Countering Counterfeiters and Diverters

[...]the anticounterfeiting packaging market is projected to grow at a 7.8% compound annual growth rate to USS189.9 billion (€158 billion) in 2026 (1). [...]in anticipation of a spike in counterfeiting, the US Immigration and Customs Enforcement Homeland Security Investigations (HSI) has launched Operation Stolen Promise 2, to halt the production, distribution, and sale of illicit COVID-19 treatments and vaccines. The fact that the COVID-19 vaccines need to be shipped in stringent cold storage containers with radio frequency identification (RFID) temperature sensors along with specialized transportation methods will make it more difficult for counterfeiters to enter the supply chain, but not impossible." [...]Pitts predicts an increased focus on consumer engagement.

COVID-19 Pandemic Learning: The Uprising of Remote Detailing in Pharmaceutical Sector Using Sales Force Automation and Its Sustainable Impact on Continuing Medical Education

The availability of resources is vital when rapid changes and updated medical information in the provision of care are needed, such as in the fight against COVID-19, which is not a conventional disease. Continuing medical education plays an essential role in preparing for and responding to such emergencies. Workflow has improved based on the virtual meetings, online trainings, and remote detailing conducted by medical representatives in order to deliver educational content instantly through digital tools, such as salesforce automation (SFA), webinars, etc. In terms of its regulatory barriers, the pharmaceutical industry mainly targets healthcare professionals, unlike most businesses that reach end users directly. Medical representatives are equipped with an SFA to enhance customer relationship management (CRM) and closed loop marketing (CLM) capabilities in pharmaceutical companies. This study aimed to fill a gap in the literature by investigating the use of SFA in work patterns, such as health professionals' loyalty and involvement in their medical knowledge in Turkey, and how it allows for differentiating training from marketing. This study intended to compare the data on internists and medical products gathered from a well-known pharmaceutical company's SFA. The data covered the first three months of the year 2020, when medical representatives had a normal daily routine, and that of 2021, when Turkey experienced the most powerful surge of the COVID-19 pandemic. The analysis was based on simple correspondence analysis (SCA) and multiple correspondence analysis (MCA) for 11 variables. Monitoring product, physician's segment, and medical representatives' behaviors with SFA had a significant influence on the pharma-physician relationship strategy, as expected. The findings supported the view that SFA technologies can be deployed to advance the medical knowledge of physicians, in addition to managing and designing superior CRM and CLM capabilities.

Innovative high-fidelity simulation for vaccination training of pharmacist including emergency cases - a randomised controlled study

IntroductionRecently, pharmacists in Germany were allowed to administer influenza and COVID-19 vaccines for people aged 12 years and older in order to increase vaccination coverage rates. To adapt pharmacy curriculum for clinical practice, an innovative, high level vaccination training course comprising clinical skills, techniques required for level of competence was developed with participants interacting either with a high-fidelity simulator or low-fidelity injection pad. Clinical scenarios to manage adverse events were also implemented.MethodsA randomized controlled trial using a pre-post-design with pharmacy undergraduates alongside with a theoretical part was performed. The intervention group interacted with a high-fidelity simulator, while the control group was trained with low-fidelity injection pads. Before and after the respective training each participant went through an objective structured clinical examination (OSCE) and each participant completed a self-assessment questionnaire and knowledge quiz.ResultsOSCE Score were raised through an analytical checklist examining skills in anamnesis, patient information, vaccination process, and handling emergency case. Both training methods showed a significant (p<0,01) increase of skills but a significant (p<0,01) greater increase in the intervention group compared to the control group, particularly in vaccination process (p=0,007). Both Groups showed a similar increase of self-assessment score raised through a 6-point-Likert scale, and no significant differences were observed in the quizzes.ConclusionsHigh fidelity simulation proves to be an appropriate tool to train pharmacy students for vaccine administration, as a new pharmaceutical service and enable the students to recognize and manage adverse events.

How Resilience and Wellness Behaviors Affected Burnout and Academic Performance of First-Year Pharmacy Students During COVID-19

Objective. To determine whether students' levels of resilience and self-reported wellness behaviors predicted burnout and grade point average at the end of the first fall semester of the COVID-19 pandemic. Methods. We measured first-year students' resilience, burnout (exhaustion and disengagement), and self-reported wellness behaviors (sleep, nutrition, social time, and self-care activities) at the beginning and end of the fall 2020 semester of pharmacy school. We also collected students' demographic information and end-of-semester grade point average from their academic records. Using multivariable regression, we assessed whether students' resilience and wellness behaviors predicted burnout and grade point average at the end of the semester. We also assessed for changes in burnout and wellness behaviors over time. Results. Resilience was positively associated with older age and was lower among students of color. Exhaustion and disengagement were high at baseline and continued to worsen over time. Students' selfreported wellness behaviors also decreased over time, except for ratings of sleep adequacy. Resilience predicted lower levels of disengagement at the end of the semester, but its relationship with exhaustion was inconsistent. The only wellness behaviors associated with lower burnout were nutrition and sleep adequacy. Students' end-of-semester grade point average was also related to nutrition and sleep adequacy but not resilience or burnout. Conclusion. Resilience offered some protection from burnout, but its relationship to immutable factors suggests that individual-focused interventions to improve student well-being (eg, wellness behaviors such as mindfulness meditation) should be complemented by organizational support, especially for younger students and students of color.

A Survey of Pandemic Impacts on Pharmacy Residency Applications, Interviews, and Selection Factors

Objective. To assess the impact of the COVID-19 pandemic on pharmacy residency application/interview processes, match rate, and factors influencing match rankings at a single college of pharmacy Methods. In spring of 2020 and 2021, an anonymous survey of fourth-year pharmacy school (P4) residency applicants at one college of pharmacy was administered. Survey responses were compared to explore trends in showcase participation, number/type/geographic dispersion of applications submitted, interview invitations, grade point average (GPA), research experience, and match rate. A thematic analysis evaluated common factors influencing match rankings. Results. Responses were collected from 75 of 99 (75.8% response rate) residency-seeking students in 2020 and 79 of 94 (84.0% response rate) in 2021. Students in 2021 reported applying to a higher median number of programs, with no significant differences in mean reported number of interview invitations or match rate. The virtual American Society of Health-System Pharmacists (ASHP) Midyear Showcase led to a median reported savings of $1000 with no significant impact on perceived value. Virtual interviews led to a median reported savings of $430. Thematic analysis revealed feel/culture, location, and learning experience options as the most prevalent deciding factors for match rankings in both years. Conclusion. The pandemic led to an increase in the number of residency applications per student and yielded a net cost savings. There were no differences in number of interviews offered, match rate, or in deciding factors influencing match rankings. As the pandemic evolves, schools should maintain a flexible and dynamic approach to support students.

Treating children with HCV close to home through a virtual national multidisciplinary network

AimHepatitis C Virus (HCV) infection is a major global health problem. Direct Acting Anti-viral therapy (DAA) has cure rates of 99% in adults and adolescents.1 DAAs were licensed for children 3 – 12 years during the recent coronavirus pandemic. In order to ensure equitable access and a safe, effective and convenient supply of these medications during lockdown, we established a virtual national treatment pathway for children with HCV in England and evaluated its feasibility, efficacy and treatment outcomes.MethodA paediatric Multidisciplinary Team Operational Delivery Network (pMDT ODN), supported by NHS England (NHSE), was established with relevant paediatric specialists, including pharmacists, to provide a single point of contact for referrals and information. Referral, treatment protocols and family friendly patient information were developed for all HCV therapy. On referral the pMDT ODN discussed and agreed the most appropriate DAA therapy based on clinical presentation and patient preferences, including ability to swallow tablets. Treatment was then prescribed and supplied in association with the local paediatrician and pharmacist, without the need for families to travel to national centres. All children were eligible for NHS funded therapy, each referring centre was approved by the pMDT ODN, prior to approval to dispense medication and funds were reclaimed via Blueteq authorisation. Demographic, clinical and social data was collected, and treatment outcomes were recorded. Feedback on feasibility and satisfaction on the pathway and supply of medication was sought from referrers.Results34 children were referred during the first six months;median (range) age 10 (3.9 – 14.5) years;15M;19F: Majority of referrals are HCV genotype type 1 (n=17) and 2 (n=12). DAA treatments prescribed: Sofosbuvir/Ledipasvir (n=21);Sofosbuvir/Velpatisvir (n=11) Glecaprevir/Pibrentasvir (n=2).27/34 confirmed as able to swallow tablets;3/7 have received training and are now able to successfully swallow tablets;4/7 are awaiting release of granules. All children who have completed treatment to date (11/27) have cleared virus at the end of treatment. Once the network was established, referrers found the virtual process easy to access. They valued being able to discuss their patients with the MDT providing a single point of contact with national specialists to discuss therapy. Specialist pharmacists within the pMDT were able to provide pharmaceutical information and support local Trusts to ensure safe, timely and funded supply of medication to children. There were three reported dispensing errors, where adult strength tablets were dispensed in error locally, however no doses were taken as parents noticed the error prior to giving a dose. A delay in availability of the granule or pellet formulations due to manufacturing delays during COVID, has meant a delay in referring and treating those children unable to swallow tablets.ConclusionPharmacists were a valuable resource within the National HCV Paediatric MDT Operational Delivery Network. They contributed expert knowledge on formulations and doses, supporting delivery of high-quality treatment and equity of access for children and young people with HCV in England. Education and awareness of new Paediatric formulations for local Pharmacy teams may prevent future dispensing errors.ReferenceNHS News 2021. Life saving hepatitis C treatment for children on the NHS. 24th August 2021. Available at: NHS England » Lifesaving hepatitis C treatment for children on the NHS [accessed 12th June 2022].

Pharmacy Student Perceptions and Knowledge of Online Pharmacy Use

Objective. Currently, there is no set of accreditation standards for integrating the dangers of illegal online pharmacies into Doctor of Pharmacy (PharmD) curricula. As a result, many pharmacists are unable to recognize the differences between a legal and illegal online pharmacy or educate patients on the dangers of online pharmacies. The objectives of this study were to assess gaps in student pharmacists' knowledge and to assess the impact of adding education regarding online pharmacies into PharmD programs. Methods. A pre- and postsurvey design was developed. Data were collected through an electronic questionnaire distributed to second-year pharmacy (P2) students to evaluate student knowledge gaps at baseline and after education on illegal online pharmacies. Results. A total of 102 students responded to the presurvey, with 93 (91%) consenting to participate. Out of 100 respondents to the postsurvey, 84 (84%) students consented. Approximately 87% (81/93) of respondents indicated some awareness of prescription medications being purchased online. Most students (89%, 77/86) stated that they do not believe the university has provided adequate curriculum on illegal online pharmacies and counterfeit medications. After receiving education on the relevant topics, 64% (55/85) stated they now felt their education was adequate. Conclusion. Although pharmacy students were aware of the existence of illegal online pharmacies, they were not aware of the significance of this patient safety issue or how to accurately identify suspicious websites. It is imperative that PharmD programs incorporate formal education on the risks that illegal online pharmacies pose to patient and medication safety.

Drug-drug interactions with nirmatrelvir/ritonavir for COVID-19 and the role of hospital pharmacists

4CPS-043 Table 1DDI category, n(%) C: monitor therapy D: consider therapy modification X: avoid concomitant use 24(46.2) 16(30.8) 12(23.1) ATC of DDI, n (%) N-nervous system C-cardiovascular system B-blood and blood forming organs G-genito urinary system H-systemic hormonal preparations L-antineoplastic and immunomodulating agents A-alimentary tract and metabolism M-musculo-skeletal system R-respiratory system 21(40.4) 13(25) 5(9.6) 4(7.7) 3(5.8) 2(3.8) 2(3.8) 1(1.9) 1(1.9) Medical department with DDI, n(%) Haematology Oncology Nephrology Pneumology Emergency room 6(23.1) 4(15.4) 3(11.5) 3(11.5) 3(11.5) Pharmacy intervention on concomitant drugs, n(%) Discontinuation Adverse events monitoring Dose reduction Substitution Efficacy monitoring 23(44.2) 15(28.8) 7(13.5) 5(9.6) 2(3.8) Statistical significant differences were found with ATC and DDI category (p<0.001): cardiovascular system drugs had more X-category DDI (41.7%) and nervous system drugs had more C-category DDI (60.8%).Haematology department had more patients presenting any DDI (23.1%, p=0.047).No DDI provoked any adverse event during treatment with nirmatrelvir/ritonavir.Conclusion and RelevanceA high risk for DDI with nirmatrelvir/ritonavir was found, although most of them were mild and none provoked any adverse event. Cardiovascular system drugs showed the most severe DDI.Haematology patients and those receiving nervous system drugs had higher prevalence for DDI.Almost half of pharmacy recommendations were to discontinue the drug presenting the DDI. None of the pharmaceutical interventions induced any adverse event derived from the modification of concomitant treatment during nirmatrelvir/ritonavir administration.References and/or AcknowledgementsConflict of InterestNo conflict of interest

Using AI and ML to predict shipment times of therapeutics, diagnostics and vaccines in e-pharmacy supply chains during COVID-19 pandemic

PurposeThis paper aims to address the pressing problem of prediction concerning shipment times of therapeutics, diagnostics and vaccines during the ongoing COVID-19 pandemic using a novel artificial intelligence (AI) and machine learning (ML) approach.Design/methodology/approachThe present study used organic real-world therapeutic supplies data of over 3 million shipments collected during the COVID-19 pandemic through a large real-world e-pharmacy. The researchers built various ML multiclass classification models, namely, random forest (RF), extra trees (XRT), decision tree (DT), multilayer perceptron (MLP), XGBoost (XGB), CatBoost (CB), linear stochastic gradient descent (SGD) and the linear Naïve Bayes (NB) and trained them on striped datasets of (source, destination, shipper) triplets. The study stacked the base models and built stacked meta-models. Subsequently, the researchers built a model zoo with a combination of the base models and stacked meta-models trained on these striped datasets. The study used 10-fold cross-validation (CV) for performance evaluation.FindingsThe findings reveal that the turn-around-time provided by therapeutic supply logistics providers is only 62.91% accurate when compared to reality. In contrast, the solution provided in this study is up to 93.5% accurate compared to reality, resulting in up to 48.62% improvement, with a clear trend of more historic data and better performance growing each week.Research limitations/implicationsThe implication of the study has shown the efficacy of ML model zoo with a combination of base models and stacked meta-models trained on striped datasets of (source, destination and shipper) triplets for predicting the shipment times of therapeutics, diagnostics and vaccines in the e-pharmacy supply chain.Originality/valueThe novelty of the study is on the real-world e-pharmacy supply chain under post-COVID-19 lockdown conditions and has come up with a novel ML ensemble stacking based model zoo to make predictions on the shipment times of therapeutics. Through this work, it is assumed that there will be greater adoption of AI and ML techniques in shipment time prediction of therapeutics in the logistics industry in the pandemic situations.

A new pharmaceutical care programme for COVID-19 patients treated with Paxlovid®: Implementation and safety outcomes reported

Background and ImportanceThe COVID-19 pandemic has highlighted the important role that hospital pharmacists play in improving pharmacotherapy outcomes. Paxlovid® (Nirmatrelvir/ritonavir) was recently granted an Emergency Use Authorisation for the treatment of mild to moderate COVID-19. However, the use of Paxlovid® with certain other drugs in high-risk patients may result in potentially significant drug-drug interactions (DDI) and adverse drug events (ADE).Aim and ObjectivesTo assess the impact of a comprehensive pharmaceutical care program (CPCP) focusing on the prevention of DDI and ADE, initiated in a hospital pharmacy for patients with mild to moderate COVID-19 treated with Paxlovid®.Material and MethodsDesign: Quasi-experimental study performed between 1 May and 31 July 2022. Pharmacists were responsible for proposing COVID-19 local guidelines to physicians, monitoring adherence to guidelines, managing DDI and ADE, providing patient education, and evaluating health outcomes. A telephone consultation was carried out 10 days after the end of Paxlovid® treatment.Potential DDI were detected according to Lexi-Comp® and Liverpool COVID-19 databases. Paxlovid-related ADE reported were graded according to Common Terminology Criteria for Adverse Events, version 4.Results140 patients (60.7% outpatients) initiated Paxlovid® and were enrolled in the CPCP. Adherence to local guidelines for the use of Paxlovid® was 100%.Overall, 232 DDI were detected in 111 (79.3%) patients, 142 (61.2%) of which required specific management (34.5% discontinuation of the concomitant drug and 65.5% dose adjustment).Pharmacists made 267 interventions that led to the prevention of 177 ADE (1.3/patient), 96 (54.2%) of which were grade G-H (NCC MERP classification).At day 10, 96 ADEs were reported in 42 patients (26.1% of which were grade ≥3), being dysgeusia and diarrhoea the most common. Premature discontinuation of Paxlovid® due to ADEs was necessary in 4 (2.8%) patients.Conclusion and RelevanceThe implementation of a CPCP developed by hospital pharmacists for patients treated with Paxlovid® was an effective approach for monitoring adherence to guidelines, managing DDI, providing patient education, and evaluating safety outcomes. Paxlovid® showed an acceptable safety profile.References and/or AcknowledgementsConflict of InterestNo conflict of interest.

Telepharmacy and home delivery programme for outpatients through the community pharmacy

2SPD-017 Table 1Treatment Disease Number of patients Antiviral drugs HIV 38 Dermatologic and rheumatologic disorders Ankylosing spondylitis Psoriasis and others Psoriatic arthritis Rheumatoid arthritis 36 17 34 79 Digestive disorders Hepatitis B virus Inflammatory bowel disease 22 28 Erythropoiesis-stimulating agents Anaemia in patients with cancer or chronic kidney disease 30 Neurological disorders Multiple sclerosis Preventive treatment of migraine 45 11 Oral anticancer therapy Solid tumours and haematologic malignancies 10 Respiratory disorders Chronic pulmonary infection Idiopathic pulmonary fibrosis Pulmonary hypertension Severe asthma Systemic sclerosis 4 17 11 5 7 Others Hypercholesterolemia Hyperparathyroidism Miscellany 19 11 20 Eight incidents occurred: dosing error (25%), wrong drug (12.5%), wrong formulation (62.5%), that were resolved.Conclusion and RelevanceThe implementation of THDP has been a new challenge for HP. It enables us to provide drugs to patients in their immediate environment without extra cost to the healthcare system. However, the evidence of the impact of these programmes is sparse.References and/or AcknowledgementsConflict of InterestNo conflict of interest

Evaluation of inclusion criteria of outpatients included at hospital medication dispensing programme through community pharmacies

Background and ImportanceDuring the context of the COVID-19 pandemic, in order to avoid the possible transmission of SARS-COV2, some hospitals developed an outpatient hospital medication dispensing programme through delivery to community pharmacies. To access the programme , outpatients had to meet all the criteria established by Health Authorities: adherence to treatment, live more than 30 km from the hospital and present some vulnerability condition (age >65 years, reduced mobility or respiratory pathology). This programme has been maintained over time due to the excellent acceptance by patients.Aim and ObjectivesTo evaluate the compliance of our hospital with the inclusion criteria and analyse possible deviations, assessing whether it is necessary to modify them based on the current health context.Material and MethodsCross-sectional observational study in which all active outpatients in the programme between July and September 2022 were included.The following variables were collected: demographic, distance between home and hospital, vulnerability conditions and adherence to treatment.Results95 patients were evaluated, 94 (98.9%) of them were adherent to chronic treatment, 81 (85.3%) lived more than 30 km from the hospital. Regarding the vulnerability conditions: 68 (71.6%) were older than 65 years and 14 (14.7%) had a vulnerability condition other than age over 65 years.Of all the evaluated patients, 75 (78.9%) met all the inclusion criteria. 20 (21.1%) patients were in the programme , but did not meet some criteria: 6 (30.0%) patients lived less than 30 km away, 8 (40.0%) did not have a vulnerable condition and 6 (30 .0%) did not meet more than one inclusion criteria.Conclusion and RelevanceThe medication dispensing programme through community pharmacies offers an option for vulnerable patients and/or those with difficulty going to the hospital to collect their chronic medication, thus facilitating therapeutic compliance of treatment.Although a high percentage of patients met the established criteria, deviations were detected. That make us consider the need to modify these criteria in order to access in the programme according to current needs of outpatients.References and/or AcknowledgementsConflict of InterestNo conflict of interest

A patient satisfaction survey on unit dose drug distribution in hospital

Background and ImportanceSince the beginning of the COVID-19 pandemic drug distribution in the Hospital St. John of God, Linz, has been switched to automated unit dose packaging. We intended to create evidence for patients' satisfaction with pharmacy delivered blister sachets, as literature on this topic is limited and our service is so far unique in Austrian hospitals.Aim and ObjectivesWe performed a patient satisfaction survey to investigate the status quo as well as potential needs for improvement and to provide the basic data for further analyses.Material and MethodsPatients were interviewed inhouse with an internally developed questionnaire. Its mixed design – 12 multiple-choice questions and fields for comments – enabled quantitative and qualitative findings.Patients not familiar with the blister medication (e.g. no oral drugs) or not (mentally) fit enough were excluded. Within a period of two weeks hospital pharmacists carried out 38 face-to-face interviews.ResultsPatient satisfaction with the blisters was high;Transparency in administered drug therapy was considered important. Patients not or rather not satisfied stated difficulties in handling the blisters (20%). Poor physical conditions, vision deficiency and higher age correlated with utilisation problems and lower satisfaction. One in 10 patients had not been capable of opening the blister sachets and taking the medication without assistance. Two-thirds found unit dose drug distribution preferable or equal to traditional pill dispensers. Some patients commented on the environmental effects of the plastic sachets.Responding to the reported difficulties we placed infographics in the patient rooms illustrating the labelling and handling of the unit dose sachets. The staff on the wards were trained to give further information to patients and assistance in opening and emptying the blisters.Conclusion and RelevanceStudies on the effects of unit dose supply usually focus on cost-effectiveness, medication safety and nursing staff time and satisfaction. Our results add information on the patient perspective and were important for quality improvement: This pilot study not only allowed for immediately implemented actions (graphic depictions for patients and staff training) but is also a guidance for the design of a larger study (patient selection, interview technique, reliable and valid questions) to obtain sufficient statistical power and quantifiable and actionable data.References and/or AcknowledgementsConflict of InterestNo conflict of interest.

Impact of COVID-19 treatment options on hospital pharmacy's workload: lessons learned

Background and ImportanceTreatment guidelines for COVID-19 have rapidly been evolving. Different drugs against COVID-19 have urgently emerged to control the pandemic, challenging hospital pharmacies to make these antiviral and immunomodulatory therapies timely available for admitted patients.Aim and ObjectivesTo analyse the prescribing patterns of COVID-19 drugs in our hospital and its impact on the pharmacy's workload.Material and MethodsWe retrospectively analysed drug registration data from 1 January 2020 to 16 March 2022 of COVID-19 drugs (dexamethasone, remdesivir, baricitinib, casirivimab/imdevimab and sotrovimab) for hospitalised patients. Consumption data were expressed as number of patients and number of preparations. To determine pharmacy's workload, we measured the average time for drug ordering, preparation and dispensing. Hydroxychloroquine and baricitinib were excluded as these are commercially available oral drugs which are distributed according to standard procedures.ResultsThe volume of dispensed COVID-19 drugs fluctuated along with the hospitalisation waves of the COVID-19 epidemic. Oral dexamethasone was the most frequently prescribed drug throughout the whole period, which is consistent with the strong recommendation in the national guideline. Remdesivir, introduced in our practice since October 2020, was the second most prescribed drug despite low evidence. From October 2021 until December 2021, 41 infusions of remdesivir were administered, compared to 381 infusions from January 2022 until March 2022. Compared to dexamethasone and remdesivir, monoclonal antibodies (casirivimab/imdevimab and sotrovimab) were less commonly used: 48 prepared infusions between September 2021 and March 2022. Most drugs were given in combination. Remdesivir and monoclonal antibodies were manually ordered to fulfil urgent needs as the supply is managed nationwide by the government. Infusions were prepared at once due to limited stability. Ordering, preparing and dispensing required an average of 35 minutes per patient to complete.Conclusion and RelevanceThe COVID-19 pandemic impacted pharmacy's workload. We could have made more timesaving decisions such as the use of commercially available methylprednisolone instead of dexamethasone and batching remdesivir preparations. Hospital pharmacists should be involved in developing national guidelines and take into account the impact on daily practice.References and/or Acknowledgements1. Sciensano, Interim clinical guidance for adults with confirmed COVID-19, July 2022, Version 29Conflict of InterestNo conflict of interest

The clinical pharmacist: an essential actor in times of crisis

Background and ImportanceDuring the health emergency period related to the emergence of the COVID-19 pandemic, clinical pharmacists have played a vital role in mitigating medication errors, especially prescription errors in hospitals.Aim and ObjectivesThe aim of this study was to carry out a descriptive analysis of the pharmaceutical interventions (PI) on the prescriptions of the patients of the COVID units of our establishment.Material and MethodsA prospective study was conducted on patients with positive COVID-19 status admitted to a hospital COVID unit over a period of four months. The pharmaceutical analysis prompted interventions to rectify medication-related errors.ResultsThe study included 108 patients. Prescription analysis led to 63 PIs. The sex ratio (M/F) was 0.5 in a favour of female predominance. Hypertension was the most common cardiovascular disease, affecting 34% of patients. Most drug-related problems were overdose accounting for 38% (16/63). The most common PI in 40% of cases was dosage adjustment (18/63). The main drug classes concerned were general anti-infective agents for systemic use 25% (16/63), followed by corticosteroids 23% (15/63) and hydroxychloroquine 19% (12/63) especially in the event of interaction with drugs that lengthen the QT interval.Conclusion and RelevanceThe commitment of clinical pharmacy in such a pandemic is therefore important. Its presence has led to a reduction in the problems of drug prescriptions.References and/or Acknowledgements1. No conflict of interest.Conflict of InterestNo conflict of interest

In-use stability of Comirnaty and Spikevax clinical solutions: Pfizer-BioNTech and Moderna COVID-19 vaccines: a comparative study from a hospital pharmacy perspective

Background and ImportanceCOVID-19 emerged as a novel infectious disease by late 2019, spreading very rapidly and being categorised as a pandemic by March 2020 by the WHO. Several vaccines have been authorised and administered worldwide, demonstrating efficacy and safety, being Pfizer-BioNTech (Comirnaty) and Moderna (Spikevax) the mostly administered globally. Although having demonstrated efficacy and safety, one of the major issues has been their stability, from which hardly any stability data is available in the public domain. Analysing the in-use stability of these novel vaccines is paramount for ensuring rationale use in hospitals.Aim and ObjectivesThis study is aimed at assessing and comparing the in-use stability of Comirnaty and Spikevax clinical solutions by characterising the particulate profile using Dynamic Light Scattering (DLS).Material and MethodsExpired and non-expired clinical solutions of the vaccines were subjected to different stress conditions: visible light and mechanical stresses. The Z average and the polydispersity index (PDI) of the vaccines clinical solutions were evaluated by DLS, using a Zetasizer Nano ZS-90 (Malvern, UK). For statistical analysis, a simple ANOVA followed by Dunnett's post-hoc test, using GraphPad Prism 8 Software was used. Stressed samples were compared to control (non-stressed samples). Furthermore, differences were considered significant at a p-value < 0.05. The study was conducted in triplicate.ResultsComirnaty DLS parameters were mainly affected by mechanical agitation and vortex stresses. In this case, the Z-average and PDI increased significantly, even in the expired samples. On the other hand, the DLS parameters were maintained in Spikevax clinical samples regardless of the stress and the expiration date.Conclusion and RelevanceThis study highlights the necessity of a careful preparation of these vaccines, given their demonstrated fragility upon gentle stress. However, Comirnaty has proven to be more fragile than Spikevax in their handling in real-use conditions. Previous literature commented on the stability of Comirnaty, having presented similar results. Nonetheless, no stability data were available on the in-use stability of Spikevax. Therefore, this data will be of interest to hospital pharmacists towards following vaccination campaigns.References and/or AcknowledgementsAcknowledgementsTo the Farmacy Unit from the San Cecilio Clinical University Hospital (Granada, Spain) to support and facilitate this investigation.Conflict of InterestNo conflict of interest

Corporate social responsibility and customer loyalty during the Covid-19 pandemic: evidence from pharmacy practice

Purpose>In recent years, corporate social responsibility (CSR) has taken on a more prominent role in both large and small businesses because of its significant impact on various aspects of business performance. To date, a growing body of literature has demonstrated the mechanisms whereby CSR practices affect organizational outcomes;however, there has been little research examining how CSR practices contribute to customer loyalty within the pharmacy context. As such, this study aims to explore how CSR practices influence the loyalty of pharmacy customers, particularly in relation to the mediatory effects of customer-company identification (CCI) and customer trust.Design/methodology/approach>A survey questionnaire was developed and administered to collect the required data from the pharmacy context. The resultant data were subjected to exploratory factor analysis to identify the scale dimensions, followed by multiple regression analysis to test the hypotheses.Findings>Analysis of the results (n = 528) revealed that perceived CSR indirectly impacts loyalty through the mediatory effects of trust and CCI. All hypothesized effects were also confirmed via empirical testing.Originality/value>The findings of this research suggest that not only are CSR activities responsive to societal concerns, but they can also promote customer identification with pharmacies and strengthen customer trust, which can, in turn, lead to long-term customer loyalty.

Intention to consume halal pharmaceutical products: evidence from Indonesia

PurposeDespite the importance of pharmaceutical products in everyday life, particularly after the coronavirus outbreak in early 2020, only a few studies have attempted to analyse consumer behaviour with regard to halal pharmaceutical products. Therefore, this study aims to investigate the factors influencing purchase intention for halal pharmaceutical products among Indonesian Muslims.Design/methodology/approachThis study uses a theory of planned behaviour approach, in which religiosity and knowledge of halal product variables are added to attitude, subjective norms and perceived behavioural control variables. Primary data were collected from 225 Indonesian Muslims in Jakarta, the capital city of Indonesia and analysed using structural equation modelling.FindingsThe study found that the intention to purchase halal pharmaceutical products is positively affected by attitude, religiosity, knowledge of halal products and perceived behavioural control. However, the influence of the subjective norm variable was found to be insignificant in this study.Research limitations/implicationsIt is possible to improve the empirical model by including more explanatory variables and investigating the mediating effect of the variables. The study could also be scaled up to reach more respondents in different regions and countries. These additional aspects would provide better insights into the behaviour of consumers when considering halal pharmaceutical products.Practical implicationsThe findings suggest the importance of designing and implementing appropriate strategies and campaigns to enhance knowledge of halal products, of positive attitudes and of better resources/opportunities to consume halal pharmaceutical products. The industry needs to highlight its products' halal and tayyib aspects through proper branding and promotion strategies. The government and other stakeholders could also implement education campaigns to increase halal products and halal literacy knowledge. These are ultimately expected to enhance the effectiveness of halal regulations and meet Muslim consumer expectations in the country.Originality/valueDespite the importance of halal pharmaceutical products, this area has received limited attention in the academic literature. Thus, this study attempts to elaborate on consumer behaviour in this niche area.

ASSESSMENT OF THE IMPACT OF THE COVID-19 PANDEMIC ON THE FINANCIAL PERFORMANCE OF COMPANIES IN THE PHARMACEUTICAL FIELD IN ROMANIA

Performanţa financiară a unei societăţi comerciale este dependentă de o multitudine de factori, care pot fi grupaţi în factori de natură externă şi factori de natură internă. Prin studiul desfăşurat am încercat să analizăm influenţa unor factori externi specifici perioadei de pandemie COVID -19 asupra performanţei financiare a unor societăţi comerciale din domeniul fabricării produselor farmaceutice de bază din România (Antibiotice), a preparatelor farmaceutice (Biofarm, Zentiva) a activităţi de asistenţă medicală ambulatorie (Med Life). Aceste societăţi comerciale s-au confruntat cu condiţiile perioadei pandemice COVID-19, cu măsurile luate în acest sens, precum şi cu concurenţa acerbă din partea unor producători internaţionali (Sanofi, Sandoz Romania, Hoffmann la Roche, Pfizer etc. ). Astfel, unele societăţi comerciale din domeniul fabricării produselor farmaceutice şi-au redus volumul de activitate, iar altele au înregistrat o performanţă mult superioară perioadei prepandemice.Alternate :The financial performance of a commercial company is dependent on a multitude offactors, which can be grouped into external factors and internal factors. Through the conducted study, we tried to analyze the influence of external factors specific to the period of the COVID-19 pandemic, on the financial performance of some commercial companies in the field of manufacturing pharmaceutical products in Romania (Antibiotice) pharmaceutical preparations (Biofarm, Zentiva) ambulatory healthcare activity (Med Life). These commercial companies faced the conditions of the COVID-19 pandemic period, the measures taken in this regard, as well as the fierce competition from some international manufacturers (Sanofi, Sandoz Romania, Hoffmann la Roche, Pfizer, etc.). Thus, some commercial companies in the field of manufacturing pharmaceutical products have reduced their volume of activity and others have performed much higher than the pre-pandemic period.

Corporate social responsibility and customer loyalty during the Covid-19 pandemic: evidence from pharmacy practice

Purpose>In recent years, corporate social responsibility (CSR) has taken on a more prominent role in both large and small businesses because of its significant impact on various aspects of business performance. To date, a growing body of literature has demonstrated the mechanisms whereby CSR practices affect organizational outcomes;however, there has been little research examining how CSR practices contribute to customer loyalty within the pharmacy context. As such, this study aims to explore how CSR practices influence the loyalty of pharmacy customers, particularly in relation to the mediatory effects of customer-company identification (CCI) and customer trust.Design/methodology/approach>A survey questionnaire was developed and administered to collect the required data from the pharmacy context. The resultant data were subjected to exploratory factor analysis to identify the scale dimensions, followed by multiple regression analysis to test the hypotheses.Findings>Analysis of the results (n = 528) revealed that perceived CSR indirectly impacts loyalty through the mediatory effects of trust and CCI. All hypothesized effects were also confirmed via empirical testing.Originality/value>The findings of this research suggest that not only are CSR activities responsive to societal concerns, but they can also promote customer identification with pharmacies and strengthen customer trust, which can, in turn, lead to long-term customer loyalty.