Integrated Pharmacy Research and Practice最新文献

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.

Background: Pharmacy professionals in community drug retail outlets, as the most accessible personnel for the community, are engaged in consultation and responding to health problems in addition to filling prescriptions. In doing so, different dispensing malpractices are observed and much is not known on the issue in Ethiopia.

Objective: The study aimed at assessing dispensing malpractice at pharmacies, drug stores and drug vendors in South Gondar zone.

Methodology: A cross-sectional study design with a descriptive approach was applied from April 1 to June 30. The data was collected using the simulated patient method. Seven prescription-only medicines and a diarrheal case were requested during visit. All drug retail outlets in South Gondar zone that were in service during data collection were visited.

Results: Almost all prescription-only medications were dispensed without prescription at all community drug retail outlets. Of all the dispensaries, 19 (82.6%) provided a partial dosage regimen of amoxicillin. Presence of fever and pregnancy status were asked about by dispensers in only 8% and 20% of visits for diarrhea, respectively. Medication history was also rarely requested. Medication was dispensed in 80% of visits for diarrhea, all of which included antimicrobials. Oral rehydration salt was considered in only two (10%) dispensaries.

Conclusion: Dispensing medications without a prescription is common in community drug retail outlets in South Gondar zone in Amhara Regional State. Our findings also showed that detailed assessments of patients' signs and symptoms are not performed properly by the dispensers to understand the diarrheal case. Training of pharmacy professionals and strict regulatory control are needed.

Background: A pilot Independent Prescribers' Service (IPS) was introduced in 13 community pharmacies across Wales in June 2020. Independent Pharmacist Prescribers (IPPs) could prescribe in the areas of management of acute conditions, contraception, or opioid withdrawal, as agreed with local commissioners. Access to the patients' medical records was provided via Choose Pharmacy, the national community pharmacy IT platform.

Objective: To explore the experiences of IPPs delivering the service and commissioners responsible for financial resources regarding the IPS in Wales.

Methods: A qualitative methodology was employed, with purposive sampling, semi-structured interviews, and inductive thematic analysis.

Results: Five themes were constructed from 13 interviews (n=9 IPPs; n=4 commissioners): (i) patient experience and safety; (ii) professional enablement and rebalancing workload of GPs; (iii) role and limitations of remote consultations; (iv) funding and business model; (v) functionality on Choose Pharmacy to support patient care. The design of the service allowed pharmacists to determine how best to deliver the IPS, maximizing access for patients and promoting a sense of professional value amongst pharmacists.

Conclusion: This study builds on the body of evidence on enhanced patient experience with prescribing services in the community, reinforcing that IPPs have a key role in rebalancing management of common conditions from GP surgeries to community pharmacies. Several considerations need to be addressed to ensure future success of the service implementation, delivery and enhanced sustainability, such as formal referral pathways and access to medical records. These can be used by other commissioning bodies in the UK and internationally to build a network of suitably supported IPPs, confident to appropriately deal with uncomplicated acute and chronic conditions; and liaise with primary and/or secondary care when referrals are needed.

Introduction: Well trained, knowledgeable and competent pharmacists are indispensable in the fight against antimicrobial resistance (AMR), which is a current global public health problem. The aim of this work was to assess knowledge of antibiotics, antimicrobial resistance and antimicrobial stewardship of fifth year pharmacy students at three universities in Northern Nigeria.

Methods: A descriptive cross-sectional study that used a paper-based questionnaire to collect data from July to September 2021 was conducted. The questionnaire was self-administered and divided into four sections. The first section collected information about the demographic data of respondents, while section B explored their knowledge of antibiotics and AMR. Section C contained six questions assessing knowledge of various aspects of antimicrobial stewardship (AMS), while the final part assessed respondents' preparedness to work with antibiotics and perceptions of their current knowledge of these concepts. Descriptive statistics were used to report the results obtained.

Results: A total of 164 questionnaires were retrieved. Majority of respondents were male (58.3%) and aged between 21 and 25 years (53.4%). Most of them had some knowledge of antibiotics and AMR, however several misconceptions with respect to these concepts were identified. Only 80 (48.8%) of respondents indicated that they knew what AMS was, although most of these students were correctly knowledgeable about the goals and scope of AMS and composition of the AMS team. Generally, less than half of respondents agreed that their current knowledge of antibiotics, AMR or AMS was adequate for their future careers, and over 90% of them agreed that they would like more education about these topics.

Conclusion: Many of the study's' respondents were somewhat knowledgeable about these concepts, although several knowledge gaps were also observed. Improving undergraduate pharmacy education with respect to these concepts is recommended.

Introduction: Counterfeit medicines are substandard pharmaceutical products that are produced and sold with the intent to deceptively represent their authenticity, origin, or effectiveness. The risk of the existence of such products in healthcare provision remains a significant threat to public health. Pharmacists represent the most critical stakeholders in the supply, manufacture, purchase, and dispensing of pharmaceutical products, and as such can play critical roles in detecting and reducing the circulation of fake medicines. This study aimed to assess the knowledge and practices of pharmacists in Nigeria in relation to counterfeit medicines as well as the challenges associated with preventing and mitigating this menace in the country.

Methods: A cross-sectional study was undertaken to administer questionnaires to pharmacists across various sectors of practice in Nigeria. Data were analysed using Statistical Package for Social Sciences.

Results: A total of 390 valid responses were received. The respondents indicated that online drug commerce (72.68%), inadequate inspection (90.93%), inadequate legislation (88.83%), poor collaboration (89.94%), and poor cross-border enforcement (90.43%) were primary challenges to the mitigation of fake medicines circulation in the country. Whilst pharmacists were knowledgeable about counterfeit drugs, gaps were observed in their practices towards detection of these products, as about one-third (30.7%) of the sample indicated that their current knowledge and skills were inadequate to detect counterfeit medicines. Age, years of practice, and area of practice significantly influenced the abilities of the participants to detect counterfeit medicines.

Conclusion: Evidence from the study revealed that pharmacists had good knowledge of medicine counterfeiting in Nigeria. However, factors such as poor collaboration among regulatory agencies, inadequate inspection and legislation on the regulation of the pharmaceutical sector and online sales of medicines have contributed to the circulation of counterfeit medicines, and this has in turn affected healthcare services in the country.

Background: Acute diarrhea is one of the most common health problems globally as a minor ailment, it is widely managed by community pharmacists (CPs). Professional patient counseling provided in community pharmacies is essential to decide about acute diarrhea and avoid treatment failure properly.

Objective: To assess CPs' history-taking practice, medication dispensing, and patient counseling in response to acute diarrhea in adults.

Methods: A cross-sectional, covert simulated patient (SP) study was conducted in 235 community pharmacies in the Khartoum locality. Two scenarios were used, one scenario assesses afterwards compliance to treatment guidelines and patient counseling, and second scenario determines afterwards if pharmacists referred patients to medical consultation. Six final-year pharmacy students were involved as SPs. All encounters were audio-recorded by SP. Then the investigator filled the checklist that was intended to evaluate the overall practice of pharmacists.

Results: As planned, 235 pharmacies were visited twice, resulting in a total of 470 visits (visit completion rate: 100%). In history taking, the most asked questions were the patient's age (89.8% for scenario 1 and 88.5% for scenario 2). Followed by the presence of blood in the stool (25.5% for scenario 1 and 28.1% for scenario 2). In scenario 1, loperamide was the most dispensed medication (81.3%), while oral rehydration solution (ORS) was dispensed in 0.9% of the visits. In counseling, verbal and written instructions were provided in 47.7% of the visits. Duration of medications was mentioned in 3.8%, advice about fluid intake was offered in 7.2% of the visits. In scenario 2, 17% of the pharmacists managed patient history well to refer patients to medical consultation, while 42.6% recommended referral after sufficient information was provided by the SP.

Conclusion: CPs' practice in counseling toward acute diarrhea was poor; referral to medical consultation was below expectation. The current CPs dispensing practices need improvement; thus, professional education should be encouraged.