 miles of the PCP's office. Care was accessible and met patients' testing needs. For most patients (84.6%), the initial and follow-up appointments took < 20 min. Follow-up TST reading rate was 98.5%; 4.3% of tests were positive. Positive TST results were associated with use of a small city pharmacy (P = 0.003). Perception differences based on location were identified. CONCLUSIONS: Uptake of the TST service in the community pharmacy setting was high and patients reported positive experiences.


Assuntos
Serviços Comunitários de Farmácia/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Satisfação do Paciente , Teste Tuberculínico/métodos , Tuberculose/diagnóstico , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Farmácias , Farmacêuticos , Inquéritos e Questionários , Telefone
8.
Rev. bras. epidemiol ; 23: e200028, 2020. tab, graf
Artigo em Português | LILACS | ID: biblio-1101599

RESUMO

RESUMO: Objetivo: A prevalência de hipertensão arterial no Brasil e no mundo vem aumentando nas últimas décadas, sendo o uso de medicamentos uma das estratégias utilizadas no controle da doença. O objetivo deste estudo foi estimar a prevalência de uso e identificar as fontes de obtenção de anti-hipertensivos no Brasil, segundo variáveis sociodemográficas, comparando três períodos: 2011, 2014 e 2017. Métodos: Foram utilizados dados de indivíduos com idade ≥20 anos que referiram diagnóstico médico de hipertensão arterial, entrevistados pelo Vigitel nos anos de 2011, 2014 e 2017. Foi estimada a distribuição de frequências e as prevalências de uso de medicamentos, segundo variáveis sociodemográficas, de acordo com as fontes de obtenção, com intervalos de confiança de 95%. As diferenças entre as proporções foram verificadas pelo teste χ2 de Pearson (Rao-Scott), com nível de significância de 5%. Resultados: A prevalência de uso manteve-se estável (80%). Quanto às fontes de obtenção observou-se variação no período, indicando diminuição na obtenção por meio das Unidades de Saúde do SUS (44,2% em 2011; 30,5% em 2017). Esse decréscimo esteve acompanhado do aumento na obtenção pela Farmácia Popular (16,1% em 2011; 29,9% em 2017). A prevalência de obtenção por meio de farmácias privadas/drogarias mostrou estabilidade no período. Conclusões: A prevalência de uso de medicamentos se manteve alta e houve modificação no padrão de utilização segundo fontes de obtenção, evidenciando migração entre Unidades de Saúde do SUS para a Farmácia Popular, sugerindo redução da disponibilidade dos medicamentos pelas farmácias públicas de forma universal e gratuita.


ABSTRACT: Objective: The prevalence of hypertension in Brazil and worldwide has been increasing in recent decades, and drug therapy is one of the strategies used to control this condition. The objective of this study was to estimate the prevalence of use and identify the sources for obtaining antihypertensive drugs in Brazil, according to sociodemographic variables, comparing three periods: 2011, 2014 and 2017. Methods: Data from individuals aged ≥20 years who reported a medical diagnosis of hypertension, interviewed by Vigitel in 2011, 2014 and 2017 were used. Frequency and prevalence of drug use in addition to the sources for obtaining medication were estimated by sociodemographic variables, with 95% confidence intervals. The differences between proportions were verified by Pearson's chi-square test (Rao-Scott), with a significance level of 5%. Results: The prevalence of antihypertensive drug use remained stable (80%). Regarding the sources for obtaining these medicines, there was variation in the period, indicating a decrease in usage through the Brazilian Unified Health System (SUS) (44.2% in 2011; 30.5% in 2017). This decrease was accompanied with increase in PFPB (16.1% in 2011; 29.9% in 2017). The prevalence of other sources for obtaining medicine (private pharmacies/drugstores) showed stability in the period. Conclusions: The prevalence of medication use remained high and there was a change in the pattern of use according to sources, demonstrating migration between SUS pharmacies to the PFPB, and suggesting a reduction in the availability of medicines from public pharmacies universally, and for free.


Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Acesso aos Serviços de Saúde/estatística & dados numéricos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Anti-Hipertensivos/provisão & distribução , Fatores Socioeconômicos , Telefone , Brasil/epidemiologia , Prevalência , Estudos Transversais , Entrevistas como Assunto , Inquéritos Epidemiológicos , Distribuição por Sexo , Distribuição por Idade , Serviços Comunitários de Farmácia/provisão & distribução , Serviços Comunitários de Farmácia/estatística & dados numéricos , Programas Governamentais/estatística & dados numéricos , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Anti-Hipertensivos/uso terapêutico
9.
Pharm. pract. (Granada, Internet) ; 17(4): 0-0, oct.-dic. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-191960

RESUMO

OBJECTIVE: The objective of this study was to assess the quality of life and the factors associated with it among community pharmacists in Lebanon. METHODS: This cross-sectional study was carried out between March and July 2018, enrolling 435 pharmacists, using a proportionate random sample of community pharmacies from all districts of Lebanon. The validated Arabic translation of the Short-Form 12 (SF12v2) was used to derive 2 summary scores: physical and mental component summaries (PCS and MCS). RESULTS: Lebanese community pharmacists scored a mean PCS-12 and MCS-12 of 48.9 (SD 7.1) and 48.8 (SD 8.5), respectively. Higher age (Beta= -0.08), having a PhD degree (Beta= -4.54), higher depression score (Beta= -0.25), higher emotional work fatigue (Beta= -0.13) and higher physical work fatigue (Beta=-0.14) were significantly associated with lower physical QoL (lower PCS-12 scores). Increased stress (Beta= -0.17), higher insomnia (Beta= -0.21), higher depression (Beta= -0.2) and working for over 40 hours per week (Beta= -0.2) were significantly associated with lower mental QoL (lower mental MCS-12 scores). CONCLUSIONS: Our research has found a strong correlation between quality of life and psychological factors, including stress, burnout, insomnia, and depression among community pharmacists


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Qualidade de Vida , Farmacêuticos/psicologia , Serviços Comunitários de Farmácia/estatística & dados numéricos , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/epidemiologia , Líbano/epidemiologia , Estudos Transversais , Questionário de Saúde do Paciente/estatística & dados numéricos , Fadiga de Alarmes do Pessoal de Saúde , Depressão/epidemiologia , Psicometria/métodos
10.
Artigo em Inglês | MEDLINE | ID: mdl-31855570

RESUMO

Background Pharmacists are known as health care professionals who are responsible for the safety and efficacy of medicine to achieve optimal therapeutic results. Community pharmacists have an opportunity to provide direct services including giving an active medication information service in women during pregnancy and breastfeeding. This study aimed to determine the factors associated with the practice of community pharmacists for actively giving the drug information service for women with chronic diseases during pregnancy and breastfeeding based on the Health Belief Model. Methods About 300 community pharmacists were randomly chosen to participate in the study. All participants were asked to complete questionnaires that were designed based on the theory of the Health Belief Models. The questionnaires measured the community pharmacists' knowledge, beliefs, cues to action, and practice for actively giving medication information services. Results About 267 pharmacists in the community agreed to participate in this study. Nearly 80% of the participants were female pharmacists (n = 213). The results show that pharmacists' knowledge had significant influences towards perceived threat (p = 0.009), perceived benefit (p = 0.011), and pharmacists' self-efficacy (p < 0.001). The self-efficacy factor was the most influential factor in the practice of pharmacists to give medication information service actively (p < 0.001). Conclusions The findings of the study indicate that self-efficacy is the most important factor for pharmacist to be able to provide the medication information services successfully particularly in women during pregnancy and breastfeeding. Providing continuous learning programs through seminars and training related to medication use during pregnancy and breastfeeding to pharmacists is needed to optimise the confidence and the ability of pharmacists in providing the services.


Assuntos
Serviços Comunitários de Farmácia/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Farmacêuticos/psicologia , Adulto , Aleitamento Materno , Doença Crônica , Estudos Transversais , Feminino , Humanos , Masculino , Educação de Pacientes como Assunto , Gravidez , Inquéritos e Questionários
11.
BMC Health Serv Res ; 19(1): 816, 2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31703672

RESUMO

BACKGROUND: Pharmaceutical compounding is an essential component in pharmacy practice allowing pharmacists to provide dosage forms or strengths that are commercially unavailable. Medications compounded for patient-specific needs contribute to personalized medicine. Extemporaneous compounding provided by pharmacies overcomes the market shortage of these therapeutic products. The aim of this study is to investigate and characterize the prevalence, characteristics, and determinants of extemporaneous compounding in Jordanian pharmacies. METHODS: This study was based on a cross-sectional questionnaire and included 431 randomly selected pharmacies in the twelve governorates of the country. Data were collected via face to face interviews of pharmacists who voluntarily and verbally responded to the questions. RESULTS: Results revealed that 223 (51.7%) of the surveyed pharmacies practiced extemporaneous compounding. The main reason for not providing extemporaneous compounding services was lack of prescription orders for compounded preparations (53.8%). The second reason was lack of the equipment and supplies necessary for compounding (24.4%). Extemporaneous compounding prescriptions were mainly issued by dermatologists (98.2%); dermatological indication was the most common of all extemporaneous compounded prescriptions. The main reason for requesting compounded medications was the lack of a commercially available product (87.9%). The vast majority of the compounded dosage forms were creams (99.6) and ointments (91.5), followed by solutions (23.3%). Only 5 (2.2%) of the studied compounding pharmacies prepared sterile products. The major sources for compounding protocols were the physician order (94.2%), and 'in-house' protocols (44.8%). However, the main resource for estimating compounded medications expiration date was information based on pharmacist's experience (57.8%) and the physician's order (53.4%). CONCLUSIONS: Extemporaneous compounding is a common element of pharmaceutical care. Topical preparations are the most commonly compounded products. Finding from this study suggest that there is a need for standardizing the compounded product formularies, product quality testing, and improving the consistency in estimation of an expiration date of compounded products.


Assuntos
Composição de Medicamentos/estatística & dados numéricos , Farmácias/estatística & dados numéricos , Adulto , Idoso , Serviços Comunitários de Farmácia/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Jordânia , Masculino , Pessoa de Meia-Idade , Farmacêuticos/estatística & dados numéricos , Serviço de Farmácia Hospitalar/estatística & dados numéricos , Médicos/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
12.
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
13.
J Clin Pharm Ther ; 44(6): 895-903, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31479521

RESUMO

WHAT IS KNOWN AND OBJECTIVE: Evidence from clinical trials should form the foundation of healthcare advice. Comparatively little has been investigated about the implementation of evidence in over-the-counter (OTC) counselling in community pharmacies. The objective of this study was to explore the current impact of clinical trials on OTC counselling from the perspective of pharmaceutical staff. METHODS: Pharmaceutical staff in German community pharmacies were invited to participate in a nationwide cross-sectional survey using SoSci Survey. Within the questionnaire, the following items were queried: (i) attitudes towards influencing factors on OTC drug recommendation, (ii) practical procedure of OTC drug recommendations, (iii) experiences and challenges in handling clinical trials, and (iv) current and desired continuing education on self-medication. Multiple logistic regression was employed to identify predictors for OTC recommendations based on clinical trials in routine. RESULTS AND DISCUSSION: In total, 1068 participants completed the survey. (i) Clinical trial data were rated as 'very important' for drug recommendations by 33% and as 'rather important' by 50%. (ii) 8% reported that they base their recommendations on clinical trial data 'in almost all consultations', 40% 'in most consultations'. (iii) 69% faced difficulties in including clinical trial data into their counselling. (iv) 7% read original clinical trials at least once a month. Predictors for routine OTC recommendations based on clinical trials were as follows: male gender, university degree, clinical trials considered to be important for recommendations, inclusion of clinical trials in counselling assessed as easy, higher frequency of reading specialized literature per year, increasing number of working pharmacists in the pharmacy, and more casual than regular customers in the pharmacy. WHAT IS NEW AND CONCLUSION: Most of the pharmaceutical staff recognize the importance of clinical studies for self-medication advice. Based on self-report, however, clinical trial data are not taken routinely into account in practice. Only a minor proportion of staff routinely deal with studies. Therefore, appropriate instruments are required to make knowledge from clinical trials available in community pharmacies.


Assuntos
Serviços Comunitários de Farmácia/estatística & dados numéricos , Aconselhamento/estatística & dados numéricos , Medicamentos sem Prescrição/uso terapêutico , Farmácias/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Farmacêuticos/estatística & dados numéricos , Papel Profissional , Automedicação/estatística & dados numéricos , Inquéritos e Questionários
14.
PLoS One ; 14(9): e0222132, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31498831

RESUMO

BACKGROUND: Suicide prevention is a global priority. Despite the focus on primary care in suicide prevention, little is known about the contributory role of community pharmacists and nothing about the role of the wider community pharmacy team in this area. We aimed to explore the current and potential role of community pharmacy teams in self-harm and suicide prevention. METHODS: We conducted one-to-one semi-structured qualitative interviews with community pharmacy staff (pharmacists, pre-registration pharmacists, pharmacy technicians, dispensing/pharmacy assistants, delivery drivers) in the North West of England, UK. We identified themes from the interview transcripts through an iterative process of inductive thematic analysis. RESULTS: We conducted twenty-five interviews with community pharmacy staff. Many described examples of helping those who were contemplating suicide or self-harm. No participants had received suicide prevention training. We identified six themes. The first two themes (i) Relationship with Patient and (ii) Pharmacy environment were seen as facilitators, which, if supported by (iii) Training, could underpin the final three themes: (iv) Opportunities for contact, (v) Facilitated referral pathway and (v) Restricting access to means. The distinct lack of training should be overcome with evidence-informed training. Referral pathways should be clear and enable direct and accessible referral by community pharmacy teams. There are opportunities for existing pharmacy services and schemes to be adapted to maximise suicide and self-harm prevention activities. Pharmacy teams did not identify themselves to have a clear role in restricting access to medication. CONCLUSIONS: Pharmacy teams already support patients in relation to self-harm and suicide, often relying on their personal experience in the absence of formal training. With the implementation of evidence-informed training and clear referral pathways, this could be done in a more effectively.


Assuntos
Serviços Comunitários de Farmácia/estatística & dados numéricos , Comportamento Autodestrutivo/prevenção & controle , Suicídio/prevenção & controle , Adolescente , Adulto , Idoso , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Adulto Jovem
15.
Int J Clin Pharm ; 41(6): 1499-1506, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31564041

RESUMO

Background Oral emergency contraceptives containing levonorgestrel or ulipristal acetate are available without prescription and only in pharmacies in Germany since March 2015. Due to this change community pharmacists are responsible for evaluating whether the product is appropriate and to educate women on proper use. Objective To measure the utilization of emergency contraceptives without a prescription and describe potential concerns and safety issues identified by community pharmacists in Germany. Setting The Drug Commission of German Pharmacists' nationwide network of reference pharmacies which includes 860 community pharmacies. Methods Reference community pharmacies were asked to participate in the eleven-questions online survey. Respondents were asked to recall their experiences with oral emergency contraceptives in the past 3 months. Data were collected between January 8 and February 19, 2018. Main outcome measure The survey focused on the utilization of emergency contraceptives without a prescription in Germany, and on the pharmacists' experiences with (potential) problems and concerns regarding safe use. Results In total, 555 community pharmacies (64.5%) participated. Overall 38.2% of community pharmacists stated they dispensed six to ten courses of emergency contraceptives within the past 3 months. In addition, 54.3% of the pharmacists estimated they dispensed emergency contraceptives exclusively without prescription and 35.9% dispensed more than 30% of emergency contraceptives during night-time and emergency services. Moreover, 82.8% of pharmacists stated that emergency contraceptives were requested not by the women concerned but a third person and 44.3% identified uncertainties in woman's self-diagnosis. Three out of four pharmacists had concerns about the effective and safe use of emergency contraceptives. In situations suggesting sexually transmitted diseases, or suspicion for use of force, 59.5% and 55.8% of the pharmacists, respectively, dispensed emergency contraceptives. In cases of acute health impairment or chronic disease, or (potentially) relevant drug/drug interaction, the vast majority (91.0% and 90.5%) did not. Here, most pharmacists referred to gynecologists. Conclusion Pharmacists had safety concerns when dispensing emergency contraceptives. Professional expertise in evaluating the need for oral emergency contraceptives and the proper use is needed.


Assuntos
Serviços Comunitários de Farmácia/estatística & dados numéricos , Anticoncepcionais Orais/provisão & distribução , Anticoncepcionais Pós-Coito/provisão & distribução , Farmacêuticos/estatística & dados numéricos , Serviços Comunitários de Farmácia/organização & administração , Feminino , Alemanha , Pesquisas sobre Serviços de Saúde , Humanos , Levanogestrel/administração & dosagem , Norpregnadienos/administração & dosagem , Farmacêuticos/organização & administração , Papel Profissional , Encaminhamento e Consulta/estatística & dados numéricos
16.
Pharm. pract. (Granada, Internet) ; 17(3): 0-0, jul.-sept. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-188119

RESUMO

Background: The introduction of universal healthcare coverage in 2014 has affected the practice of community pharmacies in Indonesia. Studies regarding the practice of pharmacist in the chain community pharmacy setting in Indonesia are very limited. The chain community pharmacies in Indonesia are operated and controlled by the same management. The chain community pharmacies usually show better services compared to independent community pharmacies in Indonesia. Objective: The study aimed to assess the knowledge, attitude and practice (KAP) of pharmacist working in chain community pharmacy towards their current function and performance in delivering pharmacy services. Methods: A cross-sectional study using questionnaires was conducted between January and March 2017 in KF, one of the largest chain community pharmacies in Indonesia. The total sampling method was used in the recruitment process. The data were analyzed using descriptive statistics, independent t-Test and one-way ANOVA. The KAP scores were assessed and categorized as "poor", "moderate" and "good" based on the standardized scoring system. Results: A total of 949 KF's pharmacists (100% response rate) were participated in the study. The majority of pharmacists showed a good score in terms of knowledge and attitude, which is in contrast to practice as majority only obtained a moderate score. Working experience, age and the availability of standard operating procedures (SOP) for both dispensing and self-medication services were found to be statistically significant (p<0.005) aspects to KAP of pharmacists in delivering pharmacy services. Conclusions: This study identified several important aspects that could affect the KAP of pharmacists working in chain community pharmacies in Indonesia. Specific policies should be conceived to improve the competencies of pharmacist and to ensure the compliance with the SOP and standardization system within pharmacy sector


No disponible


Assuntos
Humanos , Competência Profissional/estatística & dados numéricos , Serviços Comunitários de Farmácia/estatística & dados numéricos , Farmacêuticos/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Indonésia , Estudos Transversais , Automedicação/estatística & dados numéricos , Prescrições de Medicamentos/estatística & dados numéricos , Fatores Etários
17.
Pharm. pract. (Granada, Internet) ; 17(3): 0-0, jul.-sept. 2019.
Artigo em Inglês | IBECS | ID: ibc-188122

RESUMO

Background: Kosovo is a new state and has a high consumption of antibiotics in relation to other European countries. Existing quantitative studies have shown that practices exist that is not optimal when it comes to antibiotic use in Kosovo, this includes citizens' use of antibiotics, pharmacy practices of selling antibiotics without prescriptions and physicians' prescribing behaviours. To address these problems, there is a need for a deeper understanding of why antibiotics are handled in a suboptimal way. Objective: The objective was to explore antibiotic users', community pharmacists' and prescribers' attitudes towards, experiences of, and knowledge about antibiotics in Kosovo. Methods: Semi-structured interviews were conducted with patients who recently received an antibiotic prescription for an upper respiratory tract infection (URTI), patients who recently received antibiotics for a URTI without a prescription, community pharmacists, and physicians. Interviews were recorded, translated into English, and analysed using deductive content analysis. Results: In total, 16 interviews were conducted in the period from 2015-2016. Five themes were identified: Obtaining antibiotics, Choice of antibiotics, Patient information, Patients' knowledge and views on when to use antibiotics, and Professionals' knowledge and attitudes towards antimicrobial resistance. Antibiotics were sometimes obtained without a prescription, also by patients who currently had received one. The specific antibiotic could be chosen by a physician, a pharmacist or the patient him/herself. Former experience was one reason given by patients for their choice. Patients' knowledge on antibiotics was mixed, however health professionals were knowledgeable about e.g. antimicrobial resistance. Conclusions: There is currently a culture of antibiotic use in Kosovo, including attitudes and behaviours, and hence also experiences, which is possibly underlying the high consumption of antibiotics in the country. The culture is reproduced by patients, pharmacists and physicians. There is, however, an awareness of the current problematic situation among practitioners and policy makers; and as Kosovo is a new country, opportunities to effectively tackle antimicrobial resistance exist


No disponible


Assuntos
Humanos , Antibacterianos/uso terapêutico , Doenças Transmissíveis/tratamento farmacológico , Serviços Comunitários de Farmácia/estatística & dados numéricos , Prescrições de Medicamentos/estatística & dados numéricos , Prescrição Inadequada/estatística & dados numéricos , Kosovo/epidemiologia , Fatores Culturais , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Médicos/estatística & dados numéricos , Pacientes/estatística & dados numéricos , Farmacorresistência Bacteriana , Infecções Respiratórias/tratamento farmacológico , Atitude do Pessoal de Saúde
18.
Pharm. pract. (Granada, Internet) ; 17(3): 0-0, jul.-sept. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-188127

RESUMO

Background: In Germany over-the-counter medications (OTC) - which since 2004 are no longer subject to binding prices - can only be purchased in pharmacies. Pharmacy owners and their staff therefore have a special responsibility when dispensing, advising on and setting the prices of medications. Objective: The aim of this study was to assess medication dispensing, additional therapeutic recommendations and pricing practices for acute diarrhoea in adults and to evaluate the role of the patient's approach (symptom-based versus medication-based request) in determining the outcome of these aspects. Methods: A cross-sectional study was conducted from 1 May to 31 July 2017 in all 21 community pharmacies in a medium-sized German city. Symptom-based and medication-based scenarios related to self-medication of acute diarrhoea were developed and used by five simulated patients (SPs) in all of the pharmacies (a total of 84 visits). Differentiating between the different test scenarios in terms of the commercial and active ingredient names and also the prices of the medications dispensed, the SPs recorded on collection forms whether the scenario involved generic products or original preparations as well as whether recommendations were made during the test purchases regarding an additional intake of fluids. Results: In each of the 84 test purchases one preparation was dispensed. However, a preparation for oral rehydration was not sold in a single test purchase. On the other hand, in 74/84 (88%) of test purchases, medications with the active ingredient loperamide were dispensed. In only 35/84 (42%) of test purchases, the patient was also recommended to ensure an 'adequate intake of fluids' in addition to being dispensed a medication. In symptom-based scenarios significantly more expensive medications were dispensed compared to the medication-based scenarios (Wilcoxon signed rank test: z = -4.784, p < 0.001, r = 0.738). Also within the different scenarios there were enormous price differences identified - for example, in the medication-based scenarios, even for comparable loperamide generics the cheapest preparation cost EUR 1.99 and the most expensive preparation cost EUR 4.53. Conclusions: Oral rehydration was not dispensed and only occasionally was an adequate intake of fluids recommended. There were also enormous price differences both between and within the scenarios investigated


No disponible


Assuntos
Humanos , Assistência Farmacêutica/organização & administração , Dispensários de Medicamentos , Medicamentos de Venda Assistida/provisão & distribução , Diarreia/tratamento farmacológico , Alemanha/epidemiologia , Boas Práticas de Dispensação , Loperamida/uso terapêutico , Antidiarreicos/uso terapêutico , Serviços Comunitários de Farmácia/estatística & dados numéricos , Preço de Medicamento , Automedicação/estatística & dados numéricos , Prescrições de Medicamentos/estatística & dados numéricos , Estudos Transversais
19.
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
20.
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
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