Community Pharmacies Research Articles

A qualitative analysis of opportunities to strengthen pharmacy technician career pathways across practice settings.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. To identify pharmacy technician career pathways across pharmacy practice settings and opportunities to strengthen and expand these pathways. Interviews were conducted with 17 participants from national pharmacy organizations, community pharmacies, health systems, and academia from March to May 2023. Interview questions were designed to elicit participants' perceptions of factors influencing entry into, recruitment and retention of, and advancement of the pharmacy technician workforce. Interview notes were analyzed using a rapid thematic analysis approach. Seven themes were identified, including 3 themes related to entry: (1) healthcare interest and prior exposure facilitate pharmacy technician career discovery; (2) variation in and quantity of entry-level requirements can impede entry into pharmacy technician careers; and (3) proactive promotion of pharmacy technician careers needed. Two themes were related to recruitment and retention: (4) pharmacy technician compensation not aligned with job demands and (5) career ladders or lattices create advancement opportunities. Two themes were related to professional advancement: (6) pharmacy technician advancement limited by weak professional identity and (7) scope-of-practice policies can facilitate pharmacy technician advancement. This study highlights the challenges pharmacy technicians face in their careers. Key findings stress cultivating a professional identity for pharmacy technicians, establishing career ladders or lattices, and advocating for policies that facilitate pharmacy technician professional advancement. These efforts are vital for sustaining the pharmacy technician workforce and ensuring quality patient care amidst the changing landscape of the pharmacy profession.

Impact of a clinical decision support system on identifying drug-related problems and making recommendations to providers during community pharmacist-led medication reviews in Ontario, Canada: A pilot study.

To evaluate the impact of a clinical decision support system (CDSS) to identify drug-related problems (DRPs) during community pharmacist medication reviews. Pilot 3-phase (group), open-label study. Two community pharmacies in Sarnia, Ontario, with pharmacists providing medication reviews to patients. Five pharmacists participated in three phases (groups). During Phase 1, pharmacists conducted medication reviews in 25 adult patients using the usual approaches. In Phase 2, pharmacists were trained to use a CDSS to identify DRPs, and then conducted medication reviews using the tool in a different group of 25 adult patients. In Phase 3, pharmacists conducted medication reviews without the aid of the CDSS in 25 additional adult patients. The primary outcome was recommendation to the primary care physician to alter pharmacotherapy based on medication review, assessed using mean number and frequency (yes/no) of recommendations by patient. Secondary outcomes included number of potential DRPs, actual DRPs, medication review duration time, pharmacist's perceptions of the CDSS and patient satisfaction with medication review. The mean number of recommendations to primary care physicians to alter pharmacotherapy per patient in Phases 1, 2 and 3 did not differ: 1.0 (SD = I.2) versus 1.5 (1.0) versus 1.5 (1.0), respectively; p = 0.223. The percentage of patients with a pharmacy recommendation sent to physicians across the phases, however, differed: 52% versus 80% versus 88%, respectively; p = 0.010, with more in Phases 2 and 3 compared to 1. There were more potential DRPs in group 2 compared to other groups. There were no differences in actual DRPs and medication review time. Pharmacists had positive attitudes about the CDSS. Patients were generally satisfied with their medication review. This small pilot study provides some preliminary evidence for performance and feasibility of a CDSS to identify DRPs that pharmacists will act on. Future research is recommended to validate these findings in a larger sample.

Pharmacy practice and policy research in Türkiye: a systematic review of literature.

In recent decades, there has been an interest in clinical pharmacy practice in Türkiye with emerging studies in this area. Despite the recent emergence of diverse pharmacy practice studies in Türkiye, a comprehensive assessment of overall typology of studies and impact has not been conducted thus far. This systematic review aims to document and assess pharmaceutical policy and practice literature published within the last 5 years in Türkiye. The other aim is to summarise the expected impact of published studies on policy and practice research. The systematic review was conducted according to the guidelines described in the PRISMA Statement. A comprehensive search approach, incorporating Medical Subject Headings (MeSH) queries and free-text terms was employed to locate pertinent literature related to pharmacy practice and policy in Türkiye. The search covered the period from January 1, 2019, to January 1, 2024, and involved electronic databases including PubMed, Medline Ovid, Scopus, ScienceDirect, Springer Link, PlosOne, and BMC. In the final grouping, 73 articles met the inclusion criteria and were selected for this review. Among the quantitative studies, majority studies were cross-sectional survey studies. Through the rigorous thematic content analysis seven research domains were developed from the selected literature: drug utilisation and rational drug use, the emerging role of pharmacist, access to medicines and generic medicines, community pharmacy practice, pharmacovigilance/adverse drug reactions, and pharmacoeconomic studies. The pharmacist role is evolving; however, several challenges remain in fully realising the potential of pharmacists. These include regulatory barriers, limited public awareness of pharmacists' expanded roles, workforce capacity issues, and the need for ongoing professional development and training. Research studies are needed in the areas of generic prescribing, medicine adherence, intervention studies in community and hospital pharmacy practice, and on pharmacoeconomics and pharmacovigilance.

Academia’s Support of Community Pharmacy in This Time of Transformation

Community pharmacy is currently experiencing significant changes that will likely transform practice in unpredictable ways. With student interest in pursuing community pharmacy practice postgraduation on the decline, the Academy needs to ensure that a sufficient number of students passionate in community practice enter the workforce to guide this transformation in a positive manner for the profession and patients. This commentary reviews the ways that pharmacy faculty may promote community pharmacy during the students’ academic experiences. These include being mindful of the messages we send our students, promotion of community pharmacy postgraduate training, optimization of community-focused adjunct faculty relationships, and reviewing curricula to ensure contemporary community aspects.

Pharmacist intervention to improve controlled substance dispensing and use practices in Texas: A pilot study

BackgroundPharmacists play an important role in preventing and addressing opioid-related harm; as such, efforts to encourage and improve their participation are valuable. Face-to-face peer-pharmacist-delivered academic detailing targeted at community pharmacists may serve a role to support best practices in dispensing controlled substances (CS). ObjectivesThe objectives of the project were to (1) develop and pilot an academic detailing intervention, (2) determine the feasibility of delivering the intervention, and (3) determine which knowledge and practice should be emphasized during the education. This information would drive refinements to the project before it was expanded. MethodsEducational content and materials were developed based on previous research on dispensing practices and on delivering academic detailing. A pharmacist trainer visited community pharmacists to deliver education and to collect data about knowledge and practices surrounding CS dispensing. The community pharmacists were also offered drug disposal products for distribution to patients. ResultsA total of 53 community pharmacies in Fort Bend County, TX, were identified as potential targets for the intervention. Seven were determined to be ineligible and the pharmacists in 33 pharmacies consented to participation. Before the intervention, 60.6% of the participating pharmacists reported feeling uncomfortable filling CS and disposal of leftover CS was infrequently addressed with patients. Most pharmacies did not use drug disposal systems before intervention and most pharmacies were interested in receiving free drug disposal envelopes through the intervention. ConclusionAn educational intervention was developed and pilot tested. The pilot showed the intervention’s feasibility and suggested which educational content needed to be abridged to accommodate community pharmacists’ busy practices. Plans were made to scale up the intervention to include more peer pharmacists and community pharmacies.

Satisfaction of chronic patients with community-based health insurance schemes and related factors: Explanatory sequential mixed methods study.

Chronic disease poses a serious threat to accessible, high-quality healthcare. Community-based health insurance (CBHI) schemes provide the poor with financial security. However, there is no evidence in Ethiopia on how satisfied chronic patients are with the schemes. The objective of the current study was to evaluate the satisfaction of chronic patients with the schemes and identify contributing factors. A hospital-based explanatory sequential mixed methods study on 632 chronic patients and 12 key informants was carried out between February 28 and May 31, 2022, in the hospitals of East Gojjam, Northwest Ethiopia. Hospitals and study participants were selected using multistage sampling methods. Quantitative data was entered using Epi Data 3.1 and exported to SPSS version 25 for analysis. P value <0.05 was used to consider significant association in multivariable binary logistic regression. Thematic analysis was a method to manually review qualitative data. A narrative approach was used for integrating the two data. The mean age of study participants was 46.1 (46.1± 5.2, range: 25-82). Patients aged 45 to 64 made up the majority of the population (60.6%). Rheumatoid arthritis affected the preponderance of individuals (36.4%). The overall level of satisfaction of chronic patients with the CBHI scheme was 31% (95% CI; 27-35%). Respect and friendliness (AOR = 7.05; CI: 3.71-13.36), knowledge of benefits packages (AOR = 2.02; CI: 1.24-3.27), partial or non-availability of drugs (AOR = 0.24, AOR = 0.21, respectively), waiting times (AOR = 1.84; CI: 1.12-3.0), and availability of laboratory tests (AOR = 1.59; CI: 1.01-2.48) were significantly associated with participants' satisfaction with the schemes. Our study revealed that the overall satisfaction of chronic patients was quite low and affected by the availability of drugs and laboratory tests, caregivers' respect and friendliness, waiting times, and participant knowledge. Therefore, stakeholders must concentrate on reducing waiting times, improving the availability of drugs and laboratory tests at each hospital, opening back up community pharmacies, and promoting awareness about benefits packages primarily through health education. The main focus of researchers needs to be on nationally representative studies that include more important factors.

Pharmacist-led primary care interventions to promote medicines optimisation and reduce overprescribing: a systematic review of UK studies and initiatives

ObjectivesTo systematically review and synthesise evidence on the effectiveness and implementation barriers/facilitators of pharmacist-led interventions to promote medicines optimisation and reduce overprescribing in UK primary care.DesignSystematic review.SettingUK primary care.MethodsWe searched...

Formulation and clinical evaluation of carbidopa/levodopa oral solution for the treatment of sepiapterin reductase deficiency

Backgroundsepiapterine reductase deficiency (SRD) is a rare levodopa (L-dopa)-responsive disorder treated with a combination therapy of controlled-release L-dopa and carbidopa. The currently available formulation of controlled-release carbidopa/L-dopa does not entirely meet the requirements for the long-term therapy in pediatric patients. In fact, administration of a manufactured tablet at a dose intended for adults necessitates its adjustment to the child’s needs, as the splitting of the tablet into smaller portions or its dilution in water. It’s essential to emphasize that tablets must not be crushed, as this can compromise the controlled-release mechanism and affect the efficacy of the medication. At the moment, commercial liquid formulations are not available. Given these limitations, in house drug preparation in hospitals and community pharmacies is a valid option to ensure the proper therapeutic management of these patients. Materials and methodswe described sample preparation, physical and microbiological analyses, taste testing, and tolerability of a 1:10 ratio carbidopa/L-dopa flavored (mint, raspberry, cacao, berries) and unflavored oral formulation (no sweetening agents were added). We also reported long-term follow-up of two pediatric patients with SRD. Resultswe documented the stability for 28 days at 25 °C of the liquid solution. All formulations were well-tolerated, and no adverse events were observed during or after assessing taste and tolerability. The long-term follow up of two patients was characterized by effective symptom control and optimal treatment adherence and compliance. Conclusionsin-house liquid drug formulations can be a valid option for pediatric patients with SRD. Given the significant impact of taste on medication adherence, the use of flavoring agents in the development of liquid formulations of L-dopa/carbidopa results a very useful strategy to obtain optimal adherence in the pediatric population.

Linking Inner Context and Innovation Factors: Examining a pharmacy-based intervention through the eyes of pharmacy staff

Introduction: Community pharmacies, as unique and accessible healthcare venues, are ideal locations to implement interventions aiming to improve patient care. However, these interventions may increase workload or disrupt workflow for community pharmacists, technicians, and other staff members, threatening long-term sustainment. There are growing calls from the field of implementation science to design for intervention sustainment and maintenance by maximizing innovation fit. Senior Safe™, an intervention to facilitate safer over-the-counter (OTC) product selection by older adults, serves as a case study to examine the congruence between Innovation Factors and community pharmacy Inner Context constructs and their implications for workload and sustainment.Methods: Using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, this qualitative study identified factors surrounding Senior Safe implementation. Semi-structured interviews were conducted with staff from pharmacies where Senior Safe was implemented. Two coders independently analyzed interview transcripts using deductive analysis based on EPIS constructs. Thematic analysis was used to generate three themes that encapsulated innovation fit.Results: Nineteen pharmacy staff members participated, with the majority reporting no significant change in their workload or workflow due to Senior Safe. Interview feedback supported a pre-existing culture of the healthcare system to engage patients, of leadership commitment to patient safety initiatives, and of an amplified role of pharmacy technicians.Discussion and Conclusion: Pharmacy staff interviews revealed congruence between Innovation Factors and Inner Context that likely yielded intervention workload neutrality. This study highlighted the importance for researchers to consider maintenance and sustainability when designing and implementing an intervention and the critical influence of culture and leadership support during this process.

Improving asthma self-management education through inhaler labeling

ObjectiveImproper use and poor understanding of asthma medications can lead to poorly controlled asthma, emergency department visits, and hospitalizations for children with asthma. Pharmacists play a critical role in improving asthma medication adherence through education on asthma self-management. The use of color-coded labels applied at pharmacies to help patients differentiate between rescue and maintenance inhalers has not been explored. MethodsPharmacies were recruited to join a community pharmacy asthma coalition. Pharmacists provided patient education and labeled inhalers with two types of color-coded stickers. A red sticker labeled “RESCUE” was used for short-acting β-2 agonist medication inhalers. A green sticker labeled “USE EVERY DAY” was used for inhaled corticosteroids (ICS) or combination ICS/long-acting β-2 agonist medication inhalers. ResultsDuring the two years of the pilot program, 25 pharmacy locations participated. Pharmacies labeled over 6000 rescue and 9000 controller medications using color-coded labels. Over 1000 children and 7000 adults were served by the coalition. ConclusionColor-coded asthma medication labels can be successfully utilized by pharmacies. This low-cost tool provides vital information regarding the proper use of asthma medications. InnovationThe color-coded labeling of asthma medications is a novel innovation that can be successfully used by pharmacists to improve asthma self-management education.

Assessment of PrEP and PEP furnishing in San Francisco Bay Area pharmacies: An observational cross-sectional study

BackgroundOver 1 million people in the United States are infected with human immunodeficiency virus (HIV). As of 2021, pharmacists in California can prescribe PrEP and PEP without establishing a collaborative practice agreement in an effort to reduce HIV transmission. However, in 2021 less than 3% of independent pharmacies in the San Francisco Bay Area did so. To our knowledge, there has been no follow-up research assessing potential changes in pre-exposure prophylaxis/postexposure prophylaxis (PrEP/PEP) furnishing rates in the region. ObjectiveAssess the extent of PrEP/PEP furnishing in San Francisco Bay Area pharmacies 3 years after policy implementation. MethodsWe conducted an observational, cross-sectional study to identify independent community and mail-order pharmacies furnishing PrEP/PEP in the nine-county San Francisco Bay Area in 2024. Furnishing pharmacies were identified via phone calls and the findings were validated with in-person visits. We also identified the number of retail chain pharmacies furnishing PrEP/PEP in San Francisco County. ResultsWe contacted 202 independent community and mail order pharmacies in the nine-county San Francisco Bay Area by telephone; of these, 16 reported furnishing PEP/PrEP and all confirmed their ability to furnish when visited in person. We contacted 67 retail chain pharmacies in San Francisco County; of these, 11 pharmacies reported furnishing PrEP/PEP (10 Safeway; 1 Walgreens). ConclusionsMore pharmacies furnished PrEP/PEP in the 9-county San Francisco Bay Area in 2024 (8%) than in 2021 (3%); in addition, one retail chain pharmacy had instituted a furnishing protocol. However, furnishing rates remained low. Past research suggests that advertising and the development of furnishing protocols may help increase furnishing and increase medication access.

Establishing mental health friendly pharmacies to assist in the early identification and support of older adults at risk of depression: The EMPATHISE pilot study

BackgroundLate-life depression (LLD) often goes underdiagnosed and undertreated. Community pharmacists are one of the most accessible and trusted healthcare professionals (HCPs) and may play a significant role in LLD screening. ObjectiveThis study aimed to develop and pilot a pharmacist-delivered depression screening and referral service for older adults (≥65 years) at risk of depression, within community pharmacy. MethodsCommunity pharmacists across New South Wales, Australia, were recruited to participate in a prospective pilot study. Pharmacists/pharmacy staff received specialized training before recruiting and screening patients aged ≥65 years using the Geriatric Depression Scale-15 (GDS-15). Patients scoring ≥6 were referred to another HCP, e.g., general practitioner, and followed-up by the pharmacist 1-week postscreening. Patients were also followed-up by a research team member 6-weeks postscreening to explore outcomes of the screening. Semi-structured interviews with pharmacists and patients were undertaken following completion of the pilot study to explore their experiences delivering/receiving the screening service. A thematic inductive analysis approach was used to analyze interview data. ResultsA total of 39 community pharmacies participated in this study. In total, 113 participants attended the training sessions. Pharmacists screened 15 patients from 8 pharmacies, of which 67% were female. Two thirds of patients (67%) received a GDS-15 score of ≥6, indicating possible depression and requiring referral. Pharmacists referred 80% of patients to another HCP. One patient was diagnosed with depression and commenced antidepressant therapy. Five patients and 6 pharmacists participated in semi-structured interviews. Barriers to screening included lack of time and mental illness stigma. Facilitators included pharmacist-patient relationships and training. ConclusionPharmacist-delivered LLD screening was found to be acceptable by both pharmacists and patients, with pharmacists reporting training improved their comfort and confidence with depression screening. These pilot study findings may inform future work into service delivery models to support early identification and treatment of LLD.

Traditional Beliefs and Real Influence of Full Moon Days on the Behavior of Community Pharmacy Customers in Estonia

Traditional beliefs about the influence of the moon’s phases on human well-being and health remain vague in Estonia. The study hypothesized that Estonian pharmacists have noticed a periodic increase in the number of problematic pharmacy visitors, which can be associated with full moon days (3 days before and after). The observational study was conducted in 22 community pharmacies in Estonia (11 in standard and 11 in blind group), a total of 76 pharmacists filled out an observation diary daily for 10 months. Additionally, a questionnaire was used for 400 randomly selected employees of pharmacies. During the full moon period, the number of conflicts in the community pharmacies increased by 2.7 in the standard group and 3 times in the blind group (p&lt;0.01). Pharmacists’ opinions about the full moon’s effect on the behavior of pharmacy visitors and themselves are described. Also, the sales of medicines for nervous system disorders increase on full moon days. Sensitive customers believe in the influence of the full moon and experience changes thanks to autosuggestion. The behavior of visitors is emotionally more unstable, with an increased level of anxiety. There is a need for further research on the impact of moon phases on behavioral aspects when providing medical and pharmaceutical care.

“Opportunities and responsibilities”: how do pharmacists assess their professionalism?

IntroductionProfessionalism is fundamental to the existence of professions. In pharmacy, interest in this theme improved with events that examined the resocialization of pharmacists in care. With this, evaluating professionalism can help the operationalization of the theme and, consequently, the development of strategies for pharmacy consolidation before its challenges. Therefore, this study aimed to evaluate the professionalism of Brazilian pharmacists.MethodsTo meet the objective, a cross-sectional study was conducted between March 2022 and August 2023. Data were collected using the Brazilian version of the “Modification of Hall’s Professionalism Scale for Use with Pharmacists”. The scale has 39 items grouped into the domains: autonomy, vocation, professional council, self-regulation, continuing education, and altruism. Data were analyzed using descriptive statistics and an ANOVA analysis of variance with post-hoc Hochberg or Games-Howell tests with Bootstrapping was conducted to verify differences between groups.Results600 pharmacists participated in this study. The majority (69%) was female and carried out their professional activities in community pharmacies (50%). Professionalism scores ranged between 14 and 29 points, with an average of 22.8 points. Pharmacists working in outpatient clinics had higher scores in most factors, namely, altruism, continuing education, professional council, vocation, and autonomy. This indicates that the inclination of pharmacists to occupy areas focused on care can be significant to assess professionalism.ConclusionsThe data obtained indicate that pharmacists working in outpatient clinics had higher professionalism scores compared to others. This corroborates the worldwide trend experienced by pharmacy in recent decades, which is the execution of increasingly patient-centered practice models.

The effects of free prescriptions on community pharmacy selection: A discrete choice experiment

BackgroundLittle is known about preferences for community pharmacies, particularly the influence of prescription co-payments, and for New Zealand's priority populations, Māori and Pacific Peoples. Improving understanding of community pharmacy preferences will enable tailoring services to meet community needs. ObjectivesThis study aims to investigate New Zealanders’ preferences for community pharmacies when collecting prescriptions. Additionally, variations in preferences for community pharmacy attributes between different latent and demographic groups were examined. MethodsFocus group discussions with various community groups were thematically analyzed to develop six attributes: location, wait time, customer service, prescription co-payments, parking availability, and nearby businesses. Participants were asked to complete an online survey involving 12 choice tasks, where they had to choose their preferred option of 3 unlabeled pharmacies along with demographic questions. A mixed multinomial logit model and latent classes analysis were used to assess and compare the participant preferences. ResultsThe sample of 553 participants, representative of the New Zealand population, resulted in 19,908 observations for analysis. The most attractive pharmacy attribute was its proximity, being within a 10-min travel distance from home or work. The importance of prescription co-payments is evident, with free prescriptions being the second most attractive attribute level and $15 NZD prescription co-payments being the least appealing. Different classes placed importance on different attributes, the largest of which prioritized prescription co-payments. Including demographic characteristics did not improve model accuracy nor predict class membership. ConclusionsUnder current policy, the most effective way for pharmacies to attract business is by offering free prescriptions. However, the trend of adopting lower-cost models may reduce the quality of care they deliver. Policy decision-makers must decide if they are comfortable with this potential impact.

Social Media Use and Consumption of Prescription-Free Medications for Anxiety, Sleep, and Pain among Norwegian University Students.

A relationship has been recognized between social media use and health issues. However, no studies have explored the potential link between social media use and consumption of over-the-counter (OTC) medications. We examined social media use, self-reported anxiety, depression, sleep problems, pain, and OTC medications use among Norwegian university students. The goal was to gain insights that would guide preventive health strategies for this target group. A quantitative, cross-sectional study was conducted with an online questionnaire distributed to university student Facebook groups in Norway. A total of 132 completed surveys were analyzed. Among the respondents, 28% experienced anxiety, 35% depression, 64% sleep problems, 71% headaches, and 78% musculoskeletal pain. Moreover, 56% reported using OTC analgesics or sleep aids, mostly purchased from community pharmacies. No statistically significant correlation was found between social media use and headache, musculoskeletal pain, sleep disturbances, or consumption of OTC medications among university students in Norway. The findings, however, demonstrated a positive trend, highlighting the need for further research with larger, more diverse samples, and potentially employing a qualitative or longitudinal design. We propose increased awareness of the potential negative effects of social media among university students, the inclusion of social media and health topics in study curricula, and the more proactive engagement of community pharmacists with young clients concerning the consumption of OTC medications.

Impact of a community pharmacy-based medication therapy management program on clinical and humanistic outcomes in patients with uncontrolled diabetes: a randomised controlled trial

This study was aimed to evaluate the impact of community pharmacy (CP)-based medication therapy management (MTM) program on clinical and humanistic outcomes in patients with uncontrolled diabetes. An open label, parallel-group randomised controlled trial was undertaken at a community pharmacy in Riyadh city, Kingdom of Saudi Arabia. Patients with a diagnosis of uncontrolled diabetes (HbA1c of ≥ 8%) meeting the eligibility criteria were randomised to receive either the MTM programme provided by pharmacists or standard care. The primary outcome was change in HbA1c over 6 months. Secondary outcomes included: changes in clinical parameters (blood pressure (BP), lipid profile, serum creatinine (SCr) and albumin-to- creatinine ratio (ACR)), types of drug-related problems (DRPs), health service utilization (HSU), adherence, diabetes distress and overall patient satisfaction with the service at 6-month. A sufficiently powered sample of 160 participants with a mean age was 50 years (SD ± 11.9) was recruited. The majority of the patients (68.1%) were male and had diabetes for more than eight years [IQR 3, 14]. After adjusting for baseline HbA1c, compared to the control group, the mean HbA1c level was 0.02% (p = 0.929) and 0.2% (p = 0.47) lower in the intervention arm at 3-month and 6-month respectively. However, these differences were not statistically significant. Nonetheless, within each arm, there was a significant improvement in HbA1c from baseline. Furthermore, the intervention arm demonstrated improvement in BP control (SBP lowered by 3.2 mmHg (p = 0.05) and DBP lowered by 3.8 mmHg (p = 0.008)). During the study period, none of the participants in the intervention group reported hospitalization or ER visits compared to 14 patients in the control group [OR 0.069 (95% CI 0.004, 1.3)]. Patient satisfaction as measured by Patient Satisfaction with Pharmacist Services Questionnaire 2.0 (PSPSQ 2.0) was significantly higher among MTM program participants compared to standard care (p = 0.00001). Patients in the MTM program were eight times more likely to be adherent compared to the patients in the standard care [OR 7.89 (95% CI 3.6, 17.4)]. MTM program metrics showed that per patient, the pharmacists spent a median of 35 [IQR 30, 44.5] minutes at the initial visit and 20 [IQR 10, 25] minutes during the 6-month visit. The number of DRPs had significantly dropped in the intervention arm at 3 and 6-month (p = 0.0001). In conclusion, CP-based MTM program can improve health outcomes and prevent hospitalisations in patients with diabetes. These findings support the implementation of CP-based MTM services for patients with diabetes in the Kingdom of Saudi Arabia.

Pharmacy Naloxone Standing Order and Community Opioid Fatality Rates Over Time

Despite the proliferation of pharmacy standing-order naloxone dispensing across many US states before the change to over-the-counter status, few policy analyses have evaluated the implementation of pharmacy naloxone standing orders in addressing opioid overdose fatality among communities. To determine whether the implementation of pharmacy standing-order naloxone was associated with lower opioid fatality rates compared with communities without pharmacies with standing-order naloxone. This retrospective multisite study was conducted with an interrupted time series analysis across 351 municipalities in Massachusetts over 24 quarters (from January 1, 2013, through December 31, 2018). Standing-order naloxone dispensing data were collected from 2 sources for all major chain pharmacies and many independent pharmacies, covering 70% of retail pharmacies in Massachusetts. Municipalities had various standing-order naloxone implementation inceptions during the study period. Data were analyzed from December 2021 to November 2023. The main exposure was measured by the first quarter with standing-order naloxone dispensation as the actual implementation inception. The primary study outcome was municipal opioid fatality rate per 100 000 population obtained from the Massachusetts Registry of Vital Records and Statistics. The median (IQR) population size across 351 municipalities was 10 314 (3635 to 21 781) people, with mean (SD) proportion of female individuals was 51.1% (2.8 percentage points). Pharmacies from 214 municipalities (60.9%) reported dispensing standing-order naloxone over the study period. At the baseline of the first quarter of 2013, municipalities that eventually had standing-order naloxone had greater quarterly opioid fatality rates compared with those that never implemented standing-order naloxone (3.51 vs 1.03 deaths per 100 000 population; P < .001). After adjusting for municipal-level sociodemographic and opioid prevention factors, there was significant slope decrease of opioid fatality rates (annualized rate ratio, 0.84; 95% CI, 0.78-0.91; P < .001) following standing-order naloxone dispensing, compared with the municipalities that did not implement standing-order naloxone. There were no significant level changes of opioid fatality rates in the adjusted models. Sensitivity analyses yielded similar and significant findings. These findings suggest that community pharmacy dispensing of naloxone with standing orders was associated with a relative, gradual, and significant decrease in opioid fatality rates compared with communities that did not implement the standing-order naloxone program. These findings support the expansion of naloxone access, including over-the-counter naloxone as part of a multifaceted approach to address opioid overdose.

Evaluation of community pharmacy technicians’ knowledge, attitudes, and practices about erectile dysfunction and its predictors in Gondar Town: A cross-sectional descriptive study

BackgroundErection Dysfunction, which primarily affects males older than 40 years, is the inability to regularly produce or retain a penile erection that is strong enough to satisfy sexual activity. ObjectiveTo evaluate knowledge, attitudes, and practices related to erectile dysfunction and its predictors among community pharmacy technicians in Gondar, Ethiopia. MethodWe conducted a cross-sectional descriptive study on pharmacy technicians in Gondar from June 1, 2022, to August 30, 2022. The study included 165 respondents and utilized a standardized questionnaire with 42 questions to assess their knowledge (18 items), attitudes (5 items), practices (15 items), and demographic characteristics (4 items) regarding erectile dysfunction. We performed both univariate and multivariate analyses on the collected data. ResultsMultivariate logistic regression analysis showed that greater educational attainment was independently correlated with increased knowledge of erectile dysfunction. For postgraduate pharmacy education, the adjusted odds ratio (AOR) was 0.031 (95 % CI: 0.006–0.170, p < 0.001).Regarding work experience, the adjusted odds ratios (AORs) were as follows: 6.223E-010 (95 % CI: 9.713E-011-3.987E-009, p < 0.001) for 1–5 years, 7.940E-010 (95 % CI: 1.381E-010-4.566E-009, p < 0.001) for 5–10 years, and 6.134E-010 (95 % CI: 1.333E-010-2.824E-009, p < 0.001) for over 10 years.Additionally, respondents with 5–10 years of work experience had an AOR of 8.129 (95 % CI: 1.476–44.786, p = 0.016), and the gender of the participants had an AOR of 3.399 (95 % CI: 1.239–9.325, p = 0.017), both of which were associated with erectile dysfunction behaviors.The aggregate ratings indicated that the participants had moderate knowledge, attitudes, and practices regarding erectile dysfunction. The Pearson Correlation Test revealed a significant positive relationship between knowledge of erectile dysfunction and attitude (r = 0.589 and p < 0.001) and practice (r = 0.524 and p < 0.001). Additionally, attitudes and practices showed a significant positive correlation (r = 0.321, p < 0.001). ConclusionThe study findings showed that pharmacy technicians have a moderate level of understanding, attitudes, and practices regarding erectile dysfunction. The scores for general erectile dysfunction knowledge, attitude, and practice showed a significant positive association (p < 0.001).

A Nationwide Survey on Medication Follow-up Care by Community Pharmacists: From The Japanese Nationwide Pharmacy Collaboration Survey in 2023.

In Japan, the Pharmaceutical and Medical Device Act was amended in December 2019, and now requires pharmacists to follow-up on patients during treatment. Although there have been some studies on the effectiveness of follow-ups by pharmacists, there are no reports on the status of implementation in clinical practice. We conducted a nationwide survey on follow-up care to investigate the actual situation. We randomly selected 10% of community pharmacies in each prefecture and conducted a survey. We built a web-based system for the collection of basic information on the pharmacies and follow-up cases. A total of 561 pharmacies were pre-entered. Of these, 110 pharmacies (19.6%) reported 326 follow-up cases. Information was provided to doctors in 129 cases (39.6%), of which prescription proposals were made in 10 (7.8%) instances. The follow-up implementation rate based on the number of prescriptions dispensed was estimated to be 0.84% (95% confidence interval: 0.76-0.94%). This study revealed the status of follow-ups in clinical practice. Pharmacists can contribute to the optimization of drug treatment by providing follow-up information to doctors and making prescription proposals.