Produtos fitoterápicos manipulados em um laboratório de manipulação no Estado do Paraná / Phytotherapeutic products handled in a handling laboratory in the State of Paraná / Productos fitoterapéuticos manipulados en un laboratorio de manipulación en el Estado de Paraná

As plantas medicinais foram os primeiros recursos terapêuticos obtidos pelos povos e há registros do seu uso em todos os momentos da História, por grande parte das civilizações. No Brasil, o uso das plantas medicinais é resultado dos conhecimentos de três populações: indígena, europeia e africana. O presente trabalho tem como objetivo caracterizar a manipulação mensal de um laboratório de fitoterápicos na cidade de Francisco Beltrão, Paraná. Os dados que foram coletados para a presente pesquisa são: número de cápsulas manipuladas mensalmente para cada um dos fitoterápicos, os quais serão obtidos a partir dos relatórios de manipulação de fitoterápicos mensais no ano de 2021 e individuais de cada unidade de saúde, fornecidos pela Secretaria de Saúde. Não havendo acesso a informações de pacientes e tampouco contato com eles. As informações dos relatórios foram tabuladas em planilha a fim de se estabelecer os três principais fitoterápicos manipulados no período preestabelecido. Trata-se de um estudo de campo, exploratório, documental e retrospectivo. Observamos que a média de manipulação foi de 34.029 cápsulas por mês, os fitoterápicos mais manipulados no ano de 2021, foram: Passiflora incarnata (maracujá), Aesculus hippocastanum (castanha da índia) e Curcuma longa. Também foi possível notar que houve um aumento gradual de dispensações após a capacitação dos profissionais, ocorrida entre junho e setembro. Além disso, verificamos que há uma grande diferença na quantidade dispensada por cada farmácia municipal, possivelmente devido ao nível de conhecimento dos profissionais de saúde e se preferem ou não prescrever aos pacientes.

Medicinal plants were the first therapeutic resources obtained by people and there are records of their use at all times of history, by a large part of civilizations. In Brazil, the use of medicinal plants is a result of the knowledge of three populations: indigenous, European and African. The present work aims to characterize the monthly handling of a plant medicine laboratory in the city of Francisco Beltrão, Paraná. The data that were collected for this research are: number of capsules handled monthly for each one of the phytotherapics, which will be obtained from the reports of handling of monthly phytotherapics in the year 2021 and individual of each health unit, provided by the Secretariat of Health. There is no access to patient information and no contact with them. The information in the reports was tabulated into a spreadsheet in order to establish the three main phytotherapics handled in the pre-established period. This is an exploratory, documentary and retrospective field study. We observed that the average handling was 34,029 capsules per month, the most manipulated phytotherapics in the year 2021, were: Passiflora incarnata (passion fruit), Aesculus hippocastanum (chestnut from India) and Curcuma longa. It was also possible to note that there was a gradual increase in dispensations after the training of professionals, which took place between June and September. In addition, we note that there is a big difference in the amount dispensed by each municipal pharmacy, possibly due to the level of knowledge of health professionals and whether or not they prefer to prescribe to patients.

Las plantas médicas fueron los primeros recursos terapéuticos obtenidos por los pueblos y hay registros de su uso en todo momento de la historia, por una gran parte de las civilizaciones. En Brasil, el uso de plantas medicinales es el resultado del conocimiento de tres poblaciones: indígenas, europeos y africanos. El presente trabajo tiene como objetivo caracterizar la manipulación mensual de un laboratorio fitoterapéutico en la ciudad de Francisco Beltrão, Paraná. Los datos recogidos para esta investigación son: el número de cápsulas manejadas mensualmente para cada una de las fitoterapias, que se obtendrán de los informes mensuales de manipulación fitoterapéutica en el año 2021 y el individuo de cada unidad de salud, proporcionados por el Departamento de Salud. No hay acceso a la información del paciente ni contacto con ella. La información contenida en los informes se tabuló en una hoja de cálculo para establecer las tres principales fitoterapias manipuladas en el periodo predefinido. Se trata de un estudio de campo, exploratorio, documental y retrospectivo. Observamos que la manipulación media fue de 34.029 cápsulas al mes, las fitoterapias más manipuladas en 2021 fueron: Passiflora incarnata (fruto de la pasión), Aesculus hippocastanum (castaño indio) y Curcuma longa. También es posible señalar que se ha producido un aumento gradual de las dispensaciones después de la capacitación de profesionales, que se llevó a cabo entre junio y septiembre. Además, vemos que existe una enorme diferencia en la cantidad que proporciona cada farmacia municipal, posiblemente debido al nivel de conocimiento de los profesionales de la salud y si prefieren recetarla a los pacientes o no. PALABRAS CLAVE: Fitoterapias; Farmacias Municipales; Curcuma Longa; Passiflora Incarnata; Aesculus Hippocastanum.

Grey model forecasting analysis of licensed pharmacist staffing in retail pharmacies in western China / 中国药房

OBJECTIVE To predict the development trends of licensed pharmacist staffing in retail pharmacies within the western China and provide reference for the formulation of policies related to licensed pharmacists. METHODS Based on the data of retail pharmacies and licensed pharmacists in the western China from 2016 to 2022， a grey model was constructed to analyze and predict the number development trends of retail pharmacies and licensed pharmacists in the western China from 2023 to 2026. RESULTS Currently， the 1∶1 staffing requirement for licensed pharmacists and retail pharmacies had been met in Shaanxi， Guangxi and Gansu. Based on current trends， Inner Mongolia， Chongqing， Yunnan， and Qinghai were expected to meet the 1∶1 staffing requirement for licensed pharmacists and retail pharmacies between 2023 and 2026. Sichuan and Xinjiang were also expected to meet this requirement in the future. However， there was still a significant gap in Guizhou， Xizang， and Ningxia towards achieving the above goals. CONCLUSIONS There is still a discrepancy between the deployment of licensed pharmacists and the national requirements in certain western provinces. Local authorities should formulate relevant policies according to local circumstances. Regions that have already met or will soon achieve the staffing requirement for licensed pharmacists should continue to enhance the quantity and quality of their licensed pharmacist workforce. In areas where meet this criterion in the short term is not feasible， it is necessary to strengthen the development of the licensed pharmacist workforce， and control the number of new retail pharmacies.

Management and use of high-risk drugs in western medicine pharmacies / 中国基层医药

High-risk drugs have strong efficacy and can cause remarkable patient harm or drug dependence, leading to serious consequences, when they are used in error. Management and use of high-risk drugs is an important part of clinical drug safety management. Western medicine pharmacy is the core department and an important link of drug management and use. We reviewed the literature on the management and use of clinical high-risk drugs at home and abroad, investigated the current main problems and influential factors, analyzed the main intervention measures on the management and use of high-risk drugs, so as to increase physician's and pharmacy's attention to high-risk drugs, standardize scientific use, and avoid medical accidents due to improper management and use of high-risk drugs. All of these will help us to put forward corresponding management strategies and further standardize the management and use of high-risk drugs.

Pharmacovigilance: an evaluation on the practice of pharmacists acting in pharmacies and drugstores

Abstract Pharmacists acting in pharmacies and drugstores stores are some of the most accessible healthcare providers and the last to intervene before the patient takes their medicine. This puts the pharmacist in a position of authority that should be harnessed for the benefit of health. Thus, this professional is strategic for performing pharmacovigilance. Our objective of this study was to interrogate the practice of pharmacists in relation to pharmacovigilance activities, and to identify difficulties and possible stimuli for the improvement these activities in pharmacies and drugstores. The information was collected through an online questionnaire via Survey Monkey®. The data were analyzed statistically using SPSS software. Responses were received from 5174 pharmacists: mostly young women within five years of graduation and experience in pharmaceutical retail. 81% of them reported having identified suspected substandard medicines, but only 16% used the Brazilian notification system Notivisa. More than 85% of pharmacists agreed with the importance of pharmacovigilance and the recognition of reporting services as part of pharmacist duties and pharmaceutical care. The main barriers to making notifications were the lack of access and knowledge about Notivisa. Pharmacists agreed that simplifying the system would be a stimulus for notifications, and requested more feedback from notifications, as well as material and courses to understand the notification process. Pharmacists have important data to feed into pharmacovigilance systems, recognize their responsibilities and are willing to contribute, but still demonstrate low compliance. Simplification of the system and training on it are likely to increase notifications.

Online search interest in the use of antibiotics for dental pain: an infodemiology study / Interesse em pesquisas online sobre o uso de antibióticos para dor dentária: um estudo infodemiológico

Objective: The objective of this study was to evaluate the online search interest pertaining to queries regarding antibiotics for dental pain. Material and Methods : Google Trends™ was used to identify the online search interest. Previously, a literature search was performed on the most frequently used antibiotics in dentistry in Brazil. Accordingly, the search terms used were Amoxicillin (AM), Clindamycin (CD), Azithromycin (AZ) and Metronidazole (MD), with the phrase "for toothache" in Portuguese and English. A time-series covered the last 240 weeks (from 2015 to 2020), and the results of each term were compared to their respective annual value. Geographic regions were also evaluated. To obtain a relative search volume (RSV), the resulting Google Trends™ numbers were then scaled to a range from 0 to 100 based on the ratio of searches on a topic to searches across all topics. Results : We observed an upward trend in all antibiotics search terms over the 5 years analyzed, with a peak of greater interest in 2019. The antibiotic of most interest related to toothache was 'AM', followed by 'AZ', 'MD', and 'CD'. The annual RSV of toothache searches rose steadily from 2015 to 2020. Variations were observed between Brazilian geographic regions, and the Northeast region presented with the greatest interest in the topic. Conclusion : Although there were variations in annual and regional trends, an expressive and persistent increase in collective interest regarding the use of antibiotics related to toothache, mainly amoxicillin, was observed. Our findings provide insights for public health promotion programs. (AU)

Objetivo: O objetivo deste estudo foi avaliar o interesse da pesquisa online em consultas sobre antibióticos para dor de dente. Material e métodos : o Google Trends™ foi usado para identificar o interesse de pesquisa online. Anteriormente, foi realizada uma pesquisa bibliográfica sobre os antibióticos mais utilizados em odontologia no Brasil. A partir daí, os termos de busca utilizados foram Amoxicilina (AM), Clindamicina (CD), Azitromicina (AZ) e Metronidazol (MD) com os termos "para dor de dente" em português e inglês. Uma série histórica abrangeu as últimas 240 semanas (abril de 2015 a abril de 2020), e os resultados de cada período foram comparados com seus respectivos valores anuais. Regiões geográficas também foram avaliadas. Os números resultantes do Google Trends ™ são dimensionados para um intervalo de 0 a 100 com base na proporção de um tópico para todas as pesquisas em todos os tópicos de busca. Isso é chamado de volume relativo de pesquisa (RSV). Resultados : Foi observada uma tendência crescente para todos os termos de antibióticos ao longo dos 5 anos analisados, com um pico de maior interesse em 2019. O antibiótico de maior interesse na dor de dente foi 'AM', seguido por 'AZ', 'MD' e 'CD'. O RSV anual das buscas de dor de dente cresceu continuamente de 2015 a 2020. Variações foram observadas entre as regiões geográficas brasileiras, sendo que a Região Nordeste apresentou o maior interesse pelo tema. Conclusão : Embora tenha havido variação nas tendências anuais e regionais, observou-se um aumento expressivo e persistente do interesse coletivo pelo uso de antibióticos relacionados à dor de dente, principalmente a amoxicilina. Nossas descobertas fornecem insights para programas de promoção pública.(AU)

Study on the spatial distribution and related factors of medical insurance designated retail pharmacies in Guiyang / 中国药房

OBJECTIVE To pr ovide theoretic support for Guiyang to scientifically guide the development of drug retail industry and implement national health policies . METHODS The data were collected through statistical yearbook ，data cloud ， coordinate acquisition device of Application Programming Interface of Baidu map and so on. The spatial distribution characteristics and accessibility of medical insurance designated retail pharmacies （shorted for “designated pharmacies ”）in Guiyang were analyzed by spatial analysis based on Geographic Information System. The related factors for the distribution of designated pharmacies in Guiyang were analyzed by statistical method. RESULTS The number of designated pharmacies ，designated pharmacies per thousand people and designated pharmacies per 10 km2 in Guiyang increased from 2 018，0.41 and 2.51 in 2020 to 2 500，0.42 and 3.11 in 2021，with growth rates of 23.89％，2.44％ and 23.90％ respectively. The service area of the designated pharmacies that residents of Guiyang reached within 15 minutes on foot was 10.27％ of the total service area of designated pharmacies in Guiyang. The results of correlation analysis showed that the correlation coefficients between the regional gross regional production ，total retail sales of consumer goods ，population，urban per capita disposable income and the number of designated pharmacies in Guiyang were 0.999，0.999，0.977 and 0.992，respectively （all P＜0.05）. CONCLUSIONS The distribution of designated pharmacies is insufficient in Guiyang ，the development of designated pharmacies in various administrative regions is uneven ，and the layout of pharmacies is significantly affected by economic and demographic factors. It is suggested that the local government should explore the strategy of scientifically and reasonably expanding the coverage of designated pharmacies in urban and rural areas，promote the rational layout of pharmacies with appropriate economic and demographic policies ，and pay attention to improving the service capacity of designated pharmacies ，so as to improve the quality of life of the people and guide the healthy and high-quality development of drug retail industry.

Examination of the Awareness and Behavior Effects in Local Residents by Health-Supporting Dissemination Events Focusing on Osteoporosis Prevention / 社会薬学

The number of patients with osteoporosis is an estimated 12,800,000 in Japan. Osteoporosis represents a risk factor for becoming bedridden, and also for increased mortality. It would thus be important to take measures to prevent non-examination and treatment interruption as their rate is high. We recruited participants at a health-supporting event for local residents at our pharmacy on April 14, 2019 and obtained consent from 40 individuals to participate in this study. At this event held by a pharmacy, we conducted bone density measurement and osteoporosis-related preventive education by pharmacists, considering the influence the event had on health-related awareness and behavior in the local residents. Knowledge of osteoporosis was higher after than before the events. Participant health and lifestyle awareness was not observed between before the event and one month after the event. However, one month after the event, several changes could be observed in the behavior of 79.4% (27/34) of the participants. Based on these results, bone density measurement and osteoporosis-related preventive education by pharmacists are suggested to increase osteoporosis-related knowledge among local residents and to promote behavior change related to healthcare and osteoporosis.

Status of Inquiries to Prescribing Doctors about Cancer Chemotherapy Prescriptions by Pharmacists at an Insurance Pharmacy / 医薬品情報学

Objective: Pharmacists at insurance pharmacies play an important role in the pharmaceutical care of outpatients receiving cancer chemotherapy. This study aimed to clarify the actual status of insurance pharmacies' involvement in cancer chemotherapy and associated issues, based on an analysis of prescription inquiries made to doctors by pharmacists at an insurance pharmacy.Design: This was a retrospective observational study.Methods: The data was collected in one insurance pharmacy, which received prescriptions mainly from Gunma Prefectural Cancer Center. Among 2, 258 inquiries recorded from January 2015 to May 2018, inquires related to oral anticancer drugs or supportive care medicine were extracted. The frequency of inquiries for each item, or the frequencies of factors that lead to inquiries were calculated. Inquiries considered to have potentially led to the prevention or avoidance of adverse drug reactions (ADRs), so-called “preavoidance” inquiries, were also extracted.Results: Four hundred and forty inquiries related to 20 oral anticancer drugs were included in the analysis. The prescriptions were changed after 92.7% of all prescription inquiries. Prescription inquiries for drugs with rest periods were more frequent than those for drugs without rest periods. The most common inquiries were about the medication schedules stated on the prescription, followed by inquiries about supportive care drugs. Approximately 60% of the pharmacy inquiries were related to“pre-avoidance”inquiries. Most of the pre-avoidance inquiries concerned prevention of ADRs, though these inquiries also contributed to“reduction or avoidance of mental anxiety”. The prescription inquiries were triggered by information collected by pharmacists from patient interviews and from medication histories.Conclusion: Our findings suggest that inquiries to the prescribing doctors by pharmacists at insurance pharmacies contribute significantly to the appropriate use of anticancer drugs.

Programas e intervenciones educativas ofrecidas al personal farmacéutico para mejorar la prestación de los servicios asistenciales farmacéuticos: una revisión estructurada / Educational programs and interventions offered to pharmacy staff to improve the delivery of pharmaceutical assistance services: A structured review

Resumen Objetivo: Describir los programas y las intervenciones educativas ofrecidas al personal farmacéutico, para mejorar la prestación de los servicios asistenciales farmacéuticos y los métodos utilizados para evaluar la efectividad de estos programas. Métodos: Se realizó una revisión estructurada, se utilizó la base de datos PubMed/Medline entre 2007 y 2019, sobre el desarrollo, la descripción, la evaluación del impacto, la efectividad o la comparación de una intervención educativa, un entrenamiento específico o un programa educativo dirigido al personal farmacéutico de farmacias comunitarias (ambulatorias) y/o hospitalarias. Resultados: En total, 1290 referencias bibliográficas fueron identificadas: se incluyeron 26 referencias adicionales y se seleccionaron 90 artículos para su revisión y análisis. Se encontró que el 70 % (63) de los estudios fueron realizados en países desarrollados, principalmente en Estados Unidos, Australia, Canadá e Inglaterra. El 67 % (60) de los estudios se realizaron a nivel ambulatorio, el 10 % (9) a nivel hospitalario y el 23 % (21), en ambos contextos. Las intervenciones fueron clasificadas en tres categorías: Entrenamientos Específicos (41 %), programas de Educación Continua (43 %) y de Desarrollo Profesional Continuo, (16 %). De las metodologías o métodos de provisión de la intervención, la más común fue la presencial en el 72 % (65) de los estudios, seguido de metodologías apoyadas con herramientas virtuales en el de las intervenciones educativas varió entre menos de 1 hora y 120 horas. Conclusión: Se describen los programas y las intervenciones educativas ofrecidas al personal farmacéutico, principalmente para mejorar sus competencias laborales y la prestación de los servicios asistenciales farmacéuticos, además de los métodos utilizados para evaluar la efectividad de las intervenciones educativas.

Abstract Objective: To describe the educational programs and interventions offered to pharmacy staff, to improve the delivery of pharmaceutical healthcare services and the methods used to evaluate the programs' effectiveness. Methods: A structured review was performed using the PubMed/Medline database from 2007 to 2019. Results: In total, 1290 bibliographic references were identified; besides, 26 references identified by other sources were included and 90 articles for review and analysis were selected. It was found that 70% (63) of the studies were made in developed countries, mainly in the United States, Australia, Canada, and England. 67% (60) of the studies were carried out at the outpatient level, 10% (9) at the hospital level, and 23% (21) in both contexts. The interventions were classified into three categories: Specific settings (41%), Continuing Education (43%), and Continuing Professional Development (16%) programs. The most common methodology or delivery methods for the intervention were face-to-face in 72% (65) of the studies, followed by methodologies supported by virtual tools in 28% (25) and 11% (10) of the studies combined face-to-face and virtual methods. The duration of the educational interventions ranged from less than 1 hour to 120 hours. Conclusion: The educational programs and interventions offered to the pharmacy staff are described, mainly to improve their labor competencies. Additionally the provision of pharmaceutical healthcare services and the methods used to evaluate the effectiveness of the educational intervention.

Revisión, diseño y construcción de un instrumento de medición para evaluar las competencias laborales del personal farmacéutico ambulatorio / Review, design, and construction of a measuring instrument to assess the labor competencies of outpatient pharmacy staff

Resumen Introducción: La medición y evaluación de las competencias laborales, en el personal farmacéutico ambulatorio, debe combinar aspectos relacionados con los conocimientos (que sabe), habilidades (como lo hace) y actitudes (de que modo lo hace). Objetivo: Identificar y seleccionar las directrices y recomendaciones sobre las competencias laborales que requiere el personal farmacéutico ambulatorio, y construir un instrumento para su medición. Métodos: Se realizó una revisión estructurada en dos fases: a) se revisaron y seleccionaron las funciones/dominios, los criterios de desempeño (habilidades y actitudes), los conocimientos, los marcos de competencias establecidas a nivel internacional, y los instrumentos de medición reportados en la literatura; y b) se identificaron las competencias laborales necesarias de acuerdo con la normatividad colombiana y con los procesos de los Establecimientos Farmacéuticos ambulatorios (droguerías y farmacias-droguerías). Finalmente, se construyó el instrumento de medición por un panel de expertos. Resultados: Se identificaron las competencias laborales establecidas por las organizaciones de regulación internacional. Se revisaron 993 artículos que reportaban la medición y evaluación de las competencias, seleccionándose y analizándose 9 referencias. Se analizaron los marcos de competencias de diferentes países. Se analizaron las regulaciones en Colombia sobre el tema. El instrumento construido contiene 101 competencias distribuidas en los siguientes componentes: a) suministro de cuidados al paciente; b) personales; c) solución de problemas; y d) gestión y organización. Conclusión: Directrices y recomendaciones internacionales, además, la normatividad colombiana para identificar las competencias laborales que requiere el personal farmacéutico para el correcto funcionamiento de los Establecimientos Farmacéuticos ambulatorios, y partir de esto, se construye un instrumento de medición para evaluarlas.

Abstract Introduction: The measurement and evaluation of labor competencies, in outpatient pharmacy staff, must combine aspects related to knowledge (who knows), skills (as it does) and attitudes (in what way it does). Objective: Identify and select the guidelines and recommendations on labor competencies required by outpatient pharmacy staff and build an instrument for their measurement. Methodology: A structured review was carried out in two phases: a) the functions/ domains, performance criteria (skills and attitudes), knowledge, competency frameworks established internationally, and measurement instruments reported were reviewed and selected in the literature; and b) the necessary labor competencies were identified in accordance with Colombian regulations and with the processes of the outpatient Pharmaceutical Establishments (drugstores and pharmacies-drugstores). Finally, the measuring instrument was built by a panel of experts. Results: Labor competencies established by international regulation organizations. were identified. A total of 993 articles were reviewed that reported the measurement and evaluation of competencies, selecting and analyzing 9 references. Competency frameworks from different countries were analyzed. The regulations in Colombia on the subject were analyzed. The constructed instrument contains 101 competencies distributed in the following components: a) provision of patient care; b) personal; c) troubleshooting; and d) management and organization. Conclusion: The international guidelines and recommendations were reviewed and analyzed, in addition, the Colombian regulations to identify the labor competencies required by the pharmacy staff for the correct functioning of the outpatient Pharmaceutical Establishments, and from this, an instrument was built of measurement to evaluate them.

Investigation and Analysis of the Understanding of Pharmacy Practitioners in Retail Pharmacies and Parents to Children’s OTC Drug Knowledge / 中国药房

OBJECTIVE：To standardize the use of children’s over-the-counter（OTC）drugs in China，control the risk of children’s self medication and ensure the safety of children’s medication. METHODS：The questionnaire was randomly distributed to pharmacy practitioners in retail pharmacies in 13/parents in 16 provinces and municipalities directly under the central government. The results of questionnaire survey were analyzed descriptively. The corresponding suggestions were put forward for the problems existing in the use of OTC drugs for children among pharmacy practitioners in retail pharmacies and parents.RESULTS：Totally 5 367 people filled the questionnaire at pharmacies，and 5 353 questionnaires were filled validly with effective rate of 99.74％；the number of consumers（parents）who filled the questionnaires was 6 111，and 5 094 questionnaires were filled validly with effective rate of 83.36％. The results of survey showed that 93.67％ of retail pharmacies were equipped with 1-2licensed pharmacists；most of the employees in pharmacies had college degree（46.59％），and their professional knowledge was relatively weak，and only 30.00％ of them were very familiar with pharmaceutical professional knowledge. Pharmacy practitioners could provide basic pharmaceutical care，but they were not sensitive to the information of children’s age and weight；only 44.11％of the practitioners would approve the dosage according to the age and weight of the children；98.09％ of pharmacies would regularly conduct OTC drugs knowledge training，but they did not pay attention to the knowledge of children related to drug use. About half of the pharmacy practitioners were very clear about the indications，usage and dosage，precautions of OTC drugs forchildren. About 70％ of parents did not fully understand the difference between prescription drugs，green OTC drugs and red OTC drugs，and did not know the risk of home OTC treatment；63.06％ of parents chose OTC drugs according to their previous experience， and 23.05％ of parents relied on drug advertisements to choose OTC drugs； 92.64％ of parents would read the drug instruction carefully before using OTC drugs， but they had blind spots in understanding many contents of the drug instruction. In the process of OTC drug use，46.21％ of parents had used adult OTC drugs for their children，and 41.54％ of parents did not convert the amount of children；52.89％ of parents said that their children suffered from adverse reactions after taking OTC drugs. CONCLUSIONS：The pharmacy practitioners have low education on the whole，professional level needs to be improved，their understanding of children’s OTC drugs is not comprehensive enough，and there is a lack oftraining on children’s medication knowledge. Parents have a poor awareness of children’s OTC drugs，and there are many problems in the process of using children’s OTC drugs，such as inaccurate dosage，using adult’s drugs. It is suggested that we should improve the access standard of pharmacy practitioners and increase the number of licensed pharmacists；organize special training on safe drug use for children to improve the pharmaceutical service ability of pharmacies；strengthen the supervision of retail pharmacies and formulate pharmaceutical care standards for the use of OTC drugs for children；strengthen the publicity and education on rational drug use for children and popularize the knowledge of safe drug use of OTC drugs for children；give full play to the guiding role of pharmacists and pay attention to the medication guidance of parents.

Analysis of the Implementation Status of the Classification Management Policies for Retail Pharmacies in Guangdong Province Based on Thematic Framework Analysis / 中国药房

OBJECTIVE：To provide assistance for the smooth implementation of classification management policies of retail pharmacies in Guangdong province and the scientific supervision of retail pharmacies by relevant departments. METHODS ：In this study，key interviews were conducted among 68 interviewees，involving experts from Guangdong drug regulatory department ，head of retail pharmacies and research experts on relevant policies of universities. The current situation ，problems and suggestions of the classification management policy of retail pharmacies in Guangdong province were summarized. RESULTS & CONCLUSIONS ： The implementation of the classification management policies for retail pharmacies in Guangdong province operated well. Drug regulatory authorities at all levels could conduct daily supervision in accordance with policy requirements. Retail pharmacies operated in strict accordance with the classification management policy and established a relatively complete quality management system. However ，there were still problems such as difficulty in policy implementation ，insufficient policy clarity ，increased regulatory pressure and regulatory risks from government regulatory agencies ，rising operating costs and increasing pressure in retail pharmacies，the large gap of licensed pharmacists ，difficult to investigate and deal with “affiliation of certificate ”behavior，and difficult survival for remote pharmacies ，and the impact on the convenience of drug use of the public. It is suggested to improve the content of the policy ，introduce related supporting measures ，strengthen the construction of the supervisory team ，increase policy publicity，improve the ways and methods to investigate and deal with the “affiliation of certificate ”behavior of licensed pharmacists， and help retail pharmacies to diversify their operations and chain operations. It is recommended that relevant government departments should further improve the content of the policy and actively adjust the supervision methods to make the policy better implemented.

A importância dos autotestes de HIV nas farmácias e drogarias no Brasil / The importance of HIV self tests in pharmacies and drugstores in Brazil

Muitas pessoas todos os anos são infectadas pelo HIV no Brasil e, quando infectadas, se tratadas precocemente têm mais chances de sucesso no tratamento, e assim evitam infectar outras pessoas com mudanças em seus hábitos comportamentais. Os autotestes de HIV que estão disponíveis em farmácias e drogarias de alguns países desde 1996 têm um papel fundamental na prevenção de propagação da doença. Apesar de o SUS oferecer gratuitamente a realização do teste às pessoas, é necessária a disponibilidade destes testes em farmácias e drogarias no Brasil. Esta modalidade de teste oferece resultados rápidos e seguros, porém com algumas advertências que poderão ser esclarecidas principalmente através do farmacêutico. Embora estes testes forneçam alta taxa de confiabilidade, são inúmeras as possibilidades de ocorrer um resultado falso negativo. Desta forma, é de extrema importância a orientação dos farmacêuticos junto ao consumidor. Com este artigo será possível identificar os tipos de testes disponíveis, quais as vantagens do autoteste bem como sua precisão, quais os grupos de risco que podem ser beneficiados e a abordagem social referente a este tipo de teste e como foi a experiência de se colocarem à disposição da população estes testes em outros países, como França e Estados Unidos

Many people every year are infected with HIV in Brazil and whe infected if treated early have a better chance of success in treatment, thus avoid infecting others with changes in their behavioral habits. The HIV self-tests that have been available in pharmacies and drugstores in some countries since 1996 play a key role in preventing the spread of the disease. Although the SUS offers the people free test, it is necessary the availability of these tests in pharmacies and drugstores in Brazil. This test mode offers quick and safe results, however with some warnings that can be clarified mainly through the pharmacist. Although these tests provide a high reliability rate, there are numerous possibilities of a false negative result, so the orientation of pharmacists to the consumer is extremely important. With this article it will be possible to identify the types of tests available, the advantages of self-testing as well as their accuracy, which groups of risk can benefit and the social approach to this type of test and how was the experience of putting them. These tests are available in other countries, such as France and the United States.

Antibiotic Dispensing Practices in Community Pharmacies: A Major Health Concern in the Eastern Democratic Republic of Congo

Aims:The practice of antibiotic dispensing in community pharmacies may contribute to irrational use of antibiotics. The aim of this study was to evaluate the antibiotic dispensing patterns in community pharmacies of the Eastern DRCongo.Methods:It is a cross-sectional study carried out at Bukavu city. The study included 1504 subjects attending community pharmacies. Thus, a total number of 40 pharmacies were selected. The sociodemographic profiles of patients and dispensers were also recorded. The pharmacological interventions were investigated in terms of antibiotics dispensed according to patient’s complaints antibiotic dispensing with or without prescription, the substitution of antibiotics in prescriptions.Results: Participants attending pharmacies for antibiotic needs were in the mean age of 29.8±13 years. Most of the pharmacy workers consisted of pharmacy technicians (70%) and no trained dispensers (20%). Pharmacists represented only 10% of all dispensers in community pharmacies. We found that 67.8% of subjects purchased antibiotics without prescription. The antibiotics dispensed without prescription were either on patients’ requests (70.1%) or the suggestion of dispensers (29.9%). Only 18.4% of prescriptions were subject to substitution. The conditions for requiring antibiotic dispensing without prescriptions were respectively gastrointestinal (34%), respiratory (27%), genitourinary (25%), skin (11%) and dental (2%) infections. Conditions that were not well defined represented 1%. In cephalosporins, Cefixime was the most important drug dispensed without prescription (72.5%) whereas in penicillins, this was Amoxicillin (55.5%). Doxycycline was more dispensed in the class of cyclines (69.4%). Erythromycin (53.1%) and Azithromycin (29.4%) were more dispensed in the class of macrolides. Ciprofloxacin was the most dispensed drug in the class of quinolones (74.3%) and Metronidazole (86.8%) in the class of imidazoles. Conclusion:The Antibiotic dispensing practice is very critical in the community pharmacies of Bukavu city due to the lack of qualified dispensers. This may increase the antibiotic self-medication and contribute to antibiotic resistance

Precios de medicamentos esenciales para el manejo y tratamiento de la COVID-19 en establecimientos farmacéuticos peruanos públicos y privados / Prices of essential drugs for management and treatment of COVID-19 in public and private Peruvian pharmacies

RESUMEN Objetivo: comparar los precios de venta de medicamentos esenciales para el manejo y tratamiento de la COVID-19 en establecimientos farmacéuticos peruanos públicos y privados. Además, estimar el costo por persona del tratamiento farmacológico para casos leves y severos. Materiales y métodos: estudio transversal con información reportada por establecimientos farmacéuticos públicos y privados. El precio de los medicamentos se presenta en medianas y se compararon usando la prueba no paramétrica de Kruskal-Wallis. Además, se estimó el costo por persona y asequibilidad para el tratamiento de casos leves y severos. Resultados: medicamentos para casos leves como azitromicina, hidroxicloquina, ivermectina y paracetamol tienen medianas de precios entre S/ 0,04 (US$ 0,011) y S/ 23,81 (US$ 6,71) en establecimientos públicos, mientras que los mismos medicamentos en establecimientos privados fluctúan entre S/ 1,00 y S/ 36,00. En promedio, los precios de los medicamentos en el sector privado son 11 veces los precios en el sector público. Los costos de tratamiento por persona en establecimientos públicos son más asequibles que en los privados, especialmente para los medicamentos para casos más severos. Los esquemas de tratamiento para casos leves requieren la inversión de entre uno a cuatro días de salario mínimo. Mientras que los tratamientos de casos severos pueden requerir, hasta 64 días de salario mínimo en establecimientos privados. Conclusiones: el tratamiento farmacológico para COVID-19 supone un gasto importante para el sistema de salud público y para las familias a través de gastos de bolsillo. Urge diseñar e implementar medidas regulatorias para mejorar el acceso a medicamentos a precios asequibles.

ABSTRACT Objective: to compare the sale price of essential drugs used in the management and therapy of COVID-19 in public and private pharmacies in Peru. Also, to assess the cost per person of drug therapy for both mild and severe cases. Materials and methods: this is a cross-sectional study using data reported by public and private pharmacies in Peru. Drug prices are presented as median values and they were compared using the non-parametric Kruskal-Wallis test. Also, costs per person and drug accessibility for treating mild and moderate cases were estimated. Results: drugs used when treating mild cases of COVID-19, such as azythromycin, hydroxichloroquine, ivermectin, and paracetamol had median prices between S/ 0.04 (US$ 0.011) and S/ 23.81 (US$ 6.71) in public pharmacies, while the same compounds cost between S/ 1.00 (US$ 0.28) and S/ 36.00 (US$ 10.15) in private pharmacies. On average, drug prices in private pharmacies are 11 times higher compared to those in public pharmacies. Costs for (COVID-19) therapy in public pharmacies are more accessible compared to those found in private pharmacies, particularly for drugs used for more severely affected patients. Therapy regimens for mild cases require spending 1 to 4 days of the minimum daily wages, while therapy for severe cases (of COVID-19) may require up to 64 days of the minimum daily wages in private pharmacies. Conclusions: pharmacological treatment for COVID-19 represents an important expense for the public health system and for families through out-of-pocket expenses. It is urgent to design and implement regulatory measures aiming to improve the access to drug therapy (for Covid-19) in order to have drugs sold at accessible prices.

Cumplimiento de la normatividad en droguerías con servicio de glucometría en cuatro ciudades de Santander, Colombia / Regulation Compliance in drugstores with glucometry service in four cities of Santander-Colombia

RESUMEN Objetivo Evaluar el cumplimiento normativo del servicio de glucometría en droguerías del departamento de Santander-Colombia. Métodos Estudio observacional descriptivo de corte transversal. Se usó un instrumento de evaluación basado en la norma y validado por expertos. Resultados Se aplicó una encuesta a 68 droguerías. Los resultados fueron categorizados así: recursos humanos, dotación, infraestructura, documentación-registro y procesos de vigilancia y control. En la primera categoría se identificaron falencias relacionadas con la formación académica del personal a cargo de la droguería, con un porcentaje de cumplimiento del 66,2% y en la capacitación del personal en el manejo del equipo de glucometría 35,3%. En general el conocimiento de la normatividad por parte del personal fue de 36,8%. En las categorías de dotación e infraestructura se evidencia un nivel de cumplimiento superior al 50% para todos los ítems, excepto el relacionado con la calibración del equipo. En la cuarta categoría, específicamente en documentación y registro, los niveles de cumplimiento normativo son inferiores al 50% en todos los ítems, excepto el de información, que se le ofrece al paciente durante el procedimiento. Los resultados evidencian una falla en los procesos de vigilancia y control, dado que solo el 57,4% de los establecimientos confirman visitas de inspección. Conclusiones Los resultados de este estudio revelan un desconocimiento generalizado de la normatividad en droguerías que prestan el servicio de glucometría; consecuentemente, no se cumplen todas las exigencias regulatorias. Fomentar programas de capacitación y fortalecer la cultura de la autoevaluación garantiza procesos seguros para el paciente.(AU)

ABSTRACT Objective To evaluate the compliance of the service of glucometry in drugstores in the department of Santander - Colombia. Methods Cross-sectional observational study. An assessment instrument based on the normativity and validated by experts was used. Results The poll was applied to 68 drugstores. The results were categorized as follows: human resources, equipment, infrastructure, documentation - registration, and surveillance and control processes. In the first category, shortcomings related to the academic training of the staff in charge of the drugstore were identified, with a compliance percentage of 66,2% and in the training of personnel in the management of the glucometry equipment, 35,3%. In general, the knowledge of the regulations by the staff was 36,8%. In the equipment and infrastructure categories, a level of compliance of more than 50% is evident for all items, xcept in those related to calibration equipment. In the fourth category, specifically in documentation and registration, the levels of regulatory compliance are less than 50% in all items, except in the one related with the information that is offered to the patient during the procedure. The results show a failure in the surveillance and control processes, where only 57,4% of the establishments confirm inspection visits. Conclusions The results of this study reveal widespread ignorance of the regulations in drugstores that provide the glucometry service; consequently, not all regulatory requirements are met. Promoting training programs and strengthening the culture of self-evaluation guarantees safe processes for the patient.(AU)

Conocimiento sobre el método Dáder de seguimiento farmacoterapéutico en farmacias comunitarias de la ciudad de Sucre / Knowledge of the Dadder method of pharmacotherapeutic follow-up in community pharmacies of the city of Sucre

La presente investigación tuvo la finalidad de conocer y evaluar el conocimiento sobre el método Dáder de seguimiento farmacoterapéutico en farmacias comunitarias del patrimonio histórico de la ciudad de Sucre, ya que es necesario e importante el seguimiento farmacoterapéutico en la población para detectar problemas relacionados con los medicamentos y prevenir como solucionar respuestas negativas asociadas a los medicamentos siendo útil el método Dáder por ser un procedimiento operativo sencillo pero con parámetros fundamentales y bien estructurados para realizar el seguimiento farmacoterapéutico de una forma sistematizada, continuada y documentada para registrar, monitorizar y evaluar los efectos de la farmacoterapia. Las farmacias comunitarias son farmacias privadas de interés público, en el que se accede diariamente a comprar medicamentos, en las que el farmacéutico brinda un servicio individualizado y puede coordinar con el paciente un plan de seguimiento, lo que es diferente en una farmacia hospitalaria en la cual sus acciones son limitadas por el hospital o médicos, y se tomó en cuenta la zona del patrimonio histórico de la ciudad de Sucre ya que es muy concurrida con mucha afluencia de gente y las farmacias tienen mayor gama de productos farmacéuticos e innovadores, lo cual permite realizar seguimiento farmacoterapéutico. Entre los resultados se obtuvo un insuficiente conocimiento del método Dáder de seguimiento farmacoterapéutico en las farmacias comunitarias, dando un valor del 77% (n=27) de los farmacéuticos encuestados de un total de 35 con un conocimiento insuficiente, además se relacionaron el género, edad, cargo profesional del farmacéutico en las farmacias comunitarias y asistencia del farmacéutico a cursos de Seguimiento Farmacoterapéutico, como también el uso del Método Dáder.

The present investigation had the purpose of knowing and evaluating the knowledge about the Dader Method of Pharmacotherapeutic Monitoring in community pharmacies of the historical heritage of the city of Sucre, since it is necessary and important the Pharmacotherapeutic Monitoring in the population to detect problems related to medications and prevent how to solve negative responses associated with medications, the Dader Method being useful because it is a simple operating procedure but with fundamental and well-structured parameters to carry out Pharmacotherapeutic Follow-up in a systematic, continuous and documented way to record, monitor and evaluate the effects of Pharmacotherapy Community pharmacies are private pharmacies of public interest, which are accessed daily to buy medications, in which the pharmacist provides an individualized service and can coordinate with the patient a follow-up plan, which is different in a hospital pharmacy in the which their actions are limited by the hospital or doctors, and the area of the historical heritage of the city of Sucre was taken into account since it isvery busy with a lot of people and pharmacies have a greater range of pharmaceutical and innovative products, which allows pharmacotherapeutic follow-up. Among the results, insufficient knowledge of the Dader Method of Pharmacotherapeutic Follow - up was obtained in community pharmacies, giving a value of 77% (n = 27) of the pharmacists surveyed out of a total of 35 with insufficient knowledge, in addition the gender was related, Age, professional position of the pharmacist in the community pharmacy and assistance of the pharmacist to Pharmacotherapeutic Follow-up courses, as well as the use of the Dader Method.

Research on Development of Preparations in Traditional Chinese Medicine Classics During the Han,Tang and Song Dynasties / 中国实验方剂学杂志

This paper compared and analyzed the relevant records of Chinese medicine pharmacy in the Han,Tang and Song dynasties,and summarized the changes of the dosage forms,preparation techniques and administration methods of Chinese medicine with the development of history.In this study,three classic medical works in the Han,Tang and Song dynasties,including Treatise on Febrile Diseases Caused by Cold,Valuable Prescriptions for Emergency and Formularies of the Bureau of People's Welfare Pharmacies,were taken as the research objects,and the development of the dosage forms,auxiliary materials,preparation technology and medication theory were summarized and explored by the ways of content analysis,comparative analysis and case analysis.The comparison showed that in the development process,the dosage forms gradually increased,but the liquid dosage forms gradually decreased,the solid dosage forms gradually increased.Not only the dosage forms varied in the number,types of excipients used more and more,but the level of preparation had been constantly improved while the methods of taking became more detailed.This evolution of dosage forms and pharmaceutical technologies in Chinese history is worth learning and thinking about it.Through exploring the traditional Chinese medicine(TCM) technologies and theories in the Han,Tang and Song dynasties,we can contribute to the inheritance of traditional preparations and it can provide the basis for the development of modern preparations with TCM characteristics.

Study on the Distribution ，Drug Supply and Quantity of Licensed Pharmacists in Retail Pharmacies around 5 Third Grade Class A Hospitals from Beijing / 中国药房

OBJECTIVE： To investigate the distribution， drug supply and quantity of licensed pharmacists in retail pharmacies around Third Grade Class A Hospitals， and to provide reference for decision-making of related management departments. METHODS： Field investigation and questionnaire survey were used to investigate the distribution， type， operating area， annual turnover， drug type， ranking of consumption sum， daily prescription amount and pharmacist allocation of 5 Third Grade Class A Hospitals in Beijing and general information of 100 surveyed pharmacists in 2017. RESULTS： There were 43 retail pharmacies in total within 1 km of 5 Third Grade Class A Hospitals， with an average of 8.60 retail pharmacies for each hospital. The number of retail pharmacies with distance between 200-400 m and 800-1 000 m was the largest （11）， of which 21 （48.84％） were chain drugstores. The operating area of 38 pharmacies （88.37％） was in the range of 100-175 m2， mainly ranging 100-125 m2 （16 pharmacies， 37.21％）. The annual turnover of 40 pharmacies were counted and ranged 50-10 000 ten thousand yuan， among which the pharmacies 0-200 m away from the hospital had the highest annual turnover. The average variety of drugs （prescription drugs and over-the-counter drugs） was 2 511 kinds. 34 pharmacies （79.07％） had more varieties of over-the-counter drugs than prescription drugs， and the consumption sum of over-the-counter drugs was higher than that of prescription drugs in 26 pharmacies （60.47％）. Top 3 drugs in the list of consumption sum were antineoplastic drugs， cardiovascular drugs and anti-infective drugs. Average daily prescriptions of 28 drugstores （65.11％） were less than 10 pieces； average daily prescription were more than 20 pieces in only 7 pharmacies （16.28％）. On average， each pharmacy had 7.4 staff members and 1.37 licensed pharmacists. 58 staff members’ first degree was junior college （58％）， 38 staff members’ first degree was technical secondary school or high school （38％）， and only 3 （3％） staff members’ first degree was undergraduates or above. CONCLUSIONS： With the gradual promotion of “health care policy” and the outflow of more hospital prescriptions， the retail pharmacies around hospitals should increase their numbers， expand the operating area， accelerate the construction of licensed pharmacists and improve the education level of pharmacists so as to improve the pharmaceutical care ability.

Outcome evaluation of the drug withdrawl mode as used at inpatient pharmacy / 中华医院管理杂志

Drug withdrawal has always been a tough challenge in drug quality management for the pharmacist. In order to optimize the drug withdrawal process, the hospital has introduced an inpatient pharmacy IT system. This system can efficiently minimize the drug withdrawal rate of major departments and withdrawal counts due to substandard quality problems, thus sizably avoiding human resource wastes in the conventional withdrawal process, reducing drug quality problem, enhancing management efficiency and efficiency of nursing staff and pharmacists, and ensuring clinical drug use safety.