Local Pharmacy Research Articles

Covid-19 psychological distress: Analysis of antipsychotic drugs’ use in an Italian population sample

The current pandemic, in addition to putting a strain on healthcare systems and global economies, has exacerbated psychiatric problems and undermined the mental health of many individuals. In an Italian cohort, this phenomenon has been assessed through a retrospective study aimed at evaluating the consumption and costs of antipsychotic drugs between 2020 and 2022. All dispensations made in local pharmacies accessible to the public have been extracted from a database called 'Sistema Tessera Sanitaria', which covers a population of approximately one million people residents in the ASL Napoli 3 Sud. Consumption data expressed in defined daily dose (DDD) and expenditure data expressed in Euro have been extrapolated. The results in the years 2020-2021 were relatively consistent, with consumption and expenditure decreasing slightly from 2020 to 2021. In 2022, the results showed a decrease in consumption and expenditure (2,706,951.07 DDD and €1,700,897.47) representing the reduced accessibility of patients to the healthcare facilities due to the pandemic. However, it should be noted that the antipsychotic drug aripiprazole showed an upward trend, registering an increase in consumption. Despite expectations of increased consumption of antipsychotic medications, real-world evidence indicated a different phenomenon, with the pandemic seemingly not affecting the consumption of these drugs. The difficulty in accessing care and medical appointments has probably influenced this data, masking the therapeutic needs of citizens. It will be necessary to assess in the coming years, as normal clinical activity resumes, whether there will be a growing consumption of these medications, which represent one of the main expenditure categories for the National Healthcare System.

Real-world efficacy, roll-out and uptake of intramuscular tixagevimab/cilgavimab as COVID-19 pre-exposure prophylaxis in people with multiple sclerosis and neuroimmunological conditions during the COVID-19 pandemic

BackgroundIn Australia, tixagevimab/cilgavimab 150 mg/150 mg was a government-funded pre-exposure prophylaxis for COVID-19 people with multiple sclerosis (pwMS) and other neuroimmunological conditions (pwNIc) treated with anti-CD20 antibodies or sphingosine-1-phosphate receptor...

Evaluation of Potential Urologic Prescription Drug Savings With Mark Cuban Cost Plus Drug Company.

Mark Cuban Cost Plus Drug Company (MCCPDC) launched in 2022 with a goal to decrease prescription drug costs. Thus far, research has focused on possible savings if Medicare purchased its annual volume of drugs at MCCPDC prices. The aim of this study is to analyze if MCCPDC can offer savings directly to urologic patients compared with other mail-order pharmacies, local pharmacies, and with patients using health insurance. Twelve drugs used to treat urological diseases available on MCCPDC were analyzed. Pricing data of 30-tab and 90-tab prescriptions from MCCPDC, other mail-order pharmacies, and local in-person pharmacies near our zip code 40508 (Lexington, Kentucky) were compiled. To compare if MCCPDC could offer savings to patients using health insurance to fill their prescriptions, out-of-pocket drug costs for patients from the 2020 and 2021 Medical Expenditure Panel Survey and the 2021 Medicare Part D spending data were extracted. Greater savings at MCCPDC were found at 90-tab prescriptions, but overall variability in prices existed. When comparing without health insurance, 9 of 12 drugs at MCCPDC were cheaper at 90 tabs with solifenacin and tadalafil saving $20 and $12 per prescription. When considering patients using insurance, abiraterone, sildenafil, and tadalafil offered savings on out-of-pocket costs at 30- and 90-tab prescriptions. MCCPDC may offer cheaper prices for patients filling urologic medications, especially at 90-tab prescriptions. This study is the first to show patients could save money using MCCPDC and has implications for physician counseling when prescribing common urologic drugs.

Dermatologists' Knowledge, Attitude, and Practice Pattern Toward Low-Dose Oral Minoxidil in Hair Loss in Saudi Arabia.

The utilization of low-dose oral minoxidil (LDOM) has emerged as a relatively new treatment option for hair loss, gaining recognition among dermatologists worldwide. To assess the knowledge, attitude, and practice patterns among dermatologists in Saudi Arabia regarding the use of LDOM in the management of hair loss. An online survey, which was distributed to dermatologists practicing in Saudi Arabia through email and mobile messages. Both univariate and bivariate analyses were performed to investigate the factors that may be associated with enhanced knowledge and practice patterns concerning the utilization of LDOM for the management of hair loss. A total of 84 dermatologists was included in this study, with 50 (60%) being male. It was found that 83 (99%) of the participants identified patterned hair loss as the most common indication for LDOM usage. Additionally, 77 (92%) recognized hypertrichosis as a well-known side effect. 48 (82%) of the dermatologists had never prescribed LDOM due to its unavailability in local pharmacies. The usage of LDOM for hair disorders is increasing. Nonetheless, many dermatologists abstain from prescribing this medication due to its limited availability in local pharmacies.

Spatial accessibility and travel to pharmacy by type in the Detroit region

BackgroundCommunity pharmacies are a critical part of the health care provision system. Yet less is understood about the spatial accessibility to pharmacies and how people travel to reach these services. ObjectivesThis study compared spatial accessibility and actual travel to different types of pharmacies among selected neighborhoods in the Detroit region. MethodsThree types of neighborhoods were selected and compared, including two lower income Black urban neighborhoods of high-density and four upper income White suburbs (two of low density and two of high density). Spatial accessibility was computed by pharmacy type and compared among neighborhoods using ANOVA. Pharmacy trips reported in a travel survey were geocoded and linked with community pharmacies in a list generated from ReferenceUSA business data. Destination choices were mapped and the relationship between spatial accessibility and actual distance traveled was examined using ordinary least squares regressions. ResultsOn average, urban residents in Detroit had higher access to local independent pharmacies (0.74 miles to the nearest one) but relatively lower access to national chains (1.35 miles to the nearest one), which most residents relied on. Urban residents also tended to shop around more for services even among national chains. In fact, they bypassed nearby local independent pharmacies and traveled long distances to use farther pharmacies, primarily national chains. The average trip distance to pharmacy was 2.1 miles for urban residents, but only 1.1 miles and 1.5 miles for residents in high-density suburbs and low-density suburbs, respectively. ConclusionSupposedly good spatial access considering all pharmacies together may mask excessive burden in reaching the pharmacy services needed in low-income minority urban communities, as shown in the case of Detroit. Thus, when mapping pharmacy deserts, it is important to distinguish spatial accessibility among different pharmacy types.

Evaluating the impact of a discharge pharmacy in the emergency department on emergency department revisits and admissions

ImportanceMedication nonadherence leads to worse health outcomes, increased healthcare service utilization, and increased overall healthcare costs. ObjectiveTo determine whether a discharge pharmacy located in the Emergency Department (ED) reduces ED revisits and hospitalizations. DesignThis is a cohort study where we extracted data from our electronic medical records with adult encounters between 12/2019–10/2021. For the purpose of this study, we defined a revisit to the ED as within 7 days and an admission within 30 days from prior initial ED visit. SettingThe University of Chicago Medicine is an academic medical center located in Chicago's South Side. ParticipantsBetween dates of 12/2019–11/2021, we had 78,660 adult distinct encounters. We created 5 different groups: no medications prescribed, ED discharge pharmacy only, e-prescriptions to outside pharmacies, combination of ED pharmacy and e-prescription sent elsewhere, and printed prescriptions with or without any e-prescriptions. ExposureOur ED pharmacy is located within the adult ED, serving only patients seen and discharged from the adult ED. Main Outcome(s) and Measure(s)Our primary endpoint is to evaluate if prescribing and dispensing prescriptions from only our ED pharmacy is associated with decreased ED revisits within 7 days and reduced hospitalizations within 30 days of initial ED visit. ResultsWhen comparing patients who received prescriptions only from the ED discharge pharmacy, patients who received no prescriptions were 31.6% (P < 0.001) more likely to revisit our ED, and patients who received e-prescriptions sent to other pharmacies were 10.4% (P = 0.017) more likely to revisit. Patients who received e-prescriptions from other pharmacies were 29.2% (P < 0.001) more likely to be hospitalized and mixture of e-prescriptions were 59.5% (P < 0.001) more likely to be hospitalized compared to the ED pharmacy only group. Conclusions and RelevanceWe believe having a pharmacy providing medications to patients being discharged from the ED reduces barriers like cost, transportation, and pharmacy access patients face trying to fill prescriptions at their local pharmacy. All of these reductions in barriers provides an easier and more convenient method for patients to obtain their medications at discharge from the ED, reducing the risk of a repeat ED visit and subsequent hospital admission.

Review of the Lifestyle Issues of the Khumi Community

The Khumi community is primarily patriarchal and is a notable ethnic group in Bangladesh, India, and Myanmar. They reside in the western part of Myanmar, specifically in the Arakan hill region. Their settlements are found in the hilly areas adjacent to the India-Bangladesh border. The data analysis reveals the comprehensive insights into the socio-demographic, health-related, education-related, income, and livelihood characteristics of the Khumi community in remote hilly regions of Bangladesh. Most of the participants are male, farmers, and Christian. Health issues, such as their eye problems and ankle pain, vary between the genders, with a notable reliance on local pharmacies for their healthcare services. Education-wise, illiteracy is prevalent, and economic and teacher-related obstacles hinder their education accessibility. Monthly and yearly income distributions highlight their economic disparities, with a significant proportion earning between the ranges of 3,001 to 5,500 Taka monthly. Livelihood-related characteristics showcase a heavily reliance on solar power, diverse agricultural practices, and predominantly nuclear family structures. The various challenges in livelihood, including economic, cultural, healthcare, education, communication, and linguistic issues, are addressed through the community-driven solutions. There are various notable efforts focus on water drainage, transportation system improvement, electricity infrastructure enhancement, primary school education, and agricultural training. Therefore, the study concludes that the Khumi community faces various economic vulnerability, educational disparities, and cultural erosion while the recommendations include community-centric development programs, education enhancement, healthcare access improvement, agricultural support, infrastructure development, preservation of culture, social welfare programs, government-community collaboration, research and data collection, and awareness and advocacy efforts. Implementing these numerous recommendations can contribute to the overall development of the Khumi community with addressing their various unique challenges and fostering the sustainable progress.

The emotional impact of uncomplicated urinary tract infections in women in China and Japan: a qualitative study

BackgroundUncomplicated urinary tract infections (uUTIs) are one of the most common community-acquired infections, particularly among women. Common symptoms of UTI include dysuria, urinary urgency and increased frequency, and lower abdominal pain. With appropriate treatment, symptoms may resolve in a few days. However, there is a lack of research on the emotional impact of this disease. We conducted a qualitative, interview-based study to gain a greater understanding of the emotional impact of uUTIs in women in China and Japan.MethodsA qualitative, exploratory, in-depth, interview-based study was conducted between 19 November 2020 and 25 February 2021. Women aged ≥ 18 years who experienced ≥ 1 uUTI and received antibiotic treatment in the past year were eligible for inclusion. Participants must have experienced ≥ 1 of the following symptoms during a uUTI episode: urinary urgency, frequency, dysuria, or lower abdominal/suprapubic pain. Participants who reported back pain or fever (indicative of complicated UTI) were excluded. Participants with recurrent or sporadic UTIs were included, with specific screening criteria used to ensure capture of both groups. Following a screening call, a structured, in-depth telephone interview (~ 30 min in duration) was conducted by three female external moderators trained in qualitative interviewing, assisted by an interview guide. Interviews were analysed individually and thematically, with the results presented within the identified themes.ResultsA total of 65 women with uUTI completed the in-depth telephone interview: 40 (62%) from China and 25 (38%) from Japan. Participants reported that the symptoms of uUTI affected multiple aspects of their lives, and described feelings of embarrassment, frustration, guilt, dread, and loneliness associated with symptoms that interfered with relationships, work and daily activities, and sleep. Participants reported seeking healthcare from several different points of contact, from local pharmacies to hospitals.ConclusionsOur analysis highlights the profound emotional impact of uUTIs in women in China and Japan, and the journey these participants take before their initial interaction with a healthcare professional. These insights emphasise the need to better understand the full impact of uUTI, and the role of healthcare professionals in improved patient education and support.

(164) Potential Savings with Use of Cost Plus Pharmacy for Medical Treatment of Erectile Dysfunction

Abstract Introduction With its stated goal “to end ridiculous drug prices,” the Mark Cuban Cost Plus Drug Company (MCCPDC) launched in January 2022 with over 100 generic prescription drugs available to be mailed directly to patients without the involvement of health insurance. To promote drug cost transparency, all drugs are priced at the cost to manufacture the drug with a 15% administrative markup, a $3 pharmacist fee, and a $5 shipping fee. Prior research has focused on the theoretical savings MCCPDC could offer if Medicare purchased drugs at MCCPDC prices with studies reporting a potential $3.3 billion in savings for Medicare. Prescription drug spending is continuing to rise in the United States and providers are increasingly considering patient’s out-of-pocket costs. MCCPDC touts a transparent, consistent pricing model, but it is unclear if this pricing model will actually translate to cost savings for patients. Objective We sought to analyze if Mark Cuban Cost Plus Drug Company (MCCPDC) can offer savings directly to patients compared with other mail-order pharmacies, local pharmacies (based on zip code of our urology clinic) and with patients using health insurance to fill prescriptions for their sildenafil, vardenafil and tadalafil. Methods Out of the approximately 100 generic drugs available on MCCPDC website, we analyzed the 3 drugs that are prescribed to treat erectile dysfunction. We analyzed drug prices of 30 and 90-day prescriptions at the same dose of each medication. Using Good Rx prescription drug search engine, we compared the drug prices of the cheapest mail order and local in person pharmacies near our zip code. We also included prices for the recently started telemedicine company Roman. To compare if MCCPDC could offer savings to patients using health insurance to fill their prescriptions, we extracted the out-of-pocket drug costs for patients from the 2020 Medical Expenditure Panel Survey (MEPS; a national survey that compiles data from both the pharmacy and the survey respondent to determine the exact cost of each prescription filled during that year) and the 2020 Medicare Part D spending data. Medicare Part D spending data was used to estimate the out-of-pocket cost for each medication, which is approximately a 25% copayment for Medicare prescriptions. Results MCCPDC offered the lowest direct-to-consumer price on sildenafil and tadalafil 90-day prescriptions (Table 1). MCCPDC saved patients approximately $10 per sildenafil and tadalafil prescription compared with the next cheapest option. We found additional, although smaller, savings at 30-day prescriptions for sildenafil and tadalafil. MCCPDC was not the cheapest option for vardenafil. Compared with Roman, MCCPDC offered cheaper prescriptions for sildenafil and tadalafil by over $300 and $900, respectively. Conclusions MCCPDC can offer significant cost savings to patients, especially considering the high number of sildenafil and tadalafil prescriptions each year. The transparency and consistency in pricing with MCCPDC can be utilized by providers when counseling patients on medical therapy options for erectile dysfunction. Disclosure No.

Application of a multivariate optimization strategy to validate an RP-HPLC analytical method for determining hydroxychloroquine sulphate in pharmaceutical products and in forced degradation studies

AbstractIn this study, a multivariate optimization strategy was used to develop and validate a simple, rapid, accurate, cost-effective, and stability-indicative RP-HPLC analytical method for quantifying hydroxychloroquine sulphate (HCQ) in coated tablets. The validation conditions involved isocratic elution mode, using a mixture of buffer solution at pH 2.2 and methanol (74:26, v/v) as the mobile phase, an Agilent® reverse phase column, model Zorbax Eclipse Plus C18 (250 cm × 4.6 mm × 5 μm), a flow rate of 1.3 mL min−1, column temperature 40 °C and detection at 343 nm. The method showed linearity in the range of 4–44 μg mL−1, with a correlation coefficient (R) of 0.9998. Recovery obtained average values of between 99.71 and 100.84% and precision with average RSD values of &lt;2%. The robustness demonstrated by assessing the effect of seven variables (pH of the mobile phase buffer; percentage of methanol; filter brand; mobile phase flow rate; wavelength; column temperature and sample agitation time), with effect values for each variable lower than the calculated value of s√2 (1.43), showed that none of these factors had a significant influence on the analytical response. The method was applied to samples of the reference medicine Plaquinol® 400 mg and similar Reuquinol 400 mg, nomenclature established by the National Health Surveillance Agency (Anvisa), law no. 978 of 10 February 1999, purchased from local pharmacies. Results showed advantages and benefits in relation to the official method and those reported in the literature. The application of the multivariate strategy, the choice of methanol, in a lower proportion in the organic phase, due to its low toxicity, economy and easier availability compared to acetonitrile, and the other organic solvents used was a promising and important alternative for the analytical method. Furthermore, the use of reversed stationary phase, common in quality control laboratories, provided an analyte retention time of 4.595 min, demonstrating good performance and speed in routine analyses.

The impact of changes in opioid dependency treatment upon COVID-19 transmission in Sydney, Australia: a retrospective longitudinal observational study

BackgroundIn April 2020, in response to the COVID-19 public health emergency, South Eastern Sydney Local Health District (SESLHD) Drug and Alcohol services modified their delivery of opioid dependency treatment (ODT) to reduce spread of COVID-19 and maintain continuity of care by increasing use of takeaway doses (TADs), transferring clients to local community pharmacies for dosing and encouraging the use of long-acting depot buprenorphine (LADB) which enabled once a month dosing.MethodsThis study was a retrospective longitudinal case–control study conducted from August 1st, to November 30th, 2021. Eligible clients were those admitted for treatment with SESLHD ODT Services prior to August 1st,2021 and who remained in treatment beyond November 30th, 2021. COVID-19 diagnoses were determined by a COVID-19 PCR and extracted from the electronic Medical Records (eMR) Discern Reporting Portal. Demographic, clinical and dosing related data were collected from eMR and the Australian Immunisation Register (AIR).ResultsClients attending SESLHD ODT services had significantly greater odds of acquiring COVID-19 than the NSW adult population at large (OR: 13.63, 95%CI: 9.64,18.88). Additionally, amongst SESLHD ODT clients, being of Aboriginal and Torres Strait Islander origin was associated with greater odds of acquiring COVID-19 (OR = 2.18, CI: 1.05,4.53); whilst being employed (OR = 0.06, CI:0.01,0.46), receiving doses at pharmacy (OR = 0.43, CI: 0.21,0.89), and being vaccinated (OR = 0.12, CI: 0.06,0.26) were associated with lower odds. Every additional day of attendance required for dosing was associated with a 5% increase in odds of acquiring COVID-19 (OR = 1.05, CI: 1.02,1.08).ConclusionsClients attending SESLHD ODT services are significantly more likely to acquire COVID-19 than the NSW population at large. Promoting vaccination uptake, transferring clients to pharmacy, and reducing the frequency of dosing (by use of takeaway doses or long-acting depot buprenorphine) are all potential methods to reduce this risk.

The rise of counterfeit medication: an emerging threat?

Madam, The definition of health is far more complex than initially imagined. As per the World Health Organisation (WHO), the “health” is defined as complete physical, mental, and social well-being instead of simply the absence of any disease.1 In the era of modern healthcare, medications are undoubtedly important in ensuring well-being worldwide. Despite monumental advances within the medical industry, the rise of counterfeit medication has become an emerging threat. Counterfeit medications are known as products sold with the deception of providing therapeutic benefits but consist of little-to-no active ingredients, which may or may not be harmful.2 Traditionally, the regulation of drug distribution falls under the responsibility of the health authorities of the relevant region, such as the Drug Regulatory Authority of Pakistan (DRAP). Reports of an escalating influx of counterfeit medications into Pakistan have recently created pivotal concerns within the local communities.3,4 In Karachi, officials seized a large quantity of cefixime and aspirin suspension powders, which were found to be “fake and spurious”.3 The counterfeit medication was created by repackaging locally-manufactured powder into branded bottles, which were subsequently sold across the city. In another case affecting various cities in Pakistan, a factory was illegally manufacturing spurious medication, leading to a nationwide cautionary announcement to avoid the purchase of affected drugs, including the lifesaving meropenem, among various other cephalosporin drugs.4 The distribution of counterfeit medications can have drastic consequences for the population. Patients in critical conditions may suffer further harm due to defective treatment, as a result of the failure of substandard products.5 Moreover, counterfeit drugs manufactured with inappropriate doses or concentrations may lead to fatal adverse effects, such as respiratory paralysis or death.5 In order to address this pressing issue, the national authorities must take proactive measures to tackle the production and distribution of counterfeit medication: There is a need for frequent and strict raids integrated within each city of Pakistan, in which local pharmacies have their inventory tested for substandard or inappropriate substances. Secondly. The import of medications must also be strongly monitored, in order to prevent the arrival of counterfeit or unregistered medications from foreign regions. It is recommended that the authorities establish pharmaceutical support programs for those individuals who cannot afford proper medications and eventually resort to purchasing substandard medication.

Access to community pharmacies based on drive time and by rurality across the contiguous United States

BackgroundConsidering that mail-order pharmacy use remains low in the United States, geographic accessibility of community pharmacies (pharmacy access) can have an outsized impact on a community’s access to services and care, especially among rural residents. However, previous measurements of pharmacy access rely on methods that do not capture all aspects of geographic access. ObjectivesThis study aimed to measure pharmacy access across the contiguous United States and by rural, suburban, and urban areas using drive-time analysis and an improved methodological approach. MethodsThe 2-step floating catchment area method was used to measure pharmacy access by considering the supply capacity of pharmacies, population demand for pharmacies, and the interaction between them within a reasonable travel time range. This method is a methodologically improved approach compared with previous methods for measuring geographic access. Network analysis was used to measure drive time from the population-weighted centroids of census tracts to the geocoded location of community pharmacies. Census tract-level pharmacy access was measured using a 10- and 20-minute drive time. Census tracts were also categorized based on population per square mile as rural (< 1000), suburban (1000-3000), and urban (> 3000). ResultsAcross the contiguous United States, 79.9% and 91.1% of census tracts had access to at least 1 pharmacy per 10,000 people within a 10- and 20-minute drive time, respectively. Rural census tracts had the lowest share of access to at least 1 pharmacy per 10,000 people compared with suburban and urban tracts and for both drive times. ConclusionCommunity pharmacies are highly accessible health care access points, specifically in urban and suburban areas. Pharmacies should be considered to expand access to services with limited geographic accessibility such as treatment programs for opioid use disorders, primary care, and healthy foods.

Health equity in COVID-19 testing among patients of a large national pharmacy chain.

Several social determinants of health and other structural factors drive racial and ethnic disparities in COVID-19 risk, morbidity, and mortality. Public-private collaborations with community pharmacies have been successful in expanding access to COVID-19 testing and reaching historically underserved communities. The objectives of this study were to describe individuals who sought testing for COVID-19 at a national community pharmacy chain and to understand potential racial and ethnic inequities in testing access, positivity, and infection with emerging variants of concern. We conducted a cross-sectional study of individuals aged ≥18 who were tested for COVID-19 (SARS-CoV-2) at a Walgreens pharmacy or Walgreen-affiliated mass testing site between May 1, 2021 and February 28, 2022. Positivity was defined as the proportion of positive tests among all administered tests. A geographically balanced random subset of positive tests underwent whole genome sequencing to identify specific viral variants (alpha, delta, and omicron). Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) to compare the likelihood of testing positive and testing positive with an emerging variant of concern across race and ethnicity groups. A total of 18,576,360 tests were analyzed (16.0% tests were positive for COVID-19; 59.5% of tests were from White individuals and 13.1% were from Black individuals). American Indian or Alaska Native (OR = 1.12; 95%CI = 1.10-1.13), Hispanic or Latino (1.20; 95%CI = 1.120, 1.21), and Black (1.12; 95%CI = 1.12, 1.13) individuals were more likely to test positive for COVID-19 compared to White individuals. Non-White individuals were also more likely to test positive for emerging variants of concern (e.g., Black individuals were 3.34 (95%CI = 3.14-3.56) times more likely to test positive for omicron compared to White individuals during the transition period from delta to omicron). Using a national database of testing data, we found racial and ethnic differences in the likelihood of testing positive for COVID-19 and testing positive for emerging viral strains. These results demonstrate the feasibility of public-private collaborations with local pharmacies and pharmacy chains to support pandemic response and reach harder to reach populations with important health services.

The impact of sales promotion techniques on consumer purchase decisions within community pharmacies

The study analyzeshow sales promotions affect customer behaviourin community pharmacies by looking at psychological factors, economic incentives, and ethical issues. The goal of the study is to offer practical insights and evidence-based suggestions to make sales promotion strategies more effective and ethical in community pharmacies. The objective is to study is to examine the influence of sales promotions on consumer behaviour in community pharmacies, with a specific focus on whether sales promotions effectively improve drug sales to customers. The findings suggest that a combination of product availability, brand trust, cost savings, and professional advice drives consumer decisions. Convenience-related services are particularly attractive to consumers, with 43.8% valuing extended hours and 21.5% appreciating delivery services. This influence of sales promotion highlights the need for pharmacies to consider various promotional strategies to cater to different consumer preferences. The study concludes that while sales promotions do impact consumer buying decisions at local pharmacies, their influence varies widely among individuals. Factors such as product availability, brand loyalty, price discounts, and pharmacist recommendations also play significant roles. Most of the time customers aren't influenced by sale promotions because they might be confused about whether the products are expired or if there's something wrong with the stock. The study concludes that effective promotional and service strategies should take into account these diverse consumer preferences to boost customer satisfaction and increase sales.

Prevalence of Consumers Purchasing Antibiotic Medicine Without Prescription Among Community Pharmacies

According to the Global Research on Antimicrobial Resistance, the Philippines has an average antibiotic use of 5.3 DDDs per 1,000 people, with pediatric antibiotic use constituting approximately 56.2%. Although lower than in neighboring countries, this level of use still poses a significant threat to the healthcare system. The widespread availability of antibiotics has been a major contributing factor to the rise of antibiotic resistance (ABR) in the Philippines. Historically, antibiotics could be purchased without a prescription from local pharmacies. This study examined the prevalence of consumers attempting to purchase antibiotics without a prescription in Carmona, Cavite. Utilizing quantitative descriptive and correlational research methodologies, the study employed convenience sampling due to the limited number of community pharmacies and their tendency to cluster in specific areas. A structured survey questionnaire was used to gather data and analyze correlations between variables. Findings indicate that the majority of consumers in Carmona, Cavite, frequently attempt to obtain antibiotics without a prescription, with a preference for penicillin-class antibiotics. The reasons for these purchases vary, including self-medication for minor illnesses, treatment for pets and poultry, and topical wound care. The results underscore the importance of community education and engagement on the risks of ABR. The study suggests that local government educational programs can enhance consumer awareness of the need for prescriptions. The findings indicate that awareness of prescription requirements moderately affects the frequency of attempting to buy antibiotics without a prescription. However, no significant association was found between the reasons for obtaining medicine without a prescription and the type or class of medicine purchased.

Baseline Study on the Discriminatory Laws, Attitudes and Societal Practices Hindering Diverse Sex Workers’ Access to Sexual and Reproductive Health and Rights Services in Selected Senatorial Local Governments in Rivers State, Nigeria

Achieving comprehensive access to Sexual and Reproductive Health and Rights (SRHR) services remains a pressing global health challenge, particularly for marginalized populations such as sex workers, who face the highest unmet needs. This study exposes the baseline issues related to discriminatory laws, attitudes, and societal practices that hinder diverse sex workers’ access to comprehensive SRHR services in Rivers State, Nigeria. Specifically, the study identified key barriers affecting sex workers’ access to SRHR services, evaluated their satisfaction with these service deliveries, examined the effects of societal inequalities and discriminatory legal practices on their health outcomes, and proposed sensitivity and rights-based approaches for improving service delivery. The study adopted stratified sampling methodology and collated both quantitative and qualitative data through desk reviews and analysis of existing state health policies, in-depth focus group discussions with 300 diverse sex workers, and analysis of 2000 feedbacks collected through questionnaires embedded in the Kobo Collect app. Key study findings revealed that significant majority (91.1%) of sex workers have experienced discrimination when accessing SRHR services in formal healthcare facilities, with primary sources of these discriminations perpetuated by healthcare workers (77.4%), brothel owners (47.1%), and family members (43.9%). Consequently, 89.9% of respondents have avoided formal healthcare facilities, opting instead for local pharmacies (66%), traditional medical specialists (56.8%), and self-medication (48.4%), despite its adverse effects such as recurrent Sexual Transmitted Infections (STIs) (57.5%), worsening STIs to Sexual Transmitted Diseases (STDs) (58.3%), unwanted pregnancies (18%), post-abortion complications (27.1%), adverse drug reactions (49.1%), and drug abuse/overdose (48.4%). In addition, there was notable dissatisfaction among respondents regarding SRHR services as 61.4% of engaged sex workers rated “Poor to Very Poor” for service affordability, a mixed opinions for availability and accessibility as respondents rated “Fair to Poor” (57.4% for availability and 68% for accessibility) and 75% of the respondents criticized the accountability system to be “Poor to Very Poor”. Qualitative analyses of existing laws and policies in the State revealed an institutional neglect and exclusion of sex workers from health service protections as some state laws and policies, such as Rivers State Reproductive Law, Rivers State Contributory Health Protection Programme, Rivers State Strategic Health Development Plan, and the Rivers State HIV/AIDS Anti-Discrimination Law, were non-inclusive and perpetuate discriminatory practices against sex workers in SRHR service provision. To close-in the gaps, the study recommended implementing non-discrimination policies, reducing waiting times, ensuring strict privacy and confidentiality measures, reforming laws to ensure inclusive service delivery, providing non-clinical training on gender identity and sexual orientation for healthcare providers, appointing focal persons for key populations, and enforcing accountability systems across healthcare facilities as a right based model for enhancing SRHR outcomes for diverse sex workers in Rivers State.

A novel black poplar propolis extract with promising health-promoting properties: focus on its chemical composition, antioxidant, anti-inflammatory, and anti-genotoxic activities.

Propolis is a resinous mixture produced by honeybees which has been used since ancient times for its useful properties. However, its chemical composition and bioactivity may vary, depending on the geographical area of origin and the type of tree bees use for collecting pollen. In this context, this research aimed to investigate the total phenolic content (using the Folin-Ciocalteu assay) and the total antioxidant capacity (using the FRAP, DPPH, and ABTS assays) of three black poplar (Populus nigra L.) propolis (BPP) solutions (S1, S2, and S3), as well as the chemical composition (HPLC-ESI-MSn) and biological activities (effect on cell viability, genotoxic/antigenotoxic properties, and anti-inflammatory activity, and effect on ROS production) of the one which showed the highest antioxidant activity (S1). The hydroalcoholic BPP solution S1 was a prototype of an innovative, research-type product by an Italian nutraceutical manufacturer. In contrast, hydroalcoholic BPP solutions S2 and S3 were conventional products purchased from local pharmacy stores. For the three extracts, 50 phenolic compounds, encompassing phenolic acids and flavonoids, were identified. In summary, the results showed an interesting chemical profile and the remarkable antioxidant, antigenotoxic, anti-inflammatory and ROS-modulating activities of the innovative BPP extract S1, paving the way for future research. In vivo investigations will be a possible line to take, which may help corroborate the hypothesis of the potential health benefits of this product, and even stimulate further ameliorations of the new prototype.

Proposal for the Implementation of Database Systems Teaching in Pharmacy Courses in Terms of e-Health Support

In our paper, we will discuss the design and implementation of relational databases using MS Access. Relational database is one of the most widely used databases in terms of practice and information systems. We often encounter their implementation in many solutions, for example as hybrid OLAP databases of enterprise systems or also as OLTP systems - currently most of the classical database applications as we understand them. Their importance is therefore great from a modern point of view. In our paper, through the concrete example of a local pharmacy, we will try to create a practical application that will be fully functional, but will not require deep expertise; on the contrary, it will follow the modern trend that is noticeable in many other information systems, where the emphasis is on usage and not on lengthy training and close long-term professionalization. Our aim is to provide pharmacy students with knowledge, the acquisition of which will not go beyond a maximum of three 90-minute classes and yet provide practical knowledge of relational databases at more than a minimal level.

A Study on Evaluation of Drug Package Inserts in Kashmir, India

Background: Drugs constitute a major part of the therapeutic modality for most of the patients. Accurate and authentic drug information is important for its safe and effective marketing. Drug package insert (PI) is the primary source of such information. They serve very important role in minimizing the medication errors. PIs need to be updated regularly, but despite regulations, studies have shown that Indian PIs provide inadequate information. Aims and Objectives: To check the completeness of information provided in package inserts of allopathic drugs. Material and Methods: This observational study was carried out for a period of 3months in the department of pharmacology, GMC Srinagar. 139 PIs were collected from local pharmacies and drug store of tertiary care hospital of Government Medical College, Srinagar.17 duplicate package inserts were excluded. The remaining PIs (122) were evaluated according to section 6.2, 6.3 of schedule D (II), Drugs and Cosmetics Act (1940) and Rules (1945).Data was entered in Microsoft Excel Sheet and then analyzed. Results: Among 122 PIs evaluated maximum package inserts were of antibiotics (15%) and anti-diabetics (15%) followed by CNS drugs (14%). Considering the dosage forms 60% inserts wereoral preparations followed by intravenous injections 17%. Regarding the various components of Section 6.2 of Schedule D (II), Drug and Cosmetic Act, posology and method of administration was present in 100% inserts, special precautions and warnings were present in 97%, side effects in 96%, contraindication in 94%. With regards the components of Section 6.3, excipients were mentioned in 78% inserts, incompatibility in 49% inserts, shelf life in the product package for sale was present in 28%, shelf life after dilution in 30%. Conclusion: Our study concluded that only a few inserts contained all the headings of Section 6.2 and 6.3 of Drug and Cosmetic Act (1945). Completeness of information has improved a lot as compared to past, still a lot needs to be done so that patients can derive maximum benefit from them. This demands strict scrutiny of inserts by regulatory authorities.