A Qualitative Study Exploring the Management of Medicine Shortages in the Community Pharmacy of Pakistan.

Managing medicine shortages consumes ample time of pharmacists worldwide. This study aimed to explore the strategies and resources being utilized by community pharmacists to tackle a typical shortage problem. Qualitative face-to-face interviews were conducted. A total of 31 community pharmacists from three cities (Lahore, Multan, and Dera Ghazi Khan) in Pakistan were sampled, using a purposive approach. All interviews were audio taped, transcribed verbatim, and subjected to thematic analysis. The analysis yielded five broad themes and eighteen subthemes. The themes highlighted (1) the current scenarios of medicine shortages in a community setting, (2) barriers encountered during the shortage management, (3) impacts, (4) corrective actions performed for handling shortages and (4) future interventions. Participants reported that medicine shortages were frequent. Unethical activities such as black marketing, stockpiling, bias distribution and bulk purchasing were the main barriers. With respect to managing shortages, maintaining inventories was the most common proactive approach, while the recommendation of alternative drugs to patients was the most common counteractive approach. Based on the findings, management strategies for current shortages in community pharmacies are insufficient. Shortages would continue unless potential barriers are addressed through proper monitoring of the sale and consumption of drugs, fair distribution, early communication, and collaboration.

Impact of the COVID-19 outbreak on mental health status and associated factors among general population: a cross-sectional study from Pakistan.

The recent outbreak of coronavirus disease (COVID-19) has significantly affected the mental health of people globally. This study aimed to investigate the mental health status and associated factors among residents of Pakistan. An online questionnaire survey was conducted from April 3 to May 7, 2020, using convenience and snowball sampling techniques. Data regarding demographics, physical health status and contact history during the last 2 weeks were collected. Furthermore, the Depression, Anxiety, and Stress scales (DASS-21) were utilized to measure the mental health of the participants. The analyses included descriptive statistics and regression analysis. Of the 1663 participants who completed this survey, 1598 met the inclusion criteria. The results revealed mild to moderate depression among 390 participants (24.4%), mild to moderate anxiety among 490 participants (30.7%) and mild to moderate stress among 52 participants (3.3%). A majority of the participants rated their health as good (n = 751, 47.0%). Moreover, students reported significantly higher scores on depression (B = 1.29, 95% CI = 0.71-1.88; p < 0.05), anxiety (B = 0.56, 95% CI = -0.06 to 1.18; p < 0.05) and stress (B = 0.56, 95% CI = -0.12 to 1.23; p < 0.05). Physical symptoms, including fever, cough and myalgia, and contact history in the last 14 days reported significant associations with depression, anxiety and stress (p < 0.05). The mental health status of the people was noted to be affected during the COVID-19 outbreak. Assessment of several factors with significant associations with depression, anxiety and stress may aid in developing psychological interventions for vulnerable groups.