Integrated Pharmacy Research and Practice最新文献

Purpose: The categorization of inventories using various techniques optimizes the efficiency of warehouse operations. The ABC (always, better, and control); VED (vital, essential, and desirable); and FNS (fast-, normal-, and slow-moving) analyses provide items according to cost significance, criticality value, and consumption rate respectively. Thus, this study aimed to identify the categories of items requiring focused managerial control, priority, and replenishment intervals, as well as to evaluate whether the ABC-VED-FNS matrix is fit for effective and efficient inventory control of the Ethiopian Pharmaceutical Supply Agency (EPSA).

Methods: An institution-based cross-sectional descriptive study was conducted on 393 pharmaceuticals distributed by the EPSA-Jimma hub. The annual sales list with respective total quantity and unit price was collated from the logistics data records to perform the ABC analysis. The VED data were generated from the agency's pharmaceutical procurement list. To perform FNS analysis, we take into account the number of issue transactions as well as the average monthly consumption pattern for each item. Microsoft office Excel 2013 statistical functions were used to analyse the collated data.

Results: The ABC-VED analysis revealed that 187 (47.58%) of category I items account for 90% annual sales value; of which the highest proportion (63%) was AV items (36, 9%). Remarkably, there was no desirable (D) commodity that belongs to Class A. From the ABC-VED-FNS matrix analysis, category I consisted of 12 combinations with 187 (47.6%) items. Moreover, 28 (7.13%) items (CDN = 4 and CDS = 24) constituted category-III.

Conclusion and recommendation: The ABC-VED-FNS matrix analysis can help organization implement inventory control policies and techniques, narrow down a group of items that require more managerial monitoring and control, prioritize a storage location (pick-face) plan, minimize the time and labor cost of put-away, picking, and packing, and dictate when products should be reordered or replenished.

Background: Despite medicines are a major contributor to the health and well-being of the community, irrational use of medicines is being a serious public health crisis with significant harmful implications for patients, healthcare systems, and communities as a whole.

Objective: This study was aimed at evaluating the rational use of medicine using the World Health Organization/Network of Rational Use of Drugs (WHO/INRUD) core drug use indicators at Teda and Azezo health centers of Gondar town, northwest Ethiopia.

Methods: A cross-sectional study was conducted among 1200 prescription papers retrospectively, and 60 patients prospectively at two health centers of Gondar town, northwest Ethiopia from May 01/2019 to April 30/2020. The data were collected using a standard data collection checklist. Data were analyzed using SPSS^® version 24. The data were analyzed descriptively by using mean, frequency, and proportion.

Results: Prescribing indicators: From a total of 2595 prescribed medicines, 94% of them were prescribed by generic name; percent encounters with injection was 9.5±0.28%, percent encounters with antibiotics was 73.85±0.35%, and 100% of medicines were prescribed from the essential medicine list of Ethiopia. Patient care indicators: Only 16.7% of the patients knew the correct dosage of their medications, and 17.5% of dispensed medicines were adequately labeled. From the prescribed medications, only 77.17% were actually dispensed. Average consultation and dispensing time were 5.35 minutes and 40.24 seconds, respectively. Facility-specific indicators: Only 83.5% of key medicines were available in the health centers.

Conclusion: According to the WHO/INRUD core drug use indicators, rational medicine use is not achieved in terms of most components of the prescribing, patient care, and facility-specific indicators. Therefore, both health centers should work towards promoting the rational use of medicines.

Background: Doping includes tampering, possession; trafficking; administration, assisting, encouraging, aiding, conspiring a prohibited substance, and an anti-doping rule violation. Doping in sports is increasing and diversifying involving physiological, mechanical, and pharmacological techniques and becoming a serious public health problem. Pharmacy professionals have a vital role in the fight against doping. This study assessed the knowledge, attitude, and practice of pharmacists on the use of doping agents by sportsmen and women.

Methods: A community-based cross-sectional descriptive study was done targeting community pharmacists of Dessie city, Northeast Ethiopia. Structured questionnaires were distributed and collected between April and March of 2018. Data were analyzed using SPSS version 20.0. Linear regression was used and the level of statistical significance was set at a p-value <0.05.

Results: Of the 61 pharmacy professionals who participated in the study, 46 (75.4%) were males and 15 (24.6%) were females. Only 25 (41.0%) and 13 (21.3%) of the respondents said they watch and play sport regularly, respectively. The majority of the participants, 50 (82%), supported the prohibition of performance-enhancing drugs in sport. The majority of the respondents, 55.7%, agree that pharmacists are a potential source of doping agents. Only 27.9% of them mentioned World Anti-doping Agency (WADA) as the source of information about doping agents. Regarding identifying the WADA status of 13 agents, the average score out of 13 was 4.95, while 80.3% of them scored less than or equal to seven. Factors associated with knowledge of participants were being male (β = 4.48, p= 0.02) and regularly watching sport (β = 2.64, p= 0.01).

Conclusion: Even though the pharmacists' low knowledge score revealed that they need further specialized training on doping and anti-doping, majority of them support banning doping substances from sport. Pharmacy curriculum developers should consider incorporating specific topics or courses about doping agents.

Pharmacists across the healthcare continuum are well positioned to collaborate with patients to effectively manage their chronic pain. Evidence supports positive outcomes when pharmacists undertake these roles; however, there are barriers preventing uptake across the profession. This paper aims to expand awareness of the breadth of these roles, including pharmaceutical care provision, interprofessional collaboration, pain and medication education, support for patients in self-management and acceptance of responsibility to be culturally responsive and decrease stigma. Pharmacists are accessible healthcare professionals and can improve the care of patients with chronic pain.

Purpose: Collaborative medication reviews (CMR) have been shown to reduce inappropriate prescribing (IP) in various settings. This study aimed at describing a CMR practice in an emergency department (ED) short-term ward in Finland to investigate IP in pre-admission medications.

Patients and methods: Pre-admission medications were collaboratively reviewed for all the adult ED admissions within a 5-month study period in 2016. Types of IP were inductively categorized, and descriptive statistics were used to show the incidence and type of IP events.

Results: The pre-admission medications of 855 adult ED patients were reviewed by the pharmacist, with 113 IP events identified in 83 (9.7%) of the patients. The majority (81%, n=67) of these patients were older adults (≥65 years). Of these 94 IP events identified in 67 older patients, 58 (62%) were confirmed by the ED physicians. The following 3 main categories were inductively developed for the types of identified and confirmed IP events: 1) Misprescribing (prescription of medications that significantly increase the risk of adverse drug events); 2) Overprescribing (prescription of medications for which no clear clinical indications exist); and 3) Underprescribing (omission of potentially beneficial medications that are clinically indicated for treatment or prevention of a disease). Misprescribing was the most common type of IP identified (79% of the identified and 72% confirmed IP events). Benzodiazepines (29%) and antidepressants (28%) were involved in 33 out of 58 (57%) confirmed IP events. Medications with strong anticholinergic effects were involved in 19% of the confirmed IP events.

Conclusion: The CMR practice was able to identify IP in pre-admission medications of about one-tenth of ED patients. Older patients using benzodiazepines and drugs with strong anticholinergic effects should be paid special attention to ED admissions.

Since 1999, annual opioid-related overdose (ORO) mortality has increased more than six-fold. In response to this crisis, the US Department of Health and Human Services outlined a 5-point strategy to reduce ORO mortality which included the widespread distribution of naloxone, an opioid antagonist that can rapidly reverse an opioid overdose. Increased distribution has been facilitated by the implementation of naloxone access laws in each US state aimed at increasing community access to naloxone. While these laws differ from state-to-state, most contain mechanisms to enable pharmacists to dispense naloxone without a patient-specific prescription. These laws have enhanced community naloxone distribution, both from pharmacies and overdose education and naloxone distribution programs, and produced positive effects on ORO mortality. However, a growing body of evidence has revealed that significant barriers to naloxone access from pharmacies remain, and annual ORO deaths have continued to climb. Given these concerns, there has been a push among some clinicians and policymakers for the US Food and Drug Administration to re-classify naloxone as an over-the-counter (OTC) medication as a means to further increase its accessibility. If an OTC transition occurs, educational outreach and funding for clinical innovations will continue to be crucial given the important role of health professionals in recommending naloxone to people at risk for experiencing or witnessing an ORO. Recognizing the severity of the ORO public health crisis, we believe transitioning formulations of naloxone approved for layperson use to OTC status would result in a net benefit through increased access. However, such a change should be combined with measures to ensure affordability.

Background: Effective inventory management ensures an uninterrupted supply of safe, effective, and affordable pharmaceuticals which could be achieved through developing ABC-VEN (Always, Better, Control-Vital, Essential, Desirable) and FSN-XYZ (Fast, Slow, Non-moving-High, Medium, Low Value) matrix analysis. ABC-VEN matrix analysis is used to control inventory according to their annual consumption and on their functional importance whereas, FSN-XYZ matrix analysis is applied to control inventory by identifying the items to be discarded and the amount saved during the closing of annual accounts.

Objective: To evaluate inventory management in selected health facilities of West Arsi zone, Oromia regional state for the year 2016-2018.

Methods: Facility-based cross-sectional descriptive study complemented with a qualitative study was conducted in fourteen health facilities. Data were collected from goods issuing vouchers for the year 2016-2018 to perform ABC-VEN matrix analysis. The frequency of issue was collected to perform FSN analysis and the value of each closing stock was taken to get XYZ analysis.

Results: From the ABC-VEN matrix analysis, 26.6% of items were Category I of which the highest proportion were taken by class A and V items consuming 84.7% of annual drug expenditure (ADE). The remaining 49.2% and 24.2% of the drugs accounted for only 13.2% and 2.1% of the ADE being category II and III, respectively. Based on FSN-XYZ matrix analysis findings, category I with 41.% item share account for the highest budget (average 86.5% of values). Of this category, the XN group-non-moving and high-cost drugs had the high value (20%) which need managerial measure. In category III, the ZN group items, being 25% of drugs, only had 2.2% of value-that may increase wastage, inventory holding cost, and shortage of storage space.

Conclusion: The matrix analysis for inventory control is a strong tool that enables one to identify items requiring close monitoring. The coupled ABC-VEN matrix analysis, combining their individual advantages - inventory's cost and its functional importance help in achieving a meaningful inventory management. However, to control the stock at an appropriate level with minimum shortage and oversupply, it has to be supported by XYZ-FSN matrix analysis. The XYZ-FSN matrix benefits the health facilities to determine the level of inventory with high value in dead-stock, and to take measures like transferring to others, discarding, or saving.

Purpose: Despite the formal establishment of the Health Support Pharmacy system, few community pharmacies have transitioned to this new designation in Japan. Moreover, patients' perspectives on the usefulness of health-support pharmacies and community pharmacies have not yet been investigated. In this work, we investigated patients' attitudes, opinions, and awareness as users of member pharmacies of the Japan Federation of Democratic Medical Institutions (Min-Iren), with respect to two essential functions provided by community pharmacies-primary care and health support-to identify modern challenges facing community pharmacies.

Methods: Regular visitors to participating Min-Iren community pharmacies were asked to complete an anonymous questionnaire. Responses were compared between users of health-support pharmacies and other pharmacy types, as well as between members and non-members of "collaborating organizations" (CO). CO is organizational partners of Min-Iren whose activities support affiliated facilities. Logistic regression analysis was performed to explore the predictive value of different factors on pharmacies' primary-care and health-support functionality.

Results: A total of 181 Min-Iren community pharmacies (51.7%: 181/350) participated in this study, and most patients answered the questionnaire (97.7%, n=2623). Relatively few patients recognized the term "Health Support Pharmacy" (12.2%). CO members tended to have a superior understanding of a wide variety of services provided by CPs as compared to non-members. Statistically significant predictors of primary-care and health-support functionality included male gender, having a primary-care pharmacist, age ≥60 years, recognition of the term "Health Support Pharmacy" and CO membership.

Conclusion: CO members, a class of patients with a superior awareness of health promotion, demonstrated a good understanding of the variety of services provided by community pharmacies and tended to positively rate their pharmacy. Moving forward, efforts to raise awareness about the importance of health-promotional activities among community pharmacy users should further reinforce the primary-care and health-support functions of community pharmacies.

Purpose: To assess patients' medication-related needs and the humanistic impact of patient-centered pharmaceutical care.

Patients and methods: A hospital-based cross-sectional study was conducted using self-administered structured questionnaires from February 4 to 28, 2019, on patients attending ambulatory care for chronic non-communicable diseases at the University of Gondar specialized teaching hospital, North-west Ethiopia. Data were entered to SPSS version 22 for analysis. Descriptive statistics was used to describe the socio-demographic characteristics and medication-related needs of study participants. Independent sample t-test and one-way ANOVA analysis were performed to check for possible associations between dependent and independent variables.

Results: Information about what to do if patients missed doses and the potential side-effects or abnormal conditions caused by the prescribed medicines were not explained for most of the 425 patients studied. The majority of the study participants reported that they felt worried about adverse medicine effects, drug interactions, and long-term medicine use. Patients who were older than 50 or those receiving two or more medications were less satisfied with the effect of their medicine as compared to younger ones and those on monotherapy, respectively. People who were illiterate or had attended only primary schools thought that they received less disease and medicine information from health professionals than people who attended tertiary education.

Conclusion and recommendation: Most of the participants were particularly unhappy with the amount of information received about side-effects and what to do if doses were missed. Special emphasis should be given to patients with a low level of education as they were not satisfied with medicine and disease information obtained from health professionals, experienced more psychological impacts of medicine use, and had poor overall quality-of-life.