Role of pharmaceutical care in therapeutic regimens within the community pharmacy.

The concept of pharmaceutical care (PC) has existed as a professional philosophy for more than 30 years. However, for a long period of time, little had been done for its integration into the regular practice of healthcare provision. The COVID-19 pandemic and the resulting increase in patient influx in the community pharmacies (CP) encouraged the exploration and establishment of new healthcare services provided within the CP. Nevertheless, these services of PC are still novel, and more can be done to expand the community pharmacists' current role in primary healthcare. This can be achieved by improving and expanding the newly established services, all while incorporating new ones, for the benefit of public health and the reduction of avoidable healthcare expenditures. This article reviews information about the benefits of this service regarding patient health and the reduction of financial expenses pertinent to adverse drug events within the setting of the CP. Adverse drug events account for significant healthcare expenses and patient distress due to relevant symptoms, emergency doctor visits, and increased hospitalization rates. Several studies conducted internationally have investigated the positive impact of PC practiced by community pharmacists. In spite of results sometimes presenting a non-continuous pattern, PC applied under specific conditions has tangible positive outcomes. Congestive heart failure and type 2 diabetes mellitus patients presented fewer hospital admissions, better symptom control, and higher adherence in comparison to control groups, while a study on asthma patients revealed improved inhalation techniques. All intervention groups reported psychological improvement and a better understanding of their treatment. Special reference is made to the importance of this service for patients receiving anti-cancer treatment and how community pharmacists can have a crucial role in designing, monitoring, and re-designing these therapeutic schemes whose complexity and related adverse drug events negatively affect patient adherence. The role of community pharmacists was very important, especially for primary care, for both patients and healthcare systems during the pandemic, and it seems that it will remain decisive in the post-COVID era as well. The increased complexity of therapy and polypharmacy creates the need for organized, active participation of pharmacists in healthcare provision so that they can use their knowledge and skills under continuous cooperation with other healthcare professionals, thus providing coordinated services for the benefit of the patient.

Are pharmacists' knowledge and practice the key to promoting deprescribing of potentially inappropriate medication: a missing link between treatment and outcomes.

OBJECTIVES: Deprescribing is a novel strategy whereby medical professionals aim to optimize a patient's prescription program by removing redundant medications. Few studies have looked at the viewpoints of community pharmacists and other healthcare professionals on deprescribing in daily practice. This study's objectives included evaluating community pharmacists' deprescribing knowledge, attitudes and practices, as well as identifying the obstacles to and enablers of deprescribing in daily practice. METHODS: Five pharmacy students in the last year of their studies polled employees of neighbourhood pharmacies in Abu Dhabi, Dubai, and the Northern Emirates from April 2022 to July 2022. The study's questionnaire was divided into two sections: questions that inquired about the respondents' demographic data and questions that evaluated the respondents' understanding and usage of the deprescribing of potentially harmful medications for patients. The original Bloom's cutoff points were revised and modified to assess the general knowledge and deprescribing practices of United Arab Emirates (UAE) community pharmacists. Multivariate logistic regression identified the variables influencing respondents' deprescribing knowledge and practice. KEY FINDINGS: The average age of the participants was 30.8 ± 6.4 SD. Of the total, 255 (37.7%) were male and 422 (62.3%) were female. Pharmacists from independent pharmacies constituted 52.9% of the study sample and 47.1% were from Chain pharmacies. Among the participants, 58.8% (n = 398) had 1-5 years of experience and 41.2% (n = 279) had more than 5 years. Nearly three-quarters of the pharmacists (72.1%, 488) graduated from local universities and 27.9% (n = 189) graduated from regional/international universities. The vast majority of the study sample (84.8%, 574) were bachelor's degree holders and 88.3% (n = 598) were pharmacists in charge. Of the total, 69.3% (n = 469) received deprescribing training to treat patients with multimorbid diseases. The knowledge and practice score was 71.3% with a 95% confidence interval [70.2%, 72.4%]. Of the total participants, 113 (16.7%) had poor knowledge and practice about deprescribing, 393 (58.1%) had moderate knowledge and practice and 171 (25.3%) had good knowledge and practice. CONCLUSION: This study highlights the level of understanding of community pharmacists about deprescribing in the UAE. Although most of the respondents in this study received training on deprescribing, less than half of the community pharmacists were unaware of certain classes (long-acting sulfonylureas, anti-diabetic, antihyperlipidemic and psychotropic drugs) of drugs that are candidates for potential deprescribing. This finding indicates that their knowledge about deprescribing was insufficient. Several barriers community pharmacists face in deprescribing were also identified, with patients' resistance and insufficience being the most prevalent. Therefore, there is a need for improved deprescribing practices to ensure drug safety.

Sales of antibiotics without a prescription in pharmacies, 2017 and 2021, China.

Objective: To measure sales of antibiotics without a prescription in pharmacies in China in 2017 and 2021, before and during the coronavirus disease 2019 (COVID-19) pandemic, and determine the factors associated with such sales. Methods: We conducted cross-sectional surveys using the simulated patient method in retail pharmacies in 13 provinces in eastern, central and western China in 2017 and 2021. At the pharmacies, the simulated patients (trained medical students) reported that they had mild respiratory tract symptoms and asked for treatment, using a three-stage process: (i) request some treatment; (ii) request antibiotics; (iii) request specific antibiotics. We used multivariable logistic regression analysis to determine factors associated with sale of antibiotics without a prescription. Findings: Of the pharmacies visited in 2017, 83.6% (925/1106) sold antibiotics without a prescription; this figure was 78.3% (853/1090) in 2021 (P-value: 0.002). After excluding pharmacies prohibited from selling antibiotics because of COVID-19, this difference was not significant (83.6% versus 80.9%; 853/1054; P-value: 0.11). Factors significantly associated with selling antibiotics without a prescription in both 2017 and 2019 were: location in central and western China compared with eastern China; being in a township or village compared with in a city; and presence of a counter where antibiotics were dispensed. Conclusion: Although laws became stricter between 2017 and 2021, antibiotic sales without a prescription were still common in pharmacies across China. Existing regulations need to be more strictly enforced, and pharmacy staff and the public should be made more aware of the risks of antibiotic misuse and dangers of antimicrobial resistance.

Amazon Pharmacy: distraction or disruption?

After years of anticipation about Amazon's rumored entry into pharmacy, Amazon Pharmacy launched in November 2020. What is yet to be understood is whether this new Amazon offering is a true market disruption capable of upending the pharmacy industry. This commentary describes the epic rise of Amazon from bookseller to retail giant, leading to its entry into the retail pharmacy space. Amazon Pharmacy's business model is described and its potential for industry disruption discussed.

["What choice do people have other than us?": The role of doctors' offices adjacent to private pharmacies in the Covid-19 pandemic]. / "¿Qué opción les queda a las personas, más que nosotros?": Las funciones de los consultorios adyacentes a farmacias en la pandemia de covid-19.

With the arrival of coronavirus in Mexico, doctors' offices adjacent to private pharmacies (DAPPs) played a major role in the diagnosis, care, and prevention of Covid-19, providing treatment for 11.7% to 23% of people with Covid-19 symptoms according to national surveys. Therefore, this article seeks to identify the role of DAPPs as a private health system providing care for patients with Covid-19 symptoms in the city of Oaxaca, and to describe and analyze the factors that influenced their utilization. Using a qualitative methodology, twelve physicians were interviewed and 59 users responded to a questionnaire at doctors' offices adjacent to pharmacies in the municipality of Oaxaca de Juárez between September 2020 and August 2022. Secondary data were also collected. Among the findings, the function of these offices at the front line of care for Covid-19 and other health needs that emerged with the public health crisis is described, and the determining factors in care trajectories of users that sought care there are analyzed, such as the increase in perception of risk and mistrust towards public services or strategies implemented by the federal government.

Con la llegada del coronavirus a México, los consultorios adyacentes a farmacias desempeñaron un rol preponderante en el diagnóstico, atención y prevención del covid-19. De acuerdo a las encuestas nacionales, entre el 11,7% y el 23% de las personas con síntomas de covid-19 se atendieron en uno. Por ello, este artículo busca identificar el papel de los consultorios adyacentes a farmacias (CAF) como sistema de salud privado que atendió a personas con síntomas de covid-19 en la ciudad de Oaxaca y describir y analizar los factores que influyeron en su utilización. Desde una metodología cualitativa, entre septiembre de 2020 y agosto de 2022 se entrevistó a 12 médicos y médicas y se aplicó un cuestionario a 59 personas usuarias de los consultorios adyacentes a farmacias del municipio de Oaxaca de Juárez. Asimismo se hizo una recopilación y análisis de fuentes secundarias. Entre los hallazgos, se describen sus funciones como frente de atención al covid-19 y a otras necesidades de salud que emergieron con la crisis sanitaria y se analizan los factores determinantes en las trayectorias de atención de personas usuarias de estos consultorios, como son el incremento en la percepción del riesgo y la desconfianza hacia los servicios públicos o hacia las estrategias implementadas por el gobierno federal.

Technology targeting immunocompromised patients for COVID-19 vaccine in community pharmacies.

BACKGROUND: Medication targeting by community pharmacists may assess medical history of patients for recommendation of clinical services through review of their prescription history. Previous studies have implemented medication targeting to identify patients eligible for vaccine recommendations. Targeting of immunosuppressing medications may impact the rate of third primary doses of COVID-19 vaccine administered to immunocompromised patients. OBJECTIVES: The primary objective was to determine the impact of medication targeting on the rate of third primary doses of COVID-19 vaccine given to immunocompromised patients. METHODS: This observational, retrospective cohort study occurred within one division of a large community pharmacy chain. Included patients were greater than 18 years of age with record of at least one immunosuppressing medication dispensed one year prior to study enrollment and 2 primary COVID-19 vaccine doses in the pharmacy dispensing software. An intervention for pharmacist recommendation of a third primary dose of COVID-19 vaccine was automatically loaded into their prescription profiles. The proportion of patients with completed interventions and confirmation of third dose administration was collected with demographic characteristics. RESULTS: The pharmacy dispensing software identified 1670 interventions through medication targeting, though 69 interventions met criteria for study inclusion. Baseline characteristics of the included population were a mean age of 51.8 years of primarily female sex (69.6%) and Caucasian race (78.3%). Third primary COVID-19 vaccine dose administration and completed pharmacist recommendation was recorded for 2 (2.9%) patients. CONCLUSION: Medication targeting identified immunocompromised patients for the recommendation of a third primary dose of COVID-19 vaccine. Improved specification for targeting of dosing regimen and route of administration may result in greater accuracy of appropriate recommendations identified.

Assessment of Understanding and Practices of Community Pharmacy Personnel to Tackle COVID-19 Pandemic.

BACKGROUND: The skill, accessibility, and knowledge of community pharmacists have been paramount in managing pandemics. This study was conducted to assess the knowledge, attitude, and practice of community pharmacy personnel towards tackling COVID-19 pandemic which might help concerned authorities to take effective actions to eliminate the gaps for the management of such pandemic in an efficient way. METHODS: A cross-sectional study was conducted among 428 community pharmacy personnel from different community pharmacies in Kathmandu, Nepal from December 2021 to February 2022. Statistical analysis was done through SPSS® v21 and MedCalc for Windows v12.3.0. RESULTS: Most of the participants (42.76%) had certificate-level degrees in their respective fields and one to five years of working experience (48.84%). Only 29.67% of the respondents had good knowledge towards tackling COVID-19, whereas good attitude and practice were demonstrated by 59.11% and 42.29% respectively. The participants with higher degrees and more working experience had better knowledge, attitude, and practice. Education level bachelor and above was independent predictor of good knowledge (OR 20.69, 95% CI 11.30-37.90). Knowledge and practice (Spearman's rho: 0.135; P ≤0.005) and attitude and practice (Spearman's rho: 0.095; P = 0.049) scores were positively correlated. CONCLUSIONS: The significant association of community pharmacy personnel's educational level with knowledge, attitude, and practices demands the necessity of policy-making bodies' involvement for the mandatory presence of well-qualified pharmacists and regular training at the community pharmacy level. Furthermore, it is high time to reinforce the drug regulatory acts, regulations, and codes all over the nation.

Changes in prescription drug abuse during the COVID-19 pandemic evidenced in the Catalan pharmacies.

Introduction: The impact of a pandemic on the mental health of the population is to be expected due to risk factors such as social isolation. Prescription drug abuse and misuse could be an indicator of the impact of the COVID-19 pandemic on mental health. Community pharmacists play an important role in addressing prescription drug abuse by detecting signs and behaviors that give a clearer indication that a drug abuse problem exists. Methods: A prospective observational study to observe prescription drug abuse was conducted from March 2020 to December 2021 to compare with data obtained in the previous 2 years, through the Medicine Abuse Observatory, the epidemiological surveillance system set up in Catalonia. Information was obtained through a validated questionnaire attached on a web-based system and data collection software. A total of 75 community pharmacies were enrolled in the program. Results: The number of notifications during the pandemic period (11.8/100.000 inhabitants) does not indicate a significant change compared with those from pre-pandemic period, when it was 12.5/100.000 inhabitants. However, the number of notifications during the first wave when lockdown was in place stood at 6.1/100,000 inhabitants, significantly lower than in both the pre-pandemic and the whole of the pandemic periods. Regarding the patient's profile, it was observed that the proportion of younger patients (<25 and 25-35) rose in contrast to older ones (45-65 and >65). The use of benzodiazepines and fentanyl increased. Conclusions: This study has made it possible to observe the impact of the pandemic caused by COVID-19 on the behavior of patients in terms of use of prescription drugs through analysis of the trends of abuse or misuse and by comparing them with the pre-pandemic period. Overall, the increased detection of benzodiazepines has pointed out stress and anxiety generated by the pandemic.

Exploring consumers' perspective of community pharmacists delivering COVID-19 vaccinations: an Australian pilot study.

OBJECTIVES: During the COVID-19 pandemic, Australian community pharmacists delivered a wide range of professional services, including COVID-19 vaccinations. The aim of this study was to understand the reasons for and attitudes of consumers receiving COVID-19 vaccinations from community pharmacists. METHODS: A nationwide anonymous online survey recruited consumers above the age of 18 years who had received their COVID-19 vaccinations at community pharmacies between September 2021 and April 2022. KEY FINDINGS: COVID-19 vaccinations at community pharmacies were positively received by consumers due to their convenience and accessibility. CONCLUSIONS: Future health strategies should utilise the highly trained workforce of community pharmacists for wider public outreach.

The role of community pharmacies in early detection of suspected COVID-19 cases in 2020: lessons from Dar es Salaam, Tanzania.

Tanzania reported its first COVID-19 case on 16 March 2020. We conducted event-based surveillance of COVID-19 suspect cases among pharmacy clients presenting with respiratory symptoms and influenza-like illness to increase early and rapid detection of COVID-19 cases and mitigate transmission. We conveniently sampled 103 pharmacies from Dar es Salaam, the epicentre for the COVID-19 pandemic in Tanzania at the time. Between 23 April 2020 and 18 May 2020, 67% of the pharmacies (69/103) reported an observed increase in the number of clients presenting with respiratory symptoms and influenza-like illness compared with the 1 month before the COVID-19 outbreak. In the 1-month surveillance period, the participating pharmacies recorded 75 alerts of COVID-19 suspect cases and referred all suspected COVID-19 cases to rapid response teams for additional symptomatic screening and SARS-CoV-2 testing. A key implementation challenge was that some clients identified as COVID-19 suspected cases were hesitant to provide follow-up information for linkage to rapid response teams. Addressing concerns among drug dispensers in the participating pharmacies and informing them of the benefits of the surveillance activity were important implementation components. Our approach demonstrates the overall feasibility of rapidly implementing an event-based surveillance system for an emerging health threat through an existing network of pharmacies within the community. The approach and tools used in this surveillance activity could be adapted in similar settings to detect and generate alerts of disease outbreaks in the community that other surveillance systems may otherwise miss.

Making community pharmacies psychologically informed environments (PIE): a feasibility study to improve engagement with people using drug services in Scotland.

AIM: This developmental study tested the feasibility of training pharmacy staff on the psychologically informed environments (PIE) approach to improve the delivery of care. BACKGROUND: Community pharmacies provide key services to people who use drugs (PWUD) through needle exchange services, medication-assisted treatment and naloxone distribution. PWUD often have trauma backgrounds, and an approach that has been demonstrated to work well in the homeless sector is PIEs. METHODS: Bespoke training was provided by clinical psychologists and assessed by questionnaire. Staff interviews explored changes made following PIE training to adapt the delivery of care. Changes in attitude of staff following training were assessed by questionnaire. Peer researchers interviewed patient/client on observed changes and experiences in participating pharmacies. Staff interviews were conducted six months after training to determine what changes, if any, staff had implemented. Normalisation process theory (NPT) provided a framework for assessing change. FINDINGS: Three pharmacies (16 staff) participated. Training evaluation was positive; all participants rated training structure and delivery as 'very good' or 'excellent'. There was no statistically significant change in attitudes. COVID-19 lockdowns restricted follow-up data collection. Staff interviews revealed training had encouraged staff to reflect on their practice and communication and consider potentially discriminatory practice. PIE informed communication skills were applied to manage COVID-19 changes. Staff across pharmacies noted mental health challenges for patients. Five patients were interviewed but COVID-19 delays in data collection meant changes in delivery of care were difficult to recall. However, they did reflect on interactions with pharmacy staff generally. Across staff and patient interviews, there was possible conflation of practice changes due to COVID-19 and the training. However, the study found that training pharmacy teams in PIE was feasible, well received, and further development is recommended. There was evidence of the four NPT domains to support change (coherence, cognitive participation, collective action and reflexive monitoring).

Patient Care in Community Pharmacies during the COVID-19 (SARS-CoV-2) Pandemic: Effectiveness of Post-Graduate Education and Further Training Courses on Revenues.

Thanks to their distribution throughout the territory and extended opening hours, community pharmacists are among the healthcare specialists most easily accessible to the public and often represent the first point of consultation both for the treatment of acute health conditions and, more generally, for health and therapy advice. The objective of the present study was to evaluate whether post-graduate courses/further training courses for pharmacists might influence the quality of patient management and care and, consequently, the satisfaction of the users who entered the pharmacy. We used the revenues of the pharmacies (Group A) in which these pharmacists are employed as a performance indicator. We compared the data for this group with the national averages for Italian pharmacies (Group B) and with those of a group (Group C) of selected pharmacies as similar as possible to the pharmacies in Group A based on a number of well-defined parameters. The comparison of revenues, year-on-year changes, and the average number of sales by the pharmacies in the three groups indicates that the pharmacies in Group A had the best performance, not only when compared with the national average but especially compared with the control group, specifically selected to make the comparison as significant as possible.

Community pharmacists as vaccinators in the Italian SARS-CoV-2 immunization campaign: implications beyond the pandemic.

Italy was one of the last European countries to introduce vaccination in pharmacies. The urgent need to extend the vaccination campaign against SARS-CoV-2 led to the approval of Law no. 178/2020. The Law allowed the administration of COVID-19 vaccines in Italian pharmacies by community pharmacists on an experimental basis for the years 2021-2022. Stakeholders took contrasting positions on the idea of enabling pharmacist to vaccinate after proper training. Sometimes, controversy existed even within the same associations representing pharmacists. As observed in other countries, the medical profession in Italy also expressed its opposition to the idea of pharmacists as vaccinators, while the general public and pharmacy customers were generally in favour of the policy. Over two million doses of SARS-CoV-vaccines were administered in Italian pharmacies in less than one year after the introduction of the policy. Criticism and concerns raised during the debate about the introduction of vaccination in pharmacies has subsided. It is yet unclear whether vaccination in pharmacies will be prolonged after the pandemic and whether it will, in fact, be expanded to other vaccines. Potentially, this could contribute towards increasing immunisation rates, not only for COVID-19, but also for other vaccines.

Pharmacy-based immunization in rural USA during the COVID-19 pandemic: A survey of community pharmacists from five southeastern states.

INTRODUCTION: Immunization rates for seasonal and non-seasonal vaccines dropped during the COVID-19 pandemic. Little is known about the extent to which community pharmacies in the USA continued to serve as immunization sites during the pandemic. This study compared 1) the types and perceived changes in non-COVID-19 vaccine doses administered at rural community pharmacies in 2020 (during the pandemic) to 2019 (pre-pandemic) and 2) the delivery of non-COVID-19 immunization services in 2020 to 2019. METHODS: A mixed-mode (paper/electronic) survey of a convenience sample of 385 community pharmacies operating in rural settings and have administered ≥1 vaccine in 2019 and 2020 was distributed in May-August 2021. Survey development was informed by relevant literature, pre-tested with three individuals, and pilot-tested with 20 pharmacists. Non-response bias was assessed, and survey responses were analyzed using descriptive and bivariate statistics. RESULTS: Of the 385 community pharmacies, 86 qualified pharmacies completed the survey (Response Rate = 23.8%). The percentage of pharmacies offering a given vaccine in 2019 and 2020 were similar; with one exception, a higher percentage of pharmacies reported having MMR administered for adults in the pharmacy in 2020 (McNemar's test; p-value = 0.0253). For each given vaccine, the majority of respondents did not perceive a change in the number of doses administered in 2020 compared to 2019. Further, the majority reported no difference in how they delivered immunization services during and pre-pandemic. However, a small percentage of respondents (6.0-22.0%) adapted their services by adopting several measures to ensure the safety and continuity of immunizations during the pandemic. CONCLUSION: Findings highlight the importance of community pharmacies as immunization sites during the pandemic. Community pharmacies continued immunization delivery at community pharmacies during the pandemic with almost no noticeable change to types and doses of vaccines compared to pre-pandemic nor the process of vaccine delivery.

RURAL-CP: a rural community pharmacy practice-based research network in the USA.

INTRODUCTION: To strengthen and demonstrate the ability of rural pharmacists to address their communities' health needs, we developed the first multi-state rural community pharmacy practice-based research network (PBRN) in the USA called the Rural Research Alliance of Community Pharmacies (RURAL-CP). Our objective is to describe the process for developing RURAL-CP and discuss challenges to creating a PBRN during the pandemic. METHODS: We conducted a literature review of community pharmacy PBRNs and met with expert consultants to gain insight into PBRN best practices. We obtained funding to hire a postdoctoral research associate, conducted site visits, and administered a baseline survey, which assessed many aspects of the pharmacy, including staffing, services, and organizational climate. Pharmacy site visits were initially conducted in-person but were later adapted to a virtual format due to the pandemic. RESULTS: RURAL-CP is now a PBRN registered with the Agency for Healthcare Research and Quality within the USA. Currently, 95 pharmacies across five southeastern states are enrolled. Conducting site visits was critical for developing rapport, demonstrating our commitment to engage with pharmacy staff, and appreciating the needs of each pharmacy. RURAL-CP pharmacists' main research priority was expanding reimbursable pharmacy services, especially for diabetes patients. Since enrollment, network pharmacists have participated in two COVID-19 surveys. DISCUSSION: RURAL-CP has been instrumental in identifying rural pharmacists' research priorities. COVID-19 provided an early test of the network infrastructure, which allowed us to quickly assess COVID-19 training and resource needs. We are refining policies and infrastructure to support future implementation research with network pharmacies.

Subcutaneous REGEN-COV antibody administration in a community pharmacy.

BACKGROUND: REGEN-COV is a non-Food and Drug Adminstration approved monoclonal antibody combination of casirivimab/imdevimab. Casirivimab/imdevimab was previously used for the treatment of SARS-CoV-2 infection (COVID-19), under an emergency use authorization, and has demonstrated a reduction in hospitalizations and death. With the ability to administer this monoclonal antibody combination subcutaneously in an outpatient setting, limited community pharmacies became a treatment location for patients. OBJECTIVES: The objective of this study was to describe an innovative service and evaluate the safety of administering REGEN-COV, a monoclonal antibody combination of casirivimab and imdevimab, in a community pharmacy setting as treatment for COVID-19. PRACTICE DESCRIPTION: This study was conducted in a community pharmacy during traditional business hours. PRACTICE INNOVATION: A novel service of monoclonal antibody administration for the treatment of COVID-19 was implemented in a community pharmacy in response to community needs during the pandemic. EVALUATION METHODS: A retrospective, observational study was conducted from September 1, 2021 to December 31, 2021. Patients were required to have a positive SARS-CoV-2 test and meet all inclusion and exclusion criteria. Patients were assessed for adverse drug reactions at the time of monoclonal antibody administration and 60-minutes after administration. Patients were contacted by phone to complete a survey to assess patient reported adverse drug reactions post administration, number of patients hospitalized, and number of patients able to return to normal daily activities. RESULTS: Of the 93 patients included in this study, adverse effects were reported in 4.3% of patients at administration and 9.7% at follow-up. Included patients receiving this service generated $32,688.68 in revenue for the community pharmacy. CONCLUSION: Community pharmacists can administer casirivimab/imdevimab safely and effectively in an outpatient setting with low adverse events. This innovative monoclonal antibody administration service should be used as an example for a Call to Action of expansion of pharmacist scope of practice.

Dispensing of Ivermectin From Veterans Administration Pharmacies During the COVID-19 Pandemic.

This cohort study compares changes in ivermectin dispensing during the COVID-19 pandemic between the Veterans Administration (VA) and retail pharmacy settings and examines the association of the VA national formulary restriction with ivermectin dispensing.

COVID-19 booster vaccination in rural community pharmacies.

This study assessed rural community pharmacists' attitudes about COVID-19 vaccine booster doses and explored whether rural pharmacies offered these booster doses. Of the 80 rural Southeastern U.S. pharmacists who completed the online survey, the majority (n = 68, 85 %) offered boosters and 42 (52.5 %) had received the booster themselves. Alabama and Mississippi offered boosters less often than other states, and pharmacists who had foregone receiving COVID-19 vaccination or booster doses were less likely to offer the booster to their patients. Additionally, many pharmacists reported that they and their patients felt the booster was not needed. Community pharmacies provide access points for the COVID-19 booster in rural areas. Interventions for both pharmacists and patients are needed to address hesitancy and improve booster uptake in these communities.

Processes implemented and activities carried out by the pharmacists during the COVID­19 pandemic: A scoping review.

OBJECTIVE: To identify and summarize the processes implemented and the  activities performed by community and hospital-based pharmacists during the  COVID­19 pandemic. METHOD: A scoping review was carried out of the PubMed/Medline database  with the aim of identifying articles published until 30 June 2021. The PRISMA  recommendations for this type of review were followed. The articles included  were reviewed and classified according to their main characteristics and  outcomes, according to population, concept and context. The processes and  activities identified were grouped into three categories: those performed in  community and hospital pharmacies, those performed essentially in community  pharmacies, and those performed essentially in hospital  pharmacies. RESULTS: A total of 629 articles were identified, of which 454 were excluded  because they were unrelated to the object of the review and 81 due to meeting  the exclusion criteria. So, 94 articles were included in the analysis.  Most studies were conducted in Europe and the United States. During the  COVID­19 pandemic, the processes implemented and the activities carried out  in both community and hospital-based pharmacies included pharmaceutical  care, efficient and timely management of services, information and education,  psychological support, pharmacovigilance and telepharmacy. Processes  implemented and activities carried out essentially in community pharmacies  were those related to the detection recommendations, and drug indications.  Finally, processes and activities essentially occurring in hospital pharmacies  included those related to participation in drug treatment research, drug  evaluation and guidelines development, and to managing off-label drugs. CONCLUSIONS: During the COVID­19 crisis, pharmacists have led and implemented processes aimed at mitigating the impact of the pandemic on  the population´s health. Pharmaceutical care, efficient and  timely management of services, information and education, psychological  support, pharmacovigilance and telepharmacy, both in community and hospital pharmacies, are the main processes implemented by pharmacists  during the COVID­19 pandemic. These processes and activities, in addition to contributing to the control, prevention and effective and safe treatment of  COVID­19; have ensured the implementation of biosecurity measures, proper  dispensing of medication, the drug rational use, and the provision of evidence- based information and education.

OBJETIVO: Identificar y sintetizar los procesos y actividades realizados por el  farmacéutico en la farmacia comunitaria y hospitalaria durante la pandemia por  COVID-19.Método: Revisión sistemática exploratoria en PubMed/Medline de artículos publicados hasta el 30 de junio de 2021, siguiendo las  recomendaciones PRISMA para este tipo de revisiones. Los artículos incluidos  se clasificaron según sus principales características y resultados, acorde con la  estructura: población, concepto y contexto. Los procesos y las actividades  identificados se agruparon en tres categorías: realizados en farmacia  comunitaria y hospitalaria, llevados a cabo esencialmente en farmacia  comunitaria y realizados esencialmente en farmacia hospitalaria. RESULTADOS: Se identificaron 629 artículos, de los cuales se excluyeron 454  por no estar en relación con el objeto de la revisión y 81 por los criterios de  exclusión; por tanto, se incluyeron 94 en la revisión y análisis. La mayoría de  los estudios se desarrollaron en Europa y Estados Unidos. Entre los procesos y  actividades llevados a cabo por el farmacéutico durante la pandemia, tanto en  farmacia comunitaria como en hospitalaria, destacaron: atención farmacéutica,  gestión eficiente y oportuna de los servicios, información y  educación, apoyo psicológico, farmacovigilancia y telefarmacia. En farmacia  comunitaria destacaron también los relacionados con la detección de COVID-19  y derivación de pacientes, inmunización en farmacias, recomendaciones de  cuidados en el hogar e indicación farmacéutica. Entre los procesos  realizados esencialmente en farmacia hospitalaria destacaron los relacionados  con la participación en investigaciones de tratamientos farmacológicos,  desarrollo de guías de utilización de medicamentos basadas en evidencia y  manejo de medicamentos en indicaciones no aprobadas. CONCLUSIONES: Durante la pandemia por COVID-19, los farmacéuticos han  liderado e implantado procesos orientados a mitigar su impacto en la salud de  la población. Atención farmacéutica, gestión eficiente y oportuna de los  servicios, información y educación, apoyo psicológico, farmacovigilancia y  telefarmacia fueron los principales procesos y actividades realizados en  farmacia comunitaria y hospitalaria durante la pandemia por COVID-19. Dichos  procesos y actividades buscaron, además de contribuir al control,  prevención y tratamiento efectivo y seguro de la COVID-19, asegurar la  implantación de medidas de bioseguridad, la dispensación y uso adecuado de  los medicamentos y la información y educación basadas en la mejor evidencia  disponible.