Community Pharmacies Research Articles

Assessment to Identify the Role of Community Pharmacy Practices in Major Cities in Delta State, Nigeria

Assessment to Identify the Role of Community Pharmacy Practices in Major Cities in Delta State, Nigeria

Is Community Pharmacies’ Personnel Well-Oriented about Cosmeceuticals? A Cross-sectional Survey and Costumer Simulation

Background: The cosmetics business is one of the most profitable and advanced global trade sectors, and academic and industrial investments have expanded to provide high-quality products to the right consumers. Thus, this cross-sectional survey assessed Iranian pharmacists and pharmacy technicians' (PT) cosmetic product knowledge, attitudes, and behaviors. Methods: Between December 2021 and July 2022, pharmacists and PTs who worked in CPs in Tehran province. Demographics were the first questionnaire section after eligibility and consent. Ten questions test knowledge in the second phase. The third portion has nine pharmacist cosmetic product attitudes self-developed questions. We used five-point Likert spectrum scaling. The final component of the questionnaire includes a pharmacist practice checklist. This fulfilled 12 pharmacists' obligations. PT demographics, knowledge, and attitude were measured using an eight-, five-, and eight-item questionnaire. A cosmetic sales checklist with eight practice items was devised to evaluate PTs. Pharmacists and PTs were evaluated for scientific advice on exfoliating lotion and anti-stain sunscreen use, skin type, history, and brand presentation. Using a 95% confidence interval, binary logistic regression found significant relationships between categorical dependent and independent variables. Pearson correlation measured knowledge-performance linearity. Results: The study included 325 pharmacists and 324 PTs. The average knowledge score for pharmacists was 6.38 ± 1.95, while their practice score was 6.35 ± 1.92 out of 10. The overall knowledge score for PTs was 2.8 ± 0.92 out of 5. Results indicate a strong association between pharmacist and PT knowledge and cosmeceutical performance (r= +0.635 and +0.564, respectively, P < 0.001). Conclusion: This study indicates community pharmacists and PTs in Tehran have a moderate knowledge about cosmeceuticals. Also, a significant correlation between knowledge and performance was observed in both groups.

Naloxone Availability and Cost After Transition to an Over-the-Counter Product

The US Food and Drug Administration approved Narcan, a nasal spray formulation of naloxone, for sale as an over-the-counter (OTC) medication in March 2023. The purpose of OTC approval was to improve naloxone accessibility to reduce opioid overdoses; however, research has not yet evaluated whether naloxone's availability and cost changed since this policy was implemented. To evaluate whether the accessibility and cost of naloxone at North Carolina community pharmacies changed after OTC naloxone became available and whether cost and availability varied by pharmacy type and urbanicity. This longitudinal telephone-based secret shopper survey study included a stratified sample of 202 North Carolina community pharmacies, including health department, independent, and chain pharmacies. There were 2 separate data collection efforts from March to April 2023 (before OTC naloxone could be sold at pharmacies) and November 2023 to January 2024 (after OTC naloxone was sold at pharmacies). OTC naloxone first became available for sale at community pharmacies in September 2023. The main outcomes were same-day availability of naloxone without a clinician-issued prescription and the quoted out-of-pocket cost for cash-paying patients. Data were collected from 192 pharmacies. Same-day naloxone availability increased from 42.2% (81 of 192) before OTC naloxone availability to 57.8% (111 of 192) after (P < .001). The mean (SD) quoted out-of-pocket cost decreased from $90.93 ($42.6) pre-OTC availability to $62.67 ($41.0) post-OTC availability (P < .001). Independent pharmacies had higher mean (SD) costs than chain pharmacies in both the pre-OTC phase ($109.47 [$37.90] vs $86.40 [$35.70]; P < .001) and post-OTC phase ($77.59 [$38.90] vs $57.74 [$35.90]; P = .004). Out-of-pocket costs did not differ by urbanicity in the pre-OTC phase; however, mean (SD) costs were higher at suburban ($88.67 [$66.80]) and rural ($65.43 [$35.00]) pharmacies compared with urban pharmacies ($53.58 [$29.00]) in the post-OTC phase (P = .003). The Food and Drug Administration's approval of OTC naloxone nasal spray contributed to an increase in pharmacy-based availability of naloxone and a reduction of its cost for cash-paying patients. Cost was higher at independent pharmacies compared with chain pharmacies and lower in urban pharmacies compared with suburban and rural pharmacies.

Real-world evidence from Germany and the United States: Treatment initiation on low-efficacy versus high-efficacy therapies in patients with multiple sclerosis

BackgroundThe hit-hard-and-early (HHAE) strategy where treatment is initiated with high-efficacy therapies opposed to low-efficacy therapies presents a potential paradigm shift in multiple sclerosis (MS) management. This study aimed to assess the adoption of the HHAE strategy in Germany and the United States (US) from 2020 to 2022 based on real-world data. MethodsThe analysis was based on longitudinal, patient-level data from Germany and the US. For Germany, data was extracted from the Permea platform covering approximately 44 % of all German community pharmacy dispensing. For the US, data from the Komodo Healthcare Map™ was utilized, covering medical benefit data from around 88 % of the US patient population. Patients ≥18 years old and who had at least 2 prescriptions for MS-related disease-modifying drugs (DMDs) between January 2020 and December 2022 were included. To approximate therapy beginners, a washout period of one year before treatment start was applied, excluding all patients who had an MS-related DMD prescription or claim in 2019. Cohort entry date was the day of the first MS-related DMD dispense or claim. DMDs were classified as high-efficacy and low-efficacy based on the Multiple Sclerosis Therapy Consensus Group (MSTCG). Group differences were assessed with two-sided χ2-square and t-tests. Results29,604 MS therapy beginners were identified in the German and 49,791 MS therapy beginners were identified in the US dataset. 29.6 % of MS therapy beginners in Germany and 61.6 % in the US followed the HHAE strategy. Between 2020 and 2022, a significant 14 % increase in the HHAE strategy was observed in both countries (p < 0.0001). High-efficacy therapy beginners switched from their initially prescribed therapy less frequently than low-efficacy therapy beginners: 6.9 % of high-efficacy vs. 19.5 % of low-efficacy therapy beginners in Germany (p < 0.0001) and 5.5 % of high-efficacy vs. 25.0 % low-efficacy therapy beginners in the US (p < 0.0001) switched from their first prescribed DMD. ConclusionBetween 2020 and 2022, the adoption of the HHAE strategy increased in both countries, with the US exhibiting nearly double the adoption rates. High-efficacy therapy beginners were less likely to switch from their initially prescribed medication than low-efficacy therapy beginners. Real world evidence can provide valuable insights into rapidly changing treatment patterns in patients with MS.

Comparison of Two Financial Incentives to Encourage the Use of Adalimumab Biosimilars: Results of a French Experiment Close to Clinicians.

In 2018, the French government introduced two mutually exclusive financial incentives to increase etanercept and insulin glargine biosimilar use. The general case redirects 20% of the price difference between the reference product and its biosimilars to hospitals for every biosimilar dispensed in community pharmacies from hospital prescriptions. The experimental case redirects 30% to prescribing clinical units after hospital selection. Adalimumab was added to these incentives in 2019, after its first biosimilar was launched. This retrospective observational study aimed to compare both general and experimental incentives after 19 months to assess the impact of directly incentivizing clinical units for adalimumab biosimilars. The monthly number of adalimumab boxes dispensed in community pharmacies was linked to the corresponding hospital's prescription using IQVIA Xponent data from November 2017 to October 2020. The monthly mean rate of adalimumab biosimilars was compared between incentive groups and subgroups depending on hospitals' prior experience with the etanercept experimental case. General case hospitals had a significantly lower mean biosimilar uptake (16.7% vs 23.2%, p = 0.029) than those included in the experimental case. Twenty-three of the 40 hospitals in the experimental case and ten out of the 91 hospitals studied in the general case had already taken part in the etanercept experiment. Biosimilar uptake was higher, but not statistically significant, for hospitals with prior experience in the adalimumab general case group (p = 0.086). This study confirmed that incentivizing close to physicians was more effective in increasing the biosimilar rate. It also suggested that previous incentive experience positively influenced biosimilar penetration.

Implementation of a North Dakota opioid misuse and overdose prevention program in West Virginia

BackgroundPharmacy has an important role in combating the opioid epidemic. However, there is a need for more consistency of programs and evidence-based practices across the country. ObjectivesTo describe how an evidence-based opioid misuse and overdose prevention program that originated in North Dakota was implemented in West Virginia and to compare program results between the two states including pharmacist interventions and patient screening for opioid misuse and overdose. Practice descriptionThis advancement in practice took place in participating North Dakota and West Virginia community pharmacies. Practice innovationAn evidence-based program that originated in North Dakota was implemented in West Virginia. The details of this collaboration are outlined in this manuscript. Evaluation methodsProgram screening and pharmacist intervention data were collected using DocStation, an online pharmacy patient management platform. ResultsThirty-four pharmacies in West Virginia implemented the program. Between April 2022 and September 2023, a total of 34 West Virginia pharmacies conducted 449 documented screenings compared to 12,105 screenings by 81 pharmacies in North Dakota over the same time. There were differences between the states with regard to the proportion of individuals screened as high-risk for opioid use disorder and individuals at risk of accidental opioid overdose likely attributable to different demographics. ConclusionAn opioid misuse and prevention program was successfully implemented in two states, which can serve as a model to implement similar programs in other pharmacies across the United States.

Expanding public health initiatives through community pharmacies and student pharmacists: A programmatic case study

BackgroundCommunity pharmacies are critical to the public health infrastructure in the United States and provide reliable information for public health concerns. Public health agencies curate educational materials that community pharmacy teams can disseminate. Student pharmacists participate in experiential learning at community pharmacies which could be utilized for dissemination of these resources. ObjectivesThe objectives of this project were to (1) design a model for dissemination of public health information at community pharmacies; and (2) evaluate both the dissemination model’s reach within communities and student pharmacist learnings from engagement in the model. MethodsWe engaged student pharmacists in a model to disseminate information at community pharmacies for 2 Centers for Disease Control and Prevention initiatives about Opioid Use Disorder Anti-Stigma and Antibiotic Stewardship Education. The number of pharmacies and student pharmacists who participated from 2021 from 2023 was retrospectively reviewed to demonstrate programmatic reach. A retrospective text mining of student assignments was conducted to evaluate student experiences. Descriptive statistics were used to report quantitative data. An inductive, rapid content analysis was completed for qualitative data. ResultsAcross 3 years, 333 student pharmacists participated. Students reached 121 community pharmacies, 139 practicing pharmacist preceptors, and over 2000 patients with education and resources. Eleven student learning points emerged from the qualitative analysis. These included learnings around opioid use disorder and antibiotic stewardship. Students also acknowledged that there are public health needs present in communities and that community pharmacy teams are well-positioned to address these needs. ConclusionEngaging student pharmacists to distribute curated information from public health authorities, both to pharmacist preceptors and patients at community pharmacies, is one way to educate future pharmacists, pharmacy teams, and communities on public health priorities. Pharmacies can serve as key venues in communities for dissemination of reliable public health information.

Opportunities for interprofessional collaboration between pharmacists and hearing professionals in Pennsylvania: A descriptive geographic information system study

BackgroundIn 2022, the Food and Drug Administration finalized regulations for over-the-counter (OTC) hearing aids, available without professional hearing services and without a prescription. As a result, community pharmacies now serve as locations where adults seek self-care solutions for hearing loss such as OTC hearing aids. ObjectivesWe conducted a geographic information systems (GIS) analysis to identify Pennsylvania counties served by community pharmacies and hearing aid dispensaries, the practice locations of hearing professionals. MethodsWe obtained addresses of Pennsylvania pharmacies from the National Council for Prescription Drug Programs. Hearing aid dispensaries were obtained from the Pennsylvania Department of Health. GIS software was used to plot locations of pharmacies and hearing aid dispensaries. The number of pharmacies and hearing aid dispensaries was visualized on a Pennsylvania map, by county. Mean straight-line distances, in miles, from a hearing aid dispensary to its nearest pharmacy in any county and vice versa were calculated. This analysis was performed in early 2022. ResultsIn Pennsylvania, there were more community pharmacies (2769) than hearing aid dispensaries (945). All 67 Pennsylvania counties had more pharmacies than hearing aid dispensaries. Pharmacies outnumbered hearing aid dispensaries by 1 in some rural counties to 382 in urban Philadelphia County. The mean straight-line distance from a hearing aid dispensary, starting point, to the nearest pharmacy, end point, was 0.63 miles. The mean straight-line distance from a pharmacy, starting point, to the nearest hearing aid dispensary, end point, was 3.24 miles. ConclusionThis GIS analysis supports the participation of pharmacists in initiatives such as OTC hearing aids that increase population access to hearing care.

Knowledge, Attitude, Practice, and Perceived Barriers toward Smoking Cessation among Community Pharmacists Services in Al-Karak Governorate

ABSTRACT Background: There are about a billion smokers in the world, 80% of whom are from developing countries, and also the World Health Organization stated that smoking is considered a global health problem. Jordan is one of the countries with the highest rates of tobacco smoking in the world. However, interventions related to tobacco use, which can reduce diseases resulting from or associated with smoking and thus reduce health-care costs, are still rare in Jordan. Objective: This study aimed to evaluate community pharmacists’ knowledge, attitudes, and practices toward smoking cessation (SC) and to identify the most important barriers they face in providing SC counseling in community pharmacies in Alkarak, Jordan. Materials and Methods: The study used a cross-sectional design based on a descriptive approach and included community pharmacies in April 2021. Data were collected from 199 participating pharmacists on duty in 76 pharmacies. A structured, reliable, English-language, and valid questionnaire was used to collect data consisting of five parts. The questionnaire included pharmacists’ sociodemographics, knowledge, attitudes, and practices, as well as barriers associated with SC services. The data and differences in participants’ responses were analyzed using descriptive statistics SPSS version 19, analysis of variance, and the confidence level was 80%. Results: One hundred and ninety-nine pharmacists completed the survey. The mean age of the pharmacists was 30.05 ± 7.15 years. Eighty-one percent of participating pharmacists had high knowledge regarding SC and SC products, and 80% of them agreed that it was their responsibility to advise smoking patients regarding SC. Multivariate analysis showed a statistically significant relationship between attitude and practice. Conclusions: Our study concluded from the overall findings that pharmacists generally have the knowledge and attitudes required to play an important role in counseling patients about SC. Community pharmacists in Alkarak, Jordan, generally expressed positive attitudes regarding tobacco cessation counseling. We recommend opening the way for researchers to pay attention to this topic and publish many researches on the impact of educational training programs for pharmacy students by raising their level of knowledge about SC.

Uptake and outcomes of VaxCheck, an adult life-course vaccination service: A study among community pharmacists

Vaccination rates among Canadian adults remain suboptimal. Community pharmacists have increasingly adopted an active role in vaccination and are trusted by the public to provide vaccination-related advice and care. The aim of this prospective descriptive study was to develop and test a novel clinical service, VaxCheck, to support proactive life-course vaccination assessments by community pharmacists. From October 2022-May 2023, 123 VaxCheck consultations were performed at 9 community pharmacies within the Wholehealth Pharmacy Partners banner in Ontario, Canada. Patient age averaged 60 years and 35.8 % had at least one chronic disease risk factor, 17.7 % had lifestyle-related risk factor(s), and 15.4 % were immunocompromised. 95.1 % of VaxCheck consultations resulted in at least one vaccine recommendation, averaging three vaccines per patient. Most frequently recommended vaccines were those against pneumococcal disease, tetanus/diphtheria, herpes zoster, COVID-19, and influenza, with acceptance rates highest for those available without a prescription and at no charge at the pharmacy. Patient feedback was positive with 85 % of respondents agreeing or strongly agreeing that they would recommend the service to others. Vaccine administration at the time of the consultation occurred with only 5.9 % of recommended vaccines, frequently impacted by limitations to scope of practice related to pharmacist ability to prescribe and/or administer the vaccine and lack of pharmacy access to publicly funded vaccine supply for those meeting eligibility criteria. Community pharmacists performing a VaxCheck consultation can proactively identify indicated vaccines for patients. Expansion in scope of practice and access to publicly funded vaccine is recommended to further support vaccine uptake.

Feasibility of a contraceptive-specific electronic health record system to promote the adoption of pharmacist-prescribed contraceptive services in community pharmacies in the United States.

Pharmacists in over half of the United States can prescribe contraceptives; however, low pharmacist adoption has impeded the full realization of potential public health benefits. Many barriers to adoption may be addressed by leveraging an electronic health records (EHR) system with clinical decision support tools and workflow automation. We conducted a feasibility study to determine if utilizing a contraceptive-specific EHR could improve potential barriers to the implementation of pharmacist-prescribed contraceptive services. 20 pharmacists each performed two standardized patient encounter simulations: one on the EHR and one on the current standard of care paper-based workflow. A crossover study design was utilized, with each pharmacist performing encounters on both standardized patients with the modality order randomized. Encounters were timed, contraceptive outputs were recorded, and the pharmacists completed externally validated workload and usability surveys after each encounter, and a Perception, Attitude, and Satisfaction survey created by the research team after the final encounter. Pharmacists were more likely to identify contraceptive ineligibility using the EHR-based workflow compared to the paper workflow (P = .003). Contraceptive encounter time was not significantly different between the 2 modalities (P = .280). Pharmacists reported lower mental demand (P = .003) and greater perceived usefulness (P = .029) with the EHR-based workflow compared to the paper modality. Pharmacist performance and acceptance of contraceptive services delivery were improved with the EHR workflow. Pharmacist-specific contraceptive EHR workflows show potential to improve pharmacist adoption and provision of appropriate contraceptive care.

Abandonment of prescriptions in medically underserved areas: Primary medication non-adherence in community pharmacies in the delta region of the United States

BackgroundIn the U.S. alone, medication non-adherence is estimated to cause 1 in 10 hospitalizations, approximately 125,000 deaths annually, and cost the U.S. healthcare system just under $300 billion each year. Patients in medically underserved areas (MUAs) are particularly vulnerable to all forms of non-adherence and downstream morbidity and mortality; however, the extent to which primary medication non-adherence (i.e., prescription abandonment) affects the underserved is still largely unknown. ObjectivesTo assess the difference in rates of abandonment of quality measured prescriptions in areas that are medically underserved compared to areas that are not. The secondary objective is to assess the impact that the COVID-19 pandemic had on rates of prescription abandonment in both MUAs and those that are not. MethodsIn this retrospective study, data on abandoned, quality measured prescriptions were collected and analyzed using Chi-Square analyses from one regional division of a large grocery-chain pharmacy containing ninety-one pharmacies located in Tennessee, Mississippi, Arkansas, Kentucky, and Missouri. The primary objective used 2019 data while the secondary objective used data from April – November of both 2019 and 2020. ResultsPatients from MUAs abandoned quality measured prescriptions at a higher rate of 5.44% compared to 4.77% of those not living in these areas (P < 0.01). This study also discovered that during the COVID-19 pandemic, MUAs had a decrease in abandonment from 6.14% in 2019 to 6.02% in 2020 (P < 0.01). Those from non-MUAs had non-significant change in abandonment (P = 0.87). ConclusionPatients in MUAs abandon quality measured prescriptions at a statistically significant higher rate when compared to patients who live in areas that are not considered to be medically underserved. Moreover, during the COVID-19 pandemic patients living in MUAs had a statistically significant decrease in prescription abandonment while those in non-MUAs did not statistically change.

Exploring the impact of a digital health tool on patients’ interaction with community pharmacists: A pilot randomized controlled study

BackgroundThe use of digital Patient- Reported Outcomes (PRO) tools has been shown to enhance the exchange of information and shared decision-making in medical encounters. However, their influence on patient-pharmacist interactions has not yet been explored. ObjectivesThis study aimed to examine the impact of RxTalk™, a digital PRO tool, in supporting the communication between patients and pharmacists compared to usual care. MethodsIntervention: RxTalk™ was developed to collect information about medication adherence and beliefs, using a tablet computer. Study designA pilot randomized controlled study was conducted at a community pharmacy in Wisconsin, USA. Sixty patients were randomized to either the intervention group who used RxTalk™ during medication pick-up or the control group who did not use the tool. Patients who used RxTalk™ received paper copies of their responses which were also shared with pharmacists. The consultation was audio-recorded for both groups and coded using the Active Patient Participation Coding scale. Follow-up phone interviews were conducted with both groups within one week of enrollment. ResultsPatient tapes were analyzed. In the unadjusted model, patients in the intervention group had a higher active participation rate (p = 0.004) and raised significantly more concerns during consultations (p < 0.001) compared to the control group. Pharmacists asked twice as many questions while counseling patients in the intervention group compared to the control group (p < 0.001). After controlling for patients' demographics and pharmacists’ questions, there was a statistical difference between the two patient groups in their odds of expressing at least one concern utterance. ConclusionThis pilot study suggests that collecting PRO from patients with chronic illnesses and providing results to pharmacists and patients can help patients express their health and medication concerns. RxTalk™ would be useful for pharmacists who wish to improve the recognition and management of medication-related problems.

Community Pharmacy Professionals' Knowledge and Counseling Skills for the Treatment of Acute Diarrhea in Children in Qassim Region, Saudi Arabia: Questionnaire Based and Simulated Client Study.

The study aimed to evaluate the knowledge and counseling skills of community pharmacy professionals regarding managing acute diarrhea in children in the Qassim region of Saudi Arabia. A cross-sectional study consisting of a questionnaire and simulated client scenario was conducted to collect data from pharmacy professionals working in community pharmacies over a period of 3 months in the Qassim region of Saudi Arabia. Pharmacy professionals were assessed for evaluating cases using 5 indicators (the age of the child, the frequency of diarrhea, fever and the presence of mucus or blood) and also for their recommendations and counseling. The data were collected from 60 pharmacy professionals after site visits. In the questionnaire, 60% of the pharmacy professionals used all 5 indicators, while in the simulation, 13.3% used at least 3 indicators and 80% used 2 or fewer indicators (p = 0.35). An oral rehydration solution was recommended alone by 35% of the pharmacy professionals and with other drugs by 13.3% in the questionnaire, while in the simulation, an oral rehydration solution alone was recommended by 15% and other drugs by 48.3%. Approximately 86.7% of the pharmacy professionals did not give any dietary advice, and 50% did not counsel the simulated client on the recommended drug. The community pharmacy professionals in the study did not ask enough questions to evaluate a child suffering from acute diarrhea appropriately in the simulation. More questions were asked in the questionnaire; however, the difference is not significant. Additionally, they did not provide proper dietary advice, and their recommendation of an oral rehydration solution was insufficient.

Utilization and Issues Related to Discharge Medication Summaries from Hospital Pharmacies to Community Pharmacies

Utilization and Issues Related to Discharge Medication Summaries from Hospital Pharmacies to Community Pharmacies

Development and validation of measures of pharmacists’ acceptability and willingness to screen for perinatal depression

BackgroundWhile pharmacists' roles in mental healthcare are expanding, research exploring pharmacists' acceptability and willingness to provide mental health services is limited. This study developed and validated theory-driven measures of pharmacists’ acceptability and willingness to screen for perinatal depression in community pharmacy settings. Materials/MethodsItems were developed using published literature and the Theoretical Framework of Acceptability (TFA), then content validated using consensus methods with experts who completed the content validity index (CVI). The revised items were disseminated to pharmacists in Australia. Responses were analysed descriptively. Exploratory factor analyses (EFA) were used to explore the factorial structure and generate scales. Multivariate regression analysis was conducted to explore predictors of willingness. ResultsA 58-item questionnaire was developed, encompassing the 7 domains of the TFA and an eighth domain (willingness). The average CVI was 0.92, domain range (0.88–0.96). The universal CVI was 56/58. Expert feedback informed item revision, creation and deletion. Pharmacists' responses (n = 157) to the final 42-item questionnaire indicated overall acceptance and willingness to conduct PND screening. However, perceived knowledge was lacking. The EFA resulted a two-factor solution (1 = acceptance; 2 = self-efficacy). The measurement scales created had good internal consistency. In multivariate regression analysis, ‘Acceptance’ (Beta = 0.949 (0.760–1.103)) and ‘Self-Efficacy’ (Beta = 0.107 (0.036–0.174)) were significant predictors of ‘Willingness’ and the model predicted 77 % of the variation in ‘Willingness’. ConclusionsPsychometrically-sound measures of pharmacists’ acceptability and willingness to screen for PND have been developed with stakeholder input. The questionnaire can be used for standardised measurement of these constructs across studies.

A theoretical explanation of naloxone provision among primary care physicians and community pharmacists in Tennessee

BackgroundIncreasing access to naloxone reduces opioid-related morbidity and mortality. Primary care and community pharmacy settings are critical access points, yet limited theoretical research has examined naloxone prescribing and dispensing behaviors. ObjectivesTo determine if the theory of planned behavior (TPB) combined with theoretical constructs from communication science explains intentions to co-prescribe and discuss co-dispensing naloxone among primary care physicians and community pharmacists, respectively. MethodsThis cross-sectional study surveyed cohorts of licensed primary care physicians and community pharmacists in Tennessee in 2017. Intentions were measured using profession-specific case vignettes, whereby they were asked given 10 similar patients, how many times (0–10) would they co-prescribe or discuss co-dispensing naloxone. Bivariate and multivariable analyses were used. ResultsThe analytic sample included 295 physicians (response rate = 15.6 %) and 423 pharmacists (response rate = 19.4 %). Approximately 65 % of physicians reported never intending to co-prescribe naloxone (0 out of 10 patients), while 47 % of pharmacists reported never intending to discuss co-dispensing. All TPB constructs—attitudes (AOR = 1.32, CI = 1.16–1.50), subjective norms (AOR = 1.17, CI = 1.06–1.30), and perceived behavioral control (AOR 1.16, CI = 1.02–1.33)—were associated with an increased likelihood of pharmacists always (versus never) discussing co-dispensing. Similarly, two TPB constructs—attitudes (AOR = 1.41, CI = 1.19–1.68) and subjective norms (AOR = 1.22, CI = 1.08–1.39)—were associated with an increased likelihood of physicians always co-prescribing. Among physicians only, one communication construct—self-perceived communication competence (AOR = 1.19, CI = 1.01–1.41)—was associated with an increased likelihood of always co-prescribing. ConclusionFindings support the value of theory, particularly TPB, in explaining primary care physician intentions to co-prescribe and community pharmacist intentions to discuss co-dispensing naloxone.

Reducing disparities in medication use: Responding to managed care pharmacy's imperatives.

Although disparities and inequities in health status and access to health care services have long existed in our nation, the COVID-19 pandemic cast a bright spotlight on them. Communities of color and socioeconomically disadvantaged populations were disproportionally affected by the pandemic. These same populations suffer from higher prevalences of chronic illnesses, which puts them at greater risk for poor outcomes associated with SARS-CoV-2. At long last, in the wake of the pandemic, the health care community began to acknowledge improving health equity as a public health imperative. In a November 2020 JMCP Viewpoints article, Dr Stephen Kogut of the University of Rhode Island College of Pharmacy presented an insightful analysis of disparities in medication use (DMU) and offered 4 suggestions on how the managed care pharmacy community can help eliminate DMU. This Viewpoints article assesses what progress has been made in addressing those imperatives and proposes further steps that should be taken. Although the managed care pharmacy community has broadly acknowledged the existence of DMU and taken steps to mitigate them, there is much work to do in examining and improving benefit design and coverage policies; collecting and reporting data on race and ethnicity and DMU; incorporating the perspectives of patients, including those representing minority populations, in benefit design and coverage policies; and addressing the challenges associated with traditional cost-sharing models. The entire managed care pharmacy community, including AMCP and other membership organizations, must remain steadfast in its efforts to improve health equity and eliminate DMU.

INVESTIGATING THE MEDIATING INFLUENCE OF WORK MEANINGFULNESS, JOB SATISFACTION, AND JOB STRESS ON TURNOVER INTENTION AMONG MALAYSIAN COMMUNITY PHARMACISTS

Turnover is a challenging issue for many organizations. Turnover caused organization suffer a loose of competent employees as well as costs associated with employee turnover and hiring new employees. High turnover among community pharmacists presents a significant concern due to its potential negative impact on the quality of pharmaceutical care and patient safety. Addressing this issue requires a thorough investigation of turnover intention, as it has been found to be positively associated with actual turnover. Turnover intention, although not synonymous with immediate departure, serves as a critical indicator of an employee's inclination to leave their current position. Therefore, the purpose of this study was to examine the job satisfaction and job stress, that affect turnover intention among community pharmacists in northern region of Malaysia. The meaningfulness of work was added as mediator. A quantitative study was conducted with 228 community pharmacists who participated in this study voluntarily. The data collection based on self-administered questionnaire. The findings emphasize the critical role of job satisfaction and job stress in influencing turnover intention. The insights offered by this research are valuable for top management in community pharmacies, providing them with the necessary knowledge to formulate effective strategies for managing employee turnover intention. Implementing these strategies can foster a more stable and engaged workforce, ultimately benefiting both employees and the organization as a whole.

Adolescent Perspectives on the Pharmacy-Based T-EVER (Teen E-Cigarette and Vaping Educational Resource) and Its Potential Impact on Youth Vaping.

While public health efforts have made tobacco smoking near obsolete among adolescents, vaping products are quickly taking their place. With the negative health consequences looming ahead of young vapers, there is a desperate need to curb youth vaping. Adolescents want to be actively engaged in their health which creates space to educate on vaping in this population segment. From January to May 2023, 35 adolescents aged 11-18 participated in interviews to assess the investigator-developed Teen E-cigarette and Vaping Educational Resource (T-EVER). All the interviews were recorded and transcribed for independent analysis by two study team members. The participants liked the T-EVER, indicating they were engaged in the content. However, some participants wanted more information. The participants wanted health professionals to educate them on vaping but were worried about the potential barriers facing the implementation in community pharmacy settings. Adolescents want to learn about vaping, but there are limited opportunities to do so. The T-EVER is designed to educate youth about vaping. This tool was well received and has the potential to be used by pharmacists as a vaping prevention and cessation intervention. More research is required to discern the true scope of the pharmacist's role in using an educational tool to address adolescent vaping.