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@#Introduction: The prospect of public accessing community pharmacies for minor ailment advice or treatment highly depends on the pharmacy attributes and their staff. This study aimed to investigate the extent to which community pharmacies are used as a source of minor illness management and the public’s relative preferences for pharmacy features. Methods: A cross-sectional survey among the public in Malaysia was carried out between August and December 2020. The validated self-administered questionnaires were distributed at several pharmacies and shared via email, Whatsapp group, and Facebook. Results: A total of 141 from 153 public respondents completed the survey. From the descriptive and inferential analysis, it was found that about a third of the public goes to a pharmacy for advice or treatment for minor illnesses. The vast majority of respondents had positive perceptions that community pharmacists are knowledgeable and qualified to offer advice or treatment for minor diseases. A significant positive relationship was observed between pharmacy characteristics’ scores and pharmacy staff and pharmacy services’ scores (p<0.001). The increase in pharmacy staff score significantly increased the pharmacy services’ score (p<0.001). Conclusion: The implications of the public acknowledging specific attributes were crucial in further supporting community pharmacists’ services, especially in the private practice setting.
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@#Introduction: Telepharmacy refers to the delivery of pharmaceutical care service through telecommunication to patients in locations where they may not have direct contact with a pharmacist. During the COVID-19 pandemic, the role of pharmacist has expanded to provide services remotely through telepharmacy. This study aimed to assess Malaysian community pharmacists’ perception and attitude towards implementing telepharmacy. Method: This cross-sectional study was carried out from August 2020 to October 2020 using an online self-administered questionnaire. 217 community pharmacists in Klang Valley were recruited through convenience sampling method. 5-point Likert scales were used to evaluate the respondent’s perceived benefits, perceived barriers and attitude towards the implementation of telepharmacy. Results: 37.8% of the respondents showed positive perception while 53.9% are moderately positive towards towards the benefits of telepharmacy. Age (p=0.019) was shown to impact on the perceived benefits on implementation of telepharmacy. Only 8.3% of the community pharmacists perceived low barriers in telepharmacy implementation and it was significantly associated with education level of the respondents (p=0.032). Younger community pharmacists and community pharmacists who have less years of working experience were more likely to have a positive attitude towards the implementation of telepharmacy (p<0.001). Conclusion: In conclusion, most Malaysian community pharmacists practicing in urban area has shown positive perception and attitude towards the benefits and implementation of telepharmacy. However, the perceived barriers towards its implementation is high. A separate training or education on telemedicine may be useful to promote the use of telemedicine to all the pharmacists.
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The number of heated tobacco product users is increasing rapidly in Japan; thus, smoking prevention education that includes heated tobacco products is necessary. To clarify the current status and issues related to smoking prevention education programs for school pharmacists, a questionnaire survey was conducted among 300 school pharmacists. The response rate was 45.3% (136/300). Smoking prevention education was provided by 42.6% (58/136) of school pharmacists. Among them, 56.9% (33/58) included heated tobacco products in their education programs. Moreover, 75.9% (44/58) of pharmacists also provided support for smoking cessation at pharmacies, and 93.1% (54/58) of pharmacists felt the necessity of providing support for smoking cessation for heated tobacco product users at pharmacies. On the other hand, 21.8% (17/78) of school pharmacists who did not provide smoking prevention education responded that they did not have sufficient information and knowledge about heated tobacco products. In addition, among these pharmacists, 53.8% (42/78) did not provide support for smoking cessation at pharmacies. Although both groups felt the need for the smoking prevention education provided by school pharmacists, the school pharmacists who provided such education felt the need more strongly. Regarding the necessity of including the taking up of heated tobacco products in smoking prevention education, it was found that pharmacists who provided such programs felt the necessity more strongly. It is important to obtain accurate information about heated tobacco products and change the content to unified educational in cooperation with schoolteachers to enhance smoking prevention education by school pharmacists.
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Abstract A collaborative physician-pharmacist relationship is a fundamental component of a patient's primary care. The aim of this study was to investigate the attitude of physicians toward collaborative work with community pharmacists in Sulaimani City, Iraq. A cross sectional design was utilized, and a questionnaire was sent to 60 physicians, of whom 47 completed the questionnaire. A total of 26 (55.3%) physicians stated that they had a history of collaboration with pharmacists in their routine daily work. During/before the treatment process, more than one-third of the physicians "rarely" practiced collaboratively, and one-fifth "never" collaborated. There was little agreement on the community pharmacist's recommendations; however, after the treatment decision by the physician, a higher degree of agreement was reported, and the number of physicians who were "rarely" or "never" practiced collaboratively decreased to less than 5%. Furthermore, the physicians' perspective on the pharmacists' role showed that advising patients on drug administration (85.1%) and preventing drug interactions (76.6%) were the most common duties of the community pharmacists. Physicians agreed on several barriers with respect to collaboration with pharmacists. In conclusion, the physicians' perspective on the engagement of the community pharmacist in the management of patients was relatively limited. The pharmacist's recommendation was more accepted after medications were prescribed than before or during decision making on the treatment.
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Objective: The worldwide spread of the COVID-19 pandemic since 2020 led to a lack of information even at Japanese pharmacies, which are at the forefront of community medicine. Therefore, the Kyoto University Graduate School of Public Health Pharmacy Information Group has developed information materials related to COVID-19 for pharmacies0and released them on the COVID-19 countermeasure website, which was launched in haste. However, these days in the information society, the amount of information distributed is explosively expanding. Therefore, it is not possible to reach the target people just by publishing the countermeasure website. Therefore, we set up a public relations team to carry out publicity activities for pharmacists and analyzed the effectiveness of these activities by focusing on changes in the number of page views (PV) on the countermeasure website.Methods: PV and public relations(Facebook, industry media , e-mail) activities during the first 18 days(EARLY period), which is half of the total PV, and the remaining 164 days(MIDDLE period), covering 182 days from the day before the countermeasure website was opened. The changes in quantity were compared. Furthermore, we also compared the changes in the level of interest in the new coronavirus during the target period using Google Trends.Results: PV was remarkably large in the EARLY period, and the amount of public relations activity was generally concentrated in the EARLY period and PV. The number of searches for related words on Google Trends was almost the same as PV except for some. Conclusion: The study revealed the importance of establishing a pandemic countermeasure website for pharmacists at an appropriate time and conducting intensive public relations activities in the early stages.
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Depression requires continuous long-term treatment. However, many patients drop out from their treatment program. The purpose of this study is to investigate the current status of pharmacists’ support for depressed patients at higher risk of self-discontinuation of medication. This was a cross-sectional study of community pharmacists’ support for depressed patients using a web-based questionnaire. The survey items were 1) pharmacists’ basic attributes and 2) pharmacists’ support to prevent patients from dropping out of their treatment. Morphological analysis was performed using text mining to analyze the free responses, and the relationships between the extracted categories were examined using hierarchical cluster analysis. Free responses were obtained from 77 pharmacists. The morphological analysis extracted 26 categories from their responses, and the category with the highest frequency of occurrence was “explain” (44 times). The extracted categories were stratified into clusters 1 to 6 using hierarchical cluster analysis.
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Objective: The study aimed to identify potential components of the collaboration between hospital and community pharmacists from the perspective of pharmacists in municipal hospitals. Methods: Following a preliminary study, an online survey was conducted among pharmacy directors and those on an equivalent managerial level in municipal hospital pharmacies. The survey used a 5-point Likert scale with 32 items about the components of collaboration between hospital and community pharmacists. We performed an exploratory analysis and structural equation modeling of the data. Results: The analysis proposed a five-factor model (“Organizational climate,” “Information sharing system,” “Community support system,” “Interest in healthcare policy,” and “Understanding of healthcare policy”), which consisted of 17 items. Subsequent confirmation with structural equation modeling created a model with good fit (in terms of partial evaluation and overall goodness of fit) with a chi-square of 86.218, P-value of 0.564, goodness of fit index of 0.907, adjusted goodness of fit index of 0.857, and other good model fit indices (comparative fit index of 1.000 and root mean square error of approximation of 0.000). Discussion: This study identified two core universal concepts and three concepts adhering to the current medical context, that seem to guide the behavior of municipal hospital pharmacists─who are major players in community healthcare─in their collaboration with community pharmacists.
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Objective: The aim of the study was to assess the effectiveness of educational interventions on the knowledge andcounseling practice of community pharmacists in Hue, Vietnam with respect to common cold management.Method: Thirty-eight pharmacists were invited to participate in educational initiatives, including in-class training andreference to a printed pocket handbook. The knowledge was measured before and after the interventions via a paperbased test, and actual practice was evaluated via a pseudo customer experiment a week later.Results: The interventions significantly improved pharmacists’ knowledge (p = 0.001). In the pre-test, only 37.4%of the participants provided correct answers, but this increased to 83.9% in the post-test. In the pseudo customerexperiment, pharmacists asked about patient identification, age, and symptoms (93.3%, 80.0%, and 80.0%,respectively) but not about medical and medication histories or allergies (less than 20%). All pharmacists offeredadvice as regards dosage, but only half of them shared information on drug names and indications. A third providedguidance on drug interactions. Practices related to inappropriate drug dispensing included the issuance of incorrectmedications or the sale of prescription-only drugs to customers with no prescriptions.Conclusion: Although educational interventions effectively enhance the knowledge and counseling practice ofpharmacists, a huge gap continues to exist between these variables.
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Objective: This study's objective was to determine the level of career satisfaction among practicing Community Pharmacists (CPs) and the impact of various factors on career satisfaction. Methods: This cross-sectional study used a self-administered instrument to accessthe current level of career satisfaction among CPs. The survey instrument questions were adopted from previous studiesand werecontextualized to suit studyobjectivesand revalidated using face and content validation. The study instrument was distributed and collected. Results: A total of 172 responses from CPswere received, 112(65.1%) from males and 60(34.9%) from females. The difference in age categories was significantly profound in theless than 34 years old group being 113(65.7%) compared withthe more than 34 years old being 59(34.3%). Around 98(57%) were working in chain pharmacies and 74(43%) in independent pharmacy stores. The study result showed126 (73.3%) were unsatisfiedin their careers and 46(26.7%) were satisfied. Conclusion:Age and working experience are both major contributing factors to career satisfaction levels. Only 36.5% reported having higher career satisfaction levels among total participated CPs
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Objective: Community pharmacists have an important role in promoting the appropriate use of antibiotics. There is a paucity of data describing the contributions of community pharmacists in antimicrobial stewardship program (ASP) in Nigeria. This study evaluated the practices and perceptions of community pharmacists towards ASP. Methods: This was a cross-sectional study conducted among community pharmacists in two cities in Northern Nigeria: Minna and Kaduna, using a 30-item validated and pre-tested questionnaire. Data collected between April and May 2019 and analyzed using SPSS version 23. Results: Of 130 community pharmacists, 98 completed and returned the questionnaire (response rate: 75.3%). More than 90% strongly agreed/agreed that ASP is important to reduce inappropriate use of antibiotics and antibiotic resistance, improve patient’s clinical outcomes. However, lack of training (56.1%), lack of cooperation from physicians (61.2%) and lack of access to patient records (66.8%) were identified as barriers to community pharmacists’ involvement in ASP. Overall, community pharmacists had good practices (median score: 3.5; IQR: 1–5) and positive perceptions (median score: 4.0; IQR: 3–5) towards ASP. Job status and dispensing antibiotics without prescription were significantly associated with practice, while age and job status were associated with perception towards ASP. Conclusion: Community pharmacists demonstrated good practices and positive perceptions towards ASP. However, lack of training and lack of cooperation from prescribers limit their involvement in the program. Training of community pharmacists in antimicrobial stewardship and inter-professional collaboration are recommended.
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The absence of dispensing separation between private doctor clinics and pharmacies is the main challenge of theMalaysian community pharmacists. Within this context, the utilization of non-prescription medicines for minorailments treatment is one of the major roles of the pharmacists. This study aimed to evaluate the minor ailmentsmanagement using non-prescription medicines among the Malaysian community pharmacists. This was a crosssectional descriptive study. The entire population of Malaysian community pharmacists (n = 2,730) were invitedfor participation. Data were collected across the first 10 requests for minor ailments management involved adultconsumers in a working day. A total of 173 pharmacists were participated (response rate 6.3%) and 1,704 consumerswith 2,149 minor ailments were encountered. The consumers mostly have one minor ailment (78.3%) and involvedacute conditions (92.3%). Productive cough (7.3%), fever (6.3%), and dermatitis (6.1%) were most commonlymanaged by the pharmacists. Cetirizine (5.9%), paracetamol (4.7%), and diclofenac (4.2%) were most frequentlydispensed and each consumer received an average (median) of two medications. The median duration of treatment was5 days [inter-quartile range (IQR): 3–7] and the cost of treatment involved only medicines cost (median: RM 13.40;IQR: 8.00–21.00) without any consultation fee. The majority of the consumers (75.5%) sought help from pharmacistsfirst without consulting the doctors. Only 16.4% of the consumers were followed-up by the pharmacists. In conclusion,the pharmacists actively managed the minor ailments with an affordable cost of treatment. Guidelines and an auditsystem should be established to enhance the minor ailments practices of the pharmacists.
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Objective: Owing to inconspicuous memory impairment during early disease stage, patients with dementia with Lewy bodies (DLB) are often diagnosed with mental disorders according to depressive symptoms and visual hallucinations. Severe sensitivity to antipsychotic agents, a DLB characteristic, increases mortality. Herein, we reviewed current challenges and approaches for early DLB detection and appropriate drug use by evaluating pharmacists' ability to recognition of DLB and their level of involvement in medication consultation with dementia patients.Designs: This is a cross-sectional study in Japan.Methods: We provided an anonymous self-administered survey questionnaire to 372 community pharmacists. Descriptive statistics,chi-square test (attributes, recognition, and experiences with medication consultation), and content analysis (free description of drug hypersensitivity) were used for data analysis.Results: The recognition rates for questions on DLB symptoms were as follows: visual hallucinations, 76%; delusion, 63%; other symptoms, including those categorized as core clinical features, such as fluctuating cognition, and REM sleep behavior disorder,＜40%. The rate of other symptoms was similar to that of false recognition of Alzheimer's disease symptoms. The recognition rate of certain DLB symptoms varied depending on pharmacists' experience in medication consultation with dementia patients and drug-induced evaluation during delirium/cognitive decline over the previous month. Approximately 65% of the participants did not respond to open questions on symptoms suggestive of drug hypersensitivity, whereas 55% of those who responded referred to allergic symptoms such as rashes.Conclusion: Owing to their lack of recognition of DLB symptoms, the current contribution of pharmacists to early DLB detection and proper drug use is limited. Thus, it is important to provide patients' observation points and method of questioning during interviews so that pharmacists can easily recognize DLB symptoms. It is critical to clarify that DLB drug hypersensitivity is attributed to mechanisms different from that of drug allergy.
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Introduction: This study assessed the validity and reliability of the Japanese Consultation and Relational Empathy (CARE) Measure in community pharmacist consultations.Methods: We administered an anonymous self-questionnaire about patient consultations with pharmacists to 11 community pharmacies between November 2018 and March 2019.Results: A total of 224 patients completed the questionnaire. Low numbers of missing values and 'not applicable' responses suggested high face validity of the Japanese CARE Measure. Factor analysis resulted in a single solution and internal reliability was high (Cronbach's alpha 0.943). Construct validity was supported by a significant relationship (Spearman's rho 0.43, p<0.01) with the patient's satisfaction with the consultation.Conclusion: The Japanese CARE Measure may be valid and reliable in a community pharmacy setting.
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Background@#Community pharmacists play a central role in the management of minor ailments and their clinical knowledge is vital in improving treatment outcomes of these ailments. The provision of minor ailment service in developed countries has been successful yet the practice in the Philippines has not been documented. @*Objectives@#The aim of this study was to document the involvement of community pharmacists in the management of minor ailments, the practices, and the perceived challenges in the provision of pharmacy service. @* Methods@#This was an exploratory descriptive study. Using qualitative research technique, a guided interview questionnaire was employed for data gathering. The practices employed and perceived challenges encountered by pharmacists were interpreted using conventional content analysis. @* Results@#Colds, cough, skin allergy, diarrhea were the four most common ailments managed by community pharmacists. Pharmacists had underdeveloped roles in consultation. Community pharmacists were knowledgeable on the causes of the minor ailments and the medications dispensed were compliant with approved product indications. The absence of institutional guidelines (66%), lack of ailment-specific training (100%), insufficient clinical skills (76.7%), and a dominant patient self-selection behavior for OTC medicines (73.3%) were perceived as challenges in the provision of minor ailment services.@*Conclusion@#Community pharmacists managed common ailments with non-prescription medicines however consultation roles were found to be underdeveloped.
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Pharmacists , Nonprescription Drugs , PhilippinesABSTRACT
Community pharmacists (CPs) often stock herbal and dietary supplements (HDS) at their community pharmacies. Therefore, CPs should be held responsible for ensuring safe and appropriate use of HDS. The present study aims to investigate the factors associated with the intention (INT) of CPs to assess their customers’ HDS use. A crosssectional study using a self-completed questionnaire was employed. A questionnaire along with a cover letter and stamped envelope was sent to CPs at community pharmacies located in Kuala Lumpur, Malaysia. Only 70 out of 533 CPs responded to the survey (response rate = 13.13%). The results showed that 11.4% (8/70) of CPs always assess customers’ HDS use. The CPs, however, had positive and moderately high INT to assess customers’ HDS use (mean = 3.84 ± 0.70). Positive and significant correlations were noted between INT and belief about consequences, moral norms, belief of capabilities, and role and identity. The relationship between INT and social influences was statistically insignificant. Efforts to enhance the INT of CPs to assess customers’ HDS use should be warranted. This could be achieved by enhancing beliefs that are positively associated with the CPs’ INT to assess customers’ HDS use.
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OBJECTIVE: To examine the perceptions and attitudes toward spontaneous adverse drug reaction (ADR) reporting system among community pharmacists and identify factors that influence reporting, by implementing a survey. METHODS: A structured questionnaire was developed and distributed online. Request for the survey was posted on the website of pharmacy's billing program, and the survey was conducted for 8 days. We collected the participants' response on their work environment, experience of ADR reporting, and their perception and attitude on the reporting system. Multivariate logistic regression was used to evaluate factors influencing ADR reporting. RESULTS: A total of 382 pharmacists participated in the survey. Significant contributing factors for reporting level were age (odds ratio [OR], 0.90; 95% confidence interval [CI], 0.84–0.96), knowledge of reporting method (OR, 53.56; 95% CI, 9.10–315.41), installation of reporting program (OR, 31.92; 95% CI, 4.16–244.75), and encouragement from the Korean pharmaceutical association (OR, 4.13; 95% CI, 1.11–15.35). Regarding the attitude toward spontaneous ADR reporting system, ‘lack of time for reporting’ (OR, 0.29; 95% CI, 0.15–0.53) and ‘complexity of reporting procedure’ (OR, 0.51; 95% CI, 0.31–0.84), were associated with a low likelihood of reporting. CONCLUSION: Our results indicated that the knowledge of ADR reporting method, installation of the reporting program, and encouragement from the Korean Pharmaceutical Association contribute to active reporting. It is necessary to simplify the reporting method, make the ADR reporting program user-friendly, and provide educational interventions to increase participation in spontaneous reporting by the community pharmacists.
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Humans , Drug-Related Side Effects and Adverse Reactions , Logistic Models , Methods , PharmacistsABSTRACT
Objective: To clarify challenges and strategies to execute pharmaceutical care by community pharmacists and obtain pragmatic implications for further improvement. Design: Cross-sectional study.. Methods: We conducted a nationwide internet-based questionnaire survey about pharmaceutical care by the Japanese community pharmacists in June and July 2016. Using text data of 161 respondents, we investigated their challenges and strategies in implementing pharmaceutical care. The text data were reviewed and determined for categorization through stepwise process and reconciliation between reviewers. Results: Fourteen categories were retrieved and integrated into 4 domains (pharmacists, patients, other medical professionals, and environment) from 2 dimensions (challenges and strategies). In the challenge dimension (total n＝142), communication capability (n＝26), participation in medical team (n＝17), patients’ understanding of pharmacists’ work (n＝14), lack of timeand staff (n＝14),patient- and people-centered viewpoint (n＝13). Whilein thestrategy dimension (total n＝72), communication capability (n＝21),lack of patients’ medical information (n＝18), patient- and people-centered viewpoint (n＝11), lack of timeand staff (n＝9), and self development (n＝5). As strategies for the communication capability, attitude of acceptance and collaboration, brief explanation,utilization of visual aids, adoption of objective evaluation, various acquisition of patients’ information, active listening, and sharing patients’ information were retrieved as subcategories. The highest level of attention to communication capability implies that community pharmacists certainly recognize their expected responsibility described in the government document titled “Vision for patient-centered pharmacies”. Conclusion: Community pharmacists face many challenges but have some practical strategies. Although part of such challenges is not for pharmacists themselves but for patients, other medical professionals, or entire health system, improving essential skills of pharmacists may havepositiveinfluenceto theother challenges.
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The questionnaire was distributed to caregivers regarding their management for home medication therapy. The purpose of this questionnaire was to clarify the role of community pharmacists in city “Z”, Hiroshima in supporting this activity. The results were compared among seven administrative zones. The percentage of caregivers who had routinely administered medications to dependent patients was 81%. Of these, the percentage of caregivers who had encountered difficulty in medication administration to dependent patients was 66%. Only 13% of these caregivers had sought assistance from pharmacists in dealing with issues they faced in the administration of medications. The percentage of caregivers who had easy access to pharmacists was 44%. The percentage of caregivers who received pharmacist-initiated information about patients was 23%. Among the 7 administrative zones in city “Z”, the 2 zones (H-zones) with the highest percentage of elderly citizens, 38.7%, were compared with the other 2 zones (L-zones) with the lowest percentage of elderly citizens, 25.7%, regarding medication management by caregivers. It was observed that the frequency of missing side effects or crushing medicines by caregivers was higher in H-zones as compared to L-zones. The results of this research suggest that close cooperation between pharmacists and caregivers improves the quality of medication therapy management. In an aging society, pharmacist intervention could be very beneficial to providing support and information that would improve the quality of patients’ medication therapy.
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The questionnaire was distributed to caregivers regarding their management for home medication therapy. The purpose of this questionnaire was to clarify the role of community pharmacists in city “Z”, Hiroshima in supporting this activity. The results were compared among seven administrative zones. The percentage of caregivers who had routinely administered medications to dependent patients was 81%. Of these, the percentage of caregivers who had encountered difficulty in medication administration to dependent patients was 66%. Only 13% of these caregivers had sought assistance from pharmacists in dealing with issues they faced in the administration of medications. The percentage of caregivers who had easy access to pharmacists was 44%. The percentage of caregivers who received pharmacist-initiated information about patients was 23%. Among the 7 administrative zones in city “Z”, the 2 zones (H-zones) with the highest percentage of elderly citizens, 38.7%, were compared with the other 2 zones (L-zones) with the lowest percentage of elderly citizens, 25.7%, regarding medication management by caregivers. It was observed that the frequency of missing side effects or crushing medicines by caregivers was higher in H-zones as compared to L-zones. The results of this research suggest that close cooperation between pharmacists and caregivers improves the quality of medication therapy management. In an aging society, pharmacist intervention could be very beneficial to providing support and information that would improve the quality of patients’ medication therapy.
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Objective: In this study, we surveyed the attitudes of community pharmacists regarding oral antidiabetic drugs that need to be continuously administered, focusing especially on recently available oral‐combination antidiabetic drugs, in terms of their positioning and medication adherence. In addition, we identified relevant problems from the survey results and discussed the proper use of the combination drugs.Methods: We conducted a questionnaire‐based survey on health insurance‐covered dispensing pharmacies belonging to Kanazawa, Koga, Takasaki, Hitachi, and Hitachinaka Pharmaceutical Associations via fax or post from September 1, 2017 to November 30, 2017.Results: The overall response rate to the survey was 29.8%. Although combination drugs were considered useful in terms of improved motivation to take medication, i.e., medication adherence, there were also opinions claiming that combination drugs are not particularly useful due to the following reasons: there are problems in discarding residual drugs, they are less economical than individual drugs, it is difficult to ingest tablets of combination drugs because of their large size, it is difficult to adjust doses of combination drugs, and medication adherence does not change because of concomitant drug use.Conclusion: Based on the results there was the opinion that a combination oral diabetes drug improves medication adherence but problems such as the generation of leftover unused drugs due to switching and an increase in the risk of overuse when taking medication was pointed out. It is necessary for pharmacists to give advice in recognition of the risks with each active ingredient of the oral diabetes combination drug and to continuously monitor any development of side effects. Furthermore, as with other diabetes remedies, pharmacists need to advise regarding the patient's lifestyle as well as monitor laboratory test results such as kidney function. The patient's swallowing ability is also an important consideration at the time of medication instruction.