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1.
European Journal of Clinical Pharmacology ; 78:S130, 2022.
Article in English | EMBASE | ID: covidwho-1955961

ABSTRACT

Introduction: Zolpidem and zopiclone are widely used for sleep disorders, yet their abuse and dependence potential has been underestimated. The electronic prescription of zolpidem/zopiclone became mandatory on 17.07.2019 in Greece. Objectives: To investigate descriptive characteristics of zolpidem/ zopiclone prescriptions and the impact of the mandatory electronic prescription mandate. Methods: Anonymized prescriptions of zopiclone (ATC: N05CF01) and/or zolpidem (ATC: NC05CF02) that were executed in pharmacies between 01.10.2018 and 01.10.2021 were obtained from the Greek nationwide prescription database. The database covers almost the entire Greek population and it is administrated by IDIKA of the Greek Ministry of Health. We investigated descriptive characteristics of prescriptions, and calculated themonthly number of prescriptions taking into consideration dates with potential impact, i.e., the date of the mandatory electronic prescription mandate (on 17.07.2019) and the date of the first case of COVID-19 in Greece (on 26.02.2020). Results and Conclusion: During the investigated period of three years, there were 1229842 executed prescriptions of zolpidem (89.4%), zopiclone (10.4%) or both (0.3%), considering 156554 unique patients. The patients weremainly elderly (73.1%were ≥ 65 years old) andwomen (64.5%). The majority of the prescription physicians (69.9%) were general practitioners or internists, followed by 17% psychiatrists or neurologists, 5.3% cardiologists, 4.5% physicians in specialty training, 1% nephrologists and 2.4% of physicians with another specialty. After the mandatory electronic prescription mandate and before COVID- 19 in Greece, i.e., between 08.2019 to 03.2020, there was a notable increase of prescriptions in comparison to the previous period from 10.2018 to 07.2019 (median 37267 vs median 34106;Mann-Whitney U=9, p-value=0.009). After COVID-19, the median monthly number of prescriptions was 36363, yet there were variations ranging from 16963 to 39956. In conclusion, the mandatory electronic prescription system could increase the surveillance of drugs with abuse potential such as zolpidem and zopiclone. Nevertheless, the large number of prescriptions in elderly patients and prescribed by primary care physicians is worrisome and warrants further investigation.

3.
Supportive Care in Cancer ; 30:S26, 2022.
Article in English | EMBASE | ID: covidwho-1935812

ABSTRACT

Introduction Cancer now is the top 3 causes of morbidity and mortality in Sub Saharan Africa. With limited infrastructure and resources, cancer caused havoc since the outbreak of COVID-19. Majority of specialists are located in cities and major towns in Kenya. Access to basic specialized oncological services is a major problem. Fear of traveling, contracting COVID, lack of transport and long distances to the oncology clinics negatively impacted cancer care. There was need to innovate ways to bridge gap in accessing cancer care especially in hard-to-reach places. Objective: To highlight the integrated multidisciplinary, innovative approaches to increase access to cancer care services during the COVID-19 pandemic. Methods Retrospective study utilizing descriptive statistics to analyze the activities carried out by the International Cancer Institute to provide oncological services during the COVID-19 pandemic in Sub-Saharan Africa. Results Facility-based telemedicine platform,4000 virtual consultations and 240 multidisciplinary virtual tumor boards conducted with 20,000 Healthcare Professionals in attendance within eighteen months. 70 cancer and non cancer preceptorship courses held virtually 8,000 primary healthcare workers trained. 14 rural oncology clinics established with 4 revolving fund pharmacies. 10000 patients benefited. Conclusions Embracing and adopting technology has massive impact in cancer care. Empowerment of primary healthcare providers can ensure continuity of cost effective care without interruptions.

5.
Bulletin of Pharmaceutical Sciences. Assiut ; 45(1):311-325, 2022.
Article in English | EMBASE | ID: covidwho-1929000

ABSTRACT

Background: The COVID-19 pandemic is a global public health crisis that affected human beings, businesses and the economy negatively. Community pharmacies are the frontline of health care, and pharmacists are considered as the first point of care. However, the pandemic of COVID-19 has posed a great danger to the public health and pharmaceutical markets. Aim: To investigate the impact of the COVID-19 pandemic on the community pharmacies administratively and economically. Methods: An online cross-sectional survey was conducted from 1 to 30 November 2020 among pharmacy employees in independent and chain community pharmacies. The questionnaire covered the areas of changes in different pharmaceutical business functions as pharmacy administration and management, supply chain, sales and training programs. Results: A total of 1154 respondents have participated in the survey study from different Egyptian regions. The majority of responses were from independent pharmacies 916(79.4%). Most pharmacies 1119(97%) reported an increase in the demand for pharmaceutical products. During the COVID-19 outbreak, the sales of chain pharmacies were increased compared to independent pharmacies. Several community pharmacies workforce 923(80%) were shifted towards home delivery business. Most pharmacies cancelled the training programs during the COVID-19 and only a small percentage 28(2.4%) shifted to online programs. COVID-19 pandemic resulted in a negative psychological impact on the pharmacy employees with about two-third (68.1%) of participants were seeking career shifts.Conclusion: This study identified particular influences of COVID-19 on community pharmacies services from administrative and economic perspectives. The findings of this study may help decision-makers and pharmacy professionals to impart suitable preparedness for community pharmacists and handle future pandemic waves to keep business maintenance of community pharmacies and foster pharmacy employees' satisfaction.

6.
Drug Topics ; 166(6):16-17, 2022.
Article in English | EMBASE | ID: covidwho-1925358
7.
Italian Journal of Medicine ; 16(SUPPL 1):31, 2022.
Article in English | EMBASE | ID: covidwho-1913270

ABSTRACT

Introduction: Use telemedicine to follow COVID-19 patients at home avoiding hospitalization. Objects: Safely avoid hospitalization and in any case guarantee high-level assistance, limit infections and unnecessary travel. Methods: From 30.03.20 to 31.05.21 we followed 503 families with COVID-19, at home if the following requirements were met: 1. care giver;2. the suitability of the house;3. the possession of a telephone with an internet network to provide the doctor with clinical data and to receive and tutorials;4. pulse oximeter. Therapies were modulated in relation to severity according to the guidelines, noting SPO2, walking test, respiratory rate, fever. Chest ultrasound was performed, according to the Soldiers score. set therapy with Prednisone 0.5-1 mg/kg/day, LMWH, Azithromycin 500, vitamin D 50.000U. All patients received 6 diaphragmatic breathing tutorials. Results: 503 families (1509 pt), 8 hospitalized, 4 men and 4 women four died in hospital. 2 cases of pulmonary embolism. The duration of treatment was from 8-45 days, from 1-3 contacts per day, from 4 to 48 messages per nucleus/day. Conclusions: WhatsApp is a way to monitor patients in the COVID- 19 pandemic, with minimal equipment (ultrasound), patients able to follow the prescriptions provided via social networks and present clinical data daily. Important was the network with the pharmacies for oxygen and drugs even on holidays and with the laboratory for blood sampling at home at a controlled cost.

8.
Ankara Universitesi Eczacilik Fakultesi Dergisi ; 46(2):194-211, 2022.
Article in Turkish | EMBASE | ID: covidwho-1897335

ABSTRACT

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 and Method: 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 magnitude

9.
Farmatsiya i Farmakologiya ; 10(2):198-206, 2022.
Article in English | EMBASE | ID: covidwho-1897250

ABSTRACT

The aim of the article is a comparative clinical and economic assessment of genetically engineered monoclonal antibodies against interleukins in infectious diseases facilities in Volgograd region, reassigned to treat COVID-19 patients. Materials and methods. ABC analysis of the drug consumption in infectious disease facilities in Volgograd region in 2020 and 2021, cost-minimization analysis, and volume of consumption (standard dose per 1000 patients) for genetically engineered monoclonal antibodies against interleukins, were performed on the basis of pharmacies dispensing drug reports on infectious diseases facilities, Russian State Register of maximum selling prices, and Russian guidelines for COVID-19 treatment. Results. Only a small proportion of COVID-19 patients (43.6 standard doses per 1000 patients in 2020 and 137.8 per 1000 patients in 2021) received genetically engineered biologics in infectious disease facilities in Volgograd Region. Nevertheless, in the studied facilities, medical drug expenses on them exceeded from 20% in 2020 to 40% of the total inventory value in 2021. In mild COVID-19 patients with a high comorbidity index, netaquimab was the least expensive drug therapy and levilimab was the most expensive one. For moderate COVID-19, a standart recommended dose of sarilumab was the least expensive among the drugs used in the studied facilities, and anakinra was the least expensive drug among all the recommended GEBs. In severe and extremely severe COVID-19 courses, tocilizumab and sarilumab were less the least expensive among the GEBs used in the infectious disease facilities, and anakinra was the least expensive among all the recommended GEBs. Conclusion. Accepting a possible equal effectiveness based on the currently available data, sarilumab is the least expensive for moderate COVID-19 and tocilizumab is the least expensive for severe and extremely severe COVID-19.

10.
Journal of Managed Care and Specialty Pharmacy ; 27(4-A SUPPL):S122-S123, 2021.
Article in English | EMBASE | ID: covidwho-1880782

ABSTRACT

BACKGROUND: Maintaining member adherence requires careful coordination between health plans, providers and PBMs. Too often, however, pharmacies are left without the resources they need to make a meaningful impact. As COVID-19 brings new challenges to adherence, engaging pharmacies in member health is more important than ever. OBJECTIVE: Increase member adherence for a large Medicare plan by engaging community pharmacists in a comprehensive pharmacy incentive program and improving medication access. METHODS: In 2019, Abarca reintroduced the RxTarget pharmacy incentive program and made it available to its entire pharmacy network.Through the program, pharmacies have access to: A technology platform that allows them to access advanced analytics and reporting, prioritize members who may require intervention and track their progress throughout the year;continuing pharmacy education program focused on improving patient outcomes;and daily training sessions that provide support and resources. Abarca provides the Medicare plan with weekly updates on its pharmacy network's progress in the RxTarget program, ensuring ongoing communication on the results and allowing timely decision making. In March of 2020, Abarca launched Puerto Rico's first home delivery pharmacy program to ensure members across the island had safe, reliable and convenient access to medications while social distancing amidst the global pandemic. RESULTS: In the first two years of the program, the Medicare plan saw significant year-over-year increases in adherence across three chronic conditions-even amid COVID-19. In 2020, participating pharmacies achieved a cumulative 6% increase in adherence metrics compared to 2019 and a 10% increase compared to 2018. Pharmacies that participated in the daily training sessions achieved a 20% increase in adherence in 2020, while those who did not participate achieved a 4% increase versus the previous year. 73% of prescriptions ordered through the home delivery app are 90-day supplies-a strong indicator of ongoing adherence. 7 out of 10 active pharmacies are satisfiedwith the RxTarget pharmacy program (Margin of error: 6.01%;Confidence Level: 95%). CONCLUSIONS: Engaging pharmacies and empowering them with advanced technology can significantly increase member adherence-and allow interventions to be made before a member's health has been compromised. This can also contribute to health plan CMS Star Ratings. Additionally, the availability of the home delivery pharmacy program eliminates barriers to medication access, which can also facilitate higher adherence and help members maintain their health amid unforeseen events.

11.
Topics in Antiviral Medicine ; 30(1 SUPPL):367, 2022.
Article in English | EMBASE | ID: covidwho-1880766

ABSTRACT

Background: Haiphong is a Vietnamese city of 2 million people and a historic hotspot for HIV and drug use. The DRIVE community research program recently demonstrated the end of the HIV epidemic among PWID in the city, with an incidence of 0.085/100PY, and a substantial decrease in HCV incidence in the past 5 years. After the emergence of COVID-19, a one-month strict lockdown was imposed in April 2020 in Vietnam, followed by lighter social distancing restrictions over the year. We investigated whether those measures affected PWID in terms of risk behaviors and access to prevention and care. Methods: Participants were PWID that had been enrolled in a respondent-driven sampling (RDS) survey as part of DRIVE in the last quarter of 2019. They were recalled and interviewed in the last quarter of 2020 by peer educators on their socioeconomic situation, drug use and sexual behaviors, relations to methadone maintenance treatment (MMT) and ART services. They were tested for drugs and methadone in the urine, and for HIV, HCV, and HIV plasma viral load when HIV(+). Changes following the restrictions were assessed by comparing these "after" data to the "before" data collected one year earlier during the RDS survey. In-depth interviews were conducted with 30 participants including 5 female sex workers (FSW). Results: 780 PWID were enrolled. Their mean age was 44 years and 94% were male. 56% were still actively injecting (100% heroin) at the time of the interview;their monthly consumption had decreased from 24 to 17 days on average. The main source of syringes remained pharmacies for 83% before, during and after the lockdown. The proportion of PWID still engaging in sharing decreased from 6.0 to 1.5%. No change in the frequency of condom use was reported. The proportion of PWID on MMT increased from 68.7 to 75.3%. There was no alteration in the HIV cascade of care that was still above 90/90/90. No HIV seroconversion was observed, and HCV incidence remained stable (2.6/100PY, 95%CI: 0.7-6.7). 53% reported a monthly income of less than 130 USD "after" compared to only 9% "before". One FSW reported accepting unsafe sex during the lockdown due to financial pressure. Conclusion: Six months after the beginning of COVID-19-related restrictions, access to harm reduction materials and care services for PWID was maintained and no increase in the number of new HIV or HCV infections was observed. However, this period was a major financial challenge, especially for FSW that were more likely to engage in risky sexual behaviors.

12.
Topics in Antiviral Medicine ; 30(1 SUPPL):377, 2022.
Article in English | EMBASE | ID: covidwho-1880670

ABSTRACT

Background: Since 2004, USAID Nigeria has supported the provision of antiretroviral therapy (ART) to 575,000 people living with HIV (PLHIV) in Nigeria through PEPFAR. Six decentralized drug distribution (DDD) ART delivery models were implemented in Akwa Ibom and Cross River states to improve continuous access to treatment for PLHIV, with the goal of achieving long-term retention in care and viral suppression. Methods: A retrospective analysis of 85,245 treatment patients who began ART between October 2001 and December 2020 was conducted. Patient data was extracted from electronic record systems and anonymized. All patients on first-line ART were included. Retention was defined as being alive and remaining on ART after initiation for at least 12 months after starting ART. While eligibility to all DDD models was restricted to stable patients, Community Pharmacy ART Refills Program (CPARP), Community ART Refill Clubs (CARCs), Family-Centered ART Refills Groups (F-CARGs), Fast-track clinic, and Adolescents Refill Clubs (ARCs) were all expanded to include stable and unstable patients after the onset of COVID-19. The Self-forming Community ART Refill Groups (S-CARG) model remained open only to stable patients. The Kaplan-Meier method was used to estimate retention probabilities, and Cox Proportional Hazards model was used to examine factors associated with retention. Results: Of the total sample, 63,175 (74%) remained on treatment and 13,800 (16%) experienced treatment interruption/LTFU. Median age at ART initiation was 39 years (IQR:32-47) and 69% of the cohort was female. Overall retention probability was 95%, 72% and 62% at 12, 24 and 36 months, respectively. The median retention time in the CPARP model was 73 months (95%CI: 71-74) compared to 49, 47, 18, 16, and 14 months in the CARC, Fast-track, ARC, F-CARG, and S-CARG models, respectively, log-rank test (p<.001). CARC DDD model [Hazard Ratio (HR):0.70 (0.66-0.73), ref: ARC], CPARP [HR:0.56 (0.53-0.60), ref: ARC], Fast-track [HR:0.70 (0.79-0.83), ref: ARC], female sex [HR:0.96 (0.94-0.97), ref: male], and 15+ years Age [HR:0.80 (0.77-0.84), ref: <15 years] were associated with long-term retention;while unemployed Occupation [HR:1.10 (1.08-1.13), ref: employed] and senior secondary Education [HR:1.20 (1.14-1.26), ref: junior secondary] were associated with short-term retention. Conclusion: Decentralized Drug Delivery models were associated with improved rates of continuity of ART treatment in a large real-world cohort in Nigeria.

13.
Journal of Managed Care and Specialty Pharmacy ; 27(4-A SUPPL):S129-S130, 2021.
Article in English | EMBASE | ID: covidwho-1880039

ABSTRACT

BACKGROUND: The most critical evidentiary gaps in managed care pharmacy informed the research agenda of the Academy of Managed Care Pharmacy (AMCP) and AMCP Foundation. Four overarching research pillars and six relevant research priorities were published in the Journal for Managed Care and Specialty Pharmacy (April 2020). Research pillars and priorities need to align to address evidence gaps in managed care pharmacy and support the members served. OBJECTIVE: To review and map research priorities onto pillars and determine appropriate research questions that will advance the AMCP research agenda. METHODS: The six previously-identified priorities were reviewed by the AMCP/Foundation Joint Research Committee and AMCP staff against current health care concerns and the four research pillars: 1) Real World Evidence (RWE) 2) Value Based Models (VBM) 3) Utilization Management (UM) and Benefit Design (BD) and 4) Patient Care Services (PCS). The top research priorities were selected across the four research pillars. To define research questions a Delphi approach representing managed care pharmacy stakeholders will be conducted via focus groups, priority-based workshops, interim surveys and discussion. This approach will culminate in consensus on the most essential, specific research questions for the next year. RESULTS: After the review of current priorities, two currently relevant priorities were added;addressing disparities in health care delivery and evaluating programs directed toward patients impacted by COVID. Of the eight research priorities, five focus priorities were chosen, mapped and prioritized as follows: 1) Health disparities (RWE);2) Limited data available at the time of launch due to expedited review (RWE);3) Managed care pharmacy programs focused on patient care (PCS) 4) Demonstrating the impact of formulary management on medication access and patient outcomes (UM and BD);and 5) Assessing the impact of legislative activities and policies in addressing the total cost of care (VBM). Results from the rolling focus groups, workshops and surveys will lead to a consensus on prioritized research questions to support managed care pharmacy for 2021-2022. CONCLUSIONS: AMCP and the AMCP Foundation will advance their research agenda through answering research questions aligned with the top areas of concern to managed care pharmacy. Implementing the research agenda will close critical evidence gaps, thereby optimizing medicine and improving lives.

14.
Archives of Disease in Childhood ; 107(5):15-16, 2022.
Article in English | EMBASE | ID: covidwho-1868715

ABSTRACT

Aim In March 2020, COVID-19 triggered an NHS directive to reduce face-to-face consultations and adapt to virtual clinics. 1 Hospital pharmacies, each with their own model of care, quickly innovated to ensure patients received their medication safely. The aim of this study was to evaluate the provision of medications optimisation for paediatric patients following virtual outpatient consultations (VOC) and explore potential improvements for future implementations. Method This was a mixed method study using quantitative data;which reviewed medications sent to patients in red, amber, and green categories2 and qualitative data;using patient feedback, to evaluate the processes in three London hospitals. Pathway mapping (PM) sessions, with multidisciplinary team involvement, were conducted across these hospitals to identify areas for improvement and analyse gaps in services. Virtual PM sessions were attended by 30 representatives across the multidisciplinary team including: pharmacists, nurses, consultants, pharmacy technicians, post room attendants;and general, operational, and project managers. Semi-structured questionnaires were used to conduct one to one telephone interviews with patients' families. A separate topic guide was used to interview General practitioners (GP) and primary care network (PCN) pharmacists. The audio recordings were transcribed as 'intelligent verbatim' and analysed using Nvivo. Braun and Clarke's six phases approach was used to conduct an inductive thematic analysis.3 To improve the rigorousness of the study, more than 50% of the transcript were double coded.4 As this was a service evaluation, ethics approval was not necessary. The project was registered with each hospital's clinical audit department. Results The three process maps were analysed and potential improvements for the medicines optimisation pathway were assessed by a paediatric pharmacy subgroup using ease-impact matrix. Potential improvements include: exploration and use of Electronic Prescription Service by secondary and tertiary care, improving communication through Information Technology systems between prescribers and hospital pharmacists, and the creation of a transparent standard operating procedure regarding medication supply following VOC. Seventy-one patients' families across the sites were interviewed between January-May 2021 to reflect on their experience of receiving medications following a VOC. Four GPs and one PCN pharmacist were interviewed in May 2021 to assess on the impact of VOC on primary care. Key reflections from themes generated include the convenience of receiving medications from hospital pharmacies following VOC, satisfaction of the current process, including medicines packaging and medicines information provided to patients and their families. Other reflections included limitations of the current process and its implication on patient safety. Medicines information helplines and education provided by pharmacists were regarded by patients' families and GPs as a valuable attribute. Conclusion Patients' families appreciated the current model of care, however patients' families and primary care healthcare professionals have identified both challenges and suggestions for improvement in delivering the current model. Future research should focus on a mixed mode of integrated care with green and amber medications2 prescribed directly to community pharmacies with clinical screening and counselling conducted by hospital pharmacists.

16.
Drug Topics ; 166(5):25, 2022.
Article in English | EMBASE | ID: covidwho-1866035
18.
Drug Topics ; 165(12):27, 2021.
Article in English | EMBASE | ID: covidwho-1866002
19.
Drug Topics ; 166(1):16, 2022.
Article in English | EMBASE | ID: covidwho-1865938
20.
Drug Topics ; 166(4):30-32, 2022.
Article in English | EMBASE | ID: covidwho-1865867
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