Evaluation of pharmacist's practices regarding the antimicrobials dispensing: a simulated patient study.

BACKGROUND: The indiscriminate use of antimicrobials is considered a major contributing factor to the increase in antimicrobial resistance. Community pharmacies are the main source of access to antimicrobials, and pharmacists are in a strategic position to promote rational use of these medicines. Therefore, it is important to know dispensing service quality. OBJECTIVE: To evaluate the behavior of pharmacists in dispensing antimicrobials in community pharmacies in northeast Brazil. METHODS: This cross-sectional pilot study was conducted from August to October 2021 in a private community pharmacy chain in Sergipe. Dispensing was evaluated using the simulated patient (SP) technique. Two SP asked the pharmacists for the antimicrobials (case clinic 1: upper respiratory infection; case clinic 2: urinary tract infection) and recorded the service through audio. Dispensing practices were independently analyzed by two researchers based on the tools available in the literature. Data were presented using descriptive statistics. RESULTS: A total of 54 simulated patient visits were conducted. Based on the 12 steps recommended by the research team for good dispensing, pharmacists asked an average of 1 (±1.17) question for upper respiratory infections and 0.3 (±0.54) for urinary tract infections, as well as provided counseling (mean number of recommendations, 2.6 (±1.44) and 4.5 (±2.35), respectively). As for communication skills, pharmacists had a regular score (3.07 ± 0.34). Furthermore, there was no significant difference in the number of steps and counseling recommendations by pharmacists in dispensing clinical cases 1 and 2 (p = 0.0674). CONCLUSION: The quality of antimicrobial dispensing was evaluated as suboptimal, requiring improvements in practice and multifaceted strategies to promote continuing education of these professionals. In addition, awareness actions for the population must be implemented to promote the rational use of antimicrobials and reduce microbial resistance.

An Overview of the Methodologies and the Quality of Studies on Pharmacotherapy for the Treatment of Fibromyalgia.

BACKGROUND: It is often unclear whether systematic reviews and primary studies are de-signed to elucidate the efficacy or effectiveness of interventions. This may compromise the use of the information in clinical or policy decisions. OBJECTIVE: This overview aimed to evaluate the methodological profiles of studies on fibromyalgia pharmacotherapy in terms of the quality and nature of the interventions (efficacy versus effective-ness). METHODS: The protocol was registered in the International Prospective Register of Systematic Re-views database. Seven databases were searched for relevant publications. Systematic reviews inves-tigating the effectiveness or efficacy of fibromyalgia pharmacotherapy were included. Methodolog-ical quality was investigated using A MeaSurement Tool to Assess Systematic Reviews (AM-STAR), and efficacy andeffectiveness were evaluated using Rating of Included Trials on the Effica-cy-effectiveness Spectrum (RITES). RESULTS: In this overview, 4,107 studies were initially identified. 8 systematic reviews and 34 prima-ry studies remained after overlaps were removed. Of the eight systematic reviews, 4.76% (n=3) and 7.93% (n=5) were of moderate and high quality, respectively. An analysis of systematic reviews clearly showed the criteria "participants characteristics" and "trial setting" with the most frequent answers as scales 1 and 2 (strong emphasis on efficacy or rather strong emphasis on efficacy), re-spectively. RITES analysis revealed that the most frequent response was "strong emphasis on effi-cacy" in 68% (92/136) of primary studies. CONCLUSION: This analysis showed, in both systematic reviews and primary studies, a predominantly strong emphasis on efficacy, suggesting the need for methodological quality improvement in future studies, especially those designed to provide evidence related to effectiveness. The protocol for this overview has been registered in the International Prospective Register of Sys-tematic Reviews (PROSPERO; CRD42018095943).

Using Virtual Patient Software to Improve Pharmacy Students' Knowledge of and Attitudes Toward Geriatric Patients.

Objective. To evaluate the effect of using a virtual patient software program to improve pharmacy students' knowledge of and attitudes toward geriatric patients. Methods. The Virtual Patient for Geriatric Education (VIPAGE) software program was used in two Bachelor of Pharmacy (BPharm) degree programs in Brazilian universities. The virtual consultations were divided into an initial evaluation, care plan, letter of referral to another professional, and evaluation of follow-up. Each weekly session lasted two hours. Students answered questionnaires before and after using the virtual patient software relating to the following: demographics, geriatric experiences, Geriatric Attitudes Scale, and the Facts on Aging Quiz. Results. Of the 128 students who completed the baseline questionnaires, 109 students also completed the second questionnaire. The mean Geriatric Attitudes Scale score before the intervention was 3.7 (SD=0.8) and after was 3.9 (SD=0.7). Significant improvements in Geriatric Attitudes Scale scores after using the virtual patient software were seen in students who were male, whose grandparents were still alive, or whose parents were elderly, who had frequent contact with the elderly, who did not have frequent contact with the elderly, and who did not have professional contact with the elderly. The average score on geriatrics knowledge was 44.7 (SD=12.0) before completing the virtual patient consultations and 52.6 (SD=11.9) after. The mean score measuring students' lack of geriatrics knowledge was 27.3 (SD=15.8) before and 19.1 (SD=12.8) after using the software. Conclusion. Completing virtual patient consultations using the VIPAGE software positively impacted pharmacy students' geriatrics knowledge and attitudes.