[Analysis of supplying situation in pharmacies: II. Availability of medicaments and health appliances from the viewpoint of the patient]. / Analýza zásobovací situace v lékárnách: II. Dostupnost léciv a zdravotnických prostredku z pohledu pacienta.

In two pharmacies a survey was carried out to find what medicaments and health appliances are not immediately available for dispensation on presenting a medical prescription or a voucher for a therapeutic or orthopaedic aid. The data for 2005 were subjected to frequency analysis. In pharmacy A (in a community of up to 400,000 inhabitants), mass-produced medicaments were ordered on presentation of 488 medical prescriptions, in pharmacy B (in a community of up to 10,000) it was 3 911 documents (prescriptions and vouchers). There exist no rules for ordering in the PC systems. The total value of ordered preparations in pharmacy A was 195,023.19 CZK (390 different preparations), in pharmacy B, 2,086,209.61 CZK (871 mass-produced preparations and health appliances). Medicaments not available for dispensation when required were repeatedly the identical ones; in pharmacy A, 74 different mass-produced preparations were ordered at least twice a year, in pharmacy B, 797. These preparations were prescribed in pharmacy A in 5.12% of cases by the same physician, in pharmacy B in 13.92% of cases also by the same physician. In pharmacy A, all required preparations were collected by the patients; in pharmacy B, uncollected mass-produced preparations valued at 22,947.89 CZK (39 prescriptions, i.e., 1.07%). More consistent use of the possibilities of automatic proposal of the order and more effective communication with the prescribing physicians could reduce the number of patients who have to wait for their preparation, and thus increase compliance.

[Analysis of supplying situation in pharmacies. I. Supply with medicaments and health appliances from the viewpoint of pharmacies and distributors]. / Analýza zásobovací situace v lékárnách. I. Zásobování lécivy a zdravotnickými prostredky z pohledu lékáren a distributora.

The paper describes the contemporary methods of ordering, their demands for time, and positive and negative aspects. The results of the analysis of the data from pharmacies were compared with the data found by analyzing the data provided by the distributor. The methodology of the paper includes: a questionnaire survey, the method of the autopicture, and an analysis of archival data from pharmacies and distributors. The most frequent response to the question concerning the number of supplying wholesale distributors is two (38.1% of pharmacies) and three (33.3 % of pharmacies); pharmacies receive supplies from them most frequently three times a day (28.1% of pharmacies). 61.9 % of pharmacies compile the orders intuitively, 38.1% of them use the possibilities of the automatic proposal of the order using a PC system. 66.6% of pharmacies utilize modem ordering whose advantages are rapidity (493%), time availability (41.2%), a list of confirmed preparations (28.5 %), and financial advantageousness (23.8 %). The average time of ordering amounts to 21 min a day for telephone orders and 4 min a day for modem orders, the average proportion in the use of the individual methods of ordering is 59.1% to 40.9% of items to the benefit of modem orders. A concrete pharmacy was selected to demonstrate the effect of changes resulting from the transition from exclusively telephonic ordering to prevalently modem ordering; saved time period amounted to 62.5 % (from 14.4 s to 5.4 s per 1 ordered item). The analysis of distributors' data reveals an increase in the share of the items and packages ordered via modem (from 22.2%, and 20.6%, respectively, in the year 2000, to 54.5% and 49.8%, respectively, in the year 2004).

[Preparation of pharmaceuticals in pharmacies. I. Contemporary situation from the viewpoint of computer records]. / Príprava lécivých prípravku v lékárne. I. Soucasný stav z pohledu pocítacové evidence.

Pharmaceuticals prepared in pharmacies represent approximately 5 % of the total number of dispensed packages, in financial terms approximately 2.3 % of the total turnover of a pharmacy. For the preparation of pharmaceuticals, 70 % of pharmacies under study use computer files of prescriptions. In most cases, the number of recorded prescriptions does not exceed 150, both for preparations made in larger amounts and those made individually. But not all prescriptions are really used. On the other hand, frequently required prescriptions are often missing. Prescriptions used in pharmacies of different regions are similar or identical. The computer files of prescriptions could be utilized in a more effective way and could also include algorithms to secure the appropriate quality of preparation.

[Prescription of health requisites to patients]. / Preskripce zdravotnických prostredku pacientum.

The survey included 3807 records (vouchers for therapeutic and orthopedic requisites) from five pharmacies of the basic type within six months. Health requisites were prescribed and issued to 1337 patients in a total number of 14,431 items, which represents 290 different kinds (codes) of health requisites. The most frequently prescribed items included: dressing materials, aids for incontinence, and requisites for diabetic patients. Health requisites prescribed in vouchers are dispensed to patients of all age categories, most of them being older than 50 years of age. The diagnoses, for which the health requisites are prescribed, are typical of the individual age categories: to 30 years of age they are primarily respiratory and allergic problems and accidents, after 30 years of age it is venous insufficiency, and after 50 years of age various types of incontinence prevail. The diagnosis of diabetes mellitus is found in all age categories. It follows from the trend of ageing of the population that dispensation of health requirements in pharmacies will be increased.

[Dispensing care at the dispensing counter in the conditions of a Czech pharmacy]. / Farmaceuticka péce za tárou v podmínkách ceské lékárny.

Evaluation of 108 cases when the pharmacist found a need to intervene into prescription verified the use of internationally employed system of classification of pharmaceutical interventions in the conditions of the Czech pharmacy of the basic type. The so-called dispensing care at the counter was provided by five participating pharmacists (out of seven working in the pharmacy) for a period of six months. The most frequently identified problems included: inappropriate use of medicaments--overdose, use at unsuitable time (28.7 %), a need to inform the patient (17.6 %), potentially ineffective therapy (12.9 %), drug interactions (7.4 %), suspected and potential undesirable effects of prescribed medicaments (7.4 %), and insufficient compliance (6.5 %). Solution of problems with medicaments was most frequently: a change in dosage (25.9 %), recommendation to consult the physician (24.1 %), and professional counselling on pharmacotherapy (23.1 %). The pharmacotherapeutic group identified as the one most frequently requiring a telephone consultation of the pharmacist and the physician was antibiotics, including antibacterial chemotherapeutic agents.

[Analysis of drugs used in out-patient practice of veterinary medicine]. / Analýza pouzívání léciv v ambulantní praxi veterinárních lékaru.

Both veterinary and human mass-produced medicinal preparations can by employed in the therapy of animals. Veterinary surgeons are allowed to dispense drugs right in their surgeries. Data were obtained by means of questionnaires from 11 respondents in the year 2002. Variability and consumption of mass-produced medicaments were evaluated in altogether 27 pharmacotherapeutic groups (17 groups were represented both in the assortment of veterinary and human brand products, 4 groups included only human brand products, and 6 groups were exclusively veterinary brand products). The greatest variability of human brand products prescribed in veterinary practice was found in antibiotics, vitamins, and analgesics including antiphlogistics. Of veterinary brand products, the greatest variability was found in antibiotics, anti-ectoparasitic agents, and minerals including calcium preparations. In the assortment of human brand products, the largest consumption is that of corticosteroids, antibiotics, and analgesics including antiphlogistics. In the assortment of veterinary brand products, the largest consumption was found in anti-ectoparasitic, antibiotic, and antiparasitic-anthelmintic drugs. The number of extemporaneous preparations prescribed by the veterinary surgeons ranged from 0 to 30 per month, the number of brand products dispensed in pharmacies was 0-40 of human brand products and 0-5 of veterinary brand products per month. The number of original packages of brand products stored in surgeries of veterinary surgeons ranged within 20-150 of human brand products and 40-400 of veterinary brand products. Nearly one half of the respondents reported that they did not need any cooperation with the pharmacist.

[Medical equipment product lines in basic pharmacies]. / Zdravotnické prostredky v sortimentu lékáren základního typu.

Medical appliances dispensed in basic type pharmacies for cash or vouchers for medical or orthopedic appliances require expertise of pharmacists and laboratory assistants concerning the assortment, payment, construction of prices, conditions for prescription, ordering, properties, and functions of individual appliances. Using the method of frequency analysis, the analysis of data from five pharmacies within a period of three months (more than 17,000 records) revealed how individual subgroups of medical appliances and their concrete items are represented in both types of dispensation. The method of the semistructured questionnaire (10 respondents) was used to find what problems are encountered in dispensation, and which medical appliances and their subgroups are the sources of the problems. The respondents regard the contemporary level of knowledge concerning medical appliances gained in pregradual studies as insufficient.

[Knowledge of patients about OTC drugs as a result of pharmacist-patients consultations]. / Znalosti pacientu o OTC prípravku jako výsledek konzultace farmaceut--pacient.

Knowledge of patients about oral single-component OTC preparations containing ibuprofen, bought for their own use, was evaluated in relation to the manner of the process of communication between the pharmacist (laboratory assistant)--patient during the supply at the pharmacy. The answers of respondents were processed separately for the group of those who bought the preparation for the first time and those who had already used it for self-medication. The knowledge of contraindications and undesirable effects (judged separately) was found to be higher than 50% in both groups of respondents. Nevertheless, the patients who use the preparation repeatedly state simultaneous ignorance of undesirable effects and contraindications only in 32.2%, in contrast to the new users (60.0%). The patients who know neither contraindications nor undesirable effects of the preparation which they buy nevertheless think that they have enough information so that their self-medication can be safe (88.9% of patients using the preparation repeatedly and 80.0% of new users). Approximately a quarter of respondents in both groups under evaluation state that during the supply in the pharmacy they were not given any piece of information. Patients are passive when buying an OTC preparation and nearly 40% of them do not use the opportunity to ask for pertinent information themselves. Nearly 85% of respondents from both groups consider information gained from the pharmacy to be sufficient. When supplying an OTC preparation, in 45% of cases pharmacists (laboratory assistants) do not inquire whether the patient have already used the preparation, or whether he or she knows anything about it. The standard of counselling on self-medication in the Czech Republic should thus become more effective.

[Use of over-the-counter drugs containing ibuprofen in self-medication]. / Pouzití volne prodejných prípravku s obsahem ibuprofenu v samolécení.

Ibuprofen (MO1AE01) is a suitable means for self-medication with regard to its relatively wide spectrum of indication, good tolerance, and safety. In the Czech Republic, OTC preparations containing ibuprofen represent frequently used medicaments. The paper examines solid divided dosage forms for oral administration. A survey based on questionnaires reveals in what indications and according to what dosing schemes the purchased preparations are used, and the paper evaluates possible risks. Strengthening of the role of the pharmacist as the provider of information on drugs, keeping patients' drug records in pharmacies, and deepening of the mutual cooperation of the physician and pharmacist would contribute to increase the safety of the use of the preparations under study.

[View of pharmacists on pharmaceutical care in the Czech Republic]. / Názory lékárníku na poskytování lékárenské péce v Ceské republice.

The present paper aims to outline the opinion spectrum expressing the attitudes of Czech pharmacists to the idea of implementation of pharmaceutical care in everyday practice of public pharmacies. Using the Q-method, four different trends in opinions of the respondents were found. This gave an idea of whether and how the idea of pharmaceutical care could be accepted in this country.

[Practical experience in providing pharmaceutical services in public pharmacies in Denmark]. / Praktické zkusenosti s poskytováním lékárenské péce ve verejných lékárnách v Dánsku.

The paper evaluates practical activities of the public pharmacy in Denmark, which materialize the content of the so-called pharmaceutical care in everyday contacts of the pharmacist and patients. It has been found that the conception of pharmaceutical care is materialized in somewhat different ways in different countries and in different types of establishments (clinical pharmacy--public pharmaceutical service). The Czech pharmaceutical service could link up with the tradition of the 1970s and 1980s when there were efforts to make pharmacist's work more effective, aiming at solving the patient's problems concerning medication. This is a world-wide trend worth joining.

[Over-the-counter drug sales in pharmacies]. / Volný prodej v lékárnách.

The present legally unregulated and ever-increasing assortment of over-the-counter drugs sold in pharmacies has been analyzed. The assortment has been divided into 14 categories in which the number of sold package and their financial values was examined. The classic pharmaceutical assortment (registered mass-produced medicaments, requisites needed for health care, milk products, unregistered vitamin preparations and dietetic preparations) represent the decisive share in the financial value and number of packages of the over-the-counter assortment in pharmacies. Further extension of the supply of pharmacies with nontraditional assortment does not appear to be suitable.

[Pharmaceutical care abroad and in the Czech Republic]. / Lékárenská péce v zahranicí a u nás.

The position of the pharmaceutical service in the society of future generation will depend on the quality of pharmaceutical care. Its importance has followed from the requirements of the patients themselves. By accepting his new role, the pharmacist is able to influence the relationship of the patient to the drug in all situations when man encounters the drug: in the course of hospitalization, during the transition from hospital to domestic care, in domestic treatment, in dispensation of drugs supplied on medical prescription, and in the purchases of over-the-counter drugs. In order to cope with these tasks, the pharmacist must cooperate more intensively with a wider team of health workers of the primary and secondary care. There will be necessary changes in the hitherto style of work of pharmacies and both in the graduate and further education of pharmacists. The aim is a safe and rational use of drugs, prevention of wasting, and education of people to take the responsibility for their health.