Drug Dispensing Research Articles

Perception of community pharmacists about the work process of drug dispensing: a cross-sectional survey study

BackgroundDrug dispensing aims to promote rational medicine use. However, in many countries, the work processes are still not well defined. In this sense, the perception of pharmacists about dispensing practices presents an overview of how the service is being performed in the country and its main challenges. Thus, the purpose of this study was to determine the self-reported work process of Brazilian community pharmacists in relation to drug dispensing, challenges, and strategies for carrying out the service.MethodA cross-sectional survey was conducted between May and July 2021, with community pharmacists from all regions of Brazil. Pharmacists were invited to answer a validated, self-administered questionnaire, implemented through Google Forms, containing 33 questions related to the steps of drug dispensing (questions and counseling) and the main challenges and strategies to perform the service. The data were exported to Microsoft Office Excel and SPSS®. Multiple linear regression analysis was used to assess the association between responses and demographic information, with a significance level of less than 5% (p < 0.05). This study was approved by the Research Ethics Committee (number: 4.295.171).ResultsA total of 625 community pharmacists responded to the survey. Most pharmacists reported always or frequently performing 17 (54%) of the 31 steps described in the instrument. The steps that pharmacists reported performing more frequently were forming the medication name (n = 569, 91.04%), verifying the completeness and adequacy of the prescription according to current legislation (n = 567, 90.72%) and providing counseling on dosage (n = 549, 87.84%). Documentation was the main step in which pharmacists reported never or rarely performing (n = 424, 67.84%). The results showed that there was a significant influence of the variables of public education institution, age, and postgraduate education on the frequency of dispensing steps (F(3, 621) = 14.884, p < 0.001; R2ajdusted = 0,063).ConclusionThis study showed that most pharmacists reported always or frequently asking most of the questions and performing counseling contained in the instrument during drug dispensing. These results can contribute to an understanding of current dispensing practices and generate insights for developing strategies to qualify the service.

Evidence-based summary for the safety of multiple medication in elderly patients with ischemic stroke.

BackgroundTo retrieve, analyze, and summarize the relevant evidence of home-based medications use for stroke patients, so as to provide evidence for safe home-based medication of elderly patients with ischemic stroke.MethodsWe performed a search in the databases of British Medical Journal (BMJ) Best Practice, UpToDate, Joanna Briggs Institute (JBI) Evidence-based Health Care Center Library, Cochrane Library, PubMed, China National Knowledge Infrastructure (CNKI), Wanfang Knowledge Data Service Platform, and others, according to the evidence pyramid model. We retrieved all evidence on the safety of home-based multiple medications use in elderly patients with ischemic stroke, including clinical decision-making, expert consensus, guidelines, systematic reviews, and summary of evidence. The search time limit was from the establishment of the database to March 2021. The literature evaluation standard and evidence grading system of JBI Evidence-based Health Care Center were used to evaluate the quality of the literature, and to classify the extracted evidence.ResultsA total of 17 articles were included in this study, comprising 2 guidelines, 11 systematic reviews, 3 evidence summaries, and 1 expert consensus. This article summarizes the 7 best evidences from 5 aspects: drug dispensing, drug identification, medication time, prescription simplification, and self-management plan.ConclusionsThe evidence of home-based multiple medication use in elderly patients with ischemic stroke provides an evidence-based reference for ensuring the safety of medications for patients, and guides elderly patients with ischemic stroke and their caregivers by applying the best available evidence.

Prevalence and Incidence Rates of Dementia: A Nationwide Population-Based Study of Electronic Health Records in Israel.

Data on the rate of dementia is essential for planning and developing appropriate services at the national level. We report the prevalence and incidence of dementia, based on electronic health records available for the whole population. This national dementia dataset was established as a part of the National Program to Address Alzheimer's and Other Types of Dementia. Data from medical health records for all persons aged 45+ in Israel, for 2016, were extracted from the databases of the four health maintenance organizations. Dementia cases were identified based on either recorded dementia diagnosis, through International Classification of Diseases (ICD-9 and ICD-10) or dispensation of anti-dementia drugs. The date of first diagnosis was determined by the earliest recording. A total of 65,951 persons with dementia, aged 45+, were identified from electronic health data. Based on both ICD codes and anti-dementia drugs, the prevalence rates of dementia among individuals aged 45+ and 65+ in 2016 were 2.5%and 6.4%, respectively, and the incidence rates were 0.49%and 1.3%, respectively. Based on ICD codes alone, the prevalence rates of dementia among individuals aged 45+ and 65+ in 2016 were 2.1%and 5.4%respectively, and the incidence rates were 0.36%and 0.96%respectively. The rates were higher among females compared to males and paradoxically lower in lower socioeconomic status compared to higher statuses. This data collection reflects the present access of dementia patients to medical care resources and provides the basis for service planning and future dementia policies.

STUDY ON FACTORS INFLUENCING PATIENT SATISFACTION WITH QUALITY OF PHARMACY SERVICES AT FACULTY OF PHARMACY, HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

Background: The study aims to develop a scale measuring the quality of pharmacy services and analyze the factors influcencing patient satisfaction with quality of pharmacy services at the outpatient drug dispensary. Subjects and methods: The tool to assess the satisfaction level and related factors were developed and explored through interviewing patients. Evaluate results through measurement and analysis methods. Results: The new reliable scale was constructed with 26 observed variables. The average patient satisfaction level is 3.90 ± 0.51 by using 5-point Likert scale. Five factors including: dispensing operation, facilities, professional qualifications, medications and staffs most affected patient satisfaction in descending order; explained by 55.3% of the variation in satisfaction among patients. Conclusions: A new scale has been developed to measure patient satisfaction of pharmacy services. Patients were satisfied with the quality of pharmacy services at the outpatient drug dispensary. Dispensing operation was the most important factor of patient satisfaction. Key words: quality of pharmacy services, patient satisfaction.

Evaluate the effectiveness and safety of proton pump inhibitors (PPIs) in the treatment of upper GIT disorders

Introduction: Proton pump inhibitors (PPIs) are most prescribed medication classes and have similar efficacy between generic and brand names. PPIs are used for treatment upper GIT disorders. The aim of the present study was to evaluate the effectiveness and safety of proton pump inhibitors (PPIs). Methods: A cross sectional study conducted randomly on pharmacies, patients and Doctors to collect a data regarding the effectiveness and safely use of PPI through predesigned questionnaire containing information about dosage, types, side effect, effectiveness and safety of PPIs. The collected data was analysis by using Chi-square for determine the significant differences at α &lt; 0.05. Result: The result of present study revealed numbers of points in which the questionnaire were intended for pharmacies, patients and doctors knowledge, effectiveness and safety of PPIs. The data gathered from pharmacy shown PPI dispensed without prescription (P&lt; 0.05) in dose of 20 mg of omeprazole and for treatment of gastritis, stomachache and on medication use (P&lt; 0.05). No side effect or any problem, safe, and effective of PPIs was from patients seeking PPIs to the drug dispensers. Furthermore, questionnaire for patients whom seeking treatment shown some similarity to pharmacies answers, however lack the knowledge about side effect of PPIs, and PPIs withdraw among patients. PPIs was found to be used by patients due to the advices of friends (P&lt; 0.05). The last part in this study was doctors involved in which some common similarity were also identified between doctors, patients and pharmacies responses. Although, Doctors responses were revealed that PPIs should be used by prescription in single dose of common types of PPIs (P&lt; 0.05). Conclusion: Due to the short time use of PPIs have been reported. This study suggested that, even no side effect and highly effective of PPIs reported, the PPIs should be monitoring and use under prescription.

Association of Preeclampsia and Perinatal Complications With Offspring Neurodevelopmental and Psychiatric Disorders

Maternal preeclampsia has been reported to increase the risk of autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD), and intellectual disability in offspring. However, the association between maternal preeclampsia combined with perinatal complications and neurodevelopmental and psychiatric disorders in offspring is less well documented. To examine the association of maternal preeclampsia, separately and together with perinatal complications, with neurodevelopmental and psychiatric disorders in offspring. This population-based cohort study used data from nationwide registries in Finland to assess all singleton live births (N = 1 012 723) between January 1, 1996, and December 31, 2014. Offspring were followed up until December 31, 2018 (when the oldest reached age 22 years). Exclusion criteria were maternal inpatient psychiatric diagnoses and pregestational diabetes. The study and data analysis were conducted from May 1, 2020, to June 1, 2021. Preeclampsia and perinatal complications (delivery earlier than 34 weeks' gestation and/or small for gestational age). The primary outcomes were neurodevelopmental and psychiatric diagnoses and dispensation of psychotropic drugs among offspring until December 31, 2018. Cox proportional hazards regression analyses were performed to assess the associations. Of 1 012 723 singleton live births (51.1% boys; mean [SD] maternal age at birth, 30.0 [5.4] years; specific data on race and ethnicity were not available in the data set), 21 010 children (2.1%) were exposed to preeclampsia alone, 33 625 children (3.3%) were exposed to perinatal complications alone, and 4891 children (0.5%) were exposed to both preeclampsia and perinatal complications. A total of 93 281 children (9.2%) were diagnosed with a neurodevelopmental or psychiatric disorder. Offspring exposed to both preeclampsia and perinatal complications had an increased risk of any neurodevelopmental or psychiatric disorder after adjusting for potential confounding (adjusted hazard ratio [aHR], 2.11; 95% CI, 1.96-2.26) compared with those not exposed to either preeclampsia or perinatal complications; this risk was higher than exposure to either preeclampsia alone (aHR, 1.18; 95% CI, 1.12-1.23) or perinatal complications alone (aHR, 1.77; 95% CI, 1.72-1.82). Sibling pair analyses did not detect any increase in the risk of neurodevelopmental or psychiatric disorders after exposure to preeclampsia alone, but offspring exposed to both preeclampsia and perinatal complications had increased risks of intellectual disabilities (aHR, 3.24; 95% CI, 1.05-10.06), specific developmental disorders (aHR, 3.56; 95% CI, 2.35-5.41), ADHD and conduct disorders (aHR, 2.42; 95% CI, 1.09-5.39), and other behavioral and emotional disorders (aHR, 2.45; 95% CI, 1.17-5.13). The risk estimates for specific developmental disorders (aHR, 2.82; 95% CI, 2.60-3.05) and ADHD and conduct disorders (aHR, 1.88; 95% CI, 1.65-2.14) were higher among offspring exposed to both preeclampsia and perinatal complications compared with those exposed to perinatal complications alone (aHR, 2.26 [95% CI, 2.18-2.33] and 1.60 [95% CI, 1.52-1.68], respectively). In this study, exposure to both maternal preeclampsia and perinatal complications was associated with intellectual disabilities, specific developmental disorders, ADHD and conduct disorders, and other behavioral and emotional disorders in offspring. For specific developmental disorders and ADHD and conduct disorders, the risk estimates were higher among offspring exposed to both preeclampsia and perinatal complications compared with those exposed to perinatal complications only.

Efficacy and Safety of Mulberry Twig Alkaloids Tablet for Treatment of Type 2 Diabetes: A Randomized, Double-Blind, Placebo-Controlled Multicenter Clinical Study.

To assess the efficacy and safety of mulberry twig alkaloids (Sangzhi alkaloids, SZ-A) for treatment of type 2 diabetes in a randomized, double-blind, placebo-controlled multicenter clinical trial. A total of 200 patients were randomized to receive SZ-A (n=100) or placebo (n=100) for 16 weeks. The data analysis system for electronic data capture clinical trial central randomization system was used for randomization and dispensing of drugs. The primary outcome was the change in glycosylated hemoglobin (HbA1c) level. The secondary outcome included the proportions of cases with HbA1c <7.0% and HbA1c <6.5%, fasting blood glucose (FBG), postprandial blood glucose (PBG), area under curve for the PBG (AUC0-2h), body weight, and body mass index (BMI). Adverse events (AEs), severe adverse events (SAEs), treatment-related adverse events (TAEs), gastrointestinal disorders (GDs), blood pressure, routine blood tests, and liver and kidney function were monitored. Compared with baseline, the change of HbA1c at week 16 was -0.80% (95% CI: -0.98% to -0.62%) and -0.09% (95% CI: -0.27% to 0.09%) in SZ-A group and placebo group, respectively. The proportion of patients with HbA1c <7% and <6.5% was higher in the SZ-A group than in the placebo group (46.8% vs. 21.6% and 29.9% vs. 10.8%). The observed values and changes in FBG, 1 h-PBG, 2 h-PBG, and AUC0-2h differed significantly between groups (P<0.001), but differences were not significant in body weight and BMI (P>0.05). The incidence rates of AEs, TAEs, and GDs differed significantly between groups (P=0.010, P=0.005, and P=0.006, respectively), whereas the incidence rates of SAEs showed no significant differences between groups (P=1.000). SZ-A are effective and safe for treatment of type 2 diabetes. The protocol was registered in http://www.chictr.org.cn/showproj.aspx?proj=60117 (ChiCTR2000038550).

Implementation of E-prescription for Multidose Dispensed Drugs: Qualitative Study of General Practitioners' Experiences.

BackgroundIncreased use of pharmaceuticals challenges both capacity and safety related to medication management for patients and changes in how general practitioners (GPs) and other health personnel interact with and follow up with patients. E-prescribing of multidose drug dispensing (eMDD) is 1 of the national measures being tested in Norway.ObjectiveThe objective of this study is to explore GPs’ experiences with the challenges and benefits of implementing eMDD in Norway.MethodsQualitative in-depth and group interviews were conducted with a total of 25 GPs between 2018 and 2020. Transcribed files were saved in NVivo to conduct a step-by-step content analysis. NVivo is a software tool for organizing, managing, and analyzing qualitative data.ResultsThe study revealed that eMDD offers many benefits. At the same time, there are several challenges related to information, training, and initiation, as well as to the responsibility for the medication, interactions, and the risk of incorrect medication. An important activity in the start-up phase was an information meeting with pharmacies and technology suppliers, as well as exchanging information and instructions with pharmacies on how to get started. Four analytic themes emerged through the extraction of data: (1) start-up with eMDD (“Be patient”); (2) the need for training; (3) interaction, safety, and efficiency; and (4) the working day with eMDD.ConclusionsThere is a variation in different GPs’ needs regarding training and information, and considerable variation in competence and motivation related to the use of digital tools. There are also different degrees of understanding the everyday work of the other actors in the medication chain. In particular, the harmonization of medication lists related to the use of time, expenditures, and challenges with technological solutions in the introduction phase was emphasized as a challenge. Overall, GPs who have started using the system report great benefits; these are largely related to an increased overview of patients’ total medication lists, less time spent on prescribing prescriptions, and increased collaboration with pharmacies and nurses, both in service from providers in homes and in nursing homes.

Analysis of the Consumption of Drugs Prescribed for the Treatment of Asthma in Belgian Children.

(1) Asthma is one of the most common chronic diseases in the world among children. The main purpose of this study was to analyze the consumption of asthma medications in order to investigate asthma in children (2–18 years) and the association with health care consumption; (2) a retrospective study using anonymized administrative data for 2013–2018 from the third largest Belgian health insurer was conducted; (3) in 2018, 12.9% of children received at least one asthma medication and 4.4% received at least two packages with a minimum of 30 days between purchases. Preschool children (2–6 years) were three times more likely to take asthma medication than older children (7–18 years). ICS, in combination or not with LABA, were the most dispensed drugs among children. Children with asthma medications were almost twice as likely to receive antibiotics, more likely to end up in the emergency room, and twice as likely to be hospitalized; (4) most children took ICS, according to the GINA guidelines. High rates of nebulization in young children were observed, despite the recommendation to use an inhaler with a spacing chamber as much as possible. Finally, children who took asthma medications were more likely to end up in the ER or be hospitalized.

Factors Influencing Drug Use Information Received at Primary Healthcare Centre Pharmacies in Ghana.

Background:Health literacy addresses environmental, political, and social factors that determine health. Drug dispensers play a major role in educating patients on drug use to increase effective and efficient drug utilisation, thereby promoting positive healthcare outcomes. From the patients’ perspective, this study examined the communication quality between patients and drug dispensers at primary healthcare centres in the Cape Coast Metropolis of Ghana.Method:We conveniently surveyed 269 patients seeking health care at primary healthcare facilities using a researcher-constructed 13-item instrument. In SPSS version 21 software, we analysed the data using percentages, chi-square analysis, and logistic regression.Results:Almost half of the participants (n = 132) reported low health literacy, with 81% (n = 218) reporting that drug side effects were not discussed with them at the pharmacies. The findings further indicated that health literacy and educational level predicted general communication quality between participants and drug dispensers; participants with secondary education were about 3 times more likely to report not being told of the side effects of prescribed drugs as compared with those who had completed only basic education.Conclusions:There is still a high level of low health literacy among patients seeking healthcare at primary healthcare centres and a very high percentage of patients did not receive any education on side effects of dispensed drugs. Drug use directives from dispensers at primary healthcare facilities can make a difference between any 2 patients.

Kidney Failure Risk Equation and Cost of Care in Patients with Chronic Kidney Disease.

Patients with CKD exhibit heterogeneity in their rates of progression to kidney failure. The kidney failure risk equation (KFRE) has been shown to accurately estimate progression to kidney failure in adults with CKD. Our objective was to determine health care utilization patterns of patients on the basis of their risk of progression. We conducted a retrospective cohort study of adults with CKD and eGFR of 15-59 ml/min per 1.73 m2 enrolled in multidisciplinary CKD clinics in the province of Saskatchewan, Canada. Data were collected from January 1, 2004 to December 31, 2012 and followed for 5 years (December 31, 2017). We stratified patients by eGFR and risk of progression and compared the number and cost of hospital admissions, physician visits, and prescription drugs. In total, 1003 adults were included in the study. Within the eGFR of 15-29 ml/min per 1.73 m2 group, the costs of hospital admissions, physician visits, and drug dispensations over the 5-year study period comparing high-risk patients with low-risk patients were (Canadian dollars) $89,265 versus $48,374 (P=0.008), $23,423 versus $11,231 (P<0.001), and $21,853 versus $16,757 (P=0.01), respectively. Within the eGFR of 30-59 ml/min per 1.73 m2 group, the costs of hospital admissions, physician visits, and prescription drugs were $55,944 versus $36,740 (P=0.10), $13,414 versus $10,370 (P=0.08), and $20,394 versus $14,902 (P=0.02) in high-risk patients in comparison with low-risk patients, respectively, for progression to kidney failure. In patients with CKD and eGFR of 15-59 ml/min per 1.73 m2 followed in multidisciplinary clinics, the costs of hospital admissions, physician visits, and drugs were higher for patients at higher risk of progression to kidney failure by the KFRE compared with patients in the low-risk category. The high-risk group of patients with CKD and eGFR of 15-29 ml/min per 1.73 m2 had stronger association with hospitalizations costs, physician visits, and drug utilizations.

Factors associated with inadequate treatment of syphilis during pregnancy: an integrative review.

to analyze the evidence available in literature on factors associated with inadequate treatment of syphilis in pregnant women. an integrative review, carried out in the LILACS, CINAHL, Web of Science, Scopus, PubMed and EMBASE databases, with controlled descriptors therapeutic and prenatal syphilis. nine publications composed the interpretative analysis, in which low education, income and maternal age, temporary lack of medication and HIV infection were associated with inadequate treatment of syphilis during pregnancy, in addition to delay or absence of prenatal care and receiving the 1st dose of penicillin, lack of tests or treatment less than 30 days before childbirth, and partners' low compliance with treatment. among the main factors associated with inadequate treatment, clinical and sociodemographic aspects stand out, as well as failures in drug dispensing, prescription and monitoring of treatment of pregnant women and their partners by the health system.

Development of a Web-Based Virtual Simulated Learning Environment for Pharmacy Practice Education.

Objective:In the present study, we aimed to develop a virtual simulation that allows pharmacy students to play through actual prescriptions and pharmacy practice scenarios productively and on a personal computer. If designed properly, this program may serve as a supplementary educational tool without the need for an existing human tutor that could provide learning outcomes as good as those resulting from traditional paper-based pharmacy practice tutorials.Methods:A computer-based simulation of a community pharmacy was developed. This program mainly targeted three basic learning needs of pharmacy students: drug dispensing, patient counseling, and dealing with clinical situations related to the patients’ prescription or demand for over-the-counter (OTC) recommendations. Fundamental design decisions were based on breaking down the dispensing process into logical components to provide discrete development elements. For teaching patient counseling and clinical skills, instructors wrote scenarios covering the most prevalent pharmacy practice issues, mainly focused on medication use during pregnancy or lactation, OTC recommendations, information related to drug interactions and adverse drug reactions, and interactions between prescription drugs and patient's underlying disease.Findings:Based on the primary curriculum topics, the development team designed exercises for pharmacy practice units presented to year 5 pharmacy students. Accordingly, exercises were developed to authentically reflect tasks and challenges a community pharmacist would regularly face in the workplace. To fulfill this part, over 2000 real prescriptions were scanned and categorized based on the main drugs included. These prescriptions were used for both activities, namely medication dispensing and clinical scenarios. Furthermore, five senior pharmacy students wrote more than 200 clinical scenarios under a clinical pharmacist's supervision. The main objectives of pharmacy practice courses were followed to cover the most important must-to-know clinical tips, whether related to giving relevant advice as an OTC recommendation, referring the patient to a primary care physician, or just providing a piece of general health advice, which is expected to be comprehensively learned by pharmacy students.Conclusion:This program was designed as a simulated learning environment to help students develop prescription dispensing and clinical skills. To be considered a success, this simulation needed to provide equivalent or better learning outcomes than the current practice approach, which should be assessed in the future evaluation of the software, and then be promoted accordingly.

Effect of optimizing the process of chemotherapy drug allocation in intravenous drug allocation center on improving the quality of nursing management

To explore the effect of optimizing the chemotherapy drug allocation process in the intravenous drug allocation centre on improving the quality of nursing management in hospitals. In order to improve the efficiency and quality of nursing care, the hospital optimized the chemotherapy drug allocation process and personnel in the hospital's intravenous drug allocation centre. After optimising the dispensing process, the time to review prescriptions and the time to schedule and dispense drugs in the IV drug dispensing centre was significantly shorter than before, P<0.05; after optimising the dispensing process, the incidence of unqualified prescriptions and dispensing errors in the hospital was significantly lower than before, P<0.05. The satisfaction of nursing staff was significantly higher than before, P<0.05. Optimizing the chemotherapy drug dispensing process in the intravenous drug dispensing centre can improve efficiency and quality of care and reduce the occurrence of errors, thus helping to reduce nurses' work pressure and improve nurses' satisfaction.

Competency and Attitude of Pharmacists in the Management of Common Ailments Among Community Pharmacy in Adama Town, Adama, Ethiopia, 2021

Community pharmacists are one of the most accessible of all health workers in the community, who are playing a key role in the delivering the primary health care services. Traditionally pharmacists' role is mostly confined to dispensing medication and provides public health services rarely. The current role of community pharmacists should include dispensing medicines with a prescription or without a prescription, advice patients during dispensing of prescription and non-prescription drugs, deliver drug information to health professionals, patients and to the public, and promotes health programmes. This advancement in pharmacy service demands competent pharmacists. The objective of the study was to evaluate the competency and attitude of pharmacists in the management of common ailments among community pharmacies in Adama Town, Adama, Ethiopia, 2021. A cross sectional study was conducted on 44 pharmacists working at community pharmacies in Adama Town from April 30 to July 30, 2021. Data was collected by face-to-face interview. Data was cleared, categorized, compiled, and coded before analyzed by using SPSS version 26.0. Descriptive statistics computed for the study variables and frequency distribution tables and figures was used to describe the findings. Majority of the study participants, 23 (52.3%), were males, the mean age of the participants is 33 years old. The study revealed that 26 (59.1%) were competent [mean > 0.7815, SD=0.27] while 40.9% were incompetent [mean < 0.7815]. Accordingly 50% of respondents had positive attitude (mean > 3.67) while the rest, 50% were negative attitudes. Lack of knowledge or clinical skills, lack of access to additional training programs and lack of time are the major reasons for incompetency. Majority of the community pharmacist are competent. But, 50% of the pharmacists had a negative attitude toward managements of common ailments. Reasons for incompetency such as inadequate knowledge, lack of access to training programs, inadequate time and the negative attitudes of pharmacists may be barriers for managements of common ailments. Town Health Bureaus should organize and provide in-service training and advocate managements of common ailments as one area in a continuous professional development program to pharmacists working in community pharmacies.

Picturing the Politics of Pharmaceutics

This article historicizes the practice of separating drug dispensation from medical practice in Japan, focusing on its trajectory from the Meiji period (1868–1912) to the outbreak of the Second Sino-Japanese War in 1937. I argue that the prescribing-dispensing separation debate highlighted the paradoxical modern experience of Japan, where information on the prescribing-dispensing separation became embroiled in discourses expounding on the local/Westernization (self/other) binary. The prescribing-dispensing separation dispute codifies the professional identity and the roles of the modern pharmacist—an important chapter in the evolution of the pharmaceutical industry and medical professionalization in Japan. Recognizing that the modern pharmacists underwent a nonlinear professionalization as determined by interactions with other social players (i.e., politicians, physicians, journalists) in different discursive spaces (i.e., professional conferences, Imperial Diet sessions), I have turned to professional publications and newspapers in the major cities of Tokyo and Osaka, where the prescribing-dispensing separation movement was most active. By examining the material and working cultures of major participants in the medical industry (i.e., the pharmacists, physicians, medicinal traders, and the politicians), this article interrogates the production of knowledge in the transformative modernizing process of the apothecary and the pharmaceutical industry.

Evaluating the activity of dispensing opioid analgesic medication

Objectives. The purpose of this paper was to evaluate the drug dispensing activity of analgesic opioids in pharmacies. Materials and methods. The study was conducted in an observational and retrospective manner, based on a questionnaire distributed in different pharmacies across Romania. Results. The dispensing activity of opioid analgesics is conducted in 71 out of the 100 pharmacies that have received the questionnaire. These pharmacies are located in 12 out of the 41 counties, mostly in the urban area and 96% of them are community pharmacies. The most prescribed and dispensed pharmaceutical forms are solid forms, the injectable products and transdermic systems being dispensed in a high percentage, up to 40% respectively, only in 25% of the questioned pharmacies. The average time spent by a pharmacist for the entire activity of dispensing an opioid analgesic prescribed by a doctor was estimated at 17.82± 0.58 minutes. Conclusions. The activity regarding opioid analgesics in the community pharmacy is limited by the low rentability, high costs and time consumption. The results of the study impose a further analysis on the impact that this service has upon public health, in order to this activity be sustained by the national health insurance system. Measures must be implemented to ensure that patients from rural or unprivileged areas are able to get their analgesics from the nearest community pharmacy constantly.

Determinants of adherence to antiretroviral therapy among people living with HIV/AIDS in Chhattisgarh, India

Background: Achieving the WHO 2020 treatment goals will not only depend on access to HIV treatment, but also on good adherence. Chhattisgarh SACS under guidance of CST division NACO and community and family medicine department AIIMS, Raipur undertook this study to investigate the major factors that influence the adherence of PLHIV visiting ART centres of Chhattisgarh.Methods: From five ART centres, 415 participants were interviewed through simple random sampling method through a semi structured interview schedule. Results: We found that 346 of the 415 (83.3%) patients had ≤95% adherence to ART on the basis of pill count method. Major proportion (90.0%) of patients were on TLE regimen, among them (74.4%) were non-adherent. An association was found between health condition of patient, poor life style and adherence rate. Three-month drug dispensation was recommended by most of the participants to improve adherence.Conclusions: Multiple months drug dispension along with other innovative approaches should be tailored made to improve the adherence and compliance among PLHIV individuals.

Analysis of the pharmaceutical care activities practiced by private homeopathic pharmacies located in Rio de Janeiro North Zone

The complexity of homeopathic treatment delegates to the Pharmacist the need and the responsibility of pharmaceutical care. This paper had the objective of verifying the practices of pharmaceutical care in homeopathy. The study was conducted in homeopathic pharmacies situated in Rio de Janeiro North Zone, during March and April, 2011, where 15 pharmacists were interviewed, with the help of a semi-open questionary self-administered. For the survey were investigated variables related to pharmaceutical: sex, age, nature of the institution where he graduated, having completed post-graduate and working ties. Information professionals for the pharmaceutical care were collected in 14 questions grouped into three areas: attitudes, perceptions and satisfaction. Attending the ethical aspects, the study was submitted to and approved by the Ethics Committee of University Estácio de Sá. The results demonstrated that 33% of the pharmacists have less than 5 years of professional practice, and 53% are specialists graduated by the Hahnemann’s Institutite of Brasil. All Pharmacists claim to orient patients, mostly during dispensation and through phone contacts. Most pharmacists oriented patients passively and actively. The elderly were pointed as the ones, who most often sought orientation. During dispensation of homeopathic drugs, all patients elicit some orientation. 67% of the pharmacies keep material for pharmaceutical guidance to the patients, usually leaflets. The verbal and written orientation was predominanted on homeopathic pharmacist. Posology and instructions of use for the pharmaceutical form dispensed were described as the most common doubts of the patients. Of all pharmacists interviewed, 67% pointed to self-medication practices in the pharmacy. The questions which measure the position and perception of the pharmacists related to pharmaceutical assistance scored over 3. The question which scored higher was related to the patient trust regarding the pharmacist guidance. We concluded that there was a mobilization on the pharmacists side to overcome obstacles and focus on the patient through the practices of pharmaceutical care.

Knowledge, Perceptions and Practices of Drug Dispensers towards Self-Medication of Red Eye in a Tier Two City of South India

Knowledge, Perceptions and Practices of Drug Dispensers towards Self-Medication of Red Eye in a Tier Two City of South India