Integrated Pharmacy Research and Practice最新文献

Background: World Health Organization refers medication waste as expired, unused, spilled, and contaminated pharmaceutical items, medications, vaccines, and sera. Budget constraints in financing the health care system together with huge amount of wastage and disposal costs of unused medications at LMIC create a serious risk to the economy, health care system and environment. Thus, the aim of this study was to assess the rate of medication waste and to identify contributing factors in public health facilities in Dire-Dawa city.

Methods: An institution-based retrospective, cross-sectional study was supplemented by a qualitative study design from May 10 to June 10, 2021, at 2 public hospitals and 14 health centers. Qualitative data were collected by self-administered questionnaires and 2 years record review. In-depth interviews were used to obtain qualitative data. Excel sheets and SPSS version 20 and thematic analysis were used to analyze quantitative and qualitative data.

Results: An average medicine wastage rate was 3.07% between 2010 and 2012 EFY, in Dire-Dawa public health facilities that worth 4,048,594.0 ETB. The most wasted class of medication was anti-infectives, accounting for 2,360,330 ETB (58.3%), while tablets 2,615,391 ETB (64.6%). Medical waste has been linked to several issues, including pushing nearly expired medications to healthcare institutions, lack of clinician involvement in medication selection and quantification, rapid changes in treatment regimens, and the existence of overstocked medication shelves.

Conclusion: The average rate of medication waste was higher than the allowed level of 2%. The only medications that should be accepted by medical facilities are those that can be used before they expire. All prescribers should receive lists of the drugs that are readily available from the pharmacy department, and clinicians should be involved in the quantification and drug selection processes to increase the effectiveness of the use of medications.

Background: Inventory management ensures access to tracer medicines (TMs) for priority health-care needs. Factors that impede its performance across primary health-care units (PHCUs) are less explored in Ethiopia. The current study assessed factors affecting the inventory management performance of TMs across PHCUs, Gamo zone.

Methods: A cross-sectional survey was conducted in 46 PHCUs between April 1 and May 30, 2021. The data were collected using document review and physical observation. A stratified simple random sampling was employed. The data were analyzed by SPSS version 20. The results were summarized as mean and percentage. Pearson's product-moment coefficient and ANOVA were employed at a 95% CI. The correlation test established the relationships between dependent and independent variables. ANOVA test compared the performance between PHCUs.

Results: The inventory management performance of TMs across PHCUs is below the standard. On average stock according to the plan is 18%, the stock-out rate is 43%, the inventory accuracy rate is 78.5%, and availability across PHCUs is 78%. 72.3% of visited PHCUs fulfill storage condition criteria. Inventory management performance decreases downward the levels of PHCUs. There is a positive correlation between the availability of TMs and supplier order fill rate, r = 0.82, p < 0.01; between the availability of TMs and report accuracy, r = 0.54, p < 0.001; and between TMs stocked according to the plan and supplier order fill rate, r = 0.46, p < 0.01. The inventory accuracy was significantly different between primary hospitals and health posts (p = 0.009, 95% C.I = [7.57, 60.93]); and health centers and health posts (p = 0.016, 95% CI = [2.32, 25.97]).

Conclusion: The inventory management performance of TMs is below the standard. It is attributable to supplier performance, the quality of the report, and performance variation across PHCUs. These result in the interruption of TMs in PHCUs.

Introduction: Accessibility of available medication at pharmacies is one of the core problems in the health sector of developing countries. The mechanism for optimally accessing the available drugs in pharmacies is unclear. Usually, patients in need are compelled to haphazardly switch between pharmacies in search of their prescription medications due to lack of information about the locations of pharmacies with required drug.

Objective: The primary objective of this study is to develop a framework that will simplify the process of identifying and locating nearest pharmacy when searching for prescribed medications.

Methods: Primary constraints (distance, drug cost, travel time, travel cost, opening and closing hours of pharmacies) in accessing required prescribed medications from pharmacies were identified from literature, and the client's and pharmacies' latitude and longitude coordinates were used to find the nearest pharmacies that have the required prescribed medication in stock.

Results: The framework with web application was developed and tested on simulated patients and pharmacies and was successful in optimizing the identified constraints.

Discussions: The framework will potentially reduce patient expenses and prevent delays in obtaining medication. It will also contribute for future pharmacy and e-Health information systems.

Interstitial lung disease (ILD) is a common manifestation of systemic sclerosis (SSc), which becomes fibrosing and progressive in some patients. Regular monitoring of patients with SSc-ILD is important to assess progression and inform treatment decisions. Therapy for SSc-ILD may include immunomodulatory and antifibrotic therapies. Therapeutic decisions should be made on a case-by-case basis, ideally following multidisciplinary discussion. Most patients with SSc-ILD have several organ manifestations of SSc or comorbidities and are taking a complex medication regimen. Patients with SSc are particularly susceptible to gastrointestinal side-effects of medications due to the gastrointestinal manifestations of the disease. Pharmacists play an important role in the management of patients with SSc-ILD by assisting patients with access to medications, optimizing medication regimens, and advising on alternative dosage forms. Pharmacists can also contribute to patient education to help patients better understand their treatment and how to prevent and manage potential side effects.

Background: In developing countries like Ethiopia, medicines wastage becomes a major healthcare system challenge. However, data that displayed the type, extent, and contributing factors of medicines wastage were limited.

Methods: A health facility-based explanatory sequential mixed study was conducted from December 2021 to February 2022. One drug and therapeutics committee (DTC) and one store man per health facility, working during the study period were included for their perception of medicines wastage and possible causes. As key informants, 1 Chief Executive Officer (CEO) and 1pharmacy head were also included per facility. In total, 80 participants were included in this study. The quantitative data to determine the magnitude of medicine wastage were collected using a structured interviewer-administered questionnaire and analyzed using SPSS version 25.

Results: The overall medicines wastage in the three consecutive years was 6.3%. The trend over the three years indicated that medicines wastage is 6.5%, 5.9%, and 6.5% in 2011, 2012, and 2013 Ethiopian Fiscal Year (EFY), respectively. The medicine wastage rate has been increasing nearly by 3% between 2011/2012 and 2012/2013. The main sources of wastage of medicines were expiry (99.3%). The perceived reasons for such medicine's wastage were near-expiry medicines (<6 months) being delivered to the health facilities by suppliers, poor communication and coordination with key stakeholders, and the presence of overstocked medicines due to improper forecasting of need in the facilities.

Conclusion: There is an excessive rate of medicines wastage which needs immediate mitigation by exchanging nearly expired medicines with other health facilities, communicating with suppliers and even prescribers, using auditable pharmaceutical transactions and services (APTS), providing continuous training, pursuing quality and safety medicines reuse scheme, implementation of pharmacist waste-reducing activities in all stages of the pharmaceutical supply chain, reducing medication amounts in stock, and through the use of electronic stock management tools.

Background: Community pharmacists are uniquely positioned at the heart of communities, and their patient counseling role is the cornerstone for achieving the required therapeutic goals. Therefore, the main objective of this study is to explore the perceptions of community pharmacists regarding patient counseling, and their perception towards continuing pharmacy education programs.

Methods: A descriptive, cross-sectional design was performed among randomly selected 238 community pharmacies in Khartoum locality (Sudan) from September 2022 to December 2022. The data were collected using a self-administered questionnaire adopted from a previous study with few minor modifications, which was adding three sociodemographic questions. Descriptive statistics were carried out according to the study objective to analyze the pharmacists' responses.

Results: The majority of the community pharmacists gave counseling and understood its importance to the patients, most of them (70.6%) took 1-5 minutes during the dispensing process. The dose was the most provided information by community pharmacists (26.7%) followed by administration (23.7%) and duration (22.4%). Few (28.2%) of the patients ask the pharmacists about the cost of the medication. Lack of patients' interest (55%) was the major barrier to effective counseling followed by lack of time (47.9%). Almost all (96.2%) pharmacists in this study were interested in continuing pharmacy education programs, and they preferred programs focusing on common diseases (36.6%), and common drugs (30.3%).

Conclusion: This study showed that the majority of community pharmacists in the Khartoum locality had positive perceptions toward patient counseling and they were interested in continuing pharmacy education programs.

Purpose: Good pharmacy practice is an important standard that highlight the quality of services in community pharmacies. In 2018, The Order of Pharmacists in Lebanon (OPL) published their own good pharmacy practices (GPP) guidelines. The need exists for investigational studies to assess GPP implementation status and the professional conduct of on-site staff towards these standards.

Methods: Data collection was carried out between February and August 2020 using a questionnaire covering: Socio-demographic variables; Indicator A (Attitude of the Community Pharmacists); Indicator B (Services and Facilities); Indicator C (Dispensing); Indicator D (Storage). Data analysis were performed on SPSS version 25, T-Test and ANOVA were used. A significant p value of <0.001, 95% confidence interval and variables with missing data counting less than 10% were considered.

Results: A total of 211 staffers from pharmacies were enrolled in the study, each representing one community pharmacy. The mean percent of adherence to GPP standards by community pharmacies in the South of Lebanon was below the recommended threshold of 75%. Only 65.09% adhered to all tested indicators (27% to Indicator A, 56.91% to Indicator B, 68.61% to Indicator C, 66.31% to Indicator D). Higher indicators were seen among providers who were aware of OPL standards (OR = 4.021), female (OR= 2.011) and being a licensed pharmacist (OR=3.506). Cronbach alpha of the overall score was 0.615.

Conclusion: Further steps shall be taken to improve the compliance to GPP standards. Steps shall include, identification of the core standards, such as dispensing, provision of adequate information, monitoring of storage conditions, and ensuring the presence of a licensed pharmacist. It is highly recommended that the OPL and the Ministry of Public Health develop a "Self-assessment tool" and an efficient training program to increase community Pharmacists' awareness status. Regular assessment shall be carried to monitor the progress overtime.

Purpose: Contributing to public health by supporting people's health is the social mission of community pharmacists. This multicenter, prospective case series study aimed to evaluate changes in people's behavior and health states through community pharmacists' self-care support for healthy lifestyles.

Methods: The participants were recruited from voluntary adults aged ≥20 years who agreed to participate in the study, at community pharmacies in Gifu, Japan, between June and September 2021. Participants self-managed their lifestyles for six months while recording their health data, including blood pressure (BP), daily using devices (home BP monitor, body composition monitor, and activity meter) and a diet-recording app. They received lifestyle modification support at pharmacies at least once per month. Participants' subjective health status, attitudes, and behavioral changes were evaluated using self-report questionnaires. Due to the exploratory nature of this study, data were primarily analyzed descriptively.

Results: Fifty-four participants aged 20 to 77 (mean age: 49.6 years; female participant proportion: 55.6%) participated in this study. Their mean weekly BP shifted almost horizontally from baseline to week 24 (systolic BP: 118.8 to 121.5 mmHg; diastolic BP: 76.1 to 77.5 mmHg). At six months, 38.9% and 35.2% of the participants reported better overall health and mental health, respectively, than at baseline. Over 85% of the participants became more proactive in improving their lifestyles regarding salt intake, diet, weight loss, and exercise, although drinking and smoking habits were more challenging to change. All the participants reported that they intended to continue to improve their lifestyle.

Conclusion: The participants' responses suggested that community pharmacists' support helped increase participants' health awareness and promote their health-enhancing behaviors. However, its impact on health parameters should be further examined in future studies. More vigorous, tailored self-care support may be worth considering in developing a more effective, community-fitted health/well-being support system in Japan.

Pharmaceutical care (PhC) services interventions led by pharmacists within community pharmacies (CPs) are essential in achieving optimal medication use outcomes. PhC is a concept related to medication use goals optimization through the reduction and prevention of drug-related problems (DRPs). This review paper summarized the literature on pharmacist-led PhC interventions within CPs. PubMed and Google Scholar publications were searched, identified, and summarized. Results showed that some studies handled community pharmacists' roles, and some talked about PhC interventions. However, some studies reviewed the use of medicines, adherence, and follow-up, while other groups were on counseling, patient education, and health promotion. Pharmacists integrated some studies concerning diagnosis and disease screening into community pharmacy services. Besides these studies, there were studies on system design and installation of PhC service models. Most of the identified research results showed pharmacist-led intervention benefits for patients. These benefits include reduced DRPs, clinical, economical, humane, education and knowledge, disease prevention and immunization, identification of practice process problems, and the need for current practice redesigning. In conclusion, pharmacists can help patients achieve optimal outcomes through pharmacist-led interventions. Despite mentioned results, We recommend researching comprehensively applied PhC services provision models within CPs for more pharmacists-led interventions and role activation.

Background: Effective pain relief is an essential component of high-quality healthcare delivery, and pharmacists must be well versed in pain mechanisms, assessment, and management. This study examined community pharmacy professional's (CPPs) knowledge and attitude towards pediatric pain management in Community pharmacies (CPs) and Drug Retail Outlets (DRO) of Ambo and Ginchi towns, west central Ethiopia.

Methods: A cross sectional study was conducted in Ambo and Ginchi towns, the western part of the nation's capital. All voluntary CPPs working by CPs and DRSs in the towns of Ambo and Ginchi were included in the current study. SPSS version 25 was then used to process, analyze, and interpret the data.

Results: Among the 131 CPPs who were approached for the study, 104 agreed to participate and returned the questionnaire. CPPs mean knowledge score on pediatric pain management was 6.69 ±1.92, with a minimum score of 2 and a maximum score of 17. The majority of CPPs 82 (87.2%) in the study did not correctly answer half of the questions. Most of CPPs, 98 (94.3%), admitted they had no training in pain management, and 102 (98.2%) of the respondents said the same about pediatric pain management. The finding indicated that CPPs work experience in CP or DROs had impact on their knowledge about pediatric pain management and similarly, the mean knowledge score of pharmacists was higher than that of pharmacy technicians.

Conclusion: This study revealed that CPPs have inadequate knowledge and attitude to provide effective pediatric pain management service. To bridge the knowledge gap and effectively control pediatric pain, pharmacists who are actively practicing their profession are advised to continue their medical education and training.