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Objectives: Data showed that during the SOVID-19 pandemic the pharmacy is the first place for patient care. The purpose was to study the awareness of pharmacists about the COVID-19 for 2021-2022 in Ukraine to provide complete and quality care. Method(s): Survey was developed to determine the level of knowledge of pharmacists regarding the main symptoms, methods of diagnosis, treatment and prevention of uncomplicated forms of the COVID-19 by using Google form. The heads of pharmacies, pharmacists in eight regions of Ukraine were involved. The research period was December 2021 - December 2022. Result(s): We received, 725 completed questionnaires from 8 regions of Ukraine, of which 69.7% were pharmacy managers, 12.0% were pharmacists, and 18.3% were intern- pharmacists. Of the surveyed pharmacists, 95% called the method of airborne transmission, but 4.7% believe that the coronavirus is transmitted by the contact-household method, and 0.3% - transmissible. We found that 100% of respondents correctly named the main indicators of the condition of a patient with the COVID-19. However, only 95.4% of pharmacists correctly defined the concept of saturation, which requires improvement of information support. For the symptomatic treatment of uncomplicated forms, 91.7% of respondents correctly determined that Paracetamol, Ibuprofen are for the symptomatic treatment of uncomplicated forms, but 8.3% of pharmacists named other drugs. Assessing the need to take antibiotics, 88.5% of pharmacists gave the correct answer, but 5.5% believe that the reason for prescribing antibiotics is an increase in body temperature, and 5.4% named a decrease in saturation, 0.6% - dry a cough, that does not meet the requirements of thee national guideleines Covid-19. Conclusion(s): We found that pharmacists are 100% well-informed with the symptoms and causes of the Covid-19. However, it is necessary to improve the provision of information about the requirements for the treatment of uncomplicated forms of Covid-19 and the dispensing of antibiotics from pharmacies.Copyright © 2023
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Background It is a challenge for pharmacy courses worldwide to combine theoretical knowledge with practical skills to equip students for their future practice. Computer-based simulation offers a way of building a bridge between theory and practice. In recent years, digital simulation has expanded rapidly as a new technique of virtual learning. The digital platform ''Pharmacy Simulator'' proposes computer-based encounters with virtual patients to train clinical and communication skills in a community pharmacy setting. However, during the COVID-19 pandemic, while students were digitally resilient and endured the endless challenges of online lectures, many were dealing with Zoom and screen fatigue. Purpose To investigate pharmacy students' acceptance of Pharmacy Simulator before and during a pandemic situation. This focuses on students' self-assessment and confidence in counselling after playing the scenarios on Pharmacy Simulator. Method Two cohorts of Master of Pharmacy students at The University of Western Australia played two scenarios on Pharmacy Simulator in 2019 (anaphylaxis and salbutamol) and 2021 (anaphylaxis and vaccination). A mixed-method analysis was performed with data from (i) qualitative semi-structured interviews carried out in 2019 pertaining to participants' acceptance of Pharmacy Simulator and in 2021 (ii) a questionnaire with 25 items derived from the interviews. The interviews were transcribed verbatim into electronic format with the data management assistance MAXQDA and analyzed inductively using the Framework Method. Questionnaire responses were analyzed in Microsoft Excel using descriptive statistics. Openended questions were evaluated inductively. Findings Data were collected from 20 interviews and 31 answered questionnaires. In 2019, participants reported that Pharmacy Simulator was a fun, engaging, and straightforward learning tool and, therefore, user-friendly. They reported the feedback at the end of the session to be most valuable. The platform was perceived to fill the gap between the theory from lectures and community pharmacy practice. In 2021, participants ''agreed'' (median: 4, on a 5-point Likert scale) with seven statements about Pharmacy Simulator's usability, such as it being a helpful tool for acquiring new knowledge. Participants' confidence in counselling regarding the scenario topics improved. One participant stated, ''It taught me more through trial and error''. Conclusion Pharmacy students reported similar acceptance levels of Pharmacy Simulator before and during the COVID-19 pandemic. The use of simulation during virtual patient encounters seems to facilitate the transfer from theory to practice, independently of learning conditions that were predominantly screen-based.
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During the exceptional health crisis caused by the COVID-19 pandemic, a program of telepharmacy consultations, associated with dematerialized dispensing of treatments with delivery to the home or drive, was set up by the pharmacy department of our institution. The system has concerned 25 % of the ambulatory dispensations of the PUI over the period of the first containment, and allowed 351 patients to avoid coming to the hospital pharmacy, while maintaining a quality pharmaceutical service. Although certain limitations were identified, such as access to technology or the increase in dedicated pharmaceutical time, this system, appreciated by patients and physicians, has enabled a privileged relationship to be maintained with many patients. Expert clinical pharmacists now also perform PT, and treatments are now sent to patient's pharmacies.Copyright © 2022 Elsevier Masson SAS
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Objectives: During the current pandemic, it is recognised that pharmacies will often be the first point of contact with the health system for individuals with COVID-19 related health concerns or who require reliable information and advice. It is also important in the midst of the current public health crisis to reduce general practitioners' (GP) minor ailment-related workload. The aim of our study is to examine the problems in the midst of public health crisis of the current magnitude with the roles and activities of pharmacists. This information could help to inform future decisions about the restructuring of existing health services by governments, public health bodies and policy makers in response to public health crises such as COVID-19. Method(s): The study was carried out among 384 consumers using pharmacy in the regions of Armenia and Yerevan. Research instrument was questionnaire. Number of questionnaires distribution was determined by The Survey System Version 11.0. Analyses were performed using Statistical Package for the Social Sciences (SPSS) software (version 12.0). Result(s): During the study it becomes clear that very few percentage of consumers (17%) consulted by a pharmacy employees. Most of them don't get the necessary information from the pharmacy employee about medicine. Only 29 % of consumers are clearly satisfied with the answers of a pharmacy employee and 26% fully trust them. Conclusion(s): Steps should be taken for improving the professional knowledge of pharmacists about medicines and pharmaceutical care, which, in turn, can restore consumer trust in them, will help avoid self-medication errors by providing advice on medicines in response to public health crises such as COVID-19. There is a need to develop pharmaceutical care algorithms for minor ailments, national emergency drug formularies for COVID-19.Copyright © 2023
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Objectives Drugs and medical supplies counterfeiting is one of the worldwide major problems that pose a significant threat to both global public health and the economy. Nowadays, one of the major unprecedented challenges of the COVID-19 pandemic is the disastrous repercussions on the economy worldwide. The latter brought forth a noticeable rise in pharmaceutical and medical counterfeit products. Drug counterfeiting has thrived parallel to the expansion of electronic networks and the Internet during the COVID-19 pandemic. The objective of the current study is to explore the perceived influence of the COVID-19 lockdown on the circulation of counterfeit drugs and medical supplies through the electronic market in Jordan. Methods A cross-sectional survey study was conducted in Jordan. The questionnaire was self-administered to the public as they are the probable counterfeit medicine victims and as drug counterfeiting is a nationwide problem. To capture participants' views, a total of 460 respondents were recruited and a simple random sampling strategy was used to collect data. The inclusion criteria were consumers aged 18 years old and above, who use the Internet when purchasing drugs and medical supplies, and are willing to participate in the study. Key findings The study indicated an increase in using electronic websites when purchasing medicines during the COVID-19 lockdown. Additionally, there was a significant correlation the between COVID-19 lockdown and the circulation of counterfeit drugs and medical supplies through the electronic market in Jordan. Conclusions The study indicated that the COVID-19 lockdown had influenced counterfeit drugs and medical supplies circulation through the electronic market in Jordan.Copyright © The Author(s) 2022.
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Objectives: To determine the impact of a pharmacy-based, clinical decision support (CDS) tool on herpes zoster (HZ) vaccine series completion during the initial months of the COVID-19 pandemic across the US. Method(s): In partnership with Kroger Health, a pharmacy CDS tool alerted staff of patients due for their second HZ vaccine dose, which had been accompanied previously by a timed text message. Once operations changed due to COVID-19, the system limited outreach to only patients visiting the pharmacy. Primary outcomes included the proportion of patients receiving both doses within a Kroger-owned pharmacy (n=2,293) and the number of days between doses, both within and across two 32-week periods before and after the pandemic hit the US. Generalized estimating equation-based (GEE) logistic and linear regression models determined differences in completion rates and time to completion. Result(s): During the observation period, 38,937 adults received at least one HZ vaccine dose, with 77.2% receiving both doses. Patients engaged by the CDS tool achieved 80.5% dose completion, versus 65.4% of those not intervened (p<0.0001), which was lower than in the period immediately before the pandemic (85.8%, p<0.0001). The dosing window averaged 119.4 days (SD: 26.91), which was the longest timeframe between doses since the HZ vaccine was launched and nearly one month longer than before the pandemic (93.0 days [SD: 28.02], p<0.0001). The odds of dose completion increased in areas of higher health literacy (OR: 1.01;95% CI: 1.007-1.014), but decreased in areas of higher poverty (OR: 0.992;95% CI: 0.988-0.995). Time to completion was slightly shorter (B=-0.04, p<0.05) in areas of higher health literacy. Conclusion(s): Despite changes in clinical processes, a nationwide community pharmacy was successful in completing HZ vaccine dose series for adults during the pandemic, suggesting that processes in community pharmacies can protect staff while remaining committed to providing preventive health services during public health crises.Copyright © 2023
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Objective: The aim of this study is to demonstrate the effects of Covid-19 pandemic to the pharmaceutical services in community pharmacies in Turkey. Material(s) and Method(s): This research is a descriptive study. In the study, a quantitative research questionnaire form prepared by the researchers was used. Questionnaires were delivered to the volunteers online. Participants were informed and participated in the study if they gave their consent with an informed consent form. Result and Discussion: It is understood that the community pharmacists in Turkey provide their pharmacy services with great devotion during the pandemic process, but they also cope with many problems. In particular, giving the masks free of charge through community pharmacies increased the workload of pharmacists and caused some disruptions in pharmacy services, in addition, the crowd of the citizens in pharmacies to buy masks increased the risk of social distancing and the possibility of transmission. Major problems faced by community pharmacists during the pandemic;Due to the high demand for personal protective equipment and hygiene materials, the increase in workload, the need for personnel, taking measures with their own means to protect against disease, not delivering drugs and products needed by the society on time, economic and / or social support, especially for the pharmacists have economic problems It is one of the important results of the study that the existence of a national emergency action plan will guide community pharmacists in combating this pandemic of unprecedented magnitudeCopyright © 2022 University of Ankara. All rights reserved.
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Pharmacists in the community and ambulatory settings are primed for collaboration that can optimize care. Now is the time to capitalize on the momentum and positive disruption of the COVID-19 pandemic that propelled pharmacists and their organizations to respond with agility to deliver care in new ways, pivot to develop new partnerships, and leverage technology. The growth of collaborative practice agreements within ambulatory care settings, the enhancement of clinically integrated networks, and the growth in professional organization support create an environment ripe for implementation of pharmacist-to-pharmacist collaborations. The American College of Clinical Pharmacy 2022 Clinical Practice Affairs B Committee sought out literature, as well as prepublication contemporary examples, demonstrating models of intraprofessional collaboration among pharmacists in community and ambulatory settings. The committee formulated six key recommendations to optimize pharmacist collaborations in the community and ambulatory settings and formed a framework for practical implementation strategies at the levels of individual pharmacists, organizations, and educational institutions and for legislative advocacy.Copyright © 2023 Pharmacotherapy Publications, Inc.
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Comprehensive medication management (CMM) is increasingly provided by health care teams through telehealth or hybrid modalities. The purpose of this scoping literature review was to assess the published literature and examine the economic, clinical, and humanistic outcomes of CMM services provided by pharmacists via telehealth or hybrid modalities. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. Randomized controlled trials (RCTs) and observational studies were included if they: reported on economic, clinical, or humanistic outcomes;were conducted via telehealth or hybrid modalities;included a pharmacist on their interprofessional team;and evaluated CMM services. The search was conducted between January 1, 2000, and September 28, 2021. The search strategy was adapted for use in Medline (PubMed);Embase;Cochrane;Cumulative Index to Nursing and Allied Health Literature;PsychINFO;International Pharmaceutical s;Scopus;and grey literature. Four reviewers extracted data using a screening tool developed for this study and reviewed for risk of bias. Authors screened 3500 articles, from which 11 studies met the inclusion criteria (9 observational studies, 2 RCTs). In seven studies, clinical outcomes improved with telehealth CMM interventions compared to either usual care, face-to-face CMM, or educational controls, as shown by the statistically significant changes in chronic disease clinical outcomes. Two studies evaluated and found increased patient and provider satisfaction. One study described a source of revenue for a telehealth CMM service. Overall, study results indicate that telehealth CMM services, in select cases, may be associated with improved clinical outcomes, but the methods of the included studies were not homogenous enough to conclude that telehealth or hybrid modalities were superior to in-person CMM. To understand the full impact on the Quadruple Aim, additional research is needed to investigate the financial outcomes of CMM conducted using telehealth or hybrid technologies.Copyright © 2022 Pharmacotherapy Publications, Inc.
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Introduction: Safety culture is the product of individual and group values, attitudes, perceptions, competencies, and patterns of behaviour that determine the commitment to, and the style and proficiency of, an organisation's health and safety management.(1) Community pharmacists play a vital role in ensuring optimum medication safety however the study of patient safety culture in this setting is less developed than in secondary care. Aim(s): The study aim was to measure patient safety culture in Irish community pharmacies using the validated Community Pharmacy Survey on Patient Safety Culture (PSOPSC).(2) Methods: The survey consisted of 39 questions based on a 5-point Likert scale, within 11 dimensions. Demographic questions were asked including the pharmacist's role within the pharmacy. A free-text box allowed respondents to give comments on the survey topic. The online questionnaire, hosted on Microsoft Forms, was emailed to all 3943 community pharmacists registered with the Pharmaceutical Society of Ireland in November 2021. A reminder email was sent 14 days later. Data were analysed in Microsoft Excel. Categorical data were presented as frequencies (%). The positive rate response (PRR) of each survey question and dimension was calculated.(2) The PRR is the mean percentage of positive Likert scale responses to each item and each dimension of the survey. A PRR >75% indicated a strong safety culture, while a PRR <50% indicated a dimension that may be improved upon. Free-text responses were explored by thematic analysis. Result(s): The survey was completed by 173 pharmacists, response rate 4.5%. Of these, 33 (19.1%) were superintendent pharmacist, 65 (37.6%) supervising pharmacist, 53 (30.6%) staff pharmacist and 22 (12.7%) locum pharmacist. The mean %PRR across the 11 survey dimensions was 72.3%. Individual statements with highest PRR were Our pharmacists tell patients important information about their new prescriptions (PRR=91.3%) and Staff are treated fairly when they make mistakes (PRR=87.3%). Individual statements with lowest PRR were Interruptions/distractions in this pharmacy (from phone calls, faxes, customers, etc.) make it difficult for staff to work accurately (PRR=6.4%) and We feel rushed when processing prescriptions (PRR=8.1%). The dimension of Organizational Learning-Continuous Improvement demonstrated the highest PRR (81.6%), followed by Response to Mistakes (PRR=81.2%). The dimension of Staffing, work pressure and pace demonstrated the lowest PRR (35.6%). Respondents rated overall patient safety in their pharmacy as excellent/very good/good (88.4%). Differences in perception of patient safety emerged between pharmacists with different levels of responsibility. Patient safety rating was described as fair/poor by 0.0% of superintendent pharmacists, 6.3% of supervising pharmacists, 17.0% of staff pharmacists and 31.8% of locum pharmacists. Fifty-one (29.0%) respondents provided free-text comments. Emergent themes were impact on safety culture of staffing issues;staff training;dispensary workload;and dispensary work pressures. Conclusion(s): The study was limited by low response rate. This may reflect its timing during the COVID-19 pandemic and pharmacists' prioritisation of clinical roles at that time. Respondents reported a broadly positive patient safety culture in the pharmacy in which they work. Differences in perception of safety culture were observed between those with differing levels of responsibility in community pharmacy practice.
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Introduction: One in six adults are affected by hearing loss, and this number increases with age.(1) Inadequate communication is a barrier to the delivery of effective care for people with hearing loss.(2) Communication regarding medicines is particularly relevant to the pharmaceutical care of older people who are more likely to be living with hearing loss, have multiple comorbidities and experience polypharmacy, a risk factor for adverse drug events. This study sought to explore factors that facilitate and impede communication with people with age-related hearing loss (presbycusis) in the community pharmacy, to provide a base upon which to identify solutions/ interventions to improve these interactions. Aim(s): To explore the barriers and facilitators to effective communication with people with age-related hearing loss in the community pharmacy setting. Method(s): This qualitative study consisted of semistructured interviews with people with age-related hearing loss (presbycusis), older people (>50 years old) without hearing loss, and focus groups and interviews with community pharmacists, conducted between March - June 2022. Participants were recruited purposively via advert and snowballing. Interviews and focus groups were conducted using Microsoft Teams or Zoom;two interviews were held by telephone. Data was analysed using the framework method. Result(s): Sixteen people with age-related hearing loss and three older people without hearing loss took part. Eight community pharmacists took part across two focus groups and one interview. Four main themes were identified. The first was 'grappling with the environment'. This theme reflects the multitude of environmental barriers to communication and person-centred pharmaceutical care such as heavy workload, time constraints, lack of privacy, noise levels and Covid-19 safety measures on communication. The second was 'promoting acknowledgment and inclusion of hearing loss in the pharmacy'. This theme captures the perception among patients that their hearing loss is not relevant to the community pharmacy setting and that more could be done to signify that a pharmacy recognises the needs of those with hearing loss. Third, 'patient perceptions and use of community pharmacy services'. This theme highlights the awareness and perceptions of the role of the pharmacy that is, primarily or exclusively as a place to collect prescriptions and the limited interaction with pharmacy personnel. The final theme was 'differing perceptions of patients and pharmacists about communication'. This theme articulates the varying patient-provider perceptions about communication and levels of awareness among pharmacists about the key facilitators to communication. Conclusion(s): This study garnered rich insights about the experiences of accessing and providing pharmaceutical care for people with age-related hearing loss within the community pharmacy setting. However, due to the Covid- 19 pandemic, data collection was chiefly conducted online and the findings cannot be considered reflective of the experiences of older people facing digital exclusion. There is clearly a need to improve pharmacists' awareness of, access to and implementation of strategies, adaptations, and assistive technologies to facilitate communication with people with hearing loss. Future research should identify interventions to support the implementation of strategies/adaptations that are tailored to the needs of people with hearing loss and pharmacists in order to engender hearing-friendly community pharmacies.
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Introduction: The use of electronic systems to transfer prescriptions continues to grow in healthcare systems worldwide. In response to the COVID-19 pandemic, legislation was implemented in Ireland in April 2020 to permit the electronic transfer of prescriptions (ETP) from prescribers to pharmacies using a national secure email system (Healthmail). This has resulted in a significant increase in the volume of prescriptions transmitted via Healthmail from general practitioners (GPs) to pharmacies in Ireland. Aim(s): With a clear need to evaluate how stakeholders have been affected by this initiative and to guide the future delivery of patient care, the primary aim of this study was to investigate GPs' views on the ETP to pharmacies in Ireland via Healthmail and how it has affected their practice. Method(s): Semi-structured interviews were conducted via video-conference with GPs in Ireland. GPs were identified using convenience and snowball sampling, purposively ensuring variety in age/years of experience, gender, and practice location. Interviews were audio-recorded and transcribed verbatim. Interview transcripts underwent thematic analysis (1). Result(s): Twelve audio-recorded interviews were conducted with GPs between May 2021 and July 2021. The participants had a median of 16 years' experience as a GP. Four main themes were generated: 1) Efficiencies with prescribing and easing GP workload: even with limited training, GPs felt that Healthmail's ETP has been easy to use and seamlessly integrated into their practice. Time has been saved and overall workload decreased due to less prescription printing and delegating more to administrative staff with prescription ordering. 2) New GP-pharmacist communication pathways: GPs found asynchronous communication regarding prescription queries less disruptive to their workflow, and particularly useful for less urgent matters. Some GPs were not aware of some Healthmail functions that facilitated additional notes between GPs and pharmacists, whilst others were concerned they had no evidence if pharmacists saw these notes. 3) Security, transparency, and documentation: whilst acknowledging their lack of technological expertise, GPs perceived that Healthmail prescriptions had security advantages over physical ones overall;the increased transparency of the prescription journey minimises the risk of prescriptions being mislaid, damaged, or fraudulently altered, as well as creating an audit trail. 4) Implications for patients: ETP via Healthmail has reduced footfall to practices, reduces multiple pharmacy use, and most patients have adapted well to it. GPs were mostly reluctant to engage routinely in any hypothetical bidirectional communication with patients via Healthmail. Conclusion(s): This study provides strong evidence for continuing the ETP to pharmacies in Ireland as GPs found this initiative easy to use, time-saving, and enhancing both GP-pharmacist communication and GP workflow. However, this study has highlighted stakeholders' lack of awareness with some functions of Healthmail, so any future systems utilised for the ETP should come with best-practice guidance for all users. While the purposive sampling facilitated GP heterogeneity, snowball sampling may have somewhat reduced the diversity in views;a future survey would be useful in identifying if any GPs characteristics significantly influencing GPs' views, as well as identifying other issues experienced and novel ideas to improve the ETP process going forward.
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Community pharmacists' roles have expanded in recent years to include offering test and treat programs where they perform testing on Clinical Laboratory Improvement Amendment (CLIA)-waived point-of-care testing (POCT) devices to diagnose specific acute infectious conditions, such as influenza and group A streptococcus (GAS) pharyngitis, and then potentially prescribe and dispense appropriate antimicrobials. Availability of these services in pharmacies has several benefits, including increased access to care, decreased overutilization of other health care services, and decreased antimicrobial resistance. States have different requirements for collaborative practice agreements and reimbursement for these clinical services in community pharmacies. Several studies have looked at outcomes related to community pharmacies implementing test and treat programs for influenza and/or GAS. Other studies looked at outcomes related to implementing testing for SARS-CoV-2 and referring for treatment. Most studies described successful implementation and barriers to integration of these programs into pharmacy workflow. Some studies showed that patients want these services to be offered in community pharmacies and are willing to pay for the services. Data show that these services are cost effective compared to physician provider-based treatment. Newer CLIA-waived POCT technology may increase implementation of these services, but studies are needed to evaluate their utility in community pharmacies. Pharmacy schools should implement widespread training on these devices, and research should continue in this area to test the use of newer technology (i.e., multiplexed devices) and their economic impact.Copyright © 2023 Pharmacotherapy Publications, Inc.
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Purpose of Study: The passing of Senate Bill (SB)-159 in May, 2019 allows California pharmacies to provide HIV pre-exposure (PrEP) & post-exposure prophylaxis (PEP) to patients without a physician's prescription. The goal of this study is to investigate whether Sacramento pharmacies are familiar with SB-159 and carry PrEP/PEP, evaluate SB-159's progress over the past three years, and elucidate possible avenues for further improvement in implementation. Methods Used: This study reports findings from surveys of state-licensed pharmacies in Sacramento conducted in 2020-2021 (Year 1) and 2022-2023 (Year 2) using an IRB-approved script. The script assessed the pharmacy's stock, promotion of PrEP/PEP, and familiarity with SB-159. Surveys for Year 2 are still ongoing. Respondent pharmacies were identified as carriers or non-carriers based on whether they carried prophylaxis. Respondents that scored a familiarity >= 3 for SB-159 were assigned as "familiar." The survey also investigated reasons for not furnishing Prophylaxis, advertising of Prophylaxis without prescription, comfort with dispensing protocol, and future plans for staff training to dispense Prophylaxis. Summary of Results: We first examined if pharmacies in Sacramento, California carried stock of PEP/PrEP. In Year 1 (2020-21), 14% of surveyed pharmacies reported carrying PEP/PrEP (7 out of 50). In Year 3 (2022-2023), this increased to 62% (24 out of 39 surveyed pharmacies). Next, we examined the familiarity of pharmacies and pharmacists with SB-159. In Year 1, 43% of carriers (3/7) and 16% of non-carriers (7/43) were familiar with SB-159. By Year 3, pharmacies were more familiar with the law, with 67% of carriers (16/24) and 54% of non-carriers (7/13) reporting to be familiar with SB-159. Finally, we examined whether the pharmacies advertised the ability to obtain PEP/PrEP prophylaxis without a prescription. In Year 1, 28.6% of carriers and 6.98% of non-carriers stated they advertise the ability to obtain PEP/PrEP prophylaxis without a prescription. In Year 3, the values decreased to 4.2% and 0%, respectively. Conclusion(s): Compared to Year 1, there was an increase in the percent of Year 3 pharmacies surveyed that stock PrEP/PEP. However, data from the past 2 years show that carriers and non-carriers showed similar responses to questions related to familiarity with SB-159 and advertising. Taken together, this would suggest that the passing of SB-159 has increased access to HIV PrEP/PEP, yet has not significantly improved pharmacy advertising and awareness. Possible explanations include the focus that pharmacies have put into vaccination efforts against the COVID 19 pandemic instead of fulfilling SB-159. Future studies should include survey questions that objectively assess a pharmacy's familiarity with SB-159, and follow up with pharmacies that plan to implement training for their staff to dispense PrEP/PEP.
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Introduction: To alleviate NHS workload pressures Scottish Government wish to train more pharmacist independent prescribers (IPs) for community pharmacy (1). A critical aspect for IP training is the role of Designated Prescribing Practitioner (DPP) for the period of learning in practice. A paucity of work has focussed on implementation of the DPP role with a recent cross-sectional survey (2) indicating that further qualitative exploration is warranted. Aim(s): To explore the implementation of the DPP role in Scottish Community Pharmacy (CP). Method(s): Following a survey (2) participants opted in to qualitative semi-structured online mini-focus groups. This included key stakeholders likely be involved in the implementation of the DPP role (e.g Directors of Pharmacy, Prescribing Leads, Education and Training leads, IP qualified CPs). The topic guide was informed by the survey key findings, Royal Pharmaceutical Society DPP Framework and the Consolidated Framework for Implementation Research and piloted with academic and practice-based stakeholders. All focus groups were conducted using Zoom, recorded, transcribed, and independently analysed thematically, by two researchers, using the Framework Approach. Data generation continued until data saturation. Result(s): Data were generated from six mini-focus groups with 12 key stakeholders across Scottish Health Boards. Key themes derived related to: views on the DPP role, characteristics of potential DPPs, facilitators and barriers to implementation. Participants supported DPP implementation and noted benefits of pharmacists training pharmacists. They noted that potential DPPs need to be confident and competent and be active prescribers. Facilitators for implementation included: new contracted services (e.g. NHS Pharmacy First Plus), growing need for more IPs, and the impact of COVID-19. Barriers included: limited time, capacity, resources, and support to take on the DPP role. Pharmacists were also considered risk averse which could influence role uptake. Conclusion(s): This theory-based work involved a range of key stakeholders and highlights that there is a need to further consider interventions to overcome barriers related to capacity and resource related issues. A limitation relates to the dyadic nature of some focus groups that may have affected data collection. Future research should focus on further theory-based work evaluating structures, processes, and outcomes of DPP role implementation.
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Introduction: The COVID-19 pandemic has disproportionately affected people with dementia, especially those in care homes (1). The pandemic may have exacerbated existing medication challenges that care home residents with dementia may experience, such as issues with adherence and administration. Aim(s): To explore the views experiences of care home managers in Northern Ireland (NI) about optimising medicines use and accessing primary healthcare services for residents with dementia during the COVID-19 pandemic and identify key lessons for supporting care home staff with medicines optimisation for residents with dementia both now and during future health crises. Method(s): Care home managers were recruited using several approaches which utilised purposive and snowball sampling. Participant sampling and recruitment commenced in January 2022 and finished in July 2022. The interview topic guide was developed based on published literature, current COVID-19 guidelines for care homes, and following discussion within the research team;it was piloted with two nurses with experience of working in care homes. Semi-structured interviews were conducted either using an online video-conferencing platform or via the telephone after obtaining written informed consent from participants. All interviews were audio recorded, transcribed verbatim, and analysed using thematic analysis (2). Analysis of data is ongoing. Result(s): Fourteen interviews were conducted, lasting between 25 and 56 minutes. Findings to date have highlighted the challenges care homes have faced whilst caring for residents with dementia during the pandemic. Participants described changes to the way in which primary healthcare services were provided. In particular, provision of services from general practice (e.g. prescribing, consultations) were mostly conducted over the telephone and/or online and some participants reported that this had an impact on medication review: ''it's only the review of medication that has not been done during the pandemic'' [CHM-07]. Restrictions on visiting to care homes during the initial and middle phases of the pandemic affected aspects of medicines optimisation for residents with dementia and an already stretched care sector: There was a lot of problems prior to COVID. COVID just made those problems monumental'' [CHM-14]. Most participants perceived that community pharmacy services were not affected by the pandemic and medication supply continued: We haven't had an issue with community pharmacy to be honest with you'' [CHM-03]. Participants identified lessons for future health crises including the need for improved communication with general practitioners, the importance of a multidisciplinary team effort to optimise medicines for residents with dementia, along with input from residents' family members, and greater support for care homes. Conclusion(s): This study has highlighted the difficulties that care home managers have faced in accessing general practice services during the pandemic and the impact this has had on residents with dementia receiving medication review. Whilst these findings add to a limited evidence base, they may not be generalisable to other parts of the UK. Future work will focus on development of a questionnaire study with care home managers.
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Introduction: A report by the World Health Organisation highlighted a lack of clarity in medicine labelling regulations in Kuwait and the subsequent risk of patient harm from labelling errors (1). In response, the Undersecretary of the Kuwait Ministry of Health (MOH) issued a ministerial decree governing the labelling of medicines (M.D 4451/2021, June 2021) (2), stipulating a requirement to affix an identification label containing specific patient, medicine, and supplier information on medication packaging. Aim(s): To develop a map of the Medicines Labelling System (MLS) in a tertiary hospital in Kuwait (TH). Method(s): A Work Domain Analysis (WDA) was conducted using qualitative data from 1) semi-structured interviews with a purposive sample of 10 nurses, 10 patients/caregivers, and 10 pharmacists involved in the delivery or administration of medicines to TH patients, as well as 2) an analysis of medicine labelling documents published by the Kuwaiti MOH and TH. After gaining informed consent, one-to-one semi-structured interviews were conducted in TH, in accordance with the latest COVID-19 prevention procedures. All interviews were audio-recorded and transcribed verbatim. Both deductive - informed by ion Hierarchy (AH), the modelling tool of WDA - and inductive thematic analysis was conducted. Result(s): Thirty participants took part in semi-structured interviews averaging 34 minutes, from which five levels of ion in the AH were constructed. The first level, functional purposes, describes the reason why any given system exists: for the MLS in TH, they were compliance with regulations, policies, and protocols of the Kuwaiti MOH and TH and providing an identification of medicine issued by ISH pharmacies. Five aspects of the second level, values and priority measures, were identified, including optimisation of service workflow and timeefficient clinical practices. The third level, purpose-related functions, describes the key functions that need to be in place for the MLS to work;these were the production of medicines labels, coordination, and management of medicines and resources. The last two levels in the AH, object-related functions and physical objects, describe the resources that are required in the MLS, their functionality, and their limitations: there were 16 groups of physical objects, which afforded 19 different functions. Means-ends links showed the crucial relationships and significance between functions at different levels of the AH, the most prominent of which were coordination and communication. Conclusion(s): TH's MLS is a complex system that was visually represented using an AH, showing the constraints and structure of the work system. The AH constructed a knowledge base. Subsequent analyses of the current system issues may draw on this knowledge, such as a potential analysis of how specific tasks, like the use of labels by nurses within wards, are performed. The limitations of this study included only exploring 'work as imagined' (i.e., accounts from healthcare staff and documents), which does not fully capture how the MLS functions on a day-to-day basis. Future work will focus on deepening our understanding of the MLS through observations of work in practice.
ABSTRACT
Introduction: The traditional view of healthcare professionals as the main decision-makers has changed, recognising the importance of people managing their own conditions (1). An evidence-informed Community Pharmacy-Based Diabetes Care Plan (2) provided personcentred care for adults living with type 2 diabetes in Lagos, Nigeria. Due to the Covid-19 pandemic, community pharmacists (n =20) had monthly remote consultations with patients (n =89) over six months, supporting patients in setting and reviewing their own goals. Aim(s): Part of a larger evaluation, this paper aims to describe patients' and pharmacists' experiences, acceptability and contextual barriers and facilitators to the care plan. Method(s): An invitation for all participants to participate in study interviews during months 4-6 of the care plan was sent via the pharmacists. The researcher contacted participants that sent their consent or consent to contact form in remotely. Semi-structured telephone interviews were conducted with consent. Participants' reasons for enrolling, participation experiences, barriers and facilitators were explored. Interviews were conducted in English, audio-recorded and transcribed verbatim. Transcripts were thematically analysed, aided by NVivo12. At study completion, all patients were provided with a post-study questionnaire (PSQ). Result(s): Seventy patients completed the PSQ. Of these, 88% were satisfied with the service on a 10-point satisfaction scale (1= very dissatisfied and 10= very satisfied). All respondents stated that the care plan helped them manage their conditions better. Based on their experience with the care plan, all respondents indicated they were likely or much more likely to recommend the care plan to friends and family if they need similar care. Interviews lasting 14-42 minutes were conducted with 10 pharmacists and 15 patients. Seven themes emerged from the data: reasons for agreeing to participate;perception of pharmacy (premises and profession);remote consultations - a new way of working;service delivery and care coordination;acceptability of the care plan;types of goals, goal attainment and patients' satisfaction;and facilitators, barriers, and recommendations to the care plan. The care plan was perceived as valuable, and it improved patients' confidence regarding diabetes management. Key benefits of the care plan were patients' empowerment, including better self-care and addition to therapeutics. Monthly online (majority) meetings between the pharmacists and patients maintained patients' engagement with the care plan and allowed improvements in goal achievements and better follow-up across the pharmacies. The remote consultations were perceived as innovative and useful, though a few patients were seen face to face in particular circumstances. Identified barriers included time and technology. Patients were satisfied and passionate about the new service, and pharmacists were excited about the opportunities to provide person-centred care in their pharmacies. Conclusion(s): This study is the first mixed-methods evaluation of a person-centred goal-setting intervention for people living with diabetes in Lagos, Nigeria. It showed that the care plan was acceptable and useful to patients and pharmacists. It supports the importance of personalised care in diabetes management. A key limitation was selection bias-only those who expressed interest were interviewed. No follow-up on non-participants was done because the research team had no access to patients' contact details.